CQC report explained · a residential care home
What the CQC found at Simone's House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed clearly, medicines were managed safely, staffing was sufficient and infection control arrangements were effective.
- Effective?
- Good
- This question was not inspected during this focused inspection, so no rating was given in this report.
- Caring?
- Good
- This question was not inspected during this focused inspection, so no rating was given in this report.
- Responsive?
- Good
- Inspectors found that care was personalised, communication needs were met and people were supported to take part in activities and access the community.
- Well-led?
- Good
- Inspectors found stronger monitoring systems, regular audits, staff involvement and an open culture involving residents and relatives.
What inspectors found, June 2023
Simone's House rated Good; inspectors found safe, personalised care and improvements since the previous inspection.
This was an unannounced, focused inspection on 4 May 2023. One inspector reviewed care records, medicines records, staff records, rotas, complaints, audits and meeting notes. They also spoke with a resident and staff, and contacted relatives.
The home was rated Good for Safe, Responsive and Well-led. Inspectors found clear risk assessments, safe medicines systems, enough staff, personalised care plans and activities chosen by residents. Staff understood people’s communication needs and worked with families and healthcare professionals.
The previous inspection, published in July 2022, rated the home Requires Improvement and found breaches of regulations. The provider submitted an action plan. Inspectors found the necessary improvements had been made and that the home was no longer in breach.
Clear risk management
The home had detailed risk assessments covering people’s health, mobility, activities and emergency needs. Staff had guidance on reducing anxiety and avoiding escalation.
“Risk assessments were detailed and comprehensive and included measures in place to reduce risk.” from the report
Safe medicines
Inspectors found robust systems for ordering, storing, administering and checking medicines. They found no unexplained omitted doses in the records reviewed.
“This indicated people were receiving their medicines safely, consistently and as prescribed.” from the report
Personalised support
Care plans included people’s histories, needs and preferences. People were supported with activities, hobbies, exercise, community access and household tasks.
“People's needs were met in a person-centred way and in line with their wishes.” from the report
Improved leadership
The registered manager had introduced monthly checks and audits across the service. Inspectors found that shortfalls were recorded and acted on promptly.
“The registered manager had put in place more robust monitoring systems since our last inspection.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you keep my relative’s risk assessments up to date if their health, mobility or behaviour changes?
- 02What activities would you offer to my relative, and how would you support them if they were reluctant to go out?
- 03How would staff communicate with my relative if they could not communicate verbally?
- 04How often are medicines checked, and how would you tell the family if there was a medicines error?
- 05What changes have you made since the previous inspection, and how do your audits show that these improvements are being maintained?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and the overall rating used ratings from the previous inspection for the questions not covered. This explanation was written from the published report of 21 June 2023 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, July 2022
Rated Requires Improvement; inspectors found gaps in risk management, care records, staffing oversight and activities, although medicines and infection control were managed safely.
This was an unannounced focused inspection on 10 May 2022. One inspector spoke with one person, five relatives and three staff members. They reviewed care records, medicines records, recruitment files, rotas, complaints and management records.
The home was not always safe or responsive, and its leadership systems did not reliably identify problems. Risk assessments lacked clear instructions for staff, including for falls, asthma, diabetes, aggression and self-harm. Care plans were sometimes generic, daily records were incomplete, and there was limited evidence of meaningful activities.
There were also positive findings. People received medicines safely and as prescribed. Staff understood safeguarding and communication needs, infection control arrangements were effective, and people and relatives spoke positively about the care and management. The overall rating fell from Good at the previous inspection to Requires Improvement.
Medicines
People received their medicines as prescribed. Records had no gaps, stock balances were correct and staff checked medicines daily.
“People received their medicines safely and as prescribed.” from the report
Safeguarding
Staff had safeguarding training and knew how to recognise and report possible abuse. People and relatives said they felt safe.
“Staff had training in safeguarding and knew how to identify abuse and escalate concerns.” from the report
Communication
Staff had developed ways to communicate with people who did not use speech, including objects of reference, signing and gestures.
“Some people did not use speech to communicate and staff had developed specific ways of communicating with them by using objects of reference, basic signing and gestures.” from the report
Infection control
Inspectors were assured about infection prevention arrangements, including PPE, testing, visits and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Risk information
seriousThe home had not always assessed people's risks properly or given staff clear guidance. This included risks linked to falls, asthma, diabetes, aggression and self-harm.
“Where the service had identified risks, these were not explored and management plans had not been put in place.” from the report
Staffing and recruitment
seriousInspectors were not assured that staffing levels were sufficient. One staff member was recorded as working 24 and 18 continuous hours on different occasions, and one person started before their DBS check was complete.
“We were not assured the service deployed sufficient numbers of staff to ensure people's care and support needs were met safely.” from the report
Care planning
needs fixingCare plans contained generic or complicated wording and did not always explain people's specific needs, preferences and support clearly enough.
“There was a lack of information on people's care and personal needs including favourite foods, eating and drinking requirements, medicines and mental health needs.” from the report
Meaningful activities
needs fixingThere was not enough evidence that people took part in activities they enjoyed or that were culturally relevant. Some people spent most of the day watching television or in their rooms.
“It was not clear whether people were supported with activities that were meaningful to them and which they enjoyed.” from the report
Management checks
seriousThe home's quality checks had not found several of the problems identified by inspectors. Daily records were also incomplete and did not always show who had provided care.
“Existing quality assurance systems did not identify the issues we found at this inspection.” from the report
- 01What changes have you made to risk assessments for falls, asthma, diabetes, aggression and self-harm?
- 02How do you check that staffing levels are safe and that staff are not working excessive continuous hours?
- 03How do you make sure temporary and newly recruited staff understand each person's care needs?
- 04What meaningful activities are now available, and how do you record whether people enjoy and benefit from them?
- 05How do managers check that daily records are complete and accurately show which staff provided care?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings carried over from the 2019 inspection. This explanation was written from the published report of 6 July 2022 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 Simone's House
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2022Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2019Goodup from Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Goodstayed GoodWell-led: Requires improvement
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2014
Registered with the Care Quality Commission on 17 February 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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At least 100 live-in carers within about an hour of Hillingdon
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 £1,320 a week. 81 can care for a couple. 11 years' experience on average.
“I can truly say that Peter always put Dad at the centre of everything and I know that they found a great friendship in difficult times.”
“She has an unusual combination of kindness and firmness, is quite unflappable, physically strong, extremely savvy”
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.