CQC report explained · a residential care home
What the CQC found at Tickford Abbey
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found sufficient trained staff, safe recruitment, medicines management, infection control and arrangements for assessing and reducing risks. They also found the home learned from accidents and incidents.
- Effective?
- Good
- This key question was not assessed or rated in this focused inspection.
- Caring?
- Good
- This key question was not assessed or rated in this focused inspection.
- Responsive?
- Good
- This key question was not assessed or rated in this focused inspection.
- Well-led?
- Good
- Inspectors found better management systems, regular quality checks, improved communication and action taken in response to people's and families' feedback.
What inspectors found, November 2022
Tickford Abbey was rated Good; inspectors found safe staffing and stronger management, but care records were being rewritten after electronic data was lost.
This was an unannounced focused inspection on 20 October 2022. Two inspectors spoke with people living in the home, a family member, staff and visiting professionals. They reviewed care records, medicine records, recruitment files and management checks.
The home was rated Good for Safe and Well-led. Inspectors found enough trained staff, safe medicine systems, suitable risk assessments and good infection control. They also found that management checks, staff communication and responses to feedback had improved.
The overall rating rose from Requires Improvement at the previous inspection, published in April 2021. The home had increased staffing after the previous recommendation. However, electronic care records had been lost and replacement records were still being written during this inspection.
Staffing improved
Staff numbers had been increased to reflect people's needs. Inspectors found staff had suitable training, skills and experience.
“There were sufficient staff with the necessary training, skills and competence to promote people's safety and wellbeing.” from the report
Safe medicines
Medicines were administered, stored and disposed of safely. Staff were trained and their competence was checked regularly.
“People received their medicines as prescribed and was administered by staff trained in the management of medicine who had their competency regularly assessed.” from the report
Learning from incidents
The home analysed accidents and falls and used the findings to review care, staffing or referrals to health professionals.
“Processes and systems were in place to learn and improve people's care following an accident or incident.” from the report
Stronger oversight
The provider's quality team visited monthly and the registered manager monitored action plans and improvements.
“Governance and oversight of the service was well-embedded.” from the report
Feedback led to changes
The home listened to people and families. Changes to mealtimes were linked to improved weight and sleep for some people.
“People's views and that of family members were acted upon.” from the report
Inspectors raised no specific concerns in this report.
- 01Have all replacement care records and risk assessments now been completed after the electronic data loss?
- 02What backup arrangements are now in place to prevent care records being lost again?
- 03How are staffing numbers reviewed when people's needs or the layout of the home change?
- 04How are medicines given when required monitored to check that they have worked?
- 05How will the home keep families informed if there is an infection outbreak or another incident affecting visits?
This was a focused inspection of Safe and Well-led only; the other key questions were not rated in this report. This explanation was written from the published report of 4 November 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.
What inspectors found, April 2021
Rated Requires Improvement; inspectors found concerns about staffing arrangements, fire safety actions and quality checks.
This was a focused inspection carried out over 10, 12 and 15 March 2021. Inspectors looked only at Safe and Well-led, after concerns about staffing and infection control. They spoke with people, a relative, managers and staff, and reviewed care, medicine, staffing and management records.
The home was found to be safe and well-led only some of the time. Staffing levels were not based on a reliable assessment of people's needs, some fire safety actions were still outstanding, and quality checks had missed problems. Some areas of the building were old and tired, although cleaning arrangements and infection control measures were judged effective.
People's medicines were managed safely, risks were assessed, staff recruitment checks were completed, and people and relatives generally felt safe and welcomed. The overall rating fell from Good at the previous inspection in 2019 to Requires Improvement.
Medicines
People received their medicines on time and records were complete. The home also carried out regular medicine audits.
“Processes were in place for the timely ordering and supply of people's medicines and they were stored in accordance with requirements.” from the report
Infection control
Inspectors were assured that the home used protective equipment safely, followed social distancing and shielding rules, and had arrangements for preventing and managing outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Safeguarding and risk management
Staff had safeguarding training and knew how to report concerns. People's risks, such as falls risks, were assessed and reviewed.
“People and relatives told us that Tickford Abbey was a safe place to live.” from the report
Learning from incidents
Accidents, incidents and falls were reviewed for patterns, and people could be referred to specialist services when needed.
“Accidents and incidents were well recorded and analysed to check for any trends or themes so that any actions needed could be taken.” from the report
Staffing arrangements
seriousThe home did not have a reliable system to show that staffing matched people's needs. Staff gave examples of delays when people needed help, particularly when two staff were required.
“A lot of people need two staff to assist them. This means there are no other staff on the unit to assist and help people when they need us.” from the report
Fire safety actions
needs fixingThe fire risk assessment had been reviewed but not updated, and some actions were still waiting to be completed by the provider.
“The providers fire risk assessment had been reviewed but had not been updated. There were some outstanding actions that needed to be completed by the provider.” from the report
Quality checks
needs fixingManagement checks did not always find problems. Inspectors found gaps in training records and an error where one person's daily notes were entered in another person's record.
“We saw that one persons daily notes were recorded in a different persons record. This had not been identified by quality monitoring checks.” from the report
Building condition
needs fixingSome parts of the environment were old and tired and needed improvement so they could be cleaned effectively.
“Some areas of the environment were old and tired and needed to be improved to ensure all areas could be cleaned effectively.” from the report
Feedback from people
minorThe provider had not sent satisfaction surveys during the previous year. Meetings for people and staff had also not previously been held regularly.
“The provider had not sent out any satisfaction surveys in the last 12 months, to gain people's views about the service.” from the report
- 01How do you now calculate staffing numbers from each person's needs, including when two staff are required?
- 02What delays have people experienced when asking for help, and how are you checking that call bells and care requests are answered promptly?
- 03Have all the outstanding fire safety actions been completed, and can we see the updated fire risk assessment?
- 04What checks are now in place to prevent care notes being entered in the wrong person's electronic record?
- 05What improvements have been made to the old or tired areas so they can be cleaned effectively?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 7 April 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.
Every inspection of Tickford Abbey
5 rated inspections over 7 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 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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