CQC report explained · a residential care home
What the CQC found at Squeaks House Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2019
Rated Good overall; inspectors found kind, responsive care, but safety checks were not always thorough.
This was a planned inspection over 28 and 29 October 2019. One visit was unannounced and the second was announced. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
People and relatives were happy with the care. Inspectors found enough staff, safe recruitment, clean surroundings, good support with food and health, kind staff, personalised care and useful activities. The home was also judged to be well managed.
The main weakness was safety. Environmental risks were not always identified and acted on quickly enough, including risks linked to wardrobes, window restrictors, the attic area and the water supply. The provider acted on some of these issues during the inspection. The overall rating stayed Good, but Safe fell from Good to Requires Improvement.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw warm relationships, choice, dignity and support for independence.
“People and their relatives told us they were happy with the quality of care being provided.” from the report
Staffing and recruitment
People said there were enough staff, and inspectors saw staff respond promptly. Recruitment checks were in place.
“People told us there were enough staff to meet their needs.” from the report
Food and health support
People were offered regular meals, snacks and drinks. Staff followed dietary information and arranged timely support from health professionals.
“At lunch time we saw the mealtime experience was a positive one, with staff engaging with people, offering support where required, in a discreet and unrushed manner.” from the report
Activities and relationships
Staff encouraged people to join in with activities suited to their interests and abilities. The home also supported visits and family relationships.
“Staff encouraged people to socialise and join in with activities that would support their interests and wellbeing.” from the report
Environmental safety checks
seriousThe provider's checks did not identify all potential environmental risks. These included unsecured wardrobes, the attic area, window restrictors and the water supply.
“This included risks associated with legionella, free standing wardrobes; if they toppled over, accessing the cluttered attic area, or ensuring the window restrictors met current guidelines.” from the report
Pain assessment
needs fixingThere was no assessment tool to help staff identify pain in people whose ability to report or describe pain was limited. Inspectors made a recommendation for this to be improved.
“The registered manager confirmed that they did not use a pain assessment tool.” from the report
Oral care records
minorCare plans did not give enough information about assessing, supporting and monitoring people's oral care. The provider said it would use CQC guidance to improve this.
“However, we found the information given in people's care plans which covered assessing, supporting and monitoring people's oral care could be improved.” from the report
- 01Have all the environmental risks identified during the inspection now been assessed and dealt with, including wardrobes, window restrictors, the attic area and the water supply?
- 02What pain assessment tool do staff now use for people who cannot report or describe pain clearly?
- 03How are people's oral care needs assessed, recorded and monitored?
- 04How is the medicine fridge temperature monitored and what action is taken when it is too warm?
- 05How will you show that improvements from residents' and relatives' feedback have been completed?
This was a planned two-day inspection covering all five CQC questions, the premises and the care provided; one day was unannounced and the other announced. This explanation was written from the published report of 7 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
Rated Good in every area; inspectors found caring, personalised support and improvements since the previous inspection, with a few records and staffing issues to monitor.
This was an unannounced inspection on 28 February 2017. Inspectors spoke with people living at the home, relatives, staff, the provider, managers and a health professional. They observed care and checked care records, recruitment, training and quality checks.
The home was rated Good overall and Good for Safe, Effective, Caring, Responsive and Well-led. People were described as safe, respected and supported by staff who knew their needs and preferences. Medicines, food and drink, health care, activities and complaints systems were found to be managed well.
The previous inspection had found problems with moving and transferring people safely and with the provider supporting the manager. Inspectors found these areas had improved. Staff had received updated training, equipment had been replaced and new management meetings and checks were helping to drive improvements.
Safe moving support
Training in moving and transferring people had been refreshed since the previous inspection. Inspectors observed people being moved safely and effectively.
“This training had now been refreshed and the manager had put improved measures in place to assure themselves that staff had the necessary skills to support people.” from the report
Kind and respectful staff
Staff knew people well and adapted support to their preferences. Inspectors saw staff communicate warmly, protect people's dignity and offer reassurance.
“Staff had a good understanding of people's interests, likes and dislikes and knew how to provide comfort and reassurance if needed.” from the report
Personalised care
Care plans described people's individual needs and wishes. People were involved in choices about their care, activities, food and surroundings.
“People's care needs had been fully assessed before moving into the service.” from the report
Strong management
The manager used audits, meetings and feedback to identify improvements. The provider and manager had also improved how they worked together.
“The manager was exceptional. They ensured people were central to the service and used effective systems to ensure the service was constantly improving.” from the report
Medicines handled safely
Inspectors observed a medicines round and found that people were supported to take medicines safely and as prescribed. Records were up to date.
“People were supported to take their medicines safely and as prescribed.” from the report
Bed rail records
needs fixingRisk assessments for bed rails did not fully describe possible safety risks. The manager revised the form after inspectors raised this.
“recording of risk assessments for the use of bed rails was not sufficiently robust as it did not fully highlight potential risks to people's safety.” from the report
Mental capacity records
needs fixingSome capacity assessments did not record enough detail about who had taken part in decisions. Staff were observed offering choices and asking for consent.
“these lacked detail about who had been involved in the decision making process.” from the report
Agency staff quality
needs fixingThe home had previously had concerns about the quality of agency staff, mainly at night. The manager was working with the agency to resolve this.
“Prior to our inspection there had been concerns regarding the quality of the agency staff.” from the report
Sensory room not in use
minorA newly decorated sensory room was not being used during the inspection, and two hoists were stored there. The manager expected the new activities worker to make more use of it.
“During our visit, we noted this room was not in use and two hoists were stored there.” from the report
Some provider delays
minorNew systems had improved communication between the provider and manager, but inspectors still found some delays in responses to queries.
“There were still some delays in the provider responding to queries.” from the report
- 01How are bed rail risks assessed and reviewed now, and how will you involve families in those decisions?
- 02How do you record who is involved when a person cannot make a decision about their care?
- 03How do you check the skills and quality of agency staff, particularly at night?
- 04Is the sensory room now available for people to use, and how is it included in activities?
- 05How are outstanding requests to the provider tracked and followed up?
This was an unannounced inspection covering all five questions about quality, including observations, discussions with people and families, eight care records and management checks. This explanation was written from the published report of 28 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 Squeaks House Residential Care Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Squeaks House Residential Care Home →
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Squeaks House Residential Care Home →
- April 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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