CQC report explained · a residential care home
What the CQC found at The Crest Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found suitable risk assessments, safe medicines management, effective infection control, enough staff and appropriate safeguarding arrangements.
- Effective?
- Good
- This key question was not inspected in this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected in this visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected in this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Management checks, audits and feedback systems had improved. Inspectors found an open and supportive culture, with staff involved in developing the service.
What inspectors found, May 2023
The Crest Care Home: Rated Good; inspectors found safe care and stronger management after earlier improvements.
This was an unannounced inspection on 10 May 2023. One inspector and an Expert by Experience spoke with people, relatives, staff and managers. They reviewed care records, medicines records, recruitment records and management information.
The home was rated Good for Safe and Well-led. Inspectors found that people felt safe and were happy with their care. Medicines, infection control, staffing, safeguarding, fire safety and risk assessments were managed appropriately.
The last inspection rated the home Requires Improvement and found breaches of regulations. The provider made improvements to risk assessments, medicines records, person-centred care and management checks. Inspectors found the home was no longer in breach.
Safer risk management
Risk assessments had been improved and were reviewed regularly. Staff had guidance to help people take everyday risks safely.
“Risk assessments were in place and were regularly reviewed.” from the report
Medicines managed safely
The home had improved its instructions and records for medicines given when needed. Inspectors found that people received medicines as prescribed and at the right time.
“People received their medicines as prescribed and at the right time.” from the report
Infection control
Inspectors found suitable infection prevention measures, including cleaning, hand hygiene and appropriate use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Improved leadership
The manager used audits, action plans and feedback to monitor and improve the service. Staff said they felt supported and involved.
“The provider sought feedback from people and those important to them on their care and support and used the feedback to develop the service.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current ratings and recent findings for Effective, Caring and Responsive, which were not inspected in this visit?
- 02How are medicines given when needed recorded and checked now?
- 03What refurbishment work is still planned, and when is it expected to be completed?
- 04How will you tell relatives about changes made after feedback, accidents or incidents?
- 05How do you make sure there are enough staff for each person's individual needs?
This was a focused inspection of Safe and Well-led; the other key questions were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 24 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, April 2022
Rated Requires Improvement; inspectors found risks in safety records, visiting arrangements and management oversight, although people appeared happy and medicines were handled safely.
This was an unannounced focused inspection on 9 February 2022. Inspectors looked at Safe and Well-led because of concerns about staffing and safeguarding. They spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
The home did not always record or follow up accidents, incidents and safeguarding concerns properly. Some risk assessments, care records, monitoring forms and cleaning records had gaps. Agency staffing sometimes affected the quality of care. During a four-week COVID-19 outbreak, visiting restrictions did not give families all the options allowed by guidance.
Medicines were received, given and returned safely. Recruitment checks were in place. People appeared happy and comfortable, and staff and families said the manager was approachable. The home had to improve its systems and was in breach of regulations covering person-centred care, safe care and treatment, and good governance.
The overall rating changed from Good at the previous inspection to Requires Improvement. Only Safe and Well-led were inspected at this visit. The other ratings carried over from the previous inspection.
Medicines handling
Medicines were received, administered and returned to the pharmacy safely. Inspectors recommended better recording of the effects of medicines given when needed.
“Medicines were safely received, administered and returned to the pharmacy when they were no longer required.” from the report
Recruitment checks
The home carried out checks to help ensure new staff were safe to work with vulnerable people.
“Recruitment checks were in place to ensure new staff were safe to work with vulnerable people.” from the report
Approachable management
Staff said they felt supported and able to raise concerns. Families were regularly updated and found the service responsive to their requests.
“Staff told us they felt supported by the registered manager and they felt comfortable raising concerns or areas for improvement.” from the report
People appeared settled
Inspectors observed that people appeared happy and comfortable. One relative described a clear improvement in their family member's health and happiness.
“Shortly after my family member went in the home there was a real transformation in them.” from the report
Incident and safeguarding records
seriousThe home did not have a robust system for recording and monitoring accidents, incidents and safeguarding concerns. This increased the potential risk of harm, even though inspectors found no evidence that anyone had been hurt as a result.
“People were at increased risk, because there was not a robust system in place to record and monitor accidents, incidents or safeguarding concerns.” from the report
Risk management and care records
seriousSome identified risks were not acted on or recorded promptly. Guidance about increased observations was not always clear, and weight-loss risks were not always properly addressed.
“Where risks had been identified and documented, action was not always taken in a timely manner.” from the report
Visiting restrictions
seriousDuring a four-week COVID-19 outbreak, families were not offered all relevant visiting options, including essential care giver visits. The home reopened shortly after the inspection.
“This resulted in blanket restrictions to visiting during an outbreak that lasted four weeks.” from the report
Management checks
seriousAudits and governance systems did not identify problems found during the inspection. Cleaning records had gaps, and required checks had not always been completed.
“There was a lack of checks in place to identify the issues we found on inspection.” from the report
Agency staffing
needs fixingThe home used agency staff to cover shortages. Staff said the quality of care was sometimes lower when agency staff worked, although regular agency staff were being used to improve consistency.
“Staff told us the quality of care wasn't as good compared to when contract staff worked.” from the report
Infection control practice
needs fixingInspectors were only somewhat assured about some visitor, PPE and environmental infection control arrangements. They saw staff wearing masks under their chins.
“We observed breaches of PPE during the visit, for example, staff having their masks under their chin.” from the report
- 01What has been changed to make sure accidents, incidents and safeguarding concerns are recorded, reviewed and followed up promptly?
- 02How are risks such as weight loss, fire safety and increased observations now monitored and acted on?
- 03What visiting options are available during an outbreak, including essential care giver visits?
- 04How are cleaning records, care records and other monitoring checks reviewed so that gaps are found quickly?
- 05What is being done to reduce reliance on agency staff and maintain consistent care?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection published on 11 March 2020. This explanation was written from the published report of 1 April 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 Crest Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not rated
- March 2020GoodSafe: GoodWell-led: Requires improvement
- January 2019
Registered with the Care Quality Commission on 10 January 2019.
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 £1,010 to £1,290 a week. 27 can care for a couple. 12 years' experience on average.
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