CQC report explained · a residential care home
What the CQC found at The Amwell
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2023
The Amwell rated Good; inspectors found people were safe and the home was well managed, with some medicines records needing clearer detail.
This was an unannounced focused inspection on 15 March 2023. Two inspectors visited, an Expert by Experience spoke to relatives, and the inspection team spoke with people, relatives and staff. They also checked care records, medicine records, staff files and management records.
The inspection was carried out after concerns about medicines management. Inspectors found that people were protected from harm, medicines were given safely, staffing levels were suitable and staff were safely recruited. They also found that risks were assessed and incidents were recorded and reviewed.
The registered manager was absent, but inspectors found an effective management team in place. The home was rated Good overall, with Safe and Well-led also rated Good. The other three ratings were not reviewed during this inspection and were carried over from the previous inspection.
People were kept safe
Staff understood safeguarding procedures and knew how to report concerns. Individual risks were assessed, reviewed and shared with staff.
“People were safeguarded from the risk of harm and abuse.” from the report
Safe medicines practice
Medicines were stored securely, stock was checked daily and staff had training and regular competency checks.
“People received medicines safely and staff were trained in how to administer medicines.” from the report
Suitable staffing and recruitment
Staffing was calculated according to people's needs, and recruitment checks were completed before staff started work.
“The management team ensured that there was a good mix of staff available to meet individual needs.” from the report
Strong management cover
Although the registered manager was absent, inspectors found that the interim and regional management arrangements provided effective support and oversight.
“The provider had ensured there was an effective and supportive management team in place.” from the report
Learning from incidents
Accidents and incidents were recorded, investigated and analysed. Learning was shared with staff and action was taken to reduce the chance of recurrence.
“Information and learning was shared with staff members in daily handovers, staff meetings and supervisions.” from the report
Eye-drop training gap
needs fixingOne staff member had not completed the home's internal training for giving eye drops. The manager agreed to arrange this training immediately.
“During the inspection, 1 staff member told us they had not received internal training for eye drop administration.” from the report
Some medicine instructions lacked detail
needs fixingSome instructions for as-required medicines did not clearly explain variable doses, such as whether to give one or two tablets. Staff could explain the safe process, and the manager agreed to amend the instructions.
“Some protocols had missing details for PRN medicines where the dose was variable, for example one or two paracetamol.” from the report
Visits suspended during an outbreak
minorNon-essential visits were suspended at the time of inspection because of an outbreak. The home used telephone and video calls to help people stay in contact with family.
“At the time of inspection, non-essential visits had been suspended due to an outbreak.” from the report
- 01Have the as-required medicine protocols been amended so variable doses are clearly explained?
- 02Has all staff training for eye-drop administration now been completed and checked?
- 03How are staffing levels adjusted when people's needs change?
- 04How will family visits be arranged if there is another infection outbreak?
- 05How are accidents, incidents and falls reviewed, and how are lessons shared with staff?
This was an unannounced focused inspection of Safe and Well-led only, prompted by concerns about medicines; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 10 May 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, August 2022
The Amwell is rated Good, up from Requires Improvement; inspectors found safe care and stronger management systems.
This was an unannounced focused inspection on 11 and 12 July 2022. Inspectors examined Safe and Well-led because concerns had been raised about care and there was a COVID-19 outbreak.
Inspectors spoke with people living at the home, staff, relatives and a health professional. They reviewed care records, medicine records, recruitment files and management records.
They found people were protected from abuse and avoidable harm. Medicines, staffing, infection control, risk assessments and safeguarding systems were working well. The home had systems to learn from incidents and monitor quality.
The overall rating changed from Requires Improvement to Good. However, Caring, Effective and Responsive were not assessed during this inspection, so their previous ratings were used in the overall rating.
Safeguarding
Safeguarding concerns were recorded, investigated and shared with the local authority when needed. People and relatives said they felt safe.
“People were safeguarded from the risk of harm.” from the report
Medicines
Inspectors found that medicines were given as prescribed, stored safely and monitored appropriately.
“People received medicines safely and staff were trained in how to administer medicines.” from the report
Staffing and recruitment
Recruitment checks had been completed, staff received relevant training and inspectors found enough staff to meet people's needs.
“There were enough staff. We observed the service to be calm, and staff did not appear to be rushed.” from the report
Management oversight
The home had regular meetings, audits and reviews of incidents. These systems helped managers identify concerns and take action.
“Quality assurance processes had been embedded.” from the report
Infection control
During the COVID-19 outbreak, the home used cleaning, protective equipment and self-isolation arrangements to reduce the spread of infection.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current ratings and recent findings for Caring, Effective and Responsive, which were not assessed in this inspection?
- 02How do you make sure medicines continue to be given as prescribed and records remain accurate?
- 03How do you manage visits and support residents during a COVID-19 or other infection outbreak?
- 04How are incidents, falls and accidents reviewed, and what recent changes have been made as a result?
- 05How do residents and relatives see that their suggestions have led to changes in the home?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 6 August 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 The Amwell
7 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- May 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2022Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- January 2021Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- September 2020Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- May 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2017
Registered with the Care Quality Commission on 28 February 2017.
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 £980 to £1,260 a week. 82 can care for a couple. 12 years' experience on average.
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