CQC report explained · a residential care home
What the CQC found at The Shrubbery
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Known risks were not always properly assessed, recorded or reduced. Medicines records were incomplete, although staffing, recruitment and infection control arrangements were found to be satisfactory.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Management checks had not identified important gaps in risk assessments, medicines records and records of care tasks. Staff and relatives nevertheless described a positive culture and said they felt able to raise concerns.
What inspectors found, December 2023
Rated Requires Improvement; inspectors found gaps in risk management, medicines records and oversight, although people described staff as caring.
This was an unannounced, focused inspection after concerns about record keeping, safeguarding and oversight. Inspectors looked only at Safe and Well-led. They spoke with people, relatives and staff, and reviewed care, medicines, staff and management records.
The home was not always safe. Risk assessments and care plans were missing important information. Some safety checks, repositioning records, food and fluid records and injury records were incomplete. Medicines records did not always explain why as-needed medicines were given, and thickener administration was not recorded properly.
The home was not always well-led. Audits had failed to identify problems with care records, risk management, medicines and completed care tasks. Inspectors found breaches of Regulations 12 and 17. The overall rating fell from Good at the previous inspection to Requires Improvement.
Staffing and recruitment
Inspectors found enough staff to meet people's needs and safe recruitment checks had been completed.
“Staffing levels were sufficient to meet the needs of people living at The Shrubbery.” from the report
Infection control
The home appeared clean. Inspectors were assured that staff used protective equipment safely and followed infection control guidance.
“We were assured that the provider was using personal protective equipment (PPE) effectively and safely.” from the report
Supportive culture
Staff said they felt supported and confident to raise concerns. Relatives said complaints were dealt with appropriately.
“Staff felt supported within their roles and felt confident to discuss any concerns they may have with the management team.” from the report
Caring staff
People and relatives gave positive feedback about the staff and the care they received.
“People told us staff were caring.” from the report
Incomplete risk information
seriousCare plans and risk assessments did not always explain people's risks or how staff should reduce them. Some safety checks and repositioning records were also incomplete.
“People's known risks were not managed safely.” from the report
Medicines records
seriousRecords did not always show why as-needed medicines were given. Thickener administration was not recorded, and not all staff had documented competency checks for medicines or blood sugar testing.
“People were at risk of not receiving their 'As required' (PRN) medicine as prescribed.” from the report
Weak management checks
seriousAudits had not found problems with care plans, risk assessments, care tasks, injuries or medicines. This meant managers did not have reliable oversight of safety.
“Systems and processes were not effective in ensuring staff had all the information required to support people safely.” from the report
Incomplete injury records
seriousSome injuries were not fully recorded or investigated. Incident reviews did not identify patterns clearly enough to reduce the risk of repeat incidents.
“Records of injuries were not always in place and detailed.” from the report
- 01How do you now make sure every person's risk assessment includes clear guidance for staff, including after a fall, injury or change in behaviour?
- 02How do you check that repositioning, safety checks and food and fluid records are completed on time?
- 03How do you record why as-needed medicines were given and the amount of prescribed thickener used?
- 04Which staff have had their competency checked for giving medicines and taking people's blood sugar levels?
- 05What audits are now in place to identify missing care information, medicine recording problems and unexplained injuries?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings carried over from the previous inspection. This explanation was written from the published report of 13 December 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, January 2019
Rated Good; inspectors found safe, kind and personalised care, with some people waiting for meals.
This was an unannounced, comprehensive inspection on 3 December 2018. Inspectors spoke with people living at the home, relatives, staff and a visiting health professional. They reviewed care records, recruitment files, medicines arrangements, maintenance records, audits and feedback.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people felt safe, received their medicines as prescribed, and were supported by trained staff.
People were treated with warmth and respect. Care was personalised, activities reflected people's interests, and relatives were welcomed. One improvement was identified: some people waited up to 15 minutes for meals when staff were helping others. The registered manager planned two meal sittings to address this.
The home was rated Good at the previous inspection. This inspection found that the evidence continued to support that rating, with no serious risks or concerns identified.
People felt safe
People told inspectors they felt safe. Risks were assessed and monitored, and staff understood safeguarding procedures.
“People confirmed they felt safe with the staff and we found the systems, processes and practices in place protected people from abuse.” from the report
Kind and respectful care
Staff were seen treating people with warmth and compassion. They respected privacy and supported people's independence.
“Throughout our inspection we observed staff treating people with warmth, kindness and compassion.” from the report
Personalised support
Care plans included people's preferences, interests and relationships. People and relatives were involved in planning and reviewing care.
“People's care plans demonstrated the management team had taken time to get to know them and involved them in completing risk assessments and planning their care where they were able.” from the report
Good leadership and checks
The manager and quality manager carried out audits, acted on issues and sought feedback. The home had an open and inclusive culture.
“Quality assurance systems ensured the provider was alerted at the earliest opportunity to any issues that needed resolving.” from the report
Some meals were delayed
needs fixingSome people waited up to 15 minutes for their meal while staff supported other people to eat. The manager had identified this and planned two meal sittings.
“We observed some people waiting up to fifteen minutes for their meal as care staff were supporting other people to eat.” from the report
- 01Have the two planned mealtime sittings been introduced, and how do you check that people receive their meals promptly?
- 02How are people's food preferences and dietary requirements recorded and communicated to staff?
- 03How are care plans reviewed when a person's needs or preferences change?
- 04What activities are available for someone with dementia, and how are these matched to their interests?
- 05What improvements have been made to the garden and reception area since the inspection?
This was an unannounced, comprehensive inspection covering all five CQC areas, and the previous overall rating was also Good. This explanation was written from the published report of 8 January 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 Shrubbery
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- December 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Goodstayed GoodSafe: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016
Registered with the Care Quality Commission on 11 February 2016.
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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89 live-in carers within about an hour of North Northamptonshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 76 can care for a couple. 12 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.