CQC report explained · a residential care home
What the CQC found at St Albans House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
St Albans House was rated Inadequate and placed in special measures; inspectors found serious safety and leadership failures despite some kind care and support.
This was the first inspection of the newly registered service. One inspector visited on 28 March and 5 April 2023, with inspection activity ending on 20 April. The inspector spoke with three people, two relatives and six staff, observed care, and reviewed care plans, medicines, staff records, training and management records.
The inspectors found serious risks. People were restrained and sometimes locked in rooms or communal areas without robust safeguards. Incidents and risks were not properly investigated or reduced. Care records were incomplete, and some people's health needs were not reflected in their risk assessments or support plans.
Staff often knew people well and showed warmth and patience. People were supported with meals, activities, family contact and some healthcare. However, the overall rating was Inadequate because the service was not keeping people safe or being well-led. Effective, caring and responsive care were rated Requires Improvement.
The home was placed in special measures. The CQC issued warning notices for breaches of Regulations 12, 13 and 17, requested an action plan, and said it would work with the provider and local authority to monitor progress.
Warm staff relationships
Inspectors saw staff being patient, warm and respectful. Staff knew people well, including their communication needs, likes and dislikes.
“Staff members showed warmth and respect when interacting with people. We observed people being attended to by staff in a manner that demonstrated they knew the person well.” from the report
Choice and activities
People were supported to choose food, take part in house meetings, go out locally and keep in touch with family and friends.
“People were supported to participate in social and leisure interests where possible.” from the report
Food and mealtimes
People chose what to eat and could eat at flexible times. Inspectors saw people eating the lunch they wanted when they wanted it.
“Mealtimes were flexible to meet people's needs. We observed people eating the lunch they wanted when they wanted to.” from the report
Clean premises and safety checks
The premises were clean, and fire, gas and other safety checks had been carried out. The report said recommendations from the fire risk assessment were being completed.
“The service used infection, prevention, and control measures, and staff supported people to follow them. We observed the premises to be clean.” from the report
Unsafe restraint and restrictions
seriousPeople were subject to physical, chemical and environmental restraint without robust procedures. PRN medicine was used for behaviour management without clear instructions, records or monitoring.
“People were subject to restraint without robust processes and procedures to support this practice.” from the report
Risks and incidents not acted on
seriousRepeated behaviour incidents and falls were not properly investigated or used to reduce risk. Risk assessments were incomplete, out of date or did not reflect people's needs.
“The staff team did record and report incidents, however these were not investigated and therefore the risks and behaviours and accidents continued to occur across at least a 10 month period.” from the report
Safeguarding failures
seriousIncidents involving possible or actual harm were not consistently recognised as safeguarding concerns or reported to the right organisations.
“Systems and processes had not been established to protect service users from abuse and improper treatment. This placed people at risk of harm.” from the report
Incomplete care planning
needs fixingCare and support plans did not always describe people's identities, health needs, behaviours, choices and risks in enough detail. Daily notes were also not detailed enough.
“People did not always have had care and support plans that were personalised, and which reflected their needs and aspirations, included physical and mental health needs.” from the report
Weak management oversight
seriousQuality checks did not identify serious problems. The management arrangements were also unsettled, with an interim manager sharing time between this home and another service.
“The governance system established to give assurance of the quality of service and to identify areas that required improvement was not effective.” from the report
- 01What has changed since the inspection to stop people being locked in bedrooms or communal areas, and how are any restrictions now authorised and reviewed?
- 02How are behaviour incidents, falls and safeguarding concerns recorded, investigated, escalated and used to reduce future risks?
- 03How is PRN medicine for behaviour now prescribed, authorised, recorded and monitored?
- 04Have every person's care plan and risk assessments been updated to include their health needs, behaviours, risks and choices?
- 05What action has been taken in response to each warning notice, and what evidence can you show of improvement?
This was an unannounced full inspection of the care home, covering all five key questions and including infection prevention and control checks. This explanation was written from the published report of 30 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.
Every inspection of St Albans House
Each visit the CQC has published, newest first, back to the day the home was registered.
- June 2023Inadequatecurrent ratingSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2020
Registered with the Care Quality Commission on 1 December 2020.
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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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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