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CQC report explained · a residential care home, run by Adara Healthcare

The Shrubbery

66 College Street, Higham Ferrers, Rushden, NN10 8DZ

Requires improvementpublished 13 December 2023, 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
Known risks were not always properly assessed, recorded or reduced. Medicines records were incomplete, although staffing, recruitment and infection control arrangements were found to be satisfactory.
Effective?
Good
This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
Caring?
Good
This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
Responsive?
Good
This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
Well-led?
Requires improvement
Management checks had not identified important gaps in risk assessments, medicines records and records of care tasks. Staff and relatives nevertheless described a positive culture and said they felt able to raise concerns.
The latest report, explained

What inspectors found, December 2023

Rated Requires Improvement; inspectors found gaps in risk management, medicines records and oversight, although people described staff as caring.

This was an unannounced, focused inspection after concerns about record keeping, safeguarding and oversight. Inspectors looked only at Safe and Well-led. They spoke with people, relatives and staff, and reviewed care, medicines, staff and management records.

The home was not always safe. Risk assessments and care plans were missing important information. Some safety checks, repositioning records, food and fluid records and injury records were incomplete. Medicines records did not always explain why as-needed medicines were given, and thickener administration was not recorded properly.

The home was not always well-led. Audits had failed to identify problems with care records, risk management, medicines and completed care tasks. Inspectors found breaches of Regulations 12 and 17. The overall rating fell from Good at the previous inspection to Requires Improvement.

What inspectors praised

  • Staffing and recruitment

    Inspectors found enough staff to meet people's needs and safe recruitment checks had been completed.

    “Staffing levels were sufficient to meet the needs of people living at The Shrubbery.” from the report

  • Infection control

    The home appeared clean. Inspectors were assured that staff used protective equipment safely and followed infection control guidance.

    “We were assured that the provider was using personal protective equipment (PPE) effectively and safely.” from the report

  • Supportive culture

    Staff said they felt supported and confident to raise concerns. Relatives said complaints were dealt with appropriately.

    “Staff felt supported within their roles and felt confident to discuss any concerns they may have with the management team.” from the report

  • Caring staff

    People and relatives gave positive feedback about the staff and the care they received.

    “People told us staff were caring.” from the report
What inspectors were concerned about

  • Incomplete risk information

    serious

    Care plans and risk assessments did not always explain people's risks or how staff should reduce them. Some safety checks and repositioning records were also incomplete.

    “People's known risks were not managed safely.” from the report

  • Medicines records

    serious

    Records did not always show why as-needed medicines were given. Thickener administration was not recorded, and not all staff had documented competency checks for medicines or blood sugar testing.

    “People were at risk of not receiving their 'As required' (PRN) medicine as prescribed.” from the report

  • Weak management checks

    serious

    Audits had not found problems with care plans, risk assessments, care tasks, injuries or medicines. This meant managers did not have reliable oversight of safety.

    “Systems and processes were not effective in ensuring staff had all the information required to support people safely.” from the report

  • Incomplete injury records

    serious

    Some injuries were not fully recorded or investigated. Incident reviews did not identify patterns clearly enough to reduce the risk of repeat incidents.

    “Records of injuries were not always in place and detailed.” from the report
Questions to ask them, based on this report
  1. 01How do you now make sure every person's risk assessment includes clear guidance for staff, including after a fall, injury or change in behaviour?
  2. 02How do you check that repositioning, safety checks and food and fluid records are completed on time?
  3. 03How do you record why as-needed medicines were given and the amount of prescribed thickener used?
  4. 04Which staff have had their competency checked for giving medicines and taking people's blood sugar levels?
  5. 05What audits are now in place to identify missing care information, medicine recording problems and unexplained injuries?

This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings carried over from the previous inspection. This explanation was written from the published report of 13 December 2023 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 The Shrubbery

3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.

  1. December 2023Requires improvementcurrent ratingdown from Good
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at The Shrubbery →

  2. January 2019Goodstayed Good
    Safe: GoodWell-led: Good

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

  3. August 2016Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  4. February 2016

    Registered with the Care Quality Commission on 11 February 2016.

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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