CQC report explained · a nursing home
What the CQC found at Service to the Aged
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2021
Service to the Aged was rated Requires Improvement; inspectors found kind care and good health support, but some safety risks and management checks were not strong enough.
This was an unannounced focused inspection on 21 July 2021. Inspectors, professional advisers and an Expert by Experience spoke with people, relatives and staff, observed care and meals, and checked care, medicine, recruitment and management records.
The home was rated Requires Improvement overall. Safe and well-led were rated Requires Improvement. Effective was rated Good. Inspectors found inaccurate or unclear records about swallowing, falls, medicines and tube feeding. One catheter change was six days overdue. Recruitment checks were also not always completed properly.
People told inspectors they felt safe and were treated kindly. Staff knew people's needs, medicines were managed safely, staffing levels were sufficient, and health, food, religious and cultural needs were generally well supported.
The last inspection had rated the home Good. This inspection found that the rating had deteriorated. The provider took immediate steps on some issues, and CQC requested an action plan and said it would monitor progress and return for a re-inspection.
Kind and respectful care
Staff were caring and kind, asked for consent and knew people's needs. People and relatives generally said they felt safe and were happy with the care.
“Staff were caring and kind in their interactions with people and asked their consent during daily tasks.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. One-to-one support was provided when required for safety.
“There were enough staff on duty to meet people's needs.” from the report
Medicines managed safely
Medicines were stored, administered and recorded safely. Staff administering medicines had training and their competence had been checked.
“People received their medicines safely and as prescribed. Medicines administration records (MAR) were completed accurately.” from the report
Health and nutrition support
Staff supported people's health, nutrition, oral care and pressure sore prevention. Specialist referrals and physiotherapy were available when needed.
“People's health needs were met.” from the report
Religious and cultural needs
The home provided kosher food and supported Jewish religious and cultural routines and practices.
“People's religious and cultural needs as Jewish people were met well by the food, routines, entertainment and daily practices in the home.” from the report
Swallowing risks and records
seriousSome records gave conflicting or unclear instructions about food texture and thickener. Most staff did not have recent dysphagia training that inspectors could verify, creating a risk of unsafe support.
“There were some discrepancies in the records.” from the report
Catheter monitoring
seriousOne person's catheter was six days overdue for a change. The home changed it when inspectors raised the concern and improved its monitoring system afterwards.
“One person who had a catheter was six days overdue to have this changed.” from the report
Inaccurate care plans
needs fixingSome care plans contained out-of-date information about falls and medicines support. This could have led staff to make mistakes, even though inspectors found no evidence that unsafe care had resulted.
“Inaccurate care records meant there was a risk of staff making errors.” from the report
Recruitment checks
needs fixingChecks were missing for one privately employed care worker, and two staff files did not contain enough information about conduct in previous care roles. The provider was asked to review its recruitment practice.
“The home's recruitment procedure was not always followed properly in checking applicants' conduct in previous employment.” from the report
Weak quality audits
needs fixingThe home's audits did not pick up some safety, record-keeping and recruitment problems. Inspectors recommended making the quality checks more robust and effective.
“The audits in the home had not been sufficiently effective in picking up the concerns we found about risk management, some people's care records being inaccurate and some staff recruitment concerns.” from the report
- 01What changes have you made to ensure swallowing care plans clearly state the correct food and drink consistency for each person?
- 02How do you now check that catheter changes are completed on time and recorded?
- 03How do you check that care plans are accurate when they are reviewed each month?
- 04Have all current staff and privately employed workers completed the required checks and dysphagia training?
- 05What evidence can you show that your audits now identify safety and record-keeping problems promptly?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected, and previous ratings for those questions were used in calculating the overall rating. This explanation was written from the published report of 3 September 2021 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, November 2019
Service to the Aged was rated Good; inspectors found kind, personalised care, with some fire safety and record-keeping issues already addressed or being monitored.
This was an unannounced inspection on 30 October 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed daily care, meals and medicines, and checked care plans, recruitment records, medicines records, complaints, audits, training, building safety and fire checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were described as safe and treated with kindness and respect. Care plans and risk assessments were detailed and up to date. Staff understood people's needs, preferences, faith and culture.
The home had enough staff, managed medicines safely and supported people to access healthcare. It offered religious services, activities and family involvement. Inspectors noted some issues with a previous fire risk assessment, communal bathrooms being used for storage and recording lessons from incidents, but the fire safety work had been completed and other matters were being monitored.
The overall rating stayed Good from the previous inspection in June 2017. The Effective rating improved from Requires Improvement to Good because staff training and processes around consent and mental capacity had improved.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors also observed kind interactions and found that people's dignity and independence were supported.
“People told us staff were kind and caring. We witnessed kind interactions between staff and people at the service.” from the report
Personalised support
Care records included people's histories, routines, preferences and ways to reduce anxiety. Staff understood these details and used them to arrange care around each person.
“These examples showed us that the service provided a personalised service to people as staff understood and could tell us about people and their lives.” from the report
Strong health support
The home worked with GPs and other professionals and employed a physiotherapist. Inspectors saw examples of people's health improving through nursing care and nutrition.
“The staff team was effective in providing support to people to maintain their health and well-being as well as enabling access to external healthcare services as required.” from the report
Good management and checks
Managers monitored medicines, infection control, safety, care planning, incidents, complaints and safeguarding. Staff reported that managers were supportive and approachable.
“Quality audits were in place to check medicines management, infection control, building safety and maintenance and care planning.” from the report
Fire risk assessment
needs fixingA fire risk assessment completed in January 2019 did not identify issues later found by the London Fire Brigade. The required work had been completed by the time of the report, and the home planned to use another organisation for its next assessment.
“The service had a fire risk assessment completed by an external organisation in January 2019 but this had not identified issues which the London Fire Brigade (LFB) identified during their visit in May 2019 as requiring alteration.” from the report
Bathroom and shower access
minorThere were 42 showers for 60 people, and some communal bathrooms were being used for storage. The home said it would continue monitoring whether people's preferences for showering were supported.
“The service had 42 showers for 60 people living at the service and although there were communal bathrooms, some of them were used for storage.” from the report
Incident learning records
minorLearning from accidents and incidents was not written in the relevant folder, although the manager could explain what action had been taken. Inspectors saw evidence of action to reduce falls.
“Although learning was not recorded in the accident and incident folder the registered manager could tell us what learning took place.” from the report
- 01How will you make sure the next fire risk assessment identifies all issues, and when will it be completed?
- 02How do you make sure people without an ensuite shower can shower when and how they prefer?
- 03Where are lessons from accidents and incidents now recorded, and how are actions followed up?
- 04How will you maintain the improvements in staff training and Mental Capacity Act practice?
- 05What activities are available for people who want more mental stimulation than painting?
This was an unannounced planned inspection covering the overall service, including care and premises, and all five CQC questions. This explanation was written from the published report of 23 November 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.
Every inspection of Service to the Aged
6 rated inspections over 6 years: the service has improved, from Inadequate to Requires improvement.
- September 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvement
- September 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementResponsive: Good
- May 2015InadequateSafe: InadequateEffective: InadequateCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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At least 100 live-in carers within about an hour of Barnet
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 £1,300 a week. 83 can care for a couple. 12 years' experience on average.
“The quality of life that she's given my parents has been priceless. The peace of mind she's given my sisters and I, through a very difficult time, has been invaluable.”
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