A care home has again been ordered to make improvements after inspectors found ongoing problems with medicines management, governance and record-keeping.
Applecroft Residential Care Home, on Brunswick Street, was rated requires improvement overall following a Care Quality Commission assessment carried out between 23rd February and 20th March this year. ¬The home, which supports up to 23 older people including those living with dementia, had 22 residents at the time.
Inspectors found the service was in breach of regulations for safe care and treatment, and — for the fifth consecutive inspection — in breach of regulations relating to good governance.
The report said: “This is the fifth inspection where we have found the provider to be in breach of the legal regulations relating to good governance.”¬
The home received good ratings for its effectiveness, level of care and responsiveness, but requires improvement for safety and leadership, and requires improvement overall.
The inspection found that staff did not always follow the provider’s medicines policy, and that audits carried out by the home had failed to identify the issues inspectors later uncovered.
Some risk-management records also lacked sufficient detail to guide staff, although inspectors noted that staff generally understood risks and took action to mitigate them.
“Staff assessed potential risks to people and took actions to mitigate these risks. Staff considered people’s wishes and choices as part of this planning,” the report said.
The home had staffing vacancies and was regularly using agency workers to fill gaps, the report noted. The management team was attempting to recruit, and inspectors said there were “overall sufficient staff” to meet people’s needs.
Staff were trained in safeguarding and knew how to report concerns. Recruitment procedures were described as safe.
Care plans were reviewed monthly and contained personalised information, but some lacked up-to-date details. Inspectors also found that where residents lacked capacity, staff had not always recorded the required mental capacity assessments or best-interest decisions.
The commission said the home’s governance arrangements were not robust enough to identify or address problems:
“Audits had not identified and/or addressed all the issues we identified,” said the report.
The registered manager was described as open and responsive to feedback and had already begun making improvements.
Despite the regulatory concerns, residents and relatives were largely positive about the home. Comments included: “It’s very good in here, they’re very kind”; “I’ve no complaints, I couldn’t do any better”.
People told inspectors they felt safe, staff were kind, and relationships were good. The home was also praised by external professionals for being proactive and responsive.
Staff respected people’s wishes and they advocated for them to ensure their choices were respected. The registered manager promoted an inclusive approach and met people’s diverse needs.
Some residents said there was “not much going on” due to staff shortages, the report saying that activities were “minimal”.
People knew the registered manager well and felt able to raise any concerns or issues with them. Staff were in regular contact with people’s relatives and kept them informed of any changes.
Parts of the building require refurbishment, and the home had arranged to replace flooring and continue a rolling programme of decoration.
Applecroft is owned by B & L Property Investments.
