Background to this inspection
Updated
20 April 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and one assistant inspector. The two inspectors undertook the site visit and the assistant inspector supported the inspection by speaking with relatives on the telephone and reviewing documentation off site.
Service and service type
Apple Trees Care and Reablement Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with eleven members of staff including the registered manager, head of care, senior care workers, care workers and a member of the kitchen staff.
We reviewed a range of records. This included five people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection –
We spoke with six relatives by telephone about their experience of the care provided for their family members. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
20 April 2021
About the service
Apple Trees Care and Reablement Centre is a care home registered for 64 older people including people living with dementia. The home is split into four households with 16 bedrooms in each. At the time of our inspection one unit was being used as a designated setting for transitional care for people who had been discharged from hospital recovering from COVID- 19.
People’s experience of using this service and what we found
The staffing levels at night did not always meet the needs of people at the service. Since the introduction of the designated setting the way staff had been allocated had affected staff’s ability to provide timely care.
People’s medicines were overall managed safely, but we were told of minor medicines errors not being reported.
People had information in the care plans about how to manage the risks to their safety, however some risks to people’s safety were not always managed effectively
There were quality monitoring processes in place, however the analysis of incident such as falls of care did not always show theme and trends.
Staff were aware of how to protect people from the risks of abuse. There was infection prevention and control (IPC) practices in place so people were protected from the risks of infection. 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 and their relatives told us the staff team treated them with care and respect, and their views on their care were listened to. Staff showed a good awareness of supporting people’s privacy and encouraging their independence.
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 Apple Trees Reablement Centre was Good (published 8 August 2019).
Why we inspected
The inspection was prompted in part due to concerns received about the management of staffing since the introduction of the designated unit at the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of Safe, caring and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well led section of this report
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Apple Trees Reablement Centre on our website at www.cqc.org.uk.