CQC report explained · a residential care home
What the CQC found at Qualities Services Ltd
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Most safety arrangements worked well, including staffing, medicines, premises checks and infection control. However, risk plans for seizures and for visits by people unfamiliar with one person's behaviour were not complete.
- Effective?
- Good
- People received suitable food and drink, staff had relevant training and the home worked with specialist and healthcare services. Inspectors noted that weight records did not always show whether people were at a healthy weight because ideal weights or related indicators were not recorded.
- Caring?
- Good
- Staff were kind and respectful, knew people well and supported their communication, privacy, dignity, cultural needs and independence.
- Responsive?
- Good
- Care plans were detailed and personalised. People were supported with activities, community outings, holidays and decisions about how they wanted to be cared for.
- Well-led?
- Good
- The manager was described as open and approachable. Regular checks, staff meetings and daily observations were used to monitor care and respond to concerns.
What inspectors found, May 2019
Qualities Services Ltd is rated Good overall, but Safe Requires Improvement because some risk plans were not detailed enough.
The inspection was unannounced and took place on 23 April 2019. One inspector observed care, spoke with a person using the home, a relative, staff and the manager, and checked care plans, staff files, rotas, audits and other records.
The home supported four people with learning disabilities or acquired brain injury. Inspectors found caring, effective and responsive support. Staff knew people well, promoted choice and independence, provided activities, managed medicines safely and worked with healthcare services.
The main concern was safety planning. One person needed a clearer plan for seizures, including what to do at night, possible triggers, preventative measures and aftercare. Another person's behaviour plan did not cover being alone with visitors who might not know the risks. The overall rating stayed Good, but Safe was Requires Improvement.
Kind and respectful staff
Inspectors observed friendly and respectful interactions. Staff understood people's communication and emotional support needs.
“We observed staff interacting with people in a friendly and respectful manner.” from the report
Personalised support
Care plans included people's histories, preferences, communication methods and support needs. Staff reviewed them and helped people work towards their goals.
“Each person had a care plan, which was person-centred.” from the report
Choice and independence
People were supported to make choices and do tasks for themselves safely, including household activities, cycling and swimming.
“The provider had a focus on keeping people safe while maintaining their freedom to do the things they wanted to do.” from the report
Activities and community life
People took part in activities at home and in the community, and had opportunities for outings, holidays, hobbies and daily tasks.
“Records showed that staff engaged people throughout the day in activities, domestic tasks and leisure pursuits.” from the report
Good day-to-day oversight
The small size of the home helped the manager maintain regular oversight. Checks and daily observations were used to identify and discuss issues.
“Because the service was small, the registered manager was able to maintain a good level of oversight on a day to day basis.” from the report
Incomplete seizure safety plan
seriousOne person's plan did not explain how to manage seizures at night or when the person was alone. It also lacked enough information about triggers, prevention, immediate action and aftercare, and one record did not match a staff description.
“The existing management plan did not contain any information about what might trigger seizures, any preventative measures such as medicines the person took, the immediate action staff should take in the event of a seizure” from the report
Visitor safety planning
seriousOne person's behaviour plan did not clearly cover situations where they might be alone with visitors who did not know the management plan or might be affected by the behaviour.
“There was no clear plan for managing situations where the person may be alone with visitors who were not aware of the management plan or may be affected by the behaviour.” from the report
Weight records lacked useful reference points
needs fixingPeople were weighed and supported to seek medical advice when they lost significant weight. However, records did not show ideal weight, height or BMI, making it harder to tell whether someone was at a healthy weight.
“It was not always easy to tell whether the records indicated that people were at a healthy weight.” from the report
- 01What has been added to the seizure management plan, especially for seizures at night or when the person is alone?
- 02How are staff trained to recognise different types of seizure and what action and aftercare are required?
- 03How will visitors be kept safe when they do not know about a person's behaviour management plan?
- 04Have people's ideal weights, heights or BMI indicators now been recorded and reviewed?
- 05How are risk plans reviewed when people take part in activities such as cycling, swimming or drinking alcohol?
This was an unannounced inspection of the care provided and the premises, covering all five CQC questions and checking the overall quality and safety of the home. This explanation was written from the published report of 21 May 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, October 2016
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 3 October 2016. One inspector spoke with all three people living in the home, reviewed care and medicines records, checked staff files and management records, and contacted health and social care professionals.
The inspectors rated the home Good in all five areas. They found suitable staffing, safe medicines management, trained staff, up-to-date risk assessments and safe premises. People were supported to make choices, maintain their independence and take part in activities they enjoyed.
The report says improvements had been made since the November 2015 inspection, especially in recruitment and leadership. At this inspection, the provider met all regulations and the inspectors found effective systems for checking quality and making improvements.
Safer recruitment
Recruitment had improved since the previous inspection. The provider followed checks, interviews and induction procedures to make sure staff were suitable.
“Staff recruitment had improved and was much more robust.” from the report
Personalised support
Support plans included people's communication, behaviour, social and medical needs. Staff helped people follow their interests and take part in the community.
“People told us they received care that was personalised and that put them at the centre of plans.” from the report
Good management
The manager and staff worked together, reviewed incidents and used audits, surveys and meetings to identify improvements.
“The service had quality assurance processes in place to seek the views of people using the service, relatives and stakeholders.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently check that recruitment checks, staff training, supervision and night staffing remain in place?
- 02How are medicines checked now, including medicines given only when needed?
- 03How will you support my relative's individual interests, community activities and preferred routines?
- 04How are changes in a person's health, behaviour or support needs recorded and shared with staff?
- 05How can my relative or family raise a complaint, and how will we be told what action was taken?
This was an unannounced comprehensive inspection of all five key questions, based on visits, records, discussions with people and staff, and feedback from health and social care professionals. This explanation was written from the published report of 29 October 2016 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 Qualities Services Ltd
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- May 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Registered with the Care Quality Commission on 30 September 2014.
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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