CQC report explained · a residential care home
What the CQC found at St Augustine's Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- The home had enough staff during the inspection and people received safe support with medicines and known risks. However, infection outbreaks were not always managed effectively, including delays in reporting and staff returning to work sooner than national guidance stated.
- Effective?
- Requires improvement
- Staff generally supported people's choices and worked within the principles of the Mental Capacity Act. However, consent records and applications for deprivation of liberty were not always complete or up to date.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people's preferences and encouraged independence.
- Responsive?
- Good
- People received person-centred care and could take part in activities, religious services and social events. Some activities and social contact were sometimes affected by staffing challenges.
- Well-led?
- Requires improvement
- Managers had made improvements to staffing, training, medicines and handovers. However, care records, audits, incident reviews and oversight of staffing were not consistently effective.
What inspectors found, July 2023
Rated Requires Improvement; inspectors found kind, person-centred care, but infection control and record-keeping had serious shortfalls.
This was an unannounced inspection on 12 May, 30 May and 7 June 2023. It began as a targeted inspection after concerns about infection prevention and control, then widened into a comprehensive inspection of all five areas.
The home was caring and responsive. Staff treated people with kindness, respected their dignity, knew their preferences and supported activities, healthcare and meals. There were enough staff during the inspection, and medicines were managed safely.
However, infection outbreaks were not always managed effectively. Records did not always clearly show people's current risks, needs, consent or the care they required. The systems used by managers to check quality, incidents, staffing and records were not strong enough.
The overall rating of Requires Improvement means the home was not consistently safe, effective or well-led. The caring and responsive areas were rated Good, but inspectors found breaches of Regulation 12 on safe care and treatment and Regulation 17 on good governance.
Kind and respectful care
People and relatives described staff as kind, caring and respectful. Inspectors saw staff supporting people patiently and maintaining their dignity.
“People were treated with kindness, compassion and respect.” from the report
Staff knew people well
Permanent staff understood people's individual risks, preferences and usual behaviour. People were supported safely with equipment such as sensor mats and pressure-relieving mattresses when needed.
“People received safe support as staff knew their individual risks.” from the report
Person-centred support
Staff supported people's choices, interests, relationships and religious needs. People could join activities and services or spend time quietly in their rooms.
“People were supported to do things they liked, to go out and to maintain and build social relationships.” from the report
Medicines and staffing
Inspectors found safe medicines support, trained staff and good medicines oversight. Staffing levels had recently been increased and staff were available during the inspection.
“People received safe support with their medicines.” from the report
Infection outbreak management
seriousThe provider did not manage an infection outbreak effectively enough. Inspectors found delays in reporting, insufficient infection checks and many infected staff returning to work sooner than national guidance stated.
“Staff rosters we viewed showed 10 out of 13 infected staff returned to work sooner than stated in the national guidance.” from the report
Incomplete care records
seriousSome care plans and risk assessments were not current or detailed enough. This included information about health risks, moving and handling, skin care, continence, food and fluids, and changes of position.
“People's records were not always consistent, up to date and detailed enough to ensure staff had clear guidance on all of the individual needs and risks.” from the report
Weak management checks
seriousThe home did not have strong enough systems to check care quality, staffing levels, call bell response times or trends in accidents and incidents. This meant there was limited assurance that problems would be identified and fixed promptly.
“The governance systems and processes in the service were not always effective.” from the report
Consent and liberty records
needs fixingRecords did not always show how consent was obtained, include all relevant mental capacity assessments or contain current applications for deprivation of liberty safeguards.
“There were gaps in records on how people's consent was obtained and further work was required to ensure all DoLS applications were re-applied for when needed.” from the report
Dementia-friendly environment
minorThe home had some useful adaptations, but inspectors said the environment could better support people living with dementia and people with sensory impairments.
“The environment could be made more dementia friendly and supportive for people with sensory impairments which were the needs of some of the people living in the home.” from the report
- 01What changes have you made to manage infection outbreaks, including staff return-to-work checks, outbreak reporting and infection control audits?
- 02Have all care plans and risk assessments been reviewed and updated, and how do you check that they match the care people receive?
- 03Have all required mental capacity assessments, consent records and deprivation of liberty applications been completed and reviewed?
- 04How do you now monitor staffing levels, call bell response times and whether people receive enough attention and activities?
- 05How are accidents and incidents, including repeated falls, reviewed so that lessons are identified and acted on?
This began as a targeted inspection about infection prevention and control but was widened to a comprehensive inspection covering all five key questions. This explanation was written from the published report of 4 July 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 Augustine's Care Home
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- July 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2023Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2022Inspected but not ratedSafe: Inspected but not rated
- April 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2023
Registered with the Care Quality Commission on 2 February 2023.
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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