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CQC report explained · a nursing home, run by Apex Care Homes

Crescent Nursing Home

12 The Crescent, Bedford, MK40 2RU

Requires improvementpublished 19 January 2024, 2 years ago

Rated Requires improvement: inspectors found the service was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
Medicines were not always administered safely, and medicine records and guidance were sometimes inaccurate or incomplete. Staffing, recruitment, risk management, infection control and safeguarding were otherwise found to be suitable.
Effective?
Good
This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
Caring?
Good
This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
Responsive?
Good
People's needs were generally met, and they were supported with communication, activities, relationships and complaints. Some care and end-of-life records were not sufficiently person-centred.
Well-led?
Requires improvement
Management systems did not reliably identify or address problems in medicines, care records and maintenance records. Inspectors nevertheless found an open culture and approachable management.
The latest report, explained

What inspectors found, January 2024

Rated Requires Improvement; inspectors found kind care and enough staff, but medicines were not always safe and oversight was not strong enough.

This was an unannounced focused inspection. Inspectors visited on 25 October 2023, and the medicines team visited on 9 November 2023. They spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.

The home was rated Requires Improvement overall. Safe and Well-led were rated Requires Improvement. Inspectors found medicines records and guidance were not always accurate, and checks by managers had not picked up these problems. The home was rated Good for Responsive care.

There were also positive findings. Staffing levels were suitable, staff were trained, people were treated with dignity, and relatives and professionals spoke positively about the service. However, the rating had fallen from Outstanding at the previous inspection in 2017.

What inspectors praised
  • Enough suitable staff

    The provider used a dependency tool to set staffing levels. Inspectors found enough staff and suitable recruitment checks.

    The provider ensured there were sufficient numbers of suitable staff.from the report
  • Respectful care

    Staff were described as positive and motivated. Inspectors found that they understood the importance of dignity, respect and independence.

    Staff were passionate about the people they cared for and understood the importance of providing care, which was dignified, respectful and which enabled independence.from the report
  • Support with relationships and activities

    People were supported to maintain friendships, spend time in the community and take part in activities linked to their interests.

    People were supported to maintain relationships, follow their interests and take part in activities that were relevant to them.from the report
  • Complaints were heard

    People and relatives were given information about raising concerns. Inspectors found complaints were listened to and used to improve care.

    People's concerns and complaints were listened to, responded to and used to improve the quality of care.from the report
What inspectors were concerned about
  • Medicines were not always safe

    serious

    Records showed that prescribed medicines were not always applied or recorded correctly. The home also used a medicine that was not prescribed when it had run out of the prescribed stock.

    People did not always receive their medicines safely. This was a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.from the report
  • Management checks missed problems

    serious

    Medicine audits and other quality checks did not identify issues found by inspectors. Some care records and maintenance entries were also unclear or incomplete.

    The provider failed to ensure the quality assurance systems in place were effective. This was a breach of regulation 17from the report
  • Some records were not personal enough

    needs fixing

    Some risk, care, behaviour and end-of-life records did not give enough person-centred information or clear guidance for staff.

    Not all of the records contained person centred information.from the report
Questions to ask them, based on this report
  1. 01What has been done to make sure every medicine is prescribed, available, administered correctly and recorded accurately?
  2. 02How are staff given clear, person-centred instructions for medicines taken when needed, seizure medicines and anticoagulants?
  3. 03What changes have been made to medicine audits so that they find problems before they put people at risk?
  4. 04Have care records, behaviour guidance and end-of-life plans been reviewed to make them more personal and useful to staff?
  5. 05What action has been taken on unclear maintenance requests, including the kitchen trolley temperature control?

This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 19 January 2024 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.

The story over the years

Every inspection of Crescent Nursing Home

4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.

  1. January 2024Requires improvementcurrent rating
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at Crescent Nursing Home

  2. February 2022Inspected but not rated
    Safe: Inspected but not rated

    We are reading this report · the original is on cqc.org.uk

  3. November 2017Outstandingup from Good
    Safe: GoodResponsive: OutstandingWell-led: Outstanding

    Read this report on cqc.org.uk

  4. September 2015Goodstayed Good
    Safe: Requires improvement

    Read this report on cqc.org.uk

  5. May 2015Good
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  6. June 2014

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  7. May 2013

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  8. March 2013

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  9. November 2012

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  10. October 2011

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  11. November 2010

    Registered with the Care Quality Commission on 5 November 2010.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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