You are here

Applecroft Residential Care Home Requires improvement

We are carrying out a review of quality at Applecroft Residential Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 September 2018

The inspection was unannounced and took place on 7 and 13 August 2018.

Applecroft Residential Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Applecroft is registered to provide accommodation with personal care for up to 23 people. The accommodation is located over three floors. On the day of our inspection there were 18 people living in the home.

This is the fourth consecutive time the service has been rated requires improvement overall.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions: safe, responsive and well led to at least good. We found that they were in breach of the regulations in relation to good governance.

At this inspection, we found that there had been little improvement in the overall leadership and documentation within the service, however the responsive domain had improved to good, but the service remained requires improvement in safe; well led and overall. We found a continued breach of the regulations in relation to good governance. You can see what action we have taken at the back of this report.

Applecroft has no registered manager in post. The current manager has applied to be the registered manager with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered provider did not have effective systems in place to assess and monitor the quality and safety of the service. Some of the issues which were identified as part of this inspection, had not been picked up by provider’s audits. Where shortfalls or actions were agreed, the manager was unable to provide documentation to show what progress or actions had been taken to address these shortfalls.

Staff recruitment was safe, however we saw where concerns had been raised about staff conduct, systems had not been followed to address these concerns.

Staff had completed safeguarding training and safeguarding incidents were appropriately referred to the local safeguarding team. However, we saw where recommendations or actions had been agreed following incidents, these had not always been followed up so learning opportunities on how things may be improved or prevented in the future had been missed.

Medication was being stored and administered safely. Regular medication audits were being conducted, however the issues that we identified during our inspection were not picked up by these audits. The provider had policies in place in relation to medication documentation, which were not being followed and this had not been picked up within the audits.

Staff were aware of risks to people and these were managed safely and advice taken from other professionals when necessary. However, documentation around risks was not always in place or detailed.

There were sufficient staff to meet the needs of the people living in the home and they were recruited safely.

Care plans did reflect people’s life history and their needs. We found that some care plans could be more person centred, which had been identified by the manager. People and their relatives told us that the care they received was responsive to their needs.

People and their relatives felt confident that issues that they raised would be addressed. Complaints were recorded and dealt with in accordance with the provider’s complaints policy.

People and their relatives were positive about the staff working in the home as well as the care that they received whilst living ther

Inspection areas

Safe

Requires improvement

Updated 8 September 2018

The service was not always safe.

We found safeguarding incidents were appropriately referred to the local safeguarding team and staff were clear what action to take when safeguarding incidents occurred. However, actions following incidents had not always been followed up.

We found that medications were administered and stored safely. However, documentation that should have been in place, was not always there and this had not been picked up by the quality assurance systems.

There were sufficient staff to meet the needs of the people living in the home.

Effective

Good

Updated 8 September 2018

The service was effective.

The provider was acting in accordance with the Mental Capacity Act 2005 to ensure that people were receiving the right level of support with their decision making.

We saw staff received regular training, support and supervision.

We received positive feedback about the food provided at the home. We saw people had choice in relation to what to eat as well as where to eat.

Caring

Good

Updated 8 September 2018

The service was caring.

People and their relatives were very positive about the staff and their caring attitudes and that they knew them well.

People told us they were treated with dignity and respect.

People had access to advocacy services.

Responsive

Good

Updated 8 September 2018

The service was responsive.

Care plans were informative and the manager recognised that they could be more person centred and was reviewing the plans to improve these. Comments from people and their relatives confirmed that the care they received was responsive to their needs.

People and their relatives were happy with the activities in the home.

The provider had a complaints policy and processes in place to record any complaints received and we saw concerns raised were addressed within the timescales given in the policy.

Well-led

Requires improvement

Updated 8 September 2018

The service was not always well led.

The provider did not have an effective quality assurance system to monitor and improve the standard of care provided in the home. Where issues were identified, prompt action was not always taken to address issues. Documentation was disorganised and not always clear.

Staff, people and their relatives were positive about the management within the home. Staff felt supported by the manager and people were confident that they could raise issues and these would be addressed.

We saw that staff and resident and relatives’ meetings were being held regularly within the home.