CQC report explained · a care home with nursing
What the CQC found at St Aiden's Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were managed safely, risks were well managed, staffing was sufficient and people were protected from abuse. Infection prevention and control arrangements were also found to be effective.
- Effective?
- Good
- This key question was not covered by this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not covered by this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- Staff generally responded to people's needs and care plans reflected current needs. However, one person's specific needs were not always consistently met and electronic records did not always clearly show regular reviews.
- Well-led?
- Good
- Quality monitoring had improved and the management team was acting on areas for improvement. There was no registered manager at the time, although an application had been submitted.
What inspectors found, April 2021
Rated Good; inspectors found safe care and major improvements, but some care records were not consistently maintained.
This was an unannounced focused inspection. An inspector and a pharmacist specialist visited on 1 March 2021, then the provider supplied further information between 10 March and 9 April. Inspectors spoke with five people, three relatives and seven staff, and reviewed care, medicines, recruitment and management records.
The home was rated Good overall. Safe, responsive and well-led were also rated Good. Inspectors found medicines were managed safely, risks were identified, staffing was sufficient, infection controls were in place and the premises had improved.
There were still some weaknesses. Records suggested one person's specific needs were not always consistently met. It was also not always clear from electronic records whether care plans and risk assessments had been reviewed regularly. The provider had identified these issues and was taking steps to improve them.
The previous rating was Requires Improvement, published in December 2019, with three breaches of regulation. Inspectors found the home was no longer in breach. This inspection did not reassess Effective or Caring, so those parts of the overall rating carried over from the previous comprehensive inspection.
Safe medicines
Medicine records had improved, matched the stock held and included suitable guidance for medicines given when needed.
“Medicine administration records had improved and were now completed correctly.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs safely. Recruitment files included references and appropriate background checks.
“There were enough staff to meet people's needs safely.” from the report
Safer environment
The home had new flooring, redecoration and improvements to the laundry and outdoor areas. Fire and maintenance checks were up to date.
“Improvements had been made to the environment such as new flooring and re-decoration which made the home more pleasant and homely.” from the report
Activities and relationships
Staff supported people with activities and helped them keep in touch with family and friends through video calls.
“Staff supported people to take part in activities such as arts and crafts, jigsaws, shopping at the tuck shop and going to the in-house disco.” from the report
Improved oversight
The home's quality monitoring had improved since the previous inspection, helping identify and address potential problems more quickly.
“Quality monitoring systems had improved and there was better oversight of the service.” from the report
Care records and consistency
needs fixingRecords suggested one person's specific needs were not always consistently met. Inspectors also could not always see from the electronic records whether reviews had happened regularly.
“Records suggested one person's specific needs were not always being consistently met.” from the report
Electronic audit trail
needs fixingStaff had overwritten some original electronic care plans and risk assessments instead of keeping earlier versions. This made it harder to confirm when reviews had taken place.
“It was not always clear from electronic records whether these had been consistently reviewed regularly.” from the report
- 01How do you make sure each person's specific needs are consistently met when staff provide care?
- 02How are care plans and risk assessments reviewed, and how can families see that the reviews have taken place?
- 03What progress has been made with the application for a registered manager?
- 04How are medicines given when needed, and how do you check that the guidance remains person-centred?
- 05What activities and communication support would be available for my relative's individual needs?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings carried over. This explanation was written from the published report of 22 April 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, December 2019
St Aiden's Cottage was rated Requires Improvement; inspectors found unsafe medicines management, incomplete care plans and weak quality checks.
This was an unannounced focused inspection on 22 and 25 July 2019. Inspectors spoke with people living at the home, relatives, staff and managers. They reviewed care plans, risk assessments, medicines records, recruitment records and quality checks.
The home was not always safe. Inspectors found problems with medicines records, risk assessments, wheelchair equipment and some building repairs. Agency staff were not always confident using the home's electronic systems, which affected medicines administration.
Care plans did not always reflect people's current needs or preferences. The systems used to check quality had not found the problems identified by inspectors. The overall rating fell from Good at the previous inspection to Requires Improvement.
The home also had strengths. People were supported with activities, emotional and physical support, and access to the local community. Staff recruitment checks were completed, and people and relatives generally spoke positively about the home.
Community access
People were supported to use local shops and take part in events in the community.
“People were supported to access the local community.” from the report
Therapeutic support
A therapeutic team, including physiotherapists and occupational therapists, supported people's emotional and physical needs and provided specialist guidance.
“The provider had a therapeutic service team which consisted of a range of healthcare professionals including physiotherapists and occupational therapists.” from the report
Safeguarding knowledge
Staff had safeguarding training and understood the types of abuse people might face and what action to take.
“Staff we spoke with had a good knowledge of the abuse people could face and what action to take.” from the report
Medicines records and administration
seriousMedicines were not always managed safely. Records were incomplete, guidance for some medicines was insufficient, and staff did not always record why as-required medicines were given or their effect.
“Medicines were not always managed safely and records had not been completed correctly.” from the report
Unmanaged risks
seriousSome risks had not been identified or explained clearly enough for staff to follow. Inspectors also found missing wheelchair footplates and concerns about the building's condition.
“Individual risks had not always been identified by the service.” from the report
Inaccurate care plans
seriousSome care plans described needs that were no longer current, contained conflicting information or did not explain people's preferences and safe care clearly enough.
“Care plans were not person centred and some contained conflicting information.” from the report
Weak quality checks
seriousThe home's quality assurance systems did not identify the medicines, risk and care-record problems found during the inspection.
“The quality assurance systems failed to identify the issues we found during our inspection.” from the report
Agency staff and medicines systems
needs fixingAgency staff were not always confident using the home's electronic systems. Inspectors observed one agency nurse taking five hours to administer morning medicines.
“We observed that agency staff were not confident with the provider's electronic systems.” from the report
Activities were not consistent for everyone
needs fixingPeople gave mixed views about activities. One person said they were bored every day, and inspectors raised this with the manager.
“Another person said, "I go to the cinema, swimming and shopping there's other stuff it depends…. I'm bored every day in here.” from the report
- 01What changes have been made to ensure medicines records, patch changes and as-required medicines are managed and recorded safely?
- 02How are individual risks now identified and explained in care plans, including risks involving nurse call bells and wheelchair footplates?
- 03How do you check that every care plan reflects the person's current needs, preferences and mobility?
- 04What has been done to reduce reliance on agency staff and make sure agency staff can use the home's electronic systems safely?
- 05How do your current quality checks identify problems before they affect people's safety or care?
This was a focused inspection of Safe, Responsive and Well-led only; Effective and Caring were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 5 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.
Every inspection of St Aiden's Cottage
6 rated inspections over 6 years: the service has held its Good rating throughout.
- April 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017Goodup from Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- March 2017
Location report published without a new overall rating.
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
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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47 live-in carers within about an hour of County Durham
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 £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in 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.