CQC report explained · a residential care home
What the CQC found at 23 Elm Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were handled safely, and staffing was based on people's needs. The home was recruiting new staff and used consistent agency staff when shortages occurred.
- Effective?
- Good
- People had detailed care plans, health support and staff training. However, consent was not always obtained from people with the legal authority to give it when someone lacked capacity to make an important decision.
- Caring?
- Good
- Staff were observed to be kind, respectful and compassionate. People were encouraged to make choices, take part in daily tasks and develop independence.
- Responsive?
- Good
- Care was based on people's individual needs, communication styles and interests. People were supported with activities, family relationships, complaints and access to information in ways they could understand.
- Well-led?
- Good
- Inspectors found a clear management structure, positive feedback from families and professionals, and regular checks to monitor the quality of care. The home used learning from incidents and concerns to improve practice.
What inspectors found, December 2019
Rated Good; inspectors found kind, safe and person-centred care, but consent arrangements did not always follow the law.
Inspectors visited on 16 and 21 October 2019. They spoke with family members and staff, observed care, and checked care plans, medicines records, staff files and management records.
The home supported four adults with a learning disability and/or autism. Inspectors found that people were safe, treated with kindness and supported to develop independence. Staff understood people's needs, supported activities and worked with health and social care professionals.
There was one shortfall. When people could not make important decisions, consent had not always been signed by someone with the legal authority to do so. The inspectors recommended that the home review its process.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. This was the same rating as at the previous inspection, published on 20 April 2017.
Safety and positive risk
Risks were reviewed and managed while people were still supported to make choices and build independence.
“People were supported to take positive risks enabling them to experience independence, choice and control over their lives.” from the report
Kind relationships
Inspectors saw warm and respectful interactions. Families also said staff knew their relatives well and cared for them positively.
“Warm, affectionate interactions were observed between staff and people living at the home; staff were seen to be compassionate and provided care and support in a way that made people feel at ease.” from the report
Personalised activities
People were supported to follow their interests, maintain relationships and develop social skills and independence.
“People were supported to access a range of personalised activities and encouraged to maintain hobbies and interests.” from the report
Quality monitoring
Managers carried out regular audits and checks and used them to identify areas for improvement.
“Quality assurance systems were in place and used effectively to monitor key aspects of the service.” from the report
Consent and legal authority
needs fixingWhen people lacked capacity to make important decisions about their care, consent was not always signed by someone legally authorised to give it. Inspectors recommended a review of the home's process.
“The service was not always working in accordance with the principles of the MCA.” from the report
- 01How do you check that consent has been obtained from someone with the legal authority to give it when a person lacks capacity?
- 02What action have you taken following the inspectors' recommendation about Mental Capacity Act consent?
- 03How many permanent staff are currently in place, and when is agency staff used?
- 04How do you make sure staff remain competent to administer medicines, including medicines given when required?
- 05How are each person's communication needs and activity choices recorded and reviewed?
This was a comprehensive inspection covering all five CQC questions, including the care provided and the premises; all five ratings were assessed during this visit. This explanation was written from the published report of 20 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2017
Potensial Limited - 23 Elm Road: Rated Good; inspectors found caring, person-centred support, with some staffing and monitoring issues.
The inspection took place on 22 March 2017 and was unannounced, although the home had 24 hours' notice because people might be out during the day. The inspector spoke with people, relatives, the manager and staff. They observed care and checked medicines, records, training, staffing and the building.
The home supported up to six men with learning disabilities and/or autism. Inspectors found that people were supported by staff who knew them well. Care records were clear, medicines were managed safely, and people's choices were respected.
There had been safeguarding concerns, staff recruitment difficulties and a difficult period for the home. Inspectors found these were being managed, but staff supervision was not always regular and some audits were not completed on time.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. This was the same overall rating as at the previous inspection.
Clear care plans
The care records gave staff clear information about people's health, personal care, finances, medicines and daily lives.
“Care records were clear and person centred. The important information that was needed to care for people safely was clear and available for staff to access.” from the report
Respectful care
Staff knew people well and supported them in a way that followed their choices. Inspectors saw care that was led by the person receiving it.
“We saw that the care and support provided was person centred and led by the person receiving the care.” from the report
Safe medicines
Medicines were stored, given and checked safely. Staff had received medicines training.
“The medicines were audited regularly. We saw that staff had been trained in the administration of medicines.” from the report
Good activities and choice
People were involved in shopping and cooking and had varied activities that reflected their interests.
“We saw that the people led busy, varied lives.” from the report
Open management
The manager and staff were described as approachable and transparent. Staff could raise concerns and take part in team discussions.
“There was a positive person centred culture apparent in the home and obvious respect and transparency between the manager and staff.” from the report
Safeguarding risks
seriousThere had been a number of safeguarding concerns since the previous inspection. Inspectors found that staff were managing these risks, but they were linked to behaviour that regularly created safeguarding risks.
“There had been a number of safeguarding concerns since we last visited the home.” from the report
Irregular supervision
needs fixingStaff received supervision, but it was not always carried out regularly.
“Staff had supervision from the manager but this was not always regular, however, staff told us that the manager's door was always open and that they were very approachable and supportive.” from the report
Quality checks
needs fixingThe home had quality assurance systems, but some audits were not completed at the required times.
“The audits were not always carried out when they were exactly required.” from the report
Staff recruitment
needs fixingThe home had experienced problems recruiting and keeping staff. Inspectors found this had improved and that regular agency staff were being used to reduce disruption.
“We saw that there had been problems with recruitment and retention of staff.” from the report
Mixed views about suitability
minorOne relative was unsure whether the home was suitable for their relative. The report says this was being explored.
“A relative told us that they were unsure if the service was suitable for their relative.” from the report
- 01What safeguarding concerns have occurred since this inspection, and what has changed to reduce the risks?
- 02How often do staff now receive supervision, and how is this checked?
- 03How do you make sure audits and other quality checks are completed on time?
- 04How stable is the current staff team, and how much agency staff is being used?
- 05How do you decide whether the home is suitable for someone whose needs or behaviour may affect other people living there?
This was an unannounced inspection that covered all five CQC questions and included observations, discussions and checks of care, medicines, staffing, training, records and the premises. This explanation was written from the published report of 21 April 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 23 Elm Road
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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40 live-in carers within about an hour of Wirral
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,230 a week. 37 can care for a couple. 8 years' experience on average.
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.