CQC report explained · a residential care home
What the CQC found at The Crescent
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicine records were not always accurate or complete. Fire safety actions, incident reviews and staff training also had gaps, although inspectors found enough staff and no evidence that people had been harmed.
- Effective?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Management systems did not reliably identify or correct problems with medicines, fire safety, incidents and staff training. This was a breach of Regulation 17.
What inspectors found, March 2021
Requires Improvement; inspectors found gaps in medicines, fire safety, staff training and quality checks, although people felt safe and were treated with care.
This was an unannounced focused inspection on 15 December 2020. One inspector spoke with relatives and staff, observed three people, and checked care, medicine, staff and management records. The inspection looked only at Safe and Well-led, including infection control.
The home was not always safe. Medicine records were incomplete or inaccurate, fire safety recommendations had not been fully acted on, and staff training was not up to date. Incident records were also not always accurate or followed up promptly. There was no evidence that people had been harmed because of these issues.
The home was not always well-led. Quality checks had failed to identify or correct important problems, and this led to a breach of Regulation 17. The provider was working with the local authority and had an action plan.
The overall rating fell from Good at the previous inspection to Requires Improvement. The other three areas were not inspected during this visit, so their previous ratings were carried forward.
People felt safe
People and relatives said people felt safe and secure. Staff understood safeguarding responsibilities and knew how to raise concerns.
“People felt safe living at The Crescent.” from the report
Enough staff on duty
Inspectors saw enough staff to support people when they needed help. Recruitment checks had also been completed.
“We observed there were enough staff to ensure people were supported to meet their needs when they required support.” from the report
Infection control
Inspectors were assured that the home had arrangements for preventing and managing infections, including using protective equipment and supporting testing.
“We were assured that the provider was using PPE effectively and safely.” from the report
Person-centred support
Staff offered people choices, supported independence and helped people keep in contact with relatives and use the local community.
“People had their choices and freedoms respected.” from the report
Medicine records
seriousMedicine administration records were incomplete or inaccurate. Some required-medicine instructions were missing, and some entries did not show whether medicine had been given or refused.
“People's medicines administration records (MAR) were not always complete, nor information recorded accurately.” from the report
Fire safety actions
seriousThe home's fire risk assessment did not include recommendations from the Fire and Rescue Service. A door to the heater tank room still did not close or lock easily until action was arranged during the inspection.
“The provider had not acted on the advice by the fire service's risk assessment dated 27 June 2019” from the report
Staff training
needs fixingTraining was not complete or current for many requirements. For example, only 63% of staff had completed manual handling training.
“Manual Handling Training had only been completed by 63 percent of staff.” from the report
Weak quality checks
seriousManagement checks did not consistently identify problems or make sure action was taken. This was the reason for the Regulation 17 breach.
“The governance systems were not robust enough to demonstrate safety was effectively managed, placing people at risk of harm.” from the report
Incident follow-up
needs fixingSome incident records were inconsistent, and action after a person's falls was not taken promptly or analysed with dates recorded.
“Incidents and accidents were not always accurately recorded or acted upon.” from the report
- 01Have all medicine administration records been checked and corrected, including instructions for medicines given only when needed?
- 02Have all recommendations from the Fire and Rescue Service been completed, and can you show the updated fire risk assessment?
- 03What percentage of staff have now completed manual handling, medicine administration and other required training?
- 04How are incidents, falls and restrictive holds now reviewed to make sure risks are acted on promptly?
- 05What changes have been made to the quality monitoring system since the Regulation 17 breach?
This was an unannounced focused inspection of Safe and Well-led, including infection control; the other three key questions were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 11 March 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, April 2019
Rated Good; inspectors found safe, kind and personalised care, with some room to improve how incidents and accessible information were reviewed.
The inspection was unannounced and took place on 12 March 2019. One inspector met three of the four people living in the home, observed care, spoke with relatives, staff and a manager, and reviewed care records, medicines, staffing and management records.
The home was rated Good in all five areas. Inspectors found enough trained staff, safe medicines systems, suitable accommodation, detailed care plans and kind, respectful support. People were supported to make choices, stay as independent as possible and take part in activities.
There were two areas for improvement. Managers did not formally look for themes or trends in accidents and incidents. They also did not have a clear understanding of the Accessible Information Standard, although they wanted to develop more pictorial and easy-read information. The home was also rated Good at the previous inspection, published in July 2016.
Kind, personalised care
Staff knew people well and provided care that reflected their individual needs, communication and preferences. Inspectors saw people appearing comfortable with staff.
“People continued to be supported by an established team of staff who provided kind and personalised care to people living in the home.” from the report
Safe staffing
There were enough staff to meet people's needs, including when some people needed support from two staff. Recruitment checks were followed.
“There were enough staff to meet people's needs. We observed staffing levels were sufficient.” from the report
Respect and choice
People were supported to make decisions, have privacy and dignity, and develop their independence. Staff sought consent before providing care.
“People were supported to focus on their independence of their lives. They were supported to be as independent as possible” from the report
Good management systems
Managers used audits and checks to identify and address issues. Relatives and staff said the home had an open culture where suggestions could be made.
“When the quality assurance audits indicated any shortfall or an issue, the managers addressed these.” from the report
Incident trends were not formally reviewed
needs fixingManagers recorded and acted on accidents and incidents, but did not formally identify themes or trends. This could make it harder to spot repeated risks.
“However, the managers did not then formally identify any themes or trends to try to reduce the risk of incidents happening again.” from the report
Accessible information needed development
minorSome easy-read information was available, but managers did not have a clear understanding of the Accessible Information Standard. They said they wanted to develop more pictorial and easy-read information.
“The managers did not have a clear understanding of the Accessible Information Standard, but were keen to further develop pictorial or easy read information for people using the service.” from the report
- 01How do you now identify themes and trends in accidents and incidents, and what changes have resulted?
- 02What pictorial or easy-read information is currently available for residents?
- 03How will you make sure information meets each person's communication needs?
- 04Will the staff team supporting my relative remain stable, and how is absence covered?
- 05How are residents and relatives involved in reviewing care plans, activities and decisions?
This was an unannounced planned inspection of the care, premises and management of the home, covering all five CQC questions; the inspector met three of the four residents and reviewed two people's care records. This explanation was written from the published report of 17 April 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 The Crescent
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- March 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Goodstayed GoodSafe: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 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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