CQC report explained · a residential care home
What the CQC found at Viola House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment checks, regular risk reviews and safe medicines systems. They also noted that the service was working with other agencies in response to a safeguarding concern.
- Effective?
- Good
- People's health needs were supported through health action plans, appointments and timely contact with health professionals. Staff had relevant training, supervision and support.
- Caring?
- Good
- Staff were found to respect people's privacy, dignity and independence. Relatives described staff as kind, caring and compassionate.
- Responsive?
- Good
- Care was personalised and included people's communication, sensory and support needs. Information was provided in different formats, and relatives said they could raise concerns.
- Well-led?
- Good
- Management was visible and approachable, and there were systems for gathering views and checking quality. Relatives and staff reported improvements under the new management team.
What inspectors found, June 2023
Rated Good; inspectors found safe, kind and personalised care, with some cultural food needs still needing attention.
The inspection visit took place on 14 March 2023. One inspector reviewed care records, staff recruitment checks, audits and other records. They spoke with one person, six relatives, six staff and managers, and observed care because some people could not communicate with the inspector in a way they always understood.
The home supports up to 12 adults with learning disabilities and autism. Seven people lived there during the inspection. Inspectors found people were safe, treated with kindness and dignity, and supported by staff who understood their individual communication and care needs.
Medicines, staffing, risk assessments, infection control and health care arrangements were found to be safe. Care plans were personalised and regularly reviewed. Inspectors also found that people and families were involved in decisions and that management systems were effective.
The overall rating was Good, with Good ratings in all five areas: Safe, Effective, Caring, Responsive and Well-led. These ratings were unchanged from the previous inspection, published on 4 May 2018.
Kind and respectful care
Inspectors found that staff respected privacy, dignity and independence. Relatives described staff as warm, kind and compassionate.
“Staff members showed warmth and respect when interacting with people.” from the report
Personalised communication
Care plans explained how each person communicated and what support they needed. Staff used pictures, gestures, objects and other individual methods.
“There were a range of communication formats, each personalised to the specific needs of the person, including understanding facial expressions and ways of responding nonverbally, pictures, objects of reference and gestures.” from the report
Safe medicines and staffing
Inspectors found no gaps in the medicine records they checked. They also found enough staff and appropriate recruitment checks.
“There were no gaps in the MARs we reviewed which provided assurance medicines were being given as prescribed.” from the report
Good involvement of families
People and their relatives were involved in care decisions and reviews. Families said their views were listened to and could lead to changes.
“Relatives confirmed their views were acted upon and improvements made.” from the report
Cultural food choices
needs fixingSome relatives said the home did not fully meet different cultural food needs, and families sometimes brought home-cooked food. The manager said improvements would be made immediately.
“It would be good if they addressed the [different] cultural needs. The family tends to bring home cooked [cultural] food.” from the report
Safeguarding concern being investigated
seriousAt the inspection, the service was working with other agencies about a safeguarding concern. The report does not give the outcome, so families should ask what happened and what actions followed.
“At the time of the inspection, the service was working with other agencies in response to a safeguarding concern.” from the report
- 01What was the outcome of the safeguarding concern mentioned in the inspection report, and what changes were made afterwards?
- 02How do you now record and meet each person's cultural or religious food preferences?
- 03What involvement will families have in reviewing care plans and making decisions about care?
- 04How do you support each person's communication method, including non-verbal communication, pictures or gestures?
- 05Has the manager completed the process to register with the CQC?
This was an announced inspection covering all five key questions, including the premises and care provided; seven people lived at the home at the time, and inspectors reviewed four people's care records and five staff recruitment files. This explanation was written from the published report of 21 June 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, October 2022
Inspected but not rated; inspectors found safe care and personalised support, but concerns about complaints, visitor restrictions and learning from problems.
This was an unannounced targeted inspection on 12 and 16 May 2022. One inspector and one pharmacist inspector checked specific concerns about safety, COVID-19 restrictions, safeguarding, medicines, complaints, personalised care and management. They spoke with people, staff, managers, some families and health professionals, and reviewed care records and other documents.
The home supported seven people, with capacity for 12 adults with learning disabilities and autistic people. Inspectors found that risks were assessed, medicines were administered and recorded safely, and people's health needs were supported. Staff understood safeguarding and communication needs, and care was generally personalised.
Inspectors found weaknesses in how complaints and disagreements were resolved. Visitor restrictions during the COVID-19 pandemic had not been relaxed quickly enough, and the home had not learned enough from some conflicts. The home had since relaxed its visitor policy, updated its medicine-alert process and said CCTV would not be used on the property.
The service was inspected but not rated. The previous ratings from 2018 were Good, but this targeted inspection did not review all parts of the key questions and therefore did not change those ratings.
Medicine safety
Records reviewed showed that medicines were given as prescribed, and medicines were stored securely. People's medicines were also reviewed by clinicians.
“There were no gaps in the MARs we reviewed which provided assurance medicines were being given as prescribed.” from the report
Managing risks
Care files included individual plans for reducing risks linked to medical conditions and community activities. Inspectors found that people lived safely without unwarranted restrictions.
“People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well.” from the report
Understanding communication
Staff could support people who communicated through body language, sounds, pictures, symbols or gestures. Communication methods were recorded in people's support plans.
“Information was presented in different formats to support people to communicate to the best of their abilities.” from the report
Personalised care
Care plans described people's abilities, needs and preferences. Staff had a good understanding of people because the staff team was largely long-standing.
“Staff provided people with personalised and co-ordinated support in line with their support plans, health action and communication plans.” from the report
Health partnerships
The home worked with GPs, psychologists and specialist health professionals. Inspectors received positive feedback about the management team's communication with health services.
“There was evidence of partnership work with a range of health and social care agencies to provide care to people.” from the report
Complaints were not resolved promptly
needs fixingThe home had complaint procedures, but inspectors found that complaints were not always dealt with early or close to the point where they were raised. They recommended improving the complaints system.
“We received concerns from some professionals and relatives of people receiving care, which showed complaints were not resolved as close to the point of complaint as possible.” from the report
Visitor restrictions
needs fixingDuring the pandemic, visitor restrictions were not relaxed enough as government policies changed. Some families and professionals felt the restrictions were too broad and affected people's routines and choice.
“The service did not sufficiently relax visitor restrictions.” from the report
Problems were not escalated
needs fixingLong-running disagreements, including delays when people were ready to leave hospital, were not escalated effectively. This meant issues remained unresolved for a long time.
“Conflicts were not resolved in a timely way.” from the report
Medicine alerts
needs fixingThe home had a way to receive medicine alerts, but inspectors could not confirm that alerts were acted on promptly. The home later said it had updated the system.
“The process in place to receive and act on medicine alerts was not robust.” from the report
CCTV arrangements
minorCameras had been installed inside the home without a clear recorded purpose supported by assessments. After the inspection, the provider said CCTV would not be used anywhere on the property.
“There were no clear, recorded purpose for the use of CCTV, which was supported by relevant assessments.” from the report
- 01How are complaints now recorded, investigated and resolved, and how will I know what action has been taken?
- 02How will the home escalate disagreements with hospitals, local authorities or other agencies so that they do not remain unresolved?
- 03What are the current visitor arrangements, and how are they tailored to each person's needs and family relationships?
- 04How do you now make sure medicine alerts are checked and acted on promptly?
- 05Has CCTV been removed or disabled throughout the property, as stated after the inspection?
This was a targeted inspection of specific concerns under Safe, Responsive and Well-led; it did not assess all parts of those questions and did not rate Effective or Caring. This explanation was written from the published report of 6 October 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 Viola House
3 rated inspections over 8 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2022Inspected but not ratedSafe: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- May 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
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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At least 100 live-in carers within about an hour of Brent
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. 74 can care for a couple. 11 years' experience on average.
“The quality of life that she's given my parents has been priceless. The peace of mind she's given my sisters and I, through a very difficult time, has been invaluable.”
“I can truly say that Peter always put Dad at the centre of everything and I know that they found a great friendship in difficult times.”
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