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Your spotlight on local health & social care services

CQC Inspections and Reports in West Berkshire

LATEST REPORTS

Please see latest reports from inspections carried out by the CQC around the West Berkshire area:

28th August 2019 – Braeburn Lodge – Good

“Braeburn Lodge is a residential care home providing personal care to 12 people aged 65 and over, at the time of the inspection. The service can support up to 14 people.

Braeburn Lodge is a purpose-built service that provides accommodation over two floors. Each of the 12 bedrooms offer shower rooms as part of the en suites. Communal areas include, the dining room, lounge, orangery and large garden to the rear. People are able to assist themselves to drinks and fruits that are made available within the kitchenette adjoining the dining room.

People’s experience of using this service and what we found

People received safe care and treatment. Risks were effectively managed and understood. Risk assessments were completed for people that highlighted when the risk was most likely to occur, and what action to take to prevent the risk from occurring. Details were also written on what action to take should the risk occur. These were reviewed on a regular basis. Staff received training and had a comprehensive understanding of their duty of care to keep people safe from risk of harm and abuse. Staff were able to identify what action they would take and reported no issues to whistle-blow if concerns were not appropriately managed by the provider. We found that medicines were administered safely, with electronic records demonstrating people received their medicines in line with their prescription. Staff medication training and competencies were up to date. Required learning was identified from accidents and near misses, with a trigger analysis being completed every month.

People’s health and social needs were assessed regularly, reviewed and updated. Formal reviews took place which allowed discussions to be completed on any changing health needs. People, relatives and professionals consistently told us the staff delivered care in accordance with their assessed needs. Staff had the necessary training and skills to complete their tasks effectively. Staff received supportive supervisions and attended meetings that enabled them to carry out their duties in line with legislation.

People shared positive relationships with staff who clearly treated them with kindness, compassion and dignity. Staff consistently treated people with respect and maintained their privacy. People’s differences and diversities were celebrated, and welcomed, enabling an all-encompassing diverse service.

People reported that care was entirely person-centred and in line with their requirements. Care plans were personalised and contained comprehensive detail on people’s interests and preferences. People had access to activities and the necessary support to follow their interests, and to prevent isolation.

The registered manager and staff consistently placed people at the heart of the service and clearly demonstrated the caring values and ethos of the service. The registered manager drove to make the service people’s home, and not a residential care home. This was evident during the inspection and feedback by people and relatives. The quality of the service was monitored through robust governance processes, that allowed all aspects of the service to be monitored. The service had built up working relationships with external professionals that were seen as integral part in delivering care.”

Click Here to learn more about this inspection

28th August 2019 – Gracewell of Newbury – Good

“Gracewell of Newbury is a ‘care home’. People in care homes receive accommodation and nursing or personal care, as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

This care home is run by two providers; namely, Gracewell Healthcare 3 Limited and Gracewell Healthcare Limited. These two providers have a dual registration and are jointly responsible for the services at the home. This report is in relation to Gracewell Healthcare 3 Limited. A separate report has been produced for Gracewell Healthcare Limited.

Gracewell of Newbury accommodates up to 68 people in one building over three floors. The first floor was the ‘Memory Care’ community, which had been designed as a living space suitable for people living with dementia. There were 64 people living in the home at the time of inspection. People living at the service were older people, some of whom were living with dementia.

People’s experience of using this service

The service provided exceptionally responsive, person-centred support to people which consistently achieved outstanding outcomes for people.Staff provided excellent consistency and continuity of care which had a major impact on people’s quality of life.

Staff were particularly skilled at involving people and their family, together with health and social care professionals in their care and support plans, so that they felt consulted, empowered, listened to and valued.

Staff consistently went the extra mile to find out what people have done in the past to enable people to carry out person-centred activities which enriched the quality of their lives.People were supported to maintain relationships that mattered to them which protected them from the risk of social isolation and loneliness.

The registered manager used concerns to improve the service. For example, a Hydration Project initiated within the service had significantly reduced the number of falls, infections and weight loss experienced by people living in the home.

The service worked closely with healthcare professionals and provided outstanding end of life care, which ensured people experienced a comfortable, dignified and pain-free death.

People were supported by a stable core staff group who were kind, caring and inspired by the registered manager to deliver high quality, personalised care.

People were protected from discrimination, neglect, avoidable harm, and abuse by staff. Risks to people’s safety had been identified and assessed. Staff followed people’s risk management plans to keep them safe. People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed. People’s medicines management plans were reviewed regularly to ensure continued administration was still required to meet their needs.

High standards of cleanliness and hygiene were maintained throughout the home, which reduced the risk of infection. Staff followed the required standards of food safety and hygiene, when preparing, serving and handling food.

Staff felt valued and respected by the management team, and consistently demonstrated high levels of morale.Staff had the required skills to meet people’s needs effectively, which led to good outcomes for people’s care and support and promoted their quality of life.”

To learn more about this inspection please click HERE

28th August 2019 – Purley Park Trust (DCA) (Unit 2) – Good

“This service provided care and support to 15 people living in eight ‘supported living’ settings, so that they can live as independently as possible. People ranged from younger adults to older people living with a learning disability and associated conditions, such as autistic spectrum disorders.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service

People and their relatives told us the staff, management and leadership of the provider were caring, approachable and professional, which promoted a high-quality standard of care. There was a positive culture within the service, which focussed on supporting people to explore their potential and celebrate their achievements.

The registered manager played an active role in the day to day care and support people received. They had systems in place to monitor the quality and safety of the service and worked with other stakeholders to optimise the effectiveness of care.

People were supported to live full and active lives and given choices and control about how their care was delivered. People and relatives told us they were fully involved in decisions about their care and that any complaints or feedback would be listened to by the provider.

People received personalised care which promoted their health and wellbeing. People were supported appropriately with their health, behaviour, safety and wellbeing and were encouraged to be as independent as possible.

People felt safe receiving care from staff and were treated with dignity and respect. Staff understood people’s needs and received training and ongoing support in their role.

There were enough numbers of staff in place, who had been subject to appropriate recruitment checks.”

Please click HERE if you would like to learn more about this CQC inspection

28th August 2019 – Parry House – Good

“Parry House is one of eight separate residential care homes within Purley Park Trust Estate. Parry House provides personal care and support for up to eight people who have learning disabilities and associated conditions, such as autistic spectrum disorders.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People felt safe and comfortable living at the home. There was a calm atmosphere where staff were knowledgeable and skilled in supporting people with their routines, activities and behaviour.

There were safe systems in place to manage risks to people’s health and associated with the home environment. People were safeguarded from the risk of suffering abuse or avoidable harm.

People had access to healthcare services and input from specialist professionals when required. Their needs in relation to their personal care, nutrition and medicines were met.

People were able to have an input into their care planning and felt able to make complaints or give feedback about the quality of care. People had their dignity and privacy respected by staff who encouraged them to be as independent as possible.

The leadership of the home was experienced and competent. There were systems in place to monitor the quality and safety of the home and the registered manager was aware of their regulatory responsibilities.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.”

To learn more about this CQC inspection/report, please click HERE

24th August 2019 – Jigsaw Creative Care limited – Good

“Jigsaw Creative Care Limited provides both a domiciliary care agency and supported living services to people who either live in their own home, or people who share accommodation with others. The service is registered to provide care to children, younger adults, older adults and people with disabilities. At the time of the inspection the service was supporting 33 people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes.

Not all care staff felt supported and listened to. However, we found the registered managers were working with care staff and their management team to continue to develop a supportive culture.

Not all health and social care professionals felt that they had a productive working relationship with the provider.

Relatives felt the registered manager was supportive and open with them and communicated what was happening at the service and their relatives.

The registered managers had strengthened their quality assurance systems to more effectively monitor the quality of the service being delivered and took actions promptly to address any issues.

People’s experience of using this service and what we found

We have made a recommendation about ensuring people’s Equality, Diversity and Human Rights (EDHR) have been explored and documented.

The outcomes for people using the service reflected the principles and values of Registering the Right Support.

People felt safe living at the service. Relatives felt their family members were kept safe in the service. The registered manager and care staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. Risks to people’s personal safety had been assessed and plans were in place to minimise those risks.”

To learn more about this inspection please click HERE

 

1st August 2019 – Prestige Healthcare Services – Requires Improvement

CQC Presige Healthcare services August 2019

 

“Prestige Healthcare Services Ltd is a domiciliary care agency, providing personal care support to people living in their own homes. At the time of the inspection, the service was supporting 24 people with their personal care needs.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People’s medication records did not always reflect that they were administered safely. It was not always clear that people received their medications as prescribed. Where people were prescribed ‘as required’ (PRN) medication, the service did not always have protocols or guidance in place to ensure that staff knew when to administer PRN medicine.

Risks to people were not always managed in a safe way. Care records were not always up to date and accurate. Risk management plans did not always highlight how staff should mitigate risks that were identified. Action was not always taken to mitigate such risks.

Governance systems were not always effective and did not always identify actions for continuous improvements. Audits in place did not always identify when there were issues relating to the recording of medicines. We were not always notified, as required by law, of notifiable safety incidents.

Safe recruitment practices were not always followed to make sure, as far as possible, that people were protected from staff being employed who were not suitable. We have made a recommendation about ensuring robust recruitment practices.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, systems in the service did not always support this practice. We have made a recommendation about working within the principles of the Mental Capacity Act (2005).

People’s communication needs were not always documented in accordance with the Accessible Information Standard. We have made a recommendation about ensuring the registered provider meets this standard.

People and their relatives told us they felt safe with the staff who supported them, and that staff were caring and respected their privacy and dignity. People felt the service they received helped to maintain their independence where possible.

People were treated with care and kindness. They were consulted about their care and support and could change how things were done if they wanted to. Staff worked well together for the benefit of people and were focused on the needs of people living at the service.

People and their relatives knew how to complain and knew the process to follow if they had concerns. Staff were able to describe what action they would take if a person raised a concern with them.

People were supported by skilled staff with the right knowledge and training. Staff felt the management was supportive and approachable. Staff were happy in their role which had a positive effect on people’s wellbeing.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (report published 9 January 2019) and there were breaches of Regulations 12 (Safe care and treatment) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of Care Quality Commission (Registration) Regulations 2009. The provider completed an action plan after the last inspection for the breaches of Regulation 17 and 18 to show what they would do and by when, to improve. The provider was served with a Warning notice for the breach of Regulation 12. At this inspection we found there had not been enough improvements made and the provider was still in breach of regulations”

Please click Here to learn more about this inspection

19th July 2019 – Swanswell Newbury – Good

CQC Swanswell
  • “The service provided safe care. Premises where clients were seen were safe and clean. The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed. Staff managed waiting lists well to ensure that patients who required urgent care were seen promptly. Staff assessed and managed risk well and followed good practice with respect to safeguarding.

  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with clients. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the clients.

  • Managers ensured that staff received training, supervision and appraisal. Staff worked well together as a team and with relevant services outside the organisation.

  • Staff understood and discharged their roles and responsibilities under the Mental Capacity Act 2005.

  • Staff treated clients with compassion and kindness, respected their privacy and dignity, and understood their individual needs. They actively involved clients and families and carers in care decisions.

  • The service was easy to access. Staff assessed and treated clients who required urgent care promptly and those who did not require urgent care did not wait too long to start treatment. The criteria for referral to the service did not exclude clients who would have benefitted from care.

  • The service was well-led and the governance processes ensured that that procedures relating to the work of the service ran smoothly.

However:

  • Since the organisation had joined a larger group of charities, there was not yet a unified set of policies and procedures and staff had access to policies for the parent organisation as well as the ones specific to the service. No risk to service users arose from this, because staff understood all relevant clinical policies clearly understood, but there was scope for confusion amongst staff.

  • There was scope to improve staff morale. Staff told us that better terms and conditions offered to staff doing the same roles within other services run by the same provider had an impact on staff morale and retention.”

Please click Here to learn more about this inspection.

12th July 2019 – Strawberry Hill Medical Centre – Good

Strawberry Hill Medical Centre CQC inspection 2019

“We carried out an announced comprehensive inspection at Strawberry Hill Medical Centre on 2 May 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected

  • information from our ongoing monitoring of data about services and

  • information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

We rated the practice as good for providing safe, effective, caring and responsive services and outstanding for providing well-led services.

We rated patients with long-term conditions as requires improvement for effective which made this population group requires improvement overall.

We rated the population group people whose circumstances may make them vulnerable as outstanding for effective and responsive services.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.

  • Patients received effective care and treatment that met their needs.

  • Staff responded to patients with kindness and respect and involved them in decisions about their care.

  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

  • There was compassionate, inclusive and effective leadership at all levels and the practice had a clear vision and strategy to provide high quality care.

  • The practice worked with other agencies and with the multi-disciplinary team within the practice to ensure patients whose circumstances make them vulnerable were identified and had access to quality care and treatment.”

 

To learn more about this CQC inspection / report, please click HERE

 

2nd July 2019 – Telemedicne Clinic (Theale) – Good

Telemedicine Clinic CQC Theale

“Telemedicine Clinic is operated by Telemedicine Clinic Limited. Telemedicine Clinic is a European based teleradiology company providing diagnostic reporting services day and night, throughout the year, to hospitals in the UK. It does not provide patient imaging services and does not have direct contact with patients. As a teleradiology service, it receives diagnostic images from hospitals, reports on them and sends the reports back to the referrer. For some clients it also justifies diagnostic imaging, which means radiologists evaluate the radiological examination proposed, for its clinical merit and appropriateness. It reports on images generated by magnetic resonance (MR), computerized tomography (CT), X rays, dual-energy X-ray (DEXA) and nuclear medicine.

  • The service had enough radiologists and operational staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm. All staff completed a programme of induction, designed for their roles.

  • Records of patients’ care and treatment were clear, secure and accessible to all staff involved in the diagnosis pathway via password protected systems. Patient data was pseudonymised and only retained for as long as necessary.

  • Radiologists escalated unexpected or significant finding on reported images, kept clear records and asked for support when necessary. This included findings indicative of abuse. They applied the Ionising Radiation (Medical Exposure) Regulations guidelines when justifying X-ray diagnostic tests. The service followed best practice when justifying the use of contrast administration.

  • The service managed patient safety incidents well and reviewed records for discrepancies. Senior radiologists or managers investigated incidents and shared lessons learned.

  • The service supplied staff with suitable equipment, including workstations with monitors for all radiologists. There were systems to test and calibrate monitors, in line with the Royal College of Radiologists (RCR) guidelines for diagnostic display devices.

  • The service provided care and treatment based on national guidance and evidence of its effectiveness. This included guidance issued by the RCR. Managers checked to make sure staff followed guidance.

  • There was peer review and management review of radiological reports and findings were shared to improve outcomes for patients and for learning.

  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held meetings with them to provide support and monitor the effectiveness of the service.

  • Staff in different roles worked together as a team to benefit patients. Radiologists, other health staff, operational, IT and administration staff supported each other to provide a good service.”

 

For more information about this inspection please click HERE

1st July 2019 – Basingstoke and North Hampshire Hospital – Requires Improvement

Basingstoke and North Hampshire Hospital cqc report

“Our rating of this service went down. We rated it as requires improvement because:

  • There was limited assurance about safety.

  • Risk assessments were not consistently completed therefore care plans were not developed including actions to manage the identified risks appropriately.

  • Medicines were not managed effectively and staff did not follow policies and procedures to ensure these were stored, administered and disposed of safely.

  • Emergency equipment was not consistently checked in line with the trust’s policy to ensure it was fit for purpose and available when needed.

  • People did not always receive care and treatment in a caring manner.

  • Patients’ privacy was not given sufficient priority.

  • The leadership, governance and culture did not always support the delivery of high-quality person-centred care.

However,

  • Services were organised and delivered to meet the needs of the local population.

  • Staff understood how to protect patients from abuse. Safeguarding was given sufficient priority.

  • People’s needs and preferences were considered and acted on to ensure that services were delivered in a way that was convenient.”

To learn more about this report and inspection, please click HERE

28th June 2019 – Downview Residential Homes – Good

Downview CQC inspection

“Downview Residential Home is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided. Both were looked at during this inspection. At the time of our inspection there were seven people living in the service.

The service supported people with learning disabilities, autism and people who displayed behaviours which challenge. Staff did not wear anything that suggested they were care staff when coming and going with people.

People’s experience of using this service:

We received positive feedback about the service and the care people received. The service met the characteristics of good in the areas of safe, effective, caring and responsive and requires improvement in well-led.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways:

People were encouraged and supported to make choices about their care and support. Staff used individualised communication techniques to support people to express themselves.

People were supported and encouraged to maintain their independence through engaging in activities of their choice.

People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Quality assurance processes were in place to monitor and improve safety and quality in the service. However, these processes were not always consistent.

Staff roles and responsibilities were clear. There was a positive, open and empowering culture in the service.

People received safe care. Medicines were managed safely and there were enough staff to support people and keep them safe both in the home and in the community.

People were supported by skilled staff with the right knowledge and training.

Staff had respectful, caring relationships with people they supported. They respected people’s dignity and privacy and promoted their independence.

People’s care and support met their needs and reflected their preferences. The provider upheld people’s human rights.”

For more details about this inspection, please visit the CQC website HERE

28th June 2019 – 3-4 Priors Court Cottages – Good

3-4 Priors court cottages CQC

“3-4 Prior’s Court Cottages is a residential care home. It provides accommodation and personal care for up to six people living with autistic spectrum disorder, who exhibit behaviours which may harm themselves or others. It provides a continuing education service to young adults from 19-25. At the time of the inspection there were six people living at the service.

The service offers on-site educational and vocational services via a learning centre, attended daily by the young adults, based on individual assessments and needs. Some people also attended off-site supported work placements.

The service effectively applied the principles and values of Registering the Right Support and other best practice guidance. These ensured that people who used the service lived as full a life as possible and achieved the best possible outcomes, that include control, choice and independence.

People’s experience of using this service:

People experienced high quality care that was safe, effective, caring, responsive and well led.

People consistently experienced outstanding person-centred care, which had significantly reduced their anxieties, the level of behaviours that may challenge others and the incidence of self-injurious behaviour.

There was a strong, visible person-centred culture in the service which drove staff to provide care and support that was exceptionally caring and compassionate.

Staff consistently cared for individuals in a way that exceeded expectations and demonstrated a real empathy for the people they cared for.

Staff had developed close and trusting relationships with people, which supported people to achieve their ambitions and extremely positive outcomes.

Feedback from people, relatives and professionals was overwhelmingly positive.

Staff were exceptionally sensitive when people needed caring and compassionate support. They discussed this with them and helped people to explore their feelings.

Staff found innovative and creative ways to communicate with each person and were particularly skilful at helping people to express their views and choices.

Staff positively welcomed the involvement of advocates and were intensely supportive of their ideas and strategies to promote people’s independence and protect their rights.

People were protected from discrimination, neglect, avoidable harm, and abuse by staff.

Risks to people’s safety had been identified, assessed thoroughly and were managed safely.

People received their medicines safely, as prescribed from staff who had completed the required training and had their competency to do so assessed.”

Please click HERE if you would like to learn more about this CQC inspection

28th June 2019 – West Berkshire Adult Placement Scheme – Good

West Berkshire Adult Placement Scheme CQC

“About the service: The West Berkshire Adult Placement Scheme is a shared lives service which supports shared lives carers to provide a home for people who are unable to or choose not to live on their own. They live as part of the shared lives carer’s family. Shared lives carers are not directly employed by the scheme but are paid a fee which is dependent on the amount and type of support they provide for individuals. People using the service and their shared lives carers enjoy shared activities and life experiences. Frequently, the people who use the service have a learning and/or associated disabilities.

The service is provided by the local authority. At the time of the inspection 29 people received long or short

term (respite) care which included the regulated activity (personal care). There were 33 shared lives carers approved to offer support to people who required personal care as part of their need’s assessment. Additionally, the service offered day care and other services which were not regulated by the Care Quality Commission.

People’s experience of using this service:

Risk assessments were reviewed and amended on a regularly basis. Peoples changing needs were identified and appropriate updates implemented.

There was an effective shared lives arrangement matching process in place. This process involved people and shared lives carers getting to know each other at their own pace, before making any long-term commitment to sharing a home.

The quality assurance processes in place were effective in identifying areas for improvement. The service demonstrated how they had acted in response to service improvements.

People were kept safe from risk of harm in the event of an emergency as individual personal emergency plans were correct.

We found that there were numerous activities on offer to people living in shared lives carers homes. People were supported to take part in social and recreational pursuits.

Shared lives carers and officers were trained in protecting people from abuse. They were aware how to report abuse and were knowledgeable regarding safeguarding and identifying the signs of abuse.

Relatives confirmed that they were involved in the development of people’s care needs, where appropriate.

All documentation was available in easy read format for people who required this.

The service regularly involved carers and relatives to have an input on the service.

People’s risk assessments linked into their care plans and detailed treatment choices and preferred methods.”

Please click HERE to go to the CQC website if you would like to learn more about this inspection.

 

7th June 2019 – Oxford University Hospitals NHS Foundation Trust – Requires Improvement

Oxford University Hospitals NHS Foundation Trust CQC Report

 

“Our rating of the trust went down. We rated it as requires improvement because:

  • We rated, effective, caring and responsive as good, and safe and well led as requires improvement.

  • At the John Radcliffe Hospital, we rated two of the trust’s services as good and three as requires improvement. In rating the trust, we took into account the current ratings of the four services not inspected this time.

  • At the Churchill Hospital we rated one of the trust’s services as good and one as requires improvement. In rating the trust, we took into account the current ratings of the four services not inspected this time.

  • At the Horton General Hospital, we rated one of the trust’s service as good and one as requires improvement. In rating the trust, we took into account the current ratings of the six services not inspected this time.

  • At the Nuffield Orthopaedic Centre, we rated one of the trust’s services as good. In rating the trust, we took into account the current ratings of the two services not inspected this time.

  • We rated well-led for the trust overall as requires improvement.

For more information about this inspection and report, please visit the CQC website HERE

7th June 2019 – Horton General Hospital – Good

Horton General Hospital CQC

Our rating of services stayed the same. We rated it as good because:

  • People were protected from harm. Lessons were learned and communicated widely to support improvement in other areas where relevant, as well as services that are directly affected.

  • When people received care from a range of different staff, teams or services, it was co-ordinated. Staff worked collaboratively to understand and meet the range and complexity of people’s needs.

  • People were supported, treated with dignity and respect and were involved as partners in their care

  • Reasonable adjustments were made and action taken to remove barriers when people found it hard to access or use services.

  • Consent to care and treatment was obtained in line with legislation and guidance, including the Mental Capacity act 2005. People were supported to make decisions and, where appropriate, their mental capacity was assessed and recorded.

  • Leaders were visible and approachable. Leaders modelled and encouraged compassionate, inclusive and supportive relationships among staff so that they felt respected, valued and supported.

  • There was an effective and comprehensive process to identify, understand, monitor and address future and current risk.

However,

  • The services provided mandatory training in key skills to all staff but not everyone had completed it. Nursing staff compliance was significantly higher than medical staff.

  • Management and support arrangements for staff were not always effective. Appraisals were significantly below the trust target of 90% for all staff groups with the exception of medical staff.

  • The services did not always have enough nursing staff, with the right mix of qualification and skills, although they were working hard to remedy this.

  • While the trust took complaints seriously and ensured they were investigated the trust’s responses to complaints were not always completed in a timely manner.

  • A proportion of patients did experience a delay when medically fit for discharge or transfer.

  • There was no vision for what the ED at the Horton General Hospital wanted to achieve and no workable plans developed with involvement from staff, patients, and key groups representing the local community.

To read more information about this CQC inspection / report, please click here

7th June 2019 – Nuffield Orthopaedic Centre – Good

Nuffield CQC

Our rating of services stayed the same. We rated it as good because:

  • People were protected from harm. Lessons were learned and communicated widely to support improvement in other areas where relevant, as well as services that are directly affected.

  • People have good outcomes because they received effective care and treatment that met their needs. Up to date information about effectiveness was shared, and used to improve care and treatment and people’s outcomes.

  • When people received care from a range of different staff, teams or services, it was co-ordinated. All relevant teams were involved in assessing, planning and delivering people’s care and treatment. Staff worked collaboratively to understand and meet the range and complexity of people’s needs.

  • Consent to care and treatment was obtained in line with legislation and guidance, including the Mental Capacity Act 2005. People were supported to make decisions and, where appropriate, their mental capacity was assessed and recorded.

  • People were supported, treated with dignity and respect and were involved as partners in their care. People were treated with dignity, respect and kindness during all interactions with staff and relationships with staff were positive.

  • People’s needs were met through the way services were organised and delivered. Reasonable adjustments were made and action taken to remove barriers when people find it hard to access or use services.

  • Leaders were visible and approachable. Leaders modelled and encouraged compassionate, inclusive and supportive relationships among staff so that they felt respected, valued and supported.

  • There was an effective and comprehensive process to identify, understand, monitor and address future and current risk.

However

  • The service provided mandatory training in key skills to all staff but not everyone had completed it. Nursing staff compliance was significantly higher than medical staff.

  • There was a gap in the management and support arrangements for staff. Appraisals were significantly below the trust target of 90% for all staff groups with the exception of medical staff. The medicine division had developed actions to address the gap in compliance, and action plans were in place at directorate level.

  • The trust’s responses to complaints were not always completed in a timely manner. The trust did not have a target for closing complex complaints, which some of these complaints may have been.

  • A proportion of patients did experience a delay when medically fit with their transfer from hospital.

  • To keep patients safe, eight beds were closed which had impacted on the waiting list and finances. There was an average wait of two weeks for admission to the Oxford Centre for Enablement (OCE).

 

To learn more about this inspection, please visit the CQC website here

7th June 2019 – Churchill Hospital – Good

Churchill Hospital CQC

“During this inspection we inspected the core services of gynaecology and surgery. We rated the gynaecology services as requires improvement and the surgery as good. In reaching our final rating for this location we have taken in to account the ratings for the core service medicine and end of life care also provided at this location, which were not inspected on this occasion.

Our rating of services stayed the same. We rated them as good because:

  • Incident reporting systems were in place and there was a culture of reporting, investigating and learning from incidents.

  • Staff kept detailed records of patients’ care and treatment. Detailed risk assessments were carried out for patients who used the services and risk management plans were developed in line with national guidance. There were effective arrangements in place to safeguard patients from abuse and mitigate the risk of it happening.

  • Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. Patients said they were involved in decisions about their care and that staff considered their emotional well-being, not just their physical condition.

  • The service followed best practice when prescribing, giving and recording medicines and patients received the right medication at the right dose at the right time.

  • Staff assessed and monitored patients regularly to see if they were in pain and had enough to eat and drink.

  • The trust engaged well with patients, staff, the public and local organisations to plan and manage appropriate services.

However

  • In general, services provided care and treatment based on national guidance and managers monitored the effectiveness of care and treatment and used the findings to improve them. Most leaders had the skills, knowledge, experience and integrity they needed to fulfil their roles.

  • However, recent organisation changes meant there were new leaders at directorate and divisional levels for the gynaecology service. While these teams were working to ensure there were clear reporting structures and a sustained level of scrutiny to ensure they were delivering a quality service where risk were known and managed this was still under development. Therefore, it was not possible to fully assess the effectiveness or impact of the governance and risk management processes.

  • There were structures, processes and systems of accountability to support the delivery of the strategy and sustainable services. However in the gynaecology services audits and quality outcomes conducted at a local and divisional level to monitor the effectiveness of care and treatment were not always effective in identifying areas for improvement.

  • Evidence was not provided to show staffing levels were always planned, implemented and reviewed to keep people safe.

  • Staff did not always receive training identified as necessary for their role.”

To learn more about this CQC inspection / report, please click here

7th June 2019 – John Radcliffe Hospital – Requires Improvement

john radcliffe hospital cqc inspection

“Our rating of services stayed the same. We rated it them as requires improvement because:

  • Most services had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected. However, some risks which had a potential to have a high impact, were not considered as a risk and therefore were not captured on the services risk register.

  • The services provided mandatory training in key skills to all staff but not everyone had completed their training. Nursing staff compliance was significantly higher than medical staff.

  • There was a gap in the management and support arrangements for staff. Appraisals were significantly below the trust target of 90% for staff groups except medical staff.

  • The trust had a recruitment program and was undertaking various initiative to encourage staff to stay. However, some services, such as surgery, gynaecology and midwifery did not always have enough nursing or midwifery staff, with the right mix of qualification and skills.

  • Patients care records were not always stored in a way which protected patient confidentiality.

  • Medicines were not always safely stored and managed at all times.

  • Some services did not always control infection risk well. Staff did not always keep equipment and the premises clean. Control measures to prevent the spread of infection were not always in use in the main theatres.

  • The environment was not always suitable for services provided. Areas in some of the main operating department and wards were damaged and in need of repair and posed potential risks to patient and staff safety.

  • Privacy and dignity was compromised for some patients in the main operating department.

  • National standards for care and treatment in some key areas were not always met. Referral to treatment (percentage within 18 weeks) and average length of stay for elective patients did not always meet the England average. The percentage of cancelled operations was higher than the England average.

  • The trust’s responses to complaints were not always completed in a timely manner.

  • A proportion of patients experience a delay when medically fit for discharge.

  • Audits and quality outcomes conducted at a local and divisional level to monitor the effectiveness of care and treatment were not always effective in identifying areas for improvement.

However

  • The services managed patient safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learnt. When things went wrong, staff apologised and gave patients honest information and suitable support.

  • In general services provided care and treatment based on national guidance and monitored evidence of its effectiveness. Although we found the maternity service had not reviewed or updated some of the protocols and guidelines against best practice and national guidance.

  • There was good multidisciplinary working. When people received care from a range staff, teams or services, it was co-ordinated.

  • People were supported, treated with dignity and respect and were involved as partners in their care. People were treated with kindness during all interactions with staff and relationships with staff were positive.

  • Reasonable adjustments were made and action taken to remove barriers when people found it hard to access or use services.

  • Consent to care and treatment was obtained in line with legislation and guidance, including the Mental Capacity Act 2005. People were supported to make decisions and, where appropriate, their mental capacity was assessed and recorded.

  • Most leaders were visible and approachable. Leaders modelled and encouraged compassionate, inclusive and supportive relationships among staff so that they felt respected, valued and supported.”

 

For more information about this CQC inspection / report, please click here

6th June 2019 – Hollies Care Home – Good

Hollies Care Home CQC

“Hollies is a ‘care home’ which provides personal care and nursing for up to 58 people, some of who may be living with dementia. At the time of inspection there were 49 people residing at the home.

People’s experience of using this service:

Staff were highly skilled and had a natural aptitude to give reassurance and comfort to people living in the home. They treated people with the utmost dignity and respect when helping them with daily living tasks. There was an excellent understanding of seeing each person as an individual, with their own specific needs.

People were protected from avoidable harm and abuse by staff members, who understood their role and responsibility in relation to safeguarding and keeping them safe. Safe recruitment practices were followed to make sure, as far as possible, that people were protected from staff being employed who were not suitable.

People were assisted to take their prescribed medicines safely by staff who were assessed as competent to do so. Where people required their medicines at a specific time or with food, this need was met. Storage and handling of medicine was managed appropriately.

People benefited from a home that was light, spacious and free of malodours. The registered manager advised they would be reviewing best practice on how to ensure they can make the environment more dementia friendly.

People’s needs were assessed and their care delivered in accordance with appropriate guidance and best practice. The provider worked with other services to ensure consistent care. Staff received the training and support they needed to carry out their roles effectively. People received appropriate support to attend healthcare appointments, to remain healthy and to eat and drink well.

People who lived at Hollies received care from a staff team who were passionate about delivering a high-quality, person-centred service. People’s care and support met their needs and reflected their preferences. The provider upheld people’s human rights. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.”

 

For more information about this report / inspection please visit the CQC website here

17th May 2019 – The Donnington Care Home – Requires Improvement

Donnington care home cqc

 

“The Donnington Care Home is a residential care home with nursing. 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.

The home is set in its own grounds and is situated close to local amenities. People had their own bedrooms with en-suite facilities and use of an enclosed private garden. Some of the people supported at the home lived with dementia and other health related conditions. The service is registered to provide care and nursing care for up to 40 people. At the time of our inspection there were 31 people residing at the home.

People’s experience of using this service:

The service assessed risks to the health and wellbeing of people who use the service and staff. However, we could not always be assured care was delivered by staff in line with the people’s care plans to mitigate these risks.

Safe recruitment practices were not always followed to make sure, as far as possible, that people were protected from staff being employed who were not suitable.

Governance system were not always effective and did not always identify actions for continuous improvements.

We found some very positive examples of the difference staff had made to people’s lives. However, we found that care records were not always up to date and accurate.

There was an activities programme and some people were involved in activities. However, people told us that some activities didn’t always take place when they were scheduled to do so and did not always meet their needs.

We have made a recommendation that provider explores all relevant guidance and best practice on how to ensure they make environments used by people with dementia more dementia friendly.

People were assisted to take their prescribed medicines by staff who were assessed as competent to do so. Where people required their medicines at a specific time or with food, this need was met. Storage and handling of medicine was managed appropriately.

Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. They felt confident issues would be addressed appropriately.

Feedback from relatives and people was that staff were caring and respected their privacy and dignity.

We observed kind and friendly interactions between staff and people. People and relatives made positive comments about the staff and the care they provided.

People and their relatives knew how to complain and knew the process to follow if they had concerns.

People had their healthcare needs identified and were able to access healthcare professionals such as their GP, when needed. The service worked well with other health and social care professionals to provide effective care for people.

The service had regular residents and relatives’ meetings as well as staff meetings to ensure there was opportunity to feedback about the home and that there would be a consistency in action taken. The staff team had handovers and daily meetings to discuss matters relating to the service and people’s care.

People and relatives felt the service was managed well and that they could approach management and staff with any concerns they may have.”

 

Please click here to learn more about this inspection

25th April 2019 – Elizabeth House – Good

“About the service: Elizabeth House is a residential care home. It provides personal care and support for up to eight people who have learning disabilities and associated conditions, such as autistic spectrum disorders. At the time of the inspection there were eight people living at the service.

People’s experience of using this service:

People told or indicated to us that they felt safe and were happy living in Elizabeth House. The house was sociable with a calm, engaging atmosphere.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways:

• People were involved in planning their care.

• People were supported to follow their interests, set goals and increase their independence.

• People had good access to their local community and opportunities to meet people and were supported to maintain relationships with friends and family.

People were supported by a consistent team of staff who were kind and caring. Staff had good relationships with people and knew them well.

Staff had good knowledge of people’s condition, their needs, and how to support them appropriately. Care plans were person centred and gave clear guidance on how people wished to be supported with their diverse needs. Significant work had been done to ensure that the service was responsive to people’s needs. When significant decisions had been made, all people living in the service had been considered. This was continually under review to ensure that the service continued to meet the needs of everyone. People’s support and social needs were known and staff worked hard with the people to ensure that all of their needs were explored and met.

There was clear leadership and an open culture where staff and people could raise concerns or issues. The service had values which the staff worked to.”

For more information about this inspection please visit the CQC website here

24th April 2019 – Theale Medical Centre – Requires Improvement

CQC Theale Medical Centre

“We carried out an announced comprehensive inspection of the practice on 27 February and 5 March 2019 as part of our inspection programme. The practice was previously inspected in March 2017, with an overall rating of requires improvement, as safe and well-led were rated as requires improvement. A follow up inspection was undertaken in October 2017 and the practice was rated as good overall.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about the service and information from the provider, patients, the public and other organisations.

The practice is rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

This practice is rated as requires improvement overall.

We concluded that:

  • The practice had clear systems, practices and processes to keep people safeguarded from abuse.

  • Patients were supported, treated with dignity and respect and were involved as partners in their care.

However, we also found that:

  • The practice did not always have systems to keep people safe.

  • People’s needs were not always met by the way in which services were organised and delivered.

  • The delivery of high quality care was not always assured by effective governance procedures.

The areas where the provider must make improvements are:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Ensure systems for monitoring cervical screening outcomes are fully embedded and effective.”

For more information about this CQC inspection and report, please click HERE

9th April 2019 – Chrysalis Care Ltd – Good

Chrysalis Care CQC

Chrysalis Care Ltd is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 27 people receiving the regulated activity ‘personal care’.

Summary of findings:

 Records did not always clearly reflect how staff were meeting people’s specific health conditions. However, the provider responded promptly to this and put in place an action to ensure they are working in line with best practice guidance.

Records did not always reflect when people were involved in decisions about their care. However, the provider responded promptly to this and put in place an action to ensure their records clearly reflect decisions people make regarding the care they receive.

The registered person had not submitted a notification to the Care Quality Commission following an allegation of abuse. This was investigated by the registered manager and was an unfounded allegation. The provider said they would submit this following the inspection.

 People and their relatives told us they felt safe with staff.

 Medicines were handled safely by staff who had been assessed as competent to do so.

 People and their relatives said staff were caring and respected their privacy and dignity.

 People felt the service they received helped them to maintain their independence where possible.

 Staff supported people to have a meaningful life and encouraged them to be independent.

 People knew how to complain and knew the process to follow if they had concerns.

 Staff felt the management was supportive and approachable. Staff were happy in their role, which had a positive effect on people’s wellbeing.

The registered manager demonstrated a commitment to providing person centred care for people.

For more information about this CQC inspection and report, please click here.

28th March 2019 – Mayfair Homecare – Requires Improvement

Mayfair Homecare CQC

“About the service: Mayfair Homecare – Newbury is a domiciliary care agency (DCA) providing care and support to people living in their own homes. It provides a service to older adults.

Not everyone using Mayfair Homecare – Newbury receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Mayfair Homecare – Newbury does not currently have a registered manager. ‘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 previous registered manager had left in January 2019. The new manager is in post and currently in the process of applying to be registered.

People’s experience of using this service:

People were supported for by a consistent staff team who were kind and caring and appropriately trained. Staff had good relationships with people and knew them well. People were encouraged and supported to maintain their independence. They spoke highly of the care and support they received. “The carers are brilliant, I can’t fault them.”

Appropriate numbers of staff were employed, however safe recruitment practices had not always been followed. The current provider had bought out the previous provider of the service in 2016, a number of staff transferred across to the new service. However, the new provider had not assured themselves that people employed by the previous provider had been recruited safely.

Feedback was sought from people and staff through meetings and questionnaires. People told us they felt comfortable in raising any concerns or issues.

Care plans were person centred and detailed people’s support needs. However, records were not always accurate. Some risk assessments were inaccurate which meant people were at potential risk because staff did not have the most appropriate information and guidance. Quality assurance audits were carried out regularly. Some of those completed were inaccurate, recording information as being present when it was not. Branch audits were also regular. Specific issues identified were addressed but the service failed to identify that some specific issues were actually more widespread.

We identified two breaches of the regulations. Safe recruitment practices were not always followed and governance systems were not effective. You can see what action we told the provider to take at the back of the full version of the report.”

For more information about this CQC inspection, please click HERE to visit the CQC website.

22nd March 2019 – Winchcombe place – Inadequate

Winchombe Place CQC

“Winchcombe Place is a care home with nursing which provides personal care and support for up to 80 people.

The registered manager of the home had left the service in December 2018, however was still registered with the Care Quality Commission (CQC). We were assisted by the management team during the inspection. The registered manager and registered provider are ‘Registered Persons’. Registered Persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s experience of using this service:

People did not receive a service that provided them with safe, effective and high-quality care.

Risks to people’s safety and well-being were not managed effectively and this placed people at risk of harm.

Infection control was not always managed in an effective way.

Incidents and accidents were not managed safely to prevent a reoccurrence.

People’s needs and preferences were not always assessed or person-centred plans developed to guide staff on how to meet people’s needs.

Staff did not always complete training in meeting people’s needs and this meant people were at risk of inappropriate care and treatment.

People were not always treated respectfully or in a way that promoted their privacy and dignity.

Staff were not always deployed effectively.

The service was not well-led and the governance system were not always effective and did not always identify the risks to the health, safety and well-being of people or actions for continuous improvements.

Complaints had not always been managed appropriately.

Appropriate referrals were no made to the local authority in a timely way.

We were not always notified, as required by law, of notifiable safety incidents.

Medicines management was not always safe.

People told us staff were caring, although feedback received was that meaningful engagement was limited.

There is more information about this in the full report.”

 

To learn and read more about this CQC inspection, please click HERE

22nd March 2019 – The Old Vicarage – Good

CQC old vicarage

“The Old Vicarage is a residential care home which provides accommodation and personal care for up to 13 adults living with learning disabilities and autistic spectrum disorders. At the time of our inspection there were 11 people using the service.

People’s experience of using this service:

People remained safe and were relaxed and comfortable with the staff team. A consistent team of competent, knowledgeable and skilled staff was in place. Risks to people’s well-being were assessed and there was emphasis on positive risk taking. Medicines were handled safely by staff who had been assessed as competent to do so.

People received effective care that was in line with good practice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People remained treated with dignity and in a compassionate way. People’s independence was encouraged as much as possible. People received person-centred care, which was tailored around their individual preferences, needs and wishes. People enjoyed positive and respectful relationships with the staff and management team. People’s privacy and confidentiality was respected.

People’s needs were recorded in support plans and staff knew people’s needs well. People were supported to enjoy their hobbies and interests. The management saw complaints as a way to improve the service and people’s relatives told us concerns were being addressed promptly.

The service was well-run by the registered manager and a team of committed staff. People were involved and listened to. The team worked well with external professionals to ensure people’s needs were met.”

Please visit this webpage to learn more about this inspection

14th March 2019 – Notrees care home – Good

“Notrees is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Notrees accommodates up to 16 older people in one adapted building. There were 15 people at the service at the time of inspection, some of whom were living with dementia.

At our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The registered manager had systems in place to monitor the quality and safety of the home. This included audits, improvement plans and gaining feedback from people and staff. These measures were effective in promoting improvements within the service.

There were enough suitably qualified staff in place to meet people’s needs. The provider had robust procedures in place to monitor recruitment, training, induction and ongoing support of staff. This helped to ensure staff were effective in their role.

Staff were knowledgeable about people’s needs and were caring in their approach. People were treated with dignity and the care they received reflected their preferences. When people received care at the end of their lives, they were given compassionate support which reflected their needs and preferences.

People’s care plans reflected how they would like to receive care. The registered manager had developed these plans using information from people, relatives and healthcare professionals.

Staff understood the need to gain appropriate consent to care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were a range of activities which people could take part in and people were able to give feedback to the registered manager to suggest new things to do. The provider had established links with the local community which helped people feel connected to their local area.

Risks associated with people’s health and wellbeing were assessed and mitigated. The registered manager analysed incidents and accidents to establish how the risk of reoccurrence could be reduced.

Risks associated with the environment were well managed to reduce risk of harm. There were plans in place to protect people from harm in the event of an emergency.

The provider had safeguarding policies and procedures in place which helped to reduce the risk of harm to people. Where safeguarding concerns were raised, the provider worked in partnership with local safeguarding teams to help keep people safe.

People were supported appropriately with their nutrition and healthcare. Where risks were identified, the appropriate professionals were consulted and their recommendations were incorporated into people’s care.

The home was a clean, hygienic environment, which was suitable for people’s needs. People had access to outside space and were encouraged to use the garden when possible.

There were safe systems in place to manage people’s medicines.

There were systems in place to respond appropriately when people had complaints or concerns.”

Please click HERE to visit the CQC website and learn more about this inspection.

13th March 2019 – Charlotte House – Requires Improvement

Charlotte House CQC

“Charlotte House is a residential care home which is registered to support up to five people between the ages of 19 to 25 years old who are severely affected by autism. At the time of our inspection there were five people living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen

Overview of findings:

Staff were not regularly assessed as competent to administer medicines in line with clinical guidance and best practice.

Staff had not always attended training that the provider deemed as mandatory.

Audits had not always been undertaken. Those that had, did not always identify gaps or highlight trends, themes or lessons learnt.

People were happy living at the service. People were observed smiling and positively interacting with the staff supporting them.

Staff supported people to have a meaningful life and encouraged them to be independent.

People received care that was designed to meet their individual needs and preferences.

Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable.

People who lacked capacity were supported to have maximum choice and control of their lives. Policies and systems supported them in the least restrictive way possible.

The registered manager and home manager demonstrated a commitment to providing person centred care for people.

Staff felt the management was supportive and approachable. Staff were happy in their role which had a positive effect on people’s wellbeing.”

To learn more about this CQC inspection, please click here

 

6th March 2019 – Duncan House Care Home – Good

Duncan House

The registered manager conducted quality assurance audits to monitor the running of the service. However, we found that these were not always effective as they didn’t always identify gaps in medication records. People’s medication records were not always accurate and had conflicting medicine information. People did not always have ‘as required’ medicine guidance in place. We recommend that the provider seeks guidance around the proper and safe management of medicines.

The registered person did not always inform of authorisations under the Deprivation of Liberty Safeguards as required in the Care Quality Commission Regulations. We recommended the provider ensures they understand their regulatory responsibilities to ensure they are complying with the regulations.

People remained safe at the service and risks around their well-being were assessed, recorded and regularly reviewed. People were supported by sufficient staff that knew them well. Recruitment procedures to appoint new staff were thorough. People were supported to take their medicines safely.

People received their care and support from a staff team, that had a full understanding of people’s care needs and the skills and knowledge to meet them. Staff were given an induction when they started and had access to a range of training to provide them with the level of skills and knowledge to deliver care efficiently.

Staff treated people with respect and kindness at all times and were passionate about providing a quality service that was person centred. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

People’s dignity and privacy was respected. People told us staff were reliable, friendly, and caring. Staff developed positive and caring relationships with the people they supported and used creative ways to enable people to remain independent.

The registered manager and the management team strived at creating an inclusive environment to strongly encourage staff, people and their relatives to be involved in the service.

Please click HERE to visit the CQC website and learn more about this inspection

 

15th February 2019 – Newton House – Good

“People felt safe while supported by the staff team who made them feel reassured and relatives agreed with this. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. The registered manager had the knowledge to identify safeguarding concerns and acted on these appropriately. The service assessed personal and environmental risks to the safety of people, staff and visitors and took actions to minimise those risks.

The provider had employed skilled staff. They were knowledgeable and caring, making sure people received appropriate care and support. People received support that was individualised to their personal preferences and needs. Their needs were monitored and their support plans were reviewed regularly or as changes occurred. People received their prescribed medicine safely and on time. We found a minor issue with the storage of medicine but it was rectified promptly.

Staff had ongoing support, supervision and appraisals. They felt supported by the registered manager and maintained good team work. People received care and support that was personalised to meet their individual needs. People were able to continue their usual daily activities and access the local community to enhance social activities. Staff understood the needs of the people and we saw care was provided with kindness and consideration.

People and relatives were complimentary of the staff and the support and care they provided. The recruitment and selection process helped to ensure people were supported by suitable staff of good character. There were sufficient numbers of staff on each shift. The service ensured there were enough qualified and knowledgeable staff to meet people’s needs at all times. People’s rights to confidentiality, dignity and privacy were respected. Staff supported and encouraged people to develop and maintain their independence wherever possible. Relatives were complimentary of the service and the way their family members were supported.

People were given a nutritious and balanced diet and hot and cold drinks and snacks were available between meals. People had their healthcare needs identified and were able to access healthcare professionals such as their GP. The registered manager and staff team knew how to access specialist professional help when needed. People were supported in the least restrictive way possible to have maximum choice and control of their lives. The policies and systems in the service supported this practice.”

To read more details about this inspection, please visit the CQC website here

15th February 2019 – Focus Support Limited – Good

Focus Support Limited CQC inspection

“People were treated with care and kindness. They were consulted about their support and could change how things were done if they wanted to. People were treated with respect and their dignity was upheld. This was confirmed by people and the relatives who gave us their views. People were encouraged and supported to maintain and increase their independence.

People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable.

People received care and support that was personalised to meet their individual needs. They received effective care and support from staff who knew them well and were well trained. A community professional thought staff had the knowledge and skills they needed to carry out their roles and responsibilities.

People knew how to complain and knew the process to follow if they had concerns. People’s rights to make their own decisions were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the supported this practice.

Where people were potentially being deprived of their liberty, the service knew to make the relevant commissioning authorities aware. This was so that commissioners could make applications to the Court of Protection for the appropriate authorisations.

People’s right to confidentiality was protected and their diversity needs were identified and incorporated into their care plans where applicable.

People benefitted from a service which had an open and inclusive culture and encouraged suggestions and ideas for improvement from people who use the service and staff. Staff were happy working for the service and people benefitted from staff who felt well managed and supported.”

To read the full details about this CQC inspection, please visit the CQC website here

2nd February 2019 – Slade House – Good

Slade house CQC

“Slade House is a care home (without nursing) which is registered to provide a service for up to eight people with learning disabilities. People had other associated difficulties such as being on the autistic spectrum. Slade House is one of eight separate care homes within the Purley Park Trust Estate. There were eight people living at the service when we visited.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People and their relatives felt confident that people were safe and secure when receiving care. There were clear systems in place to ensure the safety of people. Staff had received training to identify if people were at risk from abuse or harm.

Sufficient staff were deployed to ensure that people had a consistently reliable service. Recruitment procedures to appoint new staff were thorough. People were supported to take their medicines safely.

People who use the service used a range of communication methods. These included non-verbal to limited verbal communication. People’s individual methods of communication were clearly understood by staff.

People received good quality care. Staff treated people with respect and kindness at all times and were passionate about providing a quality service that was person centred. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

People’s dignity and privacy was respected. People told us staff were reliable, friendly, and caring. Staff developed positive and caring relationships with the people they supported and used creative ways to enable people to remain independent.

Quality assurance frameworks in place across the service were robust. The registered manager conducted regular audits that were systematic and meaningful. They ensured the service continued to provide excellent quality and safe care. The records kept of these checks showed that, where issues were identified, prompt action had been taken.

People received their care and support from a staff team that had a full understanding of people’s care needs and the skills and knowledge to meet them. Staff were given an induction when they started and had access to a range of training to provide them with the level of skills and knowledge to deliver care efficiently.”

Please click HERE to read more details about the CQC inspection at Slade House.

29th January – Argyles Care Home – Requires Improvement

Argyles Care Home CQC

“Argyles 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. Argyles Care Home accommodates a maximum of 50 people; there are communal areas located on the ground and first floor with bedrooms and communal bathrooms situated on both floors. The home provides care and support to people who are assessed as having personal care and support needs. There were 42 people living at the home at the time of the inspection.

This comprehensive inspection took place on the 10 December 2018 and was unannounced.

At the last inspection on the 25 and 26 May 2016 we found the overall rating of the home to be Good. The service was found to be Requires Improvement in effective with all other domains rated Good. At this inspection we found that the service was rated Requires Improvement in the domains of safe, effective, responsive and well led. The service remains Good in caring. Therefore, the overall rating of the service has changed to Requires Improvement.

The service had a registered manager in post. However, they were not in the service at the time of inspection and it was not clear whether they would be returning. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Risks to people’s safety, health and welfare were not always managed in line with their care plan. We could not be assured that people were receiving the care and treatment they required in relation to managing skin integrity. Personal emergency evacuation plans were in place but did not clearly identify people’s needs in the event of an emergency. People’s personal information contained in the home’s “fire box” that would be used in the event of an emergency evacuation was conflicting and did not reflect current residents living in the home. The management team were unaware this was not up to date but promptly updated this on the day of inspection. There were procedures in place in relation to safe recruitment. However, we found that records did not always have all the information as required under schedule three of the Health and Social Care Act. We could not be assured that staff were recruited to ensure they were safe to work with people. This is a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Processes were not always followed in line with the Mental Capacity Act 2005 to ensure decisions were made in people’s best interests. Care records lacked information around people’s ability to consent and where authorisations placed restrictions on people to keep them safe, they were not understood by staff. This is a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) 2014.”

Please click HERE to read further details about the CQC inspection at Argles Care Home

25th January – Glebe Garden – Good

“Glebe Garden is residential care home for up to four people, that provides a service to younger adults, who have a diagnosis of learning disabilities and / or are on the autistic spectrum, The service is registered to provide accommodation in addition to personal care with a condition that no nursing care is delivered to people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The home offers four bedrooms and two full bathrooms, with a dining room, communal lounge and access to the kitchen. A spacious rear garden further offers additional space for people to use. Floors are accessible by stairs.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

At this inspection we found the service remained Good.

Why the service is rated good

The service continues to keep people safe. Recruitment procedures ensured suitable staff were employed to support people and help keep them safe. Risk assessments continued to consider least restrictive options to enable people to continue engaging in activities that enhances their well-being, with care documents supporting the risk assessments.

Medicine management continued to be provided in a safe way. Audits illustrated that people received their medicines in a timely manner and how they wished. Medicines were correctly stored, disposed of and ordered to ensure that people were not without their medicines at any point. A recent pharmacy inspection rated the service highly, with no recommendations or improvements suggested.

Staff training was kept up to date, and a rolling training programme was in place. Staff received frequent supervisions and annual appraisals that allowed reflective practice.

People’s needs were assessed initially upon admission, and thereafter reviewed monthly to ensure care was the most appropriate. People were thoroughly involved in their care plan, with no changes being made, until agreement had been received from the person. People were encouraged to personalise their rooms in a style that they preferred, with furnishings that brought a personal touch to their rooms. People were furthermore encouraged to take an active role in the home, by taking personal responsibility for chores, with staff assisting as required.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. This included making decisions about their care, food choice as well as activities. People received exceptionally responsive care. Staff had a thorough understanding of people’s needs and focused on developing people’s skill sets through personalised and responsive care. Family relationships were encouraged, and developed. People were enabled to achieve and attain personal targets and aspirations.”

 

Click here for more details about the inspection at Glebe Garden

18th January 2019 – River View Care Centre – Inadequate

River View Care Centre CQC

“We undertook an unannounced focused inspection of River View Care Centre on 3 December 2018. This inspection was carried out to check that improvements to meet legal requirements planned by the provider after our September and October 2018 comprehensive inspection had been made. The team inspected the service against two of the five questions we ask about services: is the service well led and is the service safe? This is because the service was not meeting eight legal requirements at their last inspection.”

“The service remained unsafe. People were not kept safe from the risk of harm. Documentation was poor and conflicting in information, and staff were unable to provide assurances as to their understanding of the individual risks associated with people’s care and support needs.

People were not appropriately monitored for adequate food and fluid intake and weight checks. As a result, potentially people did not have referrals made to external professionals in a timely way. Where bedrails were required to keep people safe, these were not always used. Staff attended to people, but failed to recognise the risk the lack of bedrails presented.

Staff were unaware of people’s changing health needs. Documentation, although stated as reviewed and therefore up to date, was inaccurate and not reflective of people’s needs. This meant that people were potentially exposed to unsafe care and treatment.”

To read more about this CQC inspection, please click HERE

12th January 2019 – People Matter Support Services Limited – Requires Improvement

People Matter Support Services

“At the last inspection on 21 and 22 August 2018 we found breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. For three of those breaches we served requirement notices. They were for staff recruitment, medicines handling and staff training. We will follow up those requirement notices at our next comprehensive inspection.

The fourth breach of regulations was for regulation 17, Good Governance. We found the provider had not established an effective system that ensured their compliance with the fundamental standards. They did not have effective systems in place to enable them to assess, monitor and improve the quality and safety of the service provided. This meant they were not aware of, and not addressing, areas that needed improvement to ensure the quality and safety of their service. On 12 September 2018, as a result of our inspection in August 2018, we served a warning notice for that breach of regulations. Warning notices tell a registered person that they are not complying with a condition of registration, requirement in the Act or a regulation and will usually require a registered person to comply with that requirement by a specified date. In this instance we gave the registered person until 10 December 2018 to become compliant with regulation 17.

We undertook an announced focused inspection of People Matter Support Services Limited on 12 December 2018 to check if the provider had made improvements we told them to. We gave two working days’ notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

This inspection was carried out to check that the warning notice had been met and that the registered person was compliant with regulation 17, good governance. We inspected the service against one of the five questions we ask about services: ‘is the service well led?’. The ratings from the previous comprehensive inspection for the remaining four Key Questions were included in calculating the overall rating of requires improvement at this inspection.

The service had a registered manager as required. The registered manager is also the only director of the provider company and is the nominated individual. 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 manager was available and assisted us during the inspection. In this report, for clarity, where we refer to the registered person we mean the provider/registered manager.

We found the service’s rating for the well-led question had deteriorated to Inadequate.”

Please click here for further details.

11th January 2019 – Crossroads Care West Berkshire – Good

Crossroads Care West Berkshire

“At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

People felt safe while supported by the staff team who made them feel reassured and relatives agreed with this. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. The registered manager had the knowledge to identify safeguarding concerns and acted on these appropriately.

The registered manager and senior staff had planned and booked training when necessary to ensure all staff had the appropriate knowledge and skills to support people. Staff had ongoing support, supervision and appraisals. They felt really supported by the registered manager and senior staff, and maintained good team work.

People and relatives were complimentary of the staff and the support and care they provided. People received support that was individualised to their specific needs which were kept under review and amended as changes occurred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated with respect, and their privacy and dignity were promoted. People felt the staff supported them in the way they wanted. Staff were responsive to the needs of the people and enabled them to improve and maintain their independence with personal care. The staff monitored people’s health and wellbeing and took appropriate action when required to address concerns. People felt confident they would be looked after well and relatives agreed with them.

Where possible, the registered manager scheduled visits so the same staff went to see people to maintain continuity of care and support. People were informed about the changes to their visits as necessary. The service assessed risks to people’s personal safety, as well as staff, and plans were in place to minimise those risks. There were safe medicines administration systems in place and people received their medicines when required. The service had recruitment procedure that they followed before new staff were employed to work with people. This included ensuring staff were of good character and suitable for their role.”

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11th January – Dimensions Berkshire Domiciliary Care Office – Good

Dimensions Berkshire Domiciliary Care

“At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People and their relatives felt confident that people were safe and secure when receiving care. Staff understood people’s needs and knew how to protect them from the risk of abuse. Risks to people’s safety were identified and assessments were in place to manage identified risks. Where people required support to take prescribed medicines, staff had received training to assist people safely.

Sufficient staff were deployed to ensure that people had a consistently reliable service. Recruitment procedures to appoint new staff were thorough.

People were supported to take their medicines safely. We have made a recommendation in relation to ensuring appropriate guidance is in place relating to ‘as required’ medication.

People who use the service used a range of communication methods. These included non-verbal to limited verbal communication. People’s individual methods of communication were clearly understood by staff.

People received good quality care. Staff treated people with respect and kindness at all times and were passionate about providing a quality service that was person centred. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.”

Please click here to read more about this CQC inspection/report.

4th January 2019 – Boxgrove House Residential homes – Good

“What life is like for people using this service:

People remained safe at the service and risks around their well-being were assessed, recorded and regularly reviewed. People were supported by sufficient staff that knew them well. Recruitment procedures to appoint new staff were thorough. People were supported to take their medicines safely.

The registered manager conducted quality assurance audits to monitor the running of the service. However, we found that these were not always effective as they didn’t always identify gaps in medication records. We recommend that the provider seeks guidance around the proper and safe management of medicines.

People received their care and support from a staff team, that had a full understanding of people’s care needs and the skills and knowledge to meet them. Staff were given an induction when they started and had access to a range of training to provide them with the level of skills and knowledge to deliver care efficiently.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People who use the service used a range of communication methods. These included non-verbal to limited verbal communication. Individual methods were supplemented by the use of pictures and objects of reference to indicate their needs and wishes, which were clearly understood by staff.

Staff treated people with respect and kindness at all times and were passionate about providing a quality service that was person centred. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

People’s dignity and privacy was respected. People told us staff were reliable, friendly, and caring. Staff developed positive and caring relationships with the people they supported and used creative ways to enable people to remain independent.

The registered manager and the management team strived at creating an inclusive environment to strongly encourage staff, people and their relatives to be involved in the service.”

Want to learn more about this inspection? Please click here to visit the CQC website and do so.

 

 

21st December – Great Western Hospital – Requires Improvement

“We carried out an announced inspection between 21 and 23 March 2017 and an unannounced inspection at Great Western Hospital on 27 and 28 March 2017 and 3 April 2017. This was a focused inspection to follow up on concerns from a previous inspection. As such, not all domains were inspected in all core services.

The inspection team inspected the following six core services at Great Western Hospital:

  • Urgent and emergency services

  • Medical care (including older people’s care)

  • Surgery

  • Critical care

  • Services for children and young people

  • Outpatients and diagnostic imaging

We also inspected:

  • Urgent care services (provided as a community service).

We did not inspect end of life care or maternity and gynaecology services (previously rated good). We did not inspect the effective, caring or responsive domains for services for children and young people (previously rated good). The effective domain was inspected but not rated for outpatients and diagnostic imaging.

Overall we rated Great Western Hospitals NHS Foundation Trust as requires improvement.

Safe

We rated the safe domain as requires improvement overall. Urgent and emergency services, medical care, surgery, critical care, services for children and young people and outpatients and diagnostic imaging were all rated as requires improvement.

  • As a result of high demand we found the emergency department was frequently full, with patients in all cubicles and around the nurses’ station. There were occasions where the emergency department was deemed to be unsafe as a result of the number of patients within the department. However, this was improving. We also found that as a result of pressures for beds in surgery some patients had to use facilities which were not always suitable for recovering from their surgery.

  • Compliance with safe systems to ensure medicines were stored at the correct temperature  needed to be improved. Daily checks of medicines were not always completed in the emergency department or critical care. We found in medical care that some areas did not have regular temperature checks. This meant there was limited assurance that medicines were being stored within required temperature ranges to ensure they were fit for use.

  • The storage of medicines needed to be improved. In medical care we found that some of the storage shelves did not allow for stock rotation, which increased the risk of medicines being out of date. We also found in critical care that the fridges used to store medicines could not be locked. This meant that medicines could be removed without authorisation.

  • Equipment used was not always checked in line with guidance to ensure it was fit for purpose. Daily checks of emergency equipment did not always take place.  In services for children and young people that heated water blankets did not have expiry dates or water change dates recorded.

  • There were areas throughout the hospital which did not have sufficient numbers of suitably qualified staff on duty to keep people safe. This included the emergency department observation unit where we observed a patient walking out of the department without staff knowing. Within medical care and surgery, services for children and young people and critical care there were wards and theatres which went through periods of understaffing, which meant that staffing numbers did not always meet national guidelines. In medical care we found that ambulatory care was sometimes left with no staff in it for short periods of time due to lone working arrangements.

  • Mandatory training rates needed to be improved in the emergency department for medical staff, in medical care, outpatients and diagnostic imaging, critical care, and surgery. In services for children and young people all medical staff fell below trust targets for all mandatory training and paediatric basic life support training was below target in all staff groups.

  • Safeguarding practices needed to be improved in outpatients and diagnostic imaging and in services for children and young people. In outpatients and diagnostic imaging only 20% of medical and dental staff had completed level two safeguarding adults training against a trust target of 80%. In services for children and young people staff did not have ready access to relevant safeguarding information on a patient due a filing backlog.

  • The security and completeness of records needed to be improved. We found in medical care and critical care that patient records were not always stored securely. We also found that in critical care patient allergies and venous flushes were not always documented. In medical care we found that not all patient documentation was completed in full and handovers between wards was not consistency provided to a high standard. This meant that patients’ full needs may not always be met.”

Please click HERE to read more.

21st December – Prestige Healthcare Services – Requires Improvement

“The inspection took place on 6 November 2018. The inspection was announced. This service is a domiciliary care agency. It provides personal care to any adults who require care and support in their own houses and flats in the community. Not everyone using Prestige Healthcare Services receives a regulated activity. The Care Quality Commission only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do receive personal care we also take into account any wider social care provided.

At the time of inspection, the service supported 22 people who were receiving personal care in their own homes. The service provides support to older people, people with physical disabilities, sensory impairment and people living with dementia.

This is the first inspection since the service was registered.

At this inspection we have found the service was not always safe and well-led. Therefore, the service has been rated as Requires Improvement in these domains. The service has been rated Good in effective, caring and responsive. As a result, the service was rated overall as Requires Improvement.

People’s medication records did not always reflect that they were administered safely. It was not always clear that people received their medications as prescribed. Risk assessments did not always provide sufficient information to provide direction for staff, or information about how to reduce risks. This was a breach of Regulation 12 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The registered manager conducted some quality assurance audits to monitor the running of the service. However, we found that these were not always effective and didn’t always identify gaps in medication records. Quality assurance records did not always reflect the provider had monitored, assessed and improved the quality of the service being delivered. This was a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014.

The provider had not always notified CQC of other incidents. This meant we could not check that appropriate action had been taken to ensure people were safe. The provider is in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

People told us they felt safe. There were some systems in place to protect people from the risk of abuse and potential harm. Staff were aware of their responsibility to report any concerns they had about people’s safety and welfare.”

Click here for more details about this inspection/report

19th December 2018 – The Boat House Surgery – Good

“We carried out an announced comprehensive inspection at The Boathouse Surgery on 30 October 2018 as part of our inspection programme. Our inspection team was led by a Care Quality Commission (CQC) Inspector and included a GP specialist advisor.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

This means that:

  • Patients were protected from avoidable harm and abuse and that legal requirements were met.

  • Patients had good outcomes because they received effective care and treatment that met their needs.

  • Patients were supported, treated with dignity and respect and were involved as partners in their care.

  • People’s needs were met by the way in which services were organised and delivered.

  • The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.

We identified the following area of outstanding practice:

  • End of life care (EOL) was tailored and reviewed to ensure outcomes were improved. The practice developed a video regarding positive EOL care and this was shared with other providers and services as a learning resource.”

Click here to read further details about this CQC inspection/report

18th December 2018 – Berkshire West Community Endoscopy Service – requires Improvement


Berkshire West Community Endoscopy Service

“Berkshire West Community Endoscopy Services is commissioned by Berkshire West Commissioning Care Group to deliver non-sedation diagnostic endoscopy services for GP practices. The service offers diagnostic endoscopy to people living in Berkshire West including North and West Reading, Newbury, Wokingham and South Reading. The service accepts adult patient referrals and does not see children and young people under the age of 18 years. The service offers clinics on Saturdays and Sundays with some additional clinics on Monday and Friday mornings. There is a booking and administrative team working Monday to Friday mornings to manage referrals. The service is hosted by a private healthcare provider in Reading.

The service carries out two different endoscopy procedures: gastroscopy (thin, flexible tube called an endoscope is used to look inside the oesophagus (gullet), stomach and first part of the small intestine) and flexible sigmoidoscopy (examination of the rectum and the lower (sigmoid) colon using an endoscope). The service is commissioned to carry out between 2000 and 2100 procedures every year.

Facilities include one procedure room, a waiting area, a reception area, a consultation room and a ward area with eight single pods for patients pre- and post-endoscopy.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 29 September 2018. This was the first time we inspected this service since it was registered with the CQC in 2016.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people’s needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.”

Please click here for more information about this report.

14th December – St Lukes Lodge – Good

We found people were now provided with safe care and support. Appropriate action had been taken to address the previous issues referred to above. The new manager and the staff fully understood their responsibilities to safeguard people from harm and the action they must take if they had concerns about this.

People felt safe and well cared for by the staff and it was evident they felt at ease around all of the staff. Staff had received nationally recognised training on how to support people whose behaviour could sometimes challenge the service.

Identified risks were assessed and action taken to mitigate them as far as possible, without restricting people’s freedom of choice.

A robust recruitment process helped ensure staff recruited had the necessary skills and the right approach to provide the support people needed. Additional staff had been recruited to provide consistent care to people, going forward.”

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11th December 2018 – Falkland Surgery – Good

 

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.

  • Patients found the appointment system easy to use and reported that they were able to access care when they needed urgent support and treatment. The practice had acted following below average feedback about access to appointments. The telephone system was in the process of being upgraded and additional staff had been recruited to offer a wider range of appointments.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

  • Patient feedback about receiving compassionate care and treatment was consistently positive.

  • The practice used technology to improve patient care and reduce risk.

Click here to read more about this report/inspection

 

30th November – River View Care Centre Nursing Home – Inadequate

“The service was rated Inadequate.

People were not kept safe. Risk assessments and comprehensive documentation was not in place to ensure people were offered responsive safe care and treatment. Care plans contained minimal information, with crucial information missing. The lack of information meant people were put at risk of harm.

Medicines were not always managed safely. Whilst we found that medicines were generally stored safely and appropriately administered, guidelines were not in place for two people who were given medicines covertly. Nurses spoken to were unclear of the correct protocol that was to be followed prior to covert medicines being administered.

People were not being kept safe due to a failure in appropriate monitoring and recording of the environmental risks and risks to people. A leak in the roof gave cause for serious concern around safety to people and staff. The service did not have robust recruitment processes in place, to ensure staff employed were safe to work with people.

Staff did not appropriately record information. Incidents were not always reported or understood to be reportable, therefore information was not accurately updated in daily records. Nutrition and hydration records were maintained for all people; however information was not cross referenced or analysed as required. As a result some referrals were not made to health professionals to seek further clarity on change in people’s hydration and nutrition.

Neither the provider nor the registered manager had effective systems in place to audit care documentation. Such systems would monitor the care provided in relation to the care plans, therefore highlighting any errors as and when these were occurring. This was specifically important given the number of discrepancies noted between day and night records.

People’s care was not always delivered in a dignified way. Their independence was not promoted nor their privacy protected. On occasions it was found that staff did not maintain confidentiality, by speaking about people in front of others. Care was found not to be responsive to their needs, and often not effective. People were not always consulted about how they wished to have care delivered, or were not consulted prior to being assisted. This meant that whilst staff had received training in the Mental Capacity Act, they did not practice the fundamental standards of the legislation.”

Click HERE to read more about this inspection

29th November – SSG UK Specialist Ambulance Service – South – Inadequate

We found the following issues that the service provider needs to improve:
  • Medicines were not managed safely and securely which may impact on the safety of patients. This included receipt, storage and disposal of controlled medicines.
  • There was no evidence that paramedics and technicians had completed the appropriate training and competency to administer medicines safely.
  • The administration of medicines via patient group directions was not effectively managed which posed risks to patients’ safety.
  • Incidents which affected the health and welfare of patients were not reported in line with the Care Quality Commission’s requirement as part of the provider’s registration.
  • The staff who undertook the transfer of mental health patients did not follow national practice guidance and risk assessments were not completed. We were not assured that patients were adequately safeguarded from the risks of harm.
  • The use of mechanical restraints had not been risk assessed and procedures for their usage were not fully developed to ensure the least restrictive means were used on potentially very vulnerable patients.
  • The recruitment process did not ensure only suitable individuals were employed. Records of checks and fitness of staff were not available or incomplete.
  • There was a lack of an effective system to review fit and proper persons being employed. Pre- employment checks for directors were not all available to assess the fitness of the directors.
  • Not all staff had completed training appropriate to their role. Training such as practical intermediate life support, medicines management and safeguarding children had not been completed by all staff.
  • There was no competency framework to provide assurance that staff were competent to undertake their role in line with best practice.
  • There were limited clinical policies and guidelines to support staff and provide evidence based care and treatment. Those policies and guidelines that were in place included out of date information, referred to roles that were not in place.
  • There was no effective incident reporting system and process in place and limited evidence of learning from incidents to improve practices and minimise the risks of these re-occurring.
  • There was an ineffective governance process that did not provide assurance and leadership.
  • There were limited systems to monitor the safety and quality of the service. Audits were not undertaken and therefore learning did not take place from the review of practices and procedures.

Read more about this inspection by clicking HERE

29th November 2018 – Bishops Green Cottage

“We carried out an announced comprehensive inspection on 1 October 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was not providing well-led care in accordance with the relevant regulations

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Bishop’s Green Cottage operates three satellite clinics where it provides advice and treatment to assist people to manage and lose excess weight. Treatments include diet management and the use of appetite suppressants.

12 people completed CQC comment cards prior to our inspection to provide feedback about the service. Patients told us that they felt they always received good care and felt respected.”

Please click HERE to read more details about this inspection.

28th November 2018 – Purley House – Good

“This was an unannounced inspection which took place on 04 October 2018.

Purley House is a care home (without nursing) which is registered to provide a service for up to three young adults who are being supported to leave care. The young people had a variety of support needs.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Purley House accommodates people in a domestic sized building.

The care home was registered in October 2017 and this is the first inspection of the service.

The service was exceptionally responsive to the needs and choices of the young adults who live there. Staff were extremely flexible and readily adapted to meet people’s development and diverse needs. The service was extraordinarily person centred and young adults were supported according to their individual needs. Activity programmes were innovative and designed to meet people’s individual development needs whilst incorporating their preferences and choices. Care planning was highly individualised and regularly reviewed which ensured the current needs of the young adults were met and their equality and diversity was supported and respected.

The registered manager was respected and highly thought of by the staff team. She and the management team ensured the service was exceptionally well-led. The registered manager and the staff team were committed to ensuring they offered the young adults positive support and assisted them to independence. The young adults were as involved as possible in running the service and were supported to adhere to the values the staff team were committed to. The quality of support the service provided was constantly assessed, reviewed and improved by the provider, the registered manager, the staff team and the young adults.”

 

Click HERE to read more about this inspection.

23rd November 2018 – Oaklands Residential homes – Good

“Oaklands is a care home without nursing for up to six people with learning disabilities and/or who are on the autistic spectrum. At the time of this inspection there were six people living at the service.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good in four of the five key questions, improving to Outstanding in the responsive question. This means the overall rating for the service remains Good.
Why the service is rated Good
The service continued to meet all the fundamental standards and had a registered manager as required. The registered manager was present and assisted us with the inspection.
People received extremely personalised care with staff demonstrating innovative and ‘lateral’ thinking in helping people to increase their independence and life skills and meet their needs. People were supported to identify their own goals and ambitions and to work towards achieving them by the highly motivated staff team.
People knew how to complain and staff knew the process to follow if they had concerns. Staff showed great skill in identifying when people, who were not able to communicate verbally, were distressed, anxious and/or concerned. Staff were quick to respond to any signs of distress. The success of their individualised interactions showed an in-depth knowledge of how each person demonstrated they were not happy and what to do to help them feel safe and calm.
People received excellent care and support from staff who were well trained and supervised. Staff demonstrated a strong commitment to ensuring people were involved in all aspects of decisions regarding their care and the development of the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. Medicines were handled correctly and safely.
People were treated with care and kindness and their right to confidentiality was protected. People were treated with respect and their dignity was upheld. People’s diversity needs were identified and incorporated into their care plans where applicable.
People benefitted from a service which had an open and inclusive culture. Staff were very happy working at the service and people benefitted from having staff who felt well managed and supported.”

 

For further information please click HERE

15th November 2018 – Hungerford Surgery – Requires Improvement

“We carried out an announced comprehensive inspection at Hungerford Surgery on 25 September 2018 as part of our inspection programme. We had initially intended to inspect this practice in January 2018 but that inspection was postponed due to a nationwide scheme in reducing the pressures on GP practices last winter.
At this inspection we found:
  • Significant staff changes had taken place, with a new senior GP in place who had also taken over the role of registered manager at the practice, the practice manager had been in post for six months.
  • Staff training was not completed in line with the practice’s own recommended schedule.
  • There was a lack of clarity on the roles and responsibilities of staff.
  • Policies were in place but there were shortfalls in their implementation to ensure consistency.
  • Recommendations from risk assessments were not consistently actioned in a timely manner or had not been undertaken at all. For example, there was no evidence of a comprehensive health and safety risk assessment having been completed at the practice.
  • Patient feedback was positive regarding the care and treatment they received at the practice, but it was negative in relation to patient experience when making an appointment.
  • The practice had adequate systems to manage risk so that incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • There was a focus on continuous learning and improvement at all levels of the organisation.”

To read more about this inspection Please click HERE

13th November – The Slater Centre – Good

“At our last inspection we rated the service good. At this inspection we found the evidence continued to support an overall rating of good. In the “Effective” domain the service had improved to “Outstanding”. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
People were provided with highly effective care and support by a well-trained and qualified staff team who received regular ongoing support and development. People’s healthcare needs were very well met and the service advocated positively for them to receive the care and treatment they needed. People living with epilepsy received excellent support because staff had been trained and understood its individual impact on each person. Effective monitoring systems had been established to monitor seizures as safely as possible with the least disturbance.
People with complex dietary needs received excellent support. Staff were well informed and trained to provide specialist diets where necessary and did so effectively to minimise the impact of their illness on people.”

Click HERE to read more details

6th November 2018 – South Central Ambulance Service NHS Foundation Trust – Good

England’s Chief Inspector of Hospitals has welcomed improvements at South Central Ambulance Service NHS Foundation Trust following its latest inspection by the Care Quality Commission.

A team of inspectors from the Care Quality Commission visited South Central Ambulance Service NHS Foundation Trust in July and August 2018 to check the quality of three core services: emergency and urgent care service, resilience, and the emergency operation centres. CQC also looked specifically at management and leadership to answer the key question: Is the trust well led?
The trust is now rated as Good for the overall quality of its services. The trust is also rated as Good for being safe, caring, effective, responsive to people’s needs and well led.
 
CQC Deputy Chief Inspector of Hospitals, Dr Nigel Acheson, said:

“We are all well aware of the pressures on our ambulance services – so I am pleased to acknowledge the continuing improvements made by South Central Ambulance Service NHS Foundation Trust to build on the findings of our last inspection.”

“The trust has implemented changes to ensure the organisation is more effective but still remains patient centred. Staff have consistently demonstrated kindness, dignity and respect to patients and callers during some very difficult and demanding situations.”

“We found a strong senior leadership team that was able to address any risks to performance, while ensuring that these improvements could also be delivered.”  

Click HERE to go to the CQC website and learn more

2nd October – Berkshire Healthcare NHS Foundation Trust – Good

“Our rating of the trust stayed the same. We rated the trust as good because:
  • Since the last inspection in 2016, the trust has continued to make improvements. We inspected seven services and carried out a well-led review.
  • We engaged with a range of staff from a variety of professional groups through a series of focus groups with staff from community health and mental health services. Staff were proud to work at the trust and spoke positively about their colleagues and managers.
  • Following this inspection twelve core services were rated as good overall and two were rated outstanding. In rating the trust, we took into account the previous ratings of the seven services not inspected this time.
  • The trust board was strong and confident in performing its role. The executive team were stable and succession planning had been embedded over the last five years. The chair and non-executive directors were committed to ensuring that patients received the best care possible and used their wide range of skills and experience to challenge the executive directors to deliver quality services.
  • The trust had made further progress in the use of a quality improvement methodology. We saw that this methodology gave genuine opportunities for staff and patients in wards and teams to identify areas for improvement and make changes. The use of quality improvement was widespread throughout the trust, both staff and patients were very positive about the potential for improvement.
  • Community Nursing had adopted the Quality Management Improvement Programme (QMIS) and had developed team skills to take a `bottom-up’ approach to problem solving. Examples of improvements included: improvements to low morale through a range of well -being initiatives; and the use of “driver metrics” to focus on harm free care which had seen a reduction in rates of pressure ulcers.
  • Learning summits, led by the Deputy Director of Nursing, were held for all pressure ulcers within community health and mental health inpatient units. All staff involved in the patients’ care are invited to attend and supported by Tissue Viability Clinical Nurse Specialists. Themes and learning from all Learning summits are shared across the organisation via Patient Safety Quality meetings.
  • The trust had addressed most of the areas where improvements were needed from the last inspection.
  • In the wards for people with a learning disability staff had received training in positive behaviour support, patients had individualised behaviour support plans and staff were supporting patients, who had challenging behaviours, appropriately.
  • The trust had strong governance systems supported by good quality performance information. This meant that at all levels of the organisation staff and members of the board had access to useful information that enabled them to gain assurance and make improvements where needed. This enabled the trust to achieve a balance between assurance and improvement work.”

Click HERE to go to the CQC website and read more information.

26th September – Basingstoke and North Hampshire Hospital – Requires Improvement

click here to learn about this inspection

Our rating of this service went down. We rated it as requires improvement because:

  • There was limited assurance about safety.

  • Risk assessments were not consistently completed therefore care plans were not developed including actions to manage the identified risks appropriately.

  • Medicines were not managed effectively and staff did not follow policies and procedures to ensure these were stored, administered and disposed of safely.

  • Emergency equipment was not consistently checked in line with the trust’s policy to ensure it was fit for purpose and available when needed.

  • People did not always receive care and treatment in a caring manner.

  • Patients’ privacy was not given sufficient priority.

  • The leadership, governance and culture did not always support the delivery of high-quality person-centred care.

14th September – Apex Prime Care – Requires improvement

“This inspection took place on 23 July 2018 and was announced. We gave the provider prior notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.
Apex Prime Care – Reading is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to people who have dementia, learning disabilities or autistic spectrum disorder, mental health, physical disability, sensory impairment, as well as older people.
The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to 60 people.
The service had a registered manager in place. 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 manager assisted us during the inspection. This was the first inspection of this service.
The provider had recruitment procedures that they followed before new staff were employed to work with people. They checked to ensure staff were of good character and suitable for their role. However, they did not gather all the necessary information for recruitment of staff according to regulation. They did not seek all the missing information after the inspection. They provided us with a plan of improvement gathering information for future applicants after the inspection.
Staff training records indicated which training was considered mandatory. The registered manager and senior staff had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. However, not all staff agreed training was sufficient and informative to ensure people were supported in the right way. Staff did not always have ongoing support via supervisions. Some of the staff did not always feel supported by the management team that could help maintain a better team work. We made a recommendation about the current best practice guidance for ongoing training, monitoring and continuous support for social care staff.”

Click HERE to go to the CQC website and read more information about this inspection.

3rd September – Frimley Park Hospital – Outstanding

Inspection carried out on 3 July 2018
During an inspection to make sure that the improvements required had been made.
Frimley Park Hospital along side two other hospitals forms part of Frimley Health NHS Foundation Trust. Frimley Park Hospital is situated in Frimley. The hospital hosts the Defence Medical Group South East, with military surgical, medical and nursing personnel working alongside the hospital’s NHS staff providing care to patients in all specialities.
We completed a focussed inspection of the surgery service at Frimley Park Hospital on 3 July 2018. This inspection was in response to information of concern about the safety of the surgical services. The focus of this inspection was to review how the hospital responded to risks, shared learning from incidents and how the service leaders ensured changes were implemented and adhered to.

Our key findings were as follows:

  • The service developed  and implemented local safety standards for invasive procedures; however, not all staff were aware of these.
  • There was a culture of openness and honesty and service leads encouraged staff to challenge poor practice.
  • The service had a positive incident reporting culture, demonstrating, which showed that there was learning from incidents, and was shared learning and sharing both locally and across the trust. 
  • Governance arrangements were clear and structured ensuring leaders and staff received  information to enable them to challenge and improve performance.
  • Staff did not adhere to the trust’s surgical site marking policy.

However, there were also areas of poor practice where the trust needs to make improvements.

The trust should:

  • Ensure there are clear guidelines on safe patient transfers and responsibilities during patient handovers from all wards to anaesthetic room or theatres. This should include patient safety checks and the patient’s involvement.
  • Involve all departments in the development of local safety standards for invasive procedures.”

     

For more details please click HERE

30th August – Oxford Health NHS Foundation Trust – Good

“Our rating of the trust stayed the same. We rated it as good because:
  • Of the eight core community health and mental health services that we inspected on this occasion, we rated five as good and three as requires improvement. When we include the previous ratings of mental health and community health core services at the trust that we did not inspect on this occasion, one is rated as outstanding, 12 are rated as good and three are rated as requires improvement. In rating the trust, we have taken into account the previous ratings of the eight mental health and community health core services not inspected this time.
  • Incident reporting and investigation systems were robust in the trust.
  • The Chief Executive actively promoted research in the trust to improve the care and treatment of patients. The trust ran one of only two mental health biomedical research centres in England.
  • The trust had planned well the transfer of the learning disability services into the trust. The learning disability services were brought into the trust with care, compassion and respect for the patients, carers and staff involved.
  • Leadership at directorate level was very strong. The directorates had clear plans and strategies to improve patient care and treatment. Trust governance systems supported and encouraged the development of strong, local leadership teams.
  • The trust supported and encouraged wards and services to take part in external accreditation schemes.
However:
  • Following this inspection, we have rated one key question – safe – as requires improvement. In rating the trust, we have taken into account the previous ratings of the eight mental health and community health core services not inspected this time.
  • The trust continued to have significant issues with recruitment and retention of staff particularly qualified nurses but we were assured that the trust was undertaking key work to find new and innovative ways of attracting staff to work at the trust.
  • The community health services operated by the trust were generally rated lower than the mental health services. Staff in the community health services did not feel as embedded in the trust structure or as well supported by the trust senior teams. This issue had been identified by the trust and the directorate re-organisation due to be completed by June 2018 planned to strengthen the management and support for community health services by establishing a community health directorate.”

To learn more about this CQC inspection please click HERE

21st August – Birchwood Nursing Homes – Requires improvement

“This inspection was completed on 31st May and 4th June 2018, and was unannounced on the first day. Birchwood is a 60 bed service that provides facilities over three floors to older adults with varying needs. The ground floor provides a respite service for up to ten people undergoing an assessment period when transitioning from hospital or home and prior to an appropriate care package being sought. The first floor provides residential services to a maximum of 25 people. The second floor provides nursing care to a maximum of 25 people. 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. People’s needs varied depending on their diagnosis. We found some people required extensive support whilst others were able to complete some tasks independently.
This inspection was carried out to establish if improvements to meet legal requirements planned by the provider after our October 2017 inspection had been completed. The team inspected the service against all five key areas. This is because the service was not meeting legal requirements and was rated overall as inadequate and placed in special measures. At our last inspection, we found the provider was in breach of nine regulations. Following that inspection, on 22 August 2017, the provider sent an action plan which identified improvements to ensure the service was no longer in breach of the regulations.
At the inspection of October 2017, the provider was rated overall inadequate, with three ratings of inadequate in ‘Safe, ‘Responsive and ‘Well-led. ‘Effective’ and ‘Caring’ were all rated as requiring improvement. At this inspection we found the provider’s had made improvements in all inadequate domains. As a result the overall rating of the service has now been changed to requires improvement. The changes to the key lines of enquiry have meant that additional information is sought in some of the domains.
The service had appointed and registered a new manager in January 2018. However, due to unforeseen circumstances the registered manager had been absent from the service for a period of two months, but had returned to work prior to the inspection. The service was managed by an interim deputy manager, with the additional support of the local authority services manager. However, the management overview remained inconsistent during the period of the registered manager’s absence. 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.
People were not always kept safe. Whilst risk assessments were in place for people, these did not provide information to staff on how to minimise the possibility of a risk. This meant that staff did not always know how to manage a risk should one arise . The provider did not have robust systems in place to ensure sufficient suitably qualified or safe staff were employed to work with people. A criminal records check and photographic identification was missing from staff files and there were gaps in people’s recorded employment history. Of the nine files reviewed all had information missing.
Medicines were not always managed safely, putting people at risk. Covert medicines did not have appropriate directions in place, or evidence of best interest decisions to illustrate how this decision had been reached.”

Click HERE to learn more about this inspection and report.

 

19th July – The Coombe House – Outstanding

“This was an unannounced inspection which took place on 24 and 30 April 2018.

The Coombe House is a care home (without nursing) which is registered to provide a service for up to 24 people who require assistance with personal care. The service currently offers a service to 22 people whose needs are related to old age. The service offers 20 single occupancy rooms and two double bedrooms across the two storey main house and the attached annexes.

At the last inspection, on 18 and 23 December 2015, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found the service had improved to outstanding in two domains and therefore had improved to an overall rating of outstanding.

Why the service is rated outstanding.

The service was exceptionally responsive and strove to meet people’s needs, wishes and lifestyle choices. It was flexible and readily adapted to meet people’s changing, diverse and complex needs. It was extraordinarily person centred and people were seen and responded to as individuals. Activity programmes were creative and designed to meet people’s preferences and choices. Menus were created to offer diverse foods that were healthy. Care planning was individualised and regularly reviewed ensuring people’s needs were met continuously.

The registered manager was extremely experienced, respected and highly thought of by staff, families and other professionals. She and the management team ensured the service was exceptionally well-led. The registered manager and the staff team were committed to ensuring they offered people the very best care possible and that people were as involved as possible in running the service. The quality of care the service provided was constantly assessed, reviewed and improved by the provider and registered manager.

People were protected from all forms of abuse by a trained and knowledgeable staff team. Staff were trained in safeguarding people and knew what action to take if they identified any concerns. The service continued to identify individual and environmental risks. Action was taken to reduce these risks, and a comprehensive account was provided of what action to take should the risk occur.

People continued to be supported by good staffing ratios, which were reviewed and increased as needed. The management supported staff and assisted people on a daily basis. Staff were able to meet people’s specific needs safely. Robust recruitment systems were implemented to ensure as far as possible, that staff were safe and suitable to work. People were supported to take their medicines correctly by trained and competent staff. Where people were able to self medicate, they were appropriately assessed and assisted to remain independent.

A well-trained staff team remained able to offer people effective care. They met people’s diverse needs. Care plans were kept up to date ensuring people’s current and changing health and emotional well-being needs were met. The service worked very closely with health and other professionals to ensure they offered individuals the best care in the most effective manner.

People continued to be supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The caring, committed and enthusiastic staff team continued to meet people’s needs with compassion, kindness and respect. They ensured they promoted people’s privacy and dignity and communicated with them effectively. Measures were taken to ensure records were maintained confidentially.”

Click HERE to read more about this inspection / report

14th July – Allied Healthcare Alice Bye Court – Requires Improvement

 

“This was an announced inspection which took place on 13 and 14 June 2018.

Allied Healthcare Alice Bye Court is a domiciliary care agency. This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. Currently, the service provides care and support to 38 people. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing, this inspection looked at people’s personal care and support.

We carried out an announced comprehensive inspection of this service on 13 February 2017. The service was rated as good in all domains and overall good at that inspection. After that inspection we received concerns in relation to people’s safety and poor management of the service. As a result we undertook a focused inspection to look into those concerns. At this inspection we rated the domains of safe and well-led as requiring improvement.

This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allied Healthcare Alice Bye Court on our website at www.cqc.org.uk”

There was not a registered manager running the service. 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 management team currently running the service were described as supportive and effective. Relevant parties told us that things were improving. However, although the service had an effective system of assessing, reviewing and improving the quality of care provided this had not been followed effectively. Some areas had been identified as requiring improvement but action had not been taken to do so. This breached the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were not supported with their medicines as safely as they could be. Medicines were not always recorded accurately. The support people needed with medicines was not clear because care plans did not give staff enough detailed information to ensure they gave the correct medicines at the right times. This breached the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

In most areas people, staff and visitors were protected from harm and were kept as safe as possible. Staff knew how to protect the people in their care and understood what action they need to take if they identified any concerns. General risks and risks to individuals were identified and action was taken to reduce them, as far as possible. People’s needs were, currently, met by sufficient numbers of staff.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report”

For further information about this inspection/report click HERE

12th July – Diamond Quality Care Services – Good

“Diamond Quality Care is a reablement service for people who have experienced acquired brain injury or strokes. It provides a domiciliary care service for ten people in addition to other services which are not subject to regulation by the Care Quality Commission.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

.

Why the service is rated good

People were kept safe because potential risks to them had been assessed and action taken to mitigate them whilst still enabling them to experience a fulfilling lifestyle. Staff understood how to keep people safe and the service responded appropriately when any concerns arose.

The service had a robust recruitment procedure to ensure, as far as possible, that staff appointed had the right skills and approach to support people.

Staff retention was good, enabling people to build trusting relationships with staff. People were supported by staff who received regular training and ongoing support through quarterly supervision and annual appraisal.

People’s rights, privacy and dignity were supported and maintained by staff in the way they worked with them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff treated people with kindness and patience and encouraged them to do as much for themselves as possible and consistent with the service’s reablement approach.

People’s needs were discussed with them and they were fully involved in agreeing their care plan and how support was to be provided. People were also involved in care plan reviews. They had the opportunity to take part in a range of social and therapeutic activities provided at the service’s headquarters as part of the support available to them.

The headquarters premises had been designed to promote accessibility and inclusion and a range of adaptations and equipment was used to maximise people’s access to the facilities. The service complied with the Accessible Information Standard, to ensure documents were in a format accessible to people receiving support.”

Click the HERE for more information.

20th June – 1-2 Prior’s Court Cottages Care Home – Good

“1-2 Prior’s Court Cottages 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. The service is provided in one of three converted and extended two-storey cottages. It provides care for up to six young adults between 19 and 25 with needs on the autistic spectrum who may require support to manage their behaviour. The service provides supported transitions for people between children’s and adults’ services. At the time of this inspection five people were receiving support within the service.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. (Registering the Right Support CQC policy). These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were treated with respect and their dignity was maximised in the way staff provided support.
People were kept as safe as possible because risks to people and staff were identified, assessed and appropriate steps taken to minimise them. Health and safety checks and servicing were carried out as required. The service had a robust recruitment system to ensure, as much as possible, that staff had the right approach and skills. People were supported by staff who were well trained and supported and who were additionally supported to develop their knowledge and skills. Staff understood the impact of their autism on each person and responded to their individual needs consistently. Where people needed support to manage their behaviours, this was delivered in planned, consistent ways which were kept under regular review. Staff had all been trained in a nationally recognised behaviour support technique.
Healthcare was very good and medical conditions were managed very well using appropriate technology where necessary to keep people safe. People’s transitions in and out of the service were extremely well planned and supported to try to give them the best chance of success.
People’s care was delivered according to detailed individual care plans which were subject to regular review. The views of relevant others were sought when reviewing people’s care needs. People had wide ranging opportunities for involvement in activities, holidays and supported employment. They continued to develop their skills through attending the on-site learning centre.
Each person’s communication preferences were recorded, understood and supported by the staff working with them. Communication aids were used effectively to enable people to be as involved in making decisions and choices as possible. People’s individual and diverse needs were met.
The provider and management exercised thorough governance over the service through a range of effective monitoring and audit systems.”
Read more about this inspection and report by clicking HERE

7th June 2018 – Peppard House Residential homes – Outstanding

“This was an unannounced inspection which took place on 03 May 2018.
Peppard House is a care home (without nursing) which is registered to provide a service for up to seven people with learning disabilities. People had other associated difficulties such as behavioural issues and being on the autistic spectrum.
People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Peppard House accommodates people in a large domestic sized building. The service was run in line with the values that underpin the “registering the right support’’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism can lead as ordinary a life as any citizen.
At the last inspection, on 23 February 2016, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found the service had improved to outstanding in two domains and therefore had improved to an overall rating of outstanding.
Why the service is rated outstanding.
The service was exceptionally responsive and strove to meet people’s aspirations and lifestyle choices. It was flexible and readily adapted to meet people’s changing, diverse and complex needs. It was extraordinarily person centred and people were seen and responded to as individuals. Activity programmes were creative and designed to meet people’s individual preferences and choices. Care planning was highly individualised and regularly reviewed which ensured people’s current needs were met and their equality and diversity was respected.”

To read more about this inspection visit the CQC website by clicking HERE

6th June 2018 – Holly Grange Residential Home – Good

“This inspection took place and was announced on the first day. At the last inspection in August 2016, the service was rated ‘Requires Improvement’ overall. Significant improvements had been made since the inspection prior to that in March 2016 but some additional improvements were still needed and we needed to see that the positive changes that had been made were sustained.
At this comprehensive inspection we found that the registered manager had acted to address the previous issues and where previous improvements had been made, these had been sustained.
Holly Grange Residential 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.
The service accommodates up to 19 people in one adapted and extended building. At the time of inspection there were 13 people receiving care in the service. A registered manager was in place.
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.
People were kept as safe as possible in the service. Health and safety and service checks were carried out and action had been taken to address any shortfalls found. Potential risks to people were assessed and action taken to minimise them. People themselves felt safe there. Specialist equipment was available to assist people with limited mobility.
People’s needs were assessed and they were involved in planning their care as much as they were able and wished to be, together with their representatives, where appropriate. People’s wishes with regard to end of life were explored with them and recorded.
People’s rights and freedom were maintained and staff supported their dignity and privacy. People’s individual and diverse needs were identified and provided for. Information was provided in accessible formats where necessary. People’s views about the service were sought via annual surveys and periodic resident’s meetings. People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.”

To read more about this inspection, visit the CQC website by clicking HERE

25th May 2018 – Audley Care Inglewood domiciliary care agency – Good

“This was an announced inspection which took place on 06 April 2018.

Audley Care – Inglewood is a domiciliary care agency. It provides care to people living in their own homes in a purpose built village setting and in the community. Not everyone using the service receives a regulated activity. Approximately 97 people receive a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, help with tasks related to personal hygiene and eating. The agency provides a service to older adults.

At the last inspection, on 14 June 2016, the service was rated as good in all domains and therefore overall good. At this inspection we found the service was still rated as overall good but the responsive domain had improved to outstanding.

The service did not have a registered manager running the service. However, the current manager had applied to be registered by the CQC and the application was being processed. 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.

People, staff and visitors remained as safe as possible whilst in the office or being provided by a service. Staff had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff knew what action to take if they identified any safety concerns during the course of their work. General risks and risks to individuals were identified and action continued to be taken to reduce them, as far as possible.

Medicine was administered as safely as possible. Care staff followed the medication procedure, completed medicine care plans and recorded medicine administration. People benefitted from being provided with adequate and skilled staff. The service did not accept a package of care unless they were able to provide staffing to meet the individual’s needs safely. The service followed a recruitment process which ensured staff were recruited safely.

Staff continued to be well trained and well supported to make sure they could meet people’s varied needs. Care staff met people’s needs effectively and as described in plans of care. The service worked closely with health and other professionals to ensure they were able to meet people’s needs, in the best way possible.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People continued to be supported by a committed and enthusiastic staff team who delivered care with kindness, respect and understanding. They built caring relationships with people and were able to meet their needs sensitively. The service and care staff were aware of people’s equality and diversity needs and endeavoured to meet them.

The service was exceptionally person centred, flexible and responsive to people’s individual’s needs. It adapted and changed care packages in response to people’s choices and specific needs. People’s needs were regularly reviewed to ensure the care provided was up-to-date. Care plans included information to ensure people’s communication needs were understood.

The manager and the management team ensured the service was very well-led. The manager, management team and office staff were described by staff as exceptionally supportive, open and approachable. The manager and the staff team were committed to ensuring there was no discrimination relating to staff or people in the service. The quality of care the service provided was continually assessed, reviewed and improved.”

For further details about this inspection, please click HERE

17th May 2018 Berkshire Health Limited Doctors/GP service

“We carried out an announced comprehensive inspection at Berkshire Health limited on 18 October 2017. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for Berkshire Health Limited on our website at www.cqc.org.uk.

Berkshire Health Limited operates under the name of The Forbury Clinic.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This inspection was an announced focused inspection carried out on 1 May 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 18 October 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

CQC inspected the service on 17 October 2017 and asked the provider to make improvements regarding the lack of a system for monitoring medicine and safety alerts and a lack of risk assessments relating to the accessability of the emergency medicines and equipment. We checked these areas as part of this focus inspection and found these had been resolved.

The service has a registered manager. A registered manager is a person who is 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.

Our key findings were:

  • Arrangements for actioning medicine and safety alerts kept patients safe.

  • The contents and accessibility of the emergency medicines and equipment had been assessed and actions undertaken to improve this.”

Click HERE to visit the CQC website and see further details.

11th May 2018 – Independence With Dignity Support Homecare agency – Good

“This inspection took place on the 6 March 2018 and was announced.

Independence with Dignity Support Services Ltd is a domiciliary care agency. It provides care to people living in their own homes. Not everyone using the service receives a regulated activity. (Approximately 4 of 24 people receive a regulated activity.) The Care Quality Commission only inspects the service being received by people provided with personal care, help with tasks related to personal hygiene and eating. The agency provides a service to people who may have a learning disability, physical disability, sensory impairment and/or mental health issues

At the last inspection, on 14 and 18 January 2016, the service was rated as good in all domains and therefore overall good. At this inspection we found the service was still rated as overall good.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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.

People told us that they felt safe with staff and would be confident to raise any concerns they had. The provider’s recruitment procedures were robust and medicines were managed safely. There were sufficient staff to provide safe and effective care at the times agreed by the people who were using the service.”

 

Visit THIS WEBPAGE to read more information.

3rd May 2018 – Eastfield House Surgery – Good

“At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. For example, clinical staff received enhanced training to deal with a range of life threatening conditions that patients might encounter whilst at the practice.
  • The practice ran a personalised list system to deliver continuity of care for patients.
  • There was a focus on prevention of health problems arising. This included scanning for liver problems, pre diabetes assessments and dementia screening.
  • There were effective systems in place to monitor usage of prescribed medicines. Data showed that 99% of patients taking four or more repeat medicines had received a review of their medicines in the last year.The practice employed practice matrons to support patients with complex needs and those whose condition made it difficult to attend the practice for appointments. For example, patients who had mental health problems and did not wish to attend the practice could be seen at their own home.

The areas where the provider should make improvements are:

  • Monitor the systems changes made on the day of inspection to evaluate their effectiveness and sustainability.

  • Review the implementation of annual health checks for patients diagnosed with a learning disability.”

Click HERE to read further information.

20th April 2018 – West Berkshire Council Home Care Service – Good

“West Berkshire Home Care Service is a domiciliary care agency providing care and support to people who live in the community. It mainly offers a short term service to assist older people with their rehabilitation after hospital admission or illness. Since November 2017, the provider also offers a long term care service. It provides a service to older adults, younger disabled adults, and people living with dementia, physical disability and sensory impairments.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This inspection took place on 19 February 2018 and was announced. We gave the provider prior notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to 49 people.

The service had a registered manager in place. 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 manager supported us with the inspection.

People felt safe while supported by the staff. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe.”

Visit this webpage to read more details.

24th March 2018 – Acorn House – Good

“Why the service is rated good.

The service was exceptionally person centred and responded creatively to people’s diverse, individualised needs and aspirations. Activity programmes were designed to meet people’s individual preferences and choices. Care planning was highly individualised and regularly reviewed which ensured people’s current needs were met and their equality and diversity was respected.
People continued to be protected from all forms of abuse. Staff were trained in safeguarding people and knew what action to take if they identified any concerns. The service identified general health and safety and individual risks. Action was taken to reduce all risks, as much as possible. All aspects of safety were considered and actions were taken to assist people to remain as safe as possible.
People continued to be supported by adequate staffing ratios. Staff were able to meet people’s specific needs, including any relating to diversity, safely. Recruitment systems made sure, that as far as possible, staff recruited were safe and suitable to work with people. People were supported to take their medicines, at the right times and in the right amounts by trained and competent staff.”
Click HERE for more details

8th March – Little Heath Court – Good

Why the service is rated good.
The service remained safe. People’s safety was contributed to by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect people and who to alert if they had any concerns. General risks and risks related to the needs of individual people were identified and appropriate action was taken to reduce them.
There were enough staff on duty at all times to meet people’s diverse, individual needs safely. The service had a stable staff team. When new staff were recruited they had systems in place to ensure, that as far as possible, they were safe and suitable to work with people. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.
The service remained effective. Staff were well-trained and able to meet people’s health and well-being needs. They were able to respond effectively to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s needs.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The service continued to be caring. The dedicated, attentive and knowledgeable staff team provided care with kindness and respect. Individualised care planning ensured people’s equality and diversity was respected. People were provided with a wide variety of activities, according to their needs, abilities, health and preferences.
Click HERE for more details.

5th Feb 2018 – Thornford Park – Good

“We rated Thornford Park as good because:

  • Risk assessments and risk management plans were detailed, thorough and up to date and patients had been involved in the development of the plans. The assessment of patients’ needs and the planning of their care was thorough, individualised and had a focus on recovery. Physical healthcare assessments and associated plans of care were thorough and consistently delivered to a high standard. Care plans had either a National Institute for Health and Care Excellence (NICE) guidance reference to an identified intervention or another nationally recognised intervention such as from the Quality Network for Forensic Mental Health led by the Royal College of Psychiatrists.
  • There were enough suitably qualified and trained staff to provide care to a safe standard. We consistently saw respectful, patient, responsive and kind interactions between staff and patients. Staff displayed a high level of understanding of the individual needs of patients. There were innovative practices used consistently across the service to engage and involve patients in the care and treatment they received, for example, the recovery star. There was a confident and thorough understanding of relational security among all of the staff. Relational security is how staff use their knowledge and understanding of their patients to ensure the ward environment is kept calm and any conflict is kept to a minimum.
  • Bed management processes were effective and there was a clear care pathway through the service from medium secure wards to the least restrictive environments, such as the shared flats. The service model optimised patients’ recovery, comfort and dignity. The needs of patients were considered at all times.
  • The service had clear guidance in place to report incidents and we saw evidence that staff learnt from when things had gone wrong. The service was responsive to listening to concerns or ideas made by patients and their relatives to improve services. We saw that when staff where able to, these ideas were taken on board and implemented.
  • Staff monitored patients’ physical healthcare and they could access specialist physical health services when needed. A GP provided regular physical health monitoring. Patients attended a well-man clinic.
  • We observed many positive engagement and interaction between staff and patients. Staff demonstrated a clear understanding of individual patient’s needs.

However:

  • Staff were not always available to facilitate section 17 leave on the forensic wards and leave was often cancelled.
  • The number of staff having access to regular supervision was below the provider’s target of 90%.
  • Not all patients were always reminded of their rights when their circumstances changed, such as on renewal of detention.
  • The seclusion room did not have a two-way intercom to ease communication between staff and patients.  Gym equipment was worn . All of these facility issues had been identified for refurbishment and upgrade in 2018
  • The recording of seclusion was documented differently across the wards. Staff made the required checks however, some was recorded electronically and some in paper form.”

 

To read more information about this inspection and report, please click HERE

24th Jan 2018 Dimensions 43 Clayhill Road – Good

“Dimensions 43, Clayhill Road is a residential care home for up to six people with a learning disability. Some people may also have needs within the autistic spectrum. The service has two floors and people’s bedrooms were on both the ground and first floors.

At the last inspection, the service was rated Good, with Requires improvement (no breach) in Safe.

At this inspection we found the service remained Good and improvements had been made so that the service was also rated Good in Safe.

The service met all of the fundamental standards. People felt safe, well cared for and that they were treated with respect and dignity. We could see from people’s body language and facial expressions that interactions with staff were relaxed, friendly and respectful. Long term positive relationships with staff had also contributed to a reduction in instances of challenging behaviour. Staff were caring and treated people with patience and kindness, involving them in their care as much as possible, enabling and encouraging choice.”

To read more information about this inspection please click HERE

18th January 2018 – St. Anne’s Opportunity Centre Limited – Kestrels – Good

“This was an unannounced inspection which took place on 18 December 2017.
Kestrels is a residential care home which is registered to provide a service for up to five people with learning disabilities. People had other associated difficulties such as behaviours that may cause distress to themselves and/or others and some people were on the autistic spectrum.
At the last inspection, on 16 December 2015, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found the service remained good in four domains and outstanding in the responsive domain. This meant the service remained overall good.”
For more information about this report please click: HERE

11th Jan – Royal Berkshire Hospital – Outstanding

The CQC inspected Royal Berkshire Hospital from the 2nd October to the 7th December, on 11th January they published a report with their findings. 

 

Royal Berkshire Hospital was given the overall rating of “Outstanding”

For individual categories it was awarded “Good” when it came to being “safe”, “effective” and “well-led”.  It was awarded “outstanding” when it came to being “caring” and “responsive”

For specific services it achieved:

  • “Outstanding” for “Medical care”
  • “Good” for “Urgent and Emergency Services”, “Surgery”, “Intensive/Critical Care”, “Services for Children and Young People” and “End of Life Care”
  • “Requires improvement” for “Maternity and Gynaecology”

You can take a look at the report and digest the full information by clicking HERE

15th December – Dr M L Swami & Partners – Good

A comprehensive inspection at Dr M L Swami and Partners in Reading, Berkshire was carried out on 21 November 2017. CQC carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of their regulatory functions. This inspection was planned to check whether Dr M L Swami and Partners were meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

“At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen and any notable events either positive or negative were learned from.
  • The practice had defined and embedded systems, processes and practices to minimise risks to patient safety.
  • However, we found these systems had not identified risks related to the ongoing monitoring of patients on medicines where care was shared with other health services. There were also risks identified related to actions following test results or other patient related information received into the practice.
  • Staff had received training appropriate to their roles and the population the practice served. Any further training needs had been identified and planned.
  • Our findings showed that systems were in place to ensure that all clinicians were up to date with both National Institute for Health and Care Excellence (NICE) guidelines and other locally agreed guidelines.
  • Clinical outcomes in national data submissions showed high performance for managing patients with long term conditions.
  • We received positive feedback from patients and external stakeholders which access GP services from the practice.
  • Patients found the appointment system easy to use.
  • The practice learned lessons from individual concerns and complaints and also from analysis of trends. For example, telephone access had been a historic concern within the practice. As a result, the practice reviewed the telephone system and increased staff who answered calls.
  • The practice had clear and visible clinical and managerial leadership and supporting governance arrangements.

The areas where the provider must make improvements are:

  • Ensure risks to patients are identified, assessed and mitigated to protect patients’ health and welfare.

The areas where the provider should make improvements are:

  • Review the potential requirements of patients with limited mobility and access to services to patients who may need additional support, with regard to the legal requirements of the Disability Discrimination Act (1995) and Equality Act (2010).

  • Undertake a full review of the requirements of the accessible information standard.”

To read the full report about this inspection, click HERE

14th December – Nuffield Orthopaedic Centre – Good

“The Care Quality Commission has published a report on the provision of safe care to patients at the Nuffield Orthopaedic Centre (the Oxford Centre for Enablement) which is part of Oxford University Hospitals NHS Foundation Trust. The centre provides specialist neurological rehabilitation for up to 26 patients across Oxfordshire, Buckinghamshire, Berkshire, Hampshire, Isle of Wight and Dorset.  There were 23 patients receiving care at the time of the inspection.
Inspectors carried out an unannounced, focused inspection in August in response to notification of an incident in July where avoidable harm had occurred to a patient and to ensure care was being provided in a safe way to current patients.
As this was a focused inspection relating to safe care in one area, no rating has been issued.  
The inspection identified a number of areas where improvements must be made.  These include:
  • Monitor and review staffing levels on the inpatients ward to ensure they are at the required level with the correct skill match to meet the assessed needs of the patients.
  • Review the standard of record keeping ensuring each patient has a contemporaneous record of care, with a care plan which reflects their needs, taking into account the assessment of risk associated with delivering the required level of care.
  • Ensure care plans are reviewed on a regular basis and when there is a change to the patients’ needs to ensure they remain current and relevant to the needs of the individual patient.
  • Ensure planned work to improve the safety of the unit is completed in a timely way.
  • Review the security control measures in place for all gates that lead from the inpatient ward garden area to help ensure it is a safe environment for patients.
Following the inspection, CQC inspectors understand action has been taken to reduce the number of beds at the centre to 18 to help ensure staff would be able to provide safe care to patients.  In addition, the inspectors have been informed that improvement work has been carried out to ensure gates and doors are made appropriately secure.
 
We will continue to monitor the service and return in due course to check the progress made in the areas for improvement that have been identified.”
 
A full report of the inspection can be found at: http://www.cqc.org.uk/location/RTH03

11 December 2017 – Bluebell Ward – Good

The Care Quality Commission has, as of December 11th 2017, published a report relating to Acute wards for adults of working age and psychiatric intensive care units based in the Bluebell Ward at Berkshire Healthcare NHS Foundation Trust

 

Previously CQC carried out a comprehensive inspection of the acute wards for adults of working age and the psychiatric intensive care unit on 13 December 2016. The acute wards for adults of  working age and psychiatric intensive care units were rated as requires improvement for safe, good for effective, good for caring, good for responsive and good for well-led. Overall the service was rated as good.

 

A full report has been published here

 

14 July 2017 Rowan Cottage – Outstanding

“Rowan Cottage is a residential care home providing care and accommodation for up to nine people with a learning disability or autistic spectrum disorder. It is a single storey building with an annexe and an enclosed garden. At the time of the inspection there were nine people living at the service, eight in the main house and one in the self-contained annexe.

The service is required to have a registered manager. There was a registered manager in post who had been registered to manage the service since July 2016. 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.

This was an unannounced comprehensive inspection which took place on 10 May 2017. We were assisted by the registered manager during the inspection.

People were safe at Rowan Cottage. They were encouraged and supported to learn about how to keep themselves safe and raise any concerns or worries they may have. People were protected from harm and abuse by staff who had been trained and had knowledge of how to safeguard people. Staff understood their responsibilities to report and act on issues if they arose. Risks were assessed, managed and reviewed to keep people safe. There were sufficient staff who had been recruited using effective procedures to ensure their suitability. Medicines were managed and administered safely. Routine health and safety checks were completed in accordance with legislation and guidance. Infection control procedures were followed.

Staff were praised by people for providing effective support. Staff were trained in areas relevant to their job role and their skills assessed and monitored. They were supported by the management team to develop and gain appropriate qualifications. Staff felt supported and received regular supervision and appraisal of their work. The provider was meeting the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. Consent to care and support was sought in line with legislation and guidance. When appropriate mental capacity assessments had been completed and where people had been assessed as not having mental capacity to make a decision, a best interests meeting had taken place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.”

 

To read further information about this inspection, please click HERE

20th June St. Anne’s Opportunity Centre Limited

“Chaffinches is a care home without nursing that provides a service to up to three people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection there were three people living at the service.
 
At the last inspection, the service was rated Good. At this inspection we found the service remained Good and had continued to meet all the fundamental standards of quality and safety.
 
Why the service remained Good:
Staff had a good understanding of how to keep people safe and protect them from abuse. Personal and environmental risks to the safety of people, staff and visitors had been assessed and plans were in place to minimise those risks. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. There were sufficient numbers of staff and medicines were stored and handled correctly”
To read the full report click HERE

26th June P & M Homecare Limited

“This was an announced inspection which took place on 23 and 24 May 2017. Bluebird Care (Newbury) is a domiciliary care service which is registered to provide personal care to people living in their own homes. The service re-registered with the Care Quality Commission (CQC) in June 2016 after a change of address. The service currently provides personal care to 51 people who live in the Newbury and West Berkshire area. Most people offered a service are self-funding (pay for their own care).

There is a registered manager running the service. 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.
 
People were kept as safe as possible by staff who had been appropriately trained and knew how to protect people in their care. Care staff were recruited via robust recruitment processes to ensure they were suitable to provide safe care to people. General risks and risks to individuals were identified and action was taken to reduce them. People were supported to take their medicines safely, at the right times and in the right amounts by trained and competent staff.”
To read the full report then click HERE

26th June Dimensions (UK) Limited

“Dimensions Baily Thomas House Haysoms Drive is a respite service for up to six people at a time with a learning disability. People may have associated physical or behavioural difficulties. The service supports a total of 50 people through planned and agreed respite stays.

Rating at last inspection: At the last inspection in October 2014, the service was rated Good.
At this inspection we found the service remained Good.
 
Why the service is rated Good?
 
The service met relevant fundamental standards. People felt safe and well cared for by staff. Where risks were identified, appropriate steps had been taken to minimise these. Medicines were managed so as to reduce the risk of errors, given the frequency of their transfer between people’s homes and the service. Potential new staff were subject to a robust recruitment process. Once appointed, staff received a thorough induction and training to equip them with the necessary knowledge and skills and were provided with ongoing support and development opportunities.”
To read the full report click HERE

1st June Thatcham court care home

“This inspection took place on 27 and 28 April 2017. The inspection was unannounced on the first day and announced on the second. The previous comprehensive inspection of the service was in May 2016. At that inspection we found the service was in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

A requirement notice was issued with respect to the breach of Regulation 12 (Safe care and treatment). The registered provider sent us an action plan in June 2016 outlining the improvements they were going to make in order to meet the requirements of the regulation.
The inspection of 27 and 28 April 2017 was a comprehensive inspection to follow up and ensure the requirement notice for Regulation 12 (Safe care and treatment) had been met and to make a judgement about the overall compliance of the service. We found the service had made the necessary improvements to meet the requirements of the regulations.
Thatcham Court Care Home provides accommodation for up to 60 people who may be living with dementia and need personal and nursing care. The service was purpose built as a care home and provides accommodation over three floors. There is a well maintained garden which provides safe outdoor space for people to enjoy.”
To read the full report click HERE.

15th June – Birchwood Road

“This inspection took place on 8 and 9 May 2017. This was a focused responsive inspection, to concerns that had been raised through a recent safeguarding referral to the local authority.
The home had a registered manager who had been in post since July 2016. 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.
Birchwood – Newbury is a care home with nursing that is registered to provide support to a total of 60 people across three floors. At the time of the inspection, we were advised that the ground floor had been closed, to allow staff to be deployed to the other two floors. A total of 46 people were being provided support and care at the service.
Staff knew how to keep people safe by reporting concerns immediately. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. However, the service required using agency staff as there were a number of vacancies within the service. This ensured sufficient staff were deployed to keep people safe.”

To read the full report click HERE

31 May 2017- Walnut Close Care Home rated ‘GOOD’ in latest CQC report

31 May 2017

Walnut Close provides support and personal care to up to 35 people in total, with needs arising from old age. Up to eleven people living with dementia are supported in a separate specialist unit. The service does not provide nursing care.

Rating at last inspection.

At the last inspection in November 2014, the service was rated Good.

Rating at this inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service had continued to develop and improve, particularly in terms of the developments in the dementia unit, which had been prioritised recently. The improvements made and planned there had significantly enhanced the experience of those living with dementia, and a range of further developments were in process.

People felt safe and well cared for and said staff were kind and attentive to their needs. Feedback from the local authority was positive and the service had worked with them to improve some records and systems. A local authority representative commented, “The staff are very person centred and from my experience during my visits are very supportive and kind to the residents.” Regarding the management of the service they said, “Management are very proactive and transparent.”

People were kept as safe as possible by the systems, policies, procedures and the training provided to staff. Health and safety and other risks were well managed.

People’s safety and wellbeing were enhanced by the changes in staffing, including additional staff at key times, piloting qualified shift leaders on night shifts and increasing management cover at weekends. The appointment of ‘champions’ in key areas also helped to drive further developments in the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Induction improvements and an effective ongoing training programme helped ensure staff had the up to date knowledge and skills to deliver person centred care. The registered manager had taken steps to improve the frequency of ongoing staff support through supervision and had ensured staff development was encouraged through annual appraisals.

People continued to receive effective healthcare support and the service worked well with external healthcare providers. Where issues had been identified with the quality of food provided, the registered manager had taken steps to address these with the external caterers and had achieved improvements.

Staff delivered support calmly and in a timely way. They respected people’s dignity, individuality and cultural or personal needs. There was a positive rapport between people and staff. The service continued to respond promptly to people’s changing needs, feedback and complaints. Ongoing improvements had been made in the variety and individualisation of activities.

The service was well led by a competent registered manager who sought to involve people and staff in plans for future developments. The view of people, staff and external professionals had been sought and identified issues acted upon.

Read full report here.

What are your experiences receiving acute hospital care living in West Berkshire? Let us know here, on facebook, twitter, email, or call us on 01635886210.

12 May 2017- Theale Medical Centre ‘requires improvement’ in latest CQC inspection

12 May 2017

Chief Inspector of General Practice

We carried out a short notice announced comprehensive inspection at Theale Medical Centre on 15 and 24 March 2017. We rated the practice as good for providing Effective, Caring and Responsive services and requires improvement for Safe and Well Led. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

  • Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks and dispensary processes.
  • There was a leadership structure but not all staff felt supported by management. The practice sought feedback from patients, which it acted on.
  • Governance arrangements in respect to documentation and record keeping for organisational management were not always effective.
  • Staff were aware of current evidence-based guidance. Most staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. However, mental capacity act training was not offered to staff.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns. However, governance arrangements had not included logging all verbal complaints and staff told us many of these had been dealt with ineffectively or not responded to in a timely way.
  • Feedback from patients reported that access to a named GP and continuity of care was not always available quickly, although urgent appointments were usually available the same day.
  • Results from the national GP patient survey showed most patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvement are:

  • The provider must ensure governance processes and systems are consistently applied in a timely manner to assess, monitor and improve the quality and safety of the services provided and in the management of risk. This includes ensuring that:
  • All staff are aware of policies and procedures and are effectively embedded in practice. For example, not all staff were aware of the whistleblowing policy and how to access it.
  • Governance arrangements include all necessary employment checks; training needs are met for all staff; dispensary governance processes identify risks and keep patients safe.
  • The complaints management processes include documenting and responding to all verbal complaints in a timely way. Learning and trends from complaints must be shared with all staff.

The areas where the provider should make improvements are:

  • Ensure all actions from the infection control audit have been documented.
  • Continue to review the learning disability register and offer health checks to improve outcomes for this patient group.

Read the full report here.

 

What are your experiences receiving acute hospital care living in West Berkshire? Let us know here, on facebook, twitter, email, or call us on 01635886210.

4 May 2017 GOOD RATING TO SOUTHMEAD SURGERY BY CQC

4 May 2017

Southmead Surgery provides GP services to 6600 patients in a suburban area of Slough. It is based in an area of mixed ethnicity and this is reflected in its patient list. The locality has a relatively low level of deprivation, with a higher working age population compared to the national average.

The practice has three GP partners and three salaried GPs, four female and two male. It currently has one practice nurse and one healthcare assistant. There are 11 members of administration, reception and support staff, including a practice manager. Southmead Surgery is a training practice and support qualified doctors undertaking their GP training.

Our key findings across all the areas we inspected were as follows:

  • We found evidence that improvements had been made. The practice had implemented new systems and processes to evidence these improvements. Our improved rating of good reflects the positive development of leadership and management systems to deliver significant progress in improving services across the board for all patient groups.
  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety.
  • Staff were aware of current evidence based guidance. Staff had been trained with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
  • Southmead Surgery has made significant improvements following the last inspection. The practice should continue to sustain these and ensure further continuous improvements are identified through their governance processes.

In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments were also available for people that needed them.

Southmead Surgery is registered to provide services from the following location:

Blackpond Lane, Farnham Common, Slough, Berkshire, SL2 3ER.

Read the full report here. What are your experiences receiving acute hospital care living in West Berkshire? Let us know here, on facebook, twitter, email, or call us on 01635886210.

CQC report of The John Redcliff Hospital

9 May 2017

CQC has carried out an inspection of  The John Radcliffe Hospital on 11 and 12 October 2016: Here is the summary of the report.

The John Radcliffe Hospital, Oxford is the largest hospital in the Oxford University Hospitals NHS Trust, with 832 beds, and serves a population of around 655,000 people. It provides acute medical and surgical services, trauma, and intensive care and offers specialist and general clinical services to the people of Oxfordshire. The John Radcliffe Hospital site includes the Children’s Hospital, Oxford Eye Hospital, Oxford Heart Centre, Women’s Centre, Neurosciences Centre, Medical Emergency Unit, Surgical Emergency Unit, and West Wing. It is Oxfordshire’s main accident and emergency (ED) site. The trust provides 90 specialist services and is the lead hospital in regional networks for trauma; vascular surgery; neonatal intensive care; primary coronary intervention and stroke.

Report overview:

Safety: Requires improvement

effectiveness: Good

Caring: Good

Responsiveness: Requires improvement

Well-led: Good

Read Full report here

What are your experiences receiving acute hospital care living in West Berkshire? Let us know here, on facebook, twitter, email, or call us on 01635886210.

 

 

28 March 2017- Hazel View residential care home

Reported: 20 April 2017

This was an unannounced inspection which took place on 28 March 2017.

Hazel View is a residential care home which is registered to provide a service for up to five people with learning disabilities. Some people had other associated difficulties including needing support with behaviours which could be distressing and/or harmful. There were five people living there on the day of the visit. The service offers accommodation in a domestic sized house, over two floors. The home is one of eight houses in a small community provided by Purley Park Trust Limited.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good:

There is a registered manager running the service. 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 service was safe, improvements had been made since the last inspection. Staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures kept people as safe as possible. Staff understood how to protect people and followed the relevant procedures. General risks and risks to individuals were identified and action was taken to reduce them.

People’s needs were met and they were supported safely by adequate numbers of staff. The service made sure, that as far as possible, staff were recruited safely and were suitable to work with the people who live in the home. People were given their medicines appropriately, at the right times and in the right amounts by trained and competent staff.

The service remained effective. People’s health and well-being needs were met by staff who were well trained and responded effectively to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s health and well-being needs.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The service continued to be caring and responsive. The staff team were committed and provided care with kindness and respect. Care staff were attentive, responsive and knowledgeable about the needs of individuals. Individualised care planning ensured people’s equality and diversity was respected. People were provided with activities, according to their needs, abilities and preferences.

The registered manager was highly thought of by people who use the service and the staff Team. She was described as approachable and supportive. The quality of care the service provided was assessed, reviewed and improved, as necessary.

Click here to read full report.

March 2017 – Alice Bye Court

March 2017 – Alice Bye Court

This inspection took place on 13 February 2017 and was announced.

Allied Healthcare Alice Bye Court provides domiciliary care visits and emergency alarm response in an extra-care housing scheme operated by a housing association. A staff team are based on-site 24 hours a day. The service is able to offer support to 52 flats, but currently supports 35 people in 35 flats.

The service is required to have a registered manager. 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. There is a registered manager running the service.

People and staff were kept as safe as possible form any form of abuse or harm. People were protected by staff who had received the appropriate training and knew how to recognise and deal with any form of abuse or risk of harm. Staff had been recruited as safely as possible and were consequently judged to be suitable to provide people with safe care. People were supported, by trained staff, to take their medicines safely, if necessary. Individual and generic risks were identified and managed to ensure people and staff were as safe as possible when being provided with or providing care.

People’s rights were protected by staff who understood the Mental Capacity Act (2005). The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

People were provided with person centred care. Individual’s specific needs were met by a well-trained staff team. People were supported to maintain and regain as much independence as possible. People’s diversity was recognised and they were treated with respect and dignity at all times.

The service was effectively managed by team who were described as approachable, open and supportive. The quality of care offered by the service was monitored and assessed and actions were taken to make necessary improvements.

March 2017 – Allied Health Care

March 2017 –  Allied Health Care

This was the first inspection of this service which took place on 20 February 2017 and was announced.
Allied Healthcare Newbury is a domiciliary care agency which offers support to people in their own homes. The service supports approximately 84 people with diverse needs who live in the community. Services offered include a wide variety of support packages, including clinical care packages commissioned by the Care Commissioning Group and Continuing Healthcare.

The service is required to have a registered manager. 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. There is a registered manager running the service.

The safety of people, staff and others safety was taken seriously. They were kept as safe as possible by staff who were trained in and followed health and safety and safeguarding procedures. They knew how to recognise and deal with abuse or risk of harm. Significant risks were identified and managed to reduce them, as much as possible. The service operated a robust recruitment procedure which checked that staff were safe and suitable to provide people with care. If people needed support to take their medicine, the service made sure care staff did this safely.

People’s right to make decisions and choices for themselves was upheld by staff. Care staff understood how important it was to people to give their consent and direct their own life. People’s capacity to make decisions was recorded, if appropriate and necessary. Relevant paperwork was, included in care plans. People’s rights were protected by staff who understood the Mental Capacity Act (2005). This legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were treated with respect and care and staff understood how important it was to maintain people’s privacy and dignity. Care staff made sure they provided people with care that met their individual needs, preferences and choices. People’s diversity was understood and people’s care reflected any special needs they may have had.

The service was well-led by a registered manager who was experienced and supported her staff team. She and her management team were described as open, approachable and very supportive by care staff. The service monitored and reviewed the quality of care they offered. Actions were taken to ensure the quality of care was maintained and improved and any necessary developments were made in a timely way.

Feb 2017 – Holly Grange Residential Home

Feb 2017 – Holly Grange Residential Home

Last updated 3 February 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.We last inspected the service on 14, 15 and 24 March 2016. At that inspection we found the service was in breach of eight regulations. The service was rated ‘inadequate’ and issued with ‘warning notices’ against some of the breaches. The service was placed in ‘Special measures’ which meant it was subject to ongoing monitoring to ensure improvements were made.As part of this process a focused inspection took place on 11 August 2016 to ensure the requirements of the three warning notices had been met. We found the registered manager had taken, or was in the process of taking, action to address all of the areas identified within the warning notices.This inspection, carried out on 8 and 9 December 2016, was a comprehensive inspection to follow up all of the previously identified breaches of regulations and make a judgement about the overall compliance of the service. This inspection was also to assess whether the service could come out of ‘special measures’. We found the service had continued to make significant progress in addressing the previous areas of concern. However, some areas still required further improvement and it was too soon to be sure that all of the initial improvements would be sustained.Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help plan the inspection. Prior to the inspection we reviewed the records we held about the service, including the details of any safeguarding events and statutory notifications sent by the provider. Statutory notifications are reports of events that the provider is required by law to inform us about.

During the inspection we spoke with three people and three relatives about their experience of the service. We observed the interactions between people and staff and saw how staff provided people’s support. We had lunch with people on the first day of the inspection. We spoke with three of the staff and the registered manager. Prior to the inspection we contacted the local authority to seek their views. They raised no new concerns about the service.

We reviewed the care plans and associated records for three people, including their risk assessments and reviews, and related this to the care we observed. We examined a sample of other records to do with the home’s operation including staff recruitment, supervision and support records, surveys and various monitoring and audit tools.