CQC report explained · a residential care home
What the CQC found at York House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people in the care home had identified risks, medicines were managed safely, infection control was suitable and there were enough trained staff. They noted that risks for people receiving home care were not fully described.
- Effective?
- Good
- This question was not rated in this targeted inspection. The report says the inspection focused on checking previous concerns and infection prevention and control.
- Caring?
- Good
- This question was not rated in this targeted inspection.
- Responsive?
- Good
- This question was not rated in this targeted inspection.
- Well-led?
- Good
- Managers had audits and had acted on issues found at the previous inspection. Staff felt able to raise concerns, and people and families were asked for their views.
What inspectors found, October 2022
Rated Good and no longer in special measures; inspectors found major improvements, but home care risk records still needed work.
This was an unannounced targeted inspection on 10 August 2022. Inspectors checked whether the home had acted on a previous Warning Notice covering safety, safeguarding, management and staffing. They spoke with people and staff, observed care, and reviewed care, medicines and management records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found enough staff, safer medicines arrangements, suitable infection control, safeguarding training and better systems for checking care quality.
There was still a weakness in the records for people receiving care in their own homes. Mobility risks were not fully described, which meant staff might not know all the care needed. The provider was recommended to improve these records.
The previous rating was Inadequate, with breaches of regulations, and the home had been in special measures. Inspectors found enough improvement for the breaches to end, and the home was no longer rated Inadequate or in special measures.
Improved safety
The home had improved its safeguarding, risk management, medicines, infection control and staffing arrangements since the previous inspection.
“Improvements had been made in the management of medicines, risk, infection control, staffing and safeguarding.” from the report
Enough trained staff
Inspectors found enough staff to meet people's needs in both the care home and home care service. Staff had completed relevant safety training.
“There were enough staff to meet people's needs in both the care home and for those people who received care in their own home.” from the report
Medicines managed safely
Medicines were stored and given safely, and staff training and competency checks were in place.
“People's medicines were stored safely and administered to people as prescribed.” from the report
Open management
Staff said they could raise concerns with managers, and inspectors found managers had worked with local professionals to keep people safe.
“Staff told us they felt able to raise concerns with the registered manager and were confident concerns would be dealt with.” from the report
Home care risk records
needs fixingRisk information for people receiving care in their own homes was not complete, particularly around mobility. Inspectors said this increased the risk that staff might not know all the care needed.
“This meant there was an increased risk to people's safety as staff may not be aware of all the care needed.” from the report
- 01What changes have been made to home care records so mobility and other risks are fully described?
- 02How do managers check that home care staff have the latest risk information before providing care?
- 03How are the improvements in medicines management checked and maintained?
- 04What staffing levels and training will be in place for the person who needs care?
- 05How can the person receiving care or their family raise a concern, and how will the home respond?
This was a targeted inspection of Safe and Well-led, including infection prevention and control and previous regulatory concerns; the other key question ratings were not given in this report. 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.
What inspectors found, August 2022
Rated Inadequate and placed in special measures; inspectors found serious risks involving safety, staffing, infection control and leadership.
This was an unannounced inspection of the residential care home. Inspectors visited on two days, spoke with staff, a resident and relatives, and reviewed care plans, medicines records, recruitment files, training records and audits. The homecare service was not included.
Inspectors found people were at risk of avoidable harm. Safeguarding concerns had not always been reported, medicines were not always stored or given safely, infection control was poor, and staffing levels and training were not sufficient. Care plans and risk assessments were also missing or out of date.
Leadership was rated Inadequate because checks did not identify or resolve important problems. The overall rating fell from Good at the last inspection, published on 2 August 2018. The home was placed in special measures, and CQC issued warning notices covering safety, safeguarding, management and staffing.
Partnership working
The home worked with the local GP surgery and other outside professionals, including district nurses.
“The service worked closely with the local GP surgery.” from the report
Consistent staff
The home used permanent staff, and relatives and residents said they knew the staff.
“Staff members deployed were consistent and the service only used permanent staff.” from the report
Some positive feedback
Despite the inspection findings, residents and relatives were mostly positive about safety and described staff as helping with basic needs.
“Despite the above concerns, people and relatives were overall positive about the safety of the service.” from the report
Safeguarding
seriousSeveral allegations of abuse had not been reported to the local authority at the time. Some staff said they were afraid to raise concerns.
“People were not protected from abuse. Several allegations of abuse were made to us by staff and relatives.” from the report
Medicines
seriousMedicines were not always securely stored or given as prescribed. Records were incomplete, and some staff did not have evidenced medicines training.
“People did not always receive medicines as prescribed.” from the report
Infection control
seriousInspectors found widespread poor infection control during a COVID-19 outbreak. PPE was not always used safely, and COVID-19 care plans and cleaning records were incomplete.
“People were at risk of harm due to widespread, poor IPC practices and a failure to implement effective measures in response to a COVID-19 outbreak.” from the report
Staffing and training
seriousThere were only two care staff on day and night shifts, even though two residents needed two staff for their care. Training records were incomplete and practical moving and handling training had not been evidenced.
“The provider had not ensured there were sufficient numbers of suitably trained staff employed to meet people's needs.” from the report
Weak oversight
seriousAudits failed to find or fix problems with medicines, infection control, recruitment, risk assessments and person-centred care. Known actions were repeated without being completed.
“The provider failed to ensure that effective governance systems were in place.” from the report
Communication with families
needs fixingRelatives were not always told about a COVID-19 outbreak in good time, and visiting arrangements were not applied consistently.
“The provider had not ensured relatives of people were informed about an outbreak of COVID-19 in a timely manner.” from the report
- 01What evidence can you show that medicines are now stored securely, given as prescribed and checked by trained staff?
- 02How do you now report and investigate safeguarding concerns, and how can staff and families raise concerns safely?
- 03How many staff are on each shift, and how do you make sure there are enough suitably trained staff when two-person care is needed?
- 04What infection control arrangements are now in place for COVID-19 or other outbreaks, including PPE, cleaning and care plans?
- 05What audits and checks now identify problems with care plans, risk assessments, recruitment and staff training, and how do you prove that actions are completed?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 23 August 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 York House
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2022Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- August 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- October 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 14 April 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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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
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.