Applecroft Residential Care Home

Updated 14 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by one Inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Applecroft Residential care home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted key stakeholders including the local authority for feedback. We reviewed the information we held about the service including notifications the provider had sent to us and any complaints and compliments we had received. We used all of this information to plan our inspection.

During the inspection

We looked at four people's care records which included a wide range of support plans and risk assessments. We reviewed a range of documents relating to how the service was managed including three staff personnel files, staff training records, policies, procedures and quality assurance audits. We also looked round the premises.

We spoke with 13 people who used the service and 2 relatives about their experience of the care provided. We spoke with six members of staff including the registered manager and care workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 14 January 2020

About the service

Applecroft Residential Care Home is a residential care home providing personal care to 19 people at the time of the inspection. Care is provided across three floors, with shared communal areas including a lounge and dining area and separate bedrooms.

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

Systems to checks and improve the standards of care were not consistently undertaken to drive improvements within the home. However, people and families told us the home was good and they felt involved in discussions. The registered manager and staff worked closely with other professionals and were responsive to suggestions for improvement. There was an improvement action plan in place and this work was ongoing.

The home had suitable systems in place when recruiting staff and there were sufficient staff to meet people’s needs. Medicines were being securely stored and safely managed and people received the support they needed to take their medicine. There were appropriate systems to check and ensure equipment was maintained and the home was clean. We noted some improvements to manage the laundry were implemented immediately. Accident and incidents were managed, and action was taken to prevent reoccurrences, but we noted some improvements that could be made to the analysis of this so that learning can be shared.

People had choice, and preferences were respected. 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. The policies and systems in the service supported this practice. People were supported to access health care as needed and advice from health care professionals was implemented and care plans updated.

People and relatives told us staff were kind and caring and we observed positive and compassionate interactions between staff and the people living at the home throughout the day. People were encouraged to remain independent and care plans reflected this. People’s privacy and dignity was maintained.

People received personalised care and support. There was a new activity coordinator and people could choose to engage in a variety of activities. People felt able to raise concerns and make complaints and told us these were addressed. Plans were in place for people who required support at end of life and staff were thoughtful and caring when supporting people and their families in this area.

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

Rating at last inspection

The last rating for this service was Requires improvement (published 10 September 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations. This service has been rated requires improvement for the last five consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to Regulation 17 (Good Governance) as the provider did not have good systems for ensuring that checks of the quality of support and safety of the environment were regularly undertaken.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.