CQC report explained · a nursing home
What the CQC found at 1 Sewardstone Close
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, risks were assessed, and staffing levels were suitable. However, medicines were not always recorded or stored correctly, and inspectors made a recommendation.
- Effective?
- Good
- People's needs were assessed and reviewed, staff received training, and people had suitable food and access to healthcare. Inspectors noted that some manual handling competency records did not cover all equipment and two staff files did not show a relevant induction.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors observed respectful, person-centred support and good relationships between people and staff.
- Responsive?
- Good
- Care plans reflected people's needs and preferences, and staff understood how to support communication. People had access to activities in the home and local community, and complaints were investigated.
- Well-led?
- Good
- People, relatives and staff said the home was well managed. Quality checks were used to monitor care and identify improvements, including actions relating to medicines.
What inspectors found, April 2020
1 Sewardstone Close was rated Good; inspectors found kind, effective care, but medicines were not always recorded and stored correctly.
Inspectors visited on 8 January and 28 February 2020 without announcing the visits. They spoke with people living in the home, relatives, staff and the manager. They also reviewed care files, staff records, medicines information and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were treated with kindness and respect. Staff knew people's needs, staffing levels were suitable, and people had access to healthcare, food, activities and support to remain independent.
There were still problems with medicines. Records did not always use the correct codes, some medicines were not labelled or discarded on time, and one person missed four doses. Inspectors made a recommendation about medicines management. The home had improved from Requires Improvement at the previous inspection, with Safe and Well-led moving to Good.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors observed that staff knew people well and supported them with patience, dignity and respect.
“People and those acting on their behalf told us they were treated with care, kindness, respect and dignity.” from the report
Enough staff
Staffing levels were suitable for people's needs, including people who needed one-to-one support. Call alarms were answered promptly.
“The deployment of staff was appropriate and there were enough staff to meet people's needs.” from the report
Good support with food and healthcare
People could choose meals and received support with dietary and swallowing needs. The home worked with healthcare professionals and other services.
“The dining experience for people was positive. People were not rushed to eat their meal and where they required staff assistance this was provided in a dignified and respectful manner.” from the report
Activities and independence
People were supported to take part in activities they enjoyed, both in the home and in the community. They were also supported to develop and keep their independence.
“Suitable arrangements were in place to ensure people had the opportunity to take part in leisure and social activities of their choice and interest, both 'in-house' and within the local community.” from the report
Improved management
The home had improved its overall rating from Requires Improvement to Good. Leaders used quality checks and feedback to identify areas for improvement.
“The quality assurance arrangements monitored the experience of people being supported and risks to the quality of the service were managed.” from the report
Medicines records and storage
seriousMedicine records did not always use the correct codes. Some medicines were not labelled properly or were still being used after the stated disposal period. One person missed four doses because the medicine was unavailable.
“Though improvements were noted since our last inspection in November 2018, there were still areas for improvement.” from the report
Manual handling records
needs fixingCompetency checks did not refer to all the equipment staff used, making it difficult to confirm that training was fully robust. The home arranged reassessments for staff.
“Manual handling competency assessments did not refer to all items of equipment in use at 1 Sewardstone Close and having been used for training purposes.” from the report
Induction evidence
needs fixingTwo of four staff employed in the previous 12 months did not have evidence in their files of a suitable induction. The home had strengthened its process since May 2019.
“Two out of four staff employed within the last 12 months, had no evidence to demonstrate they had received an induction relevant to their role and according to their level of experience and professional qualifications.” from the report
- 01What changes have you made since the inspection to ensure every medicine is correctly recorded, labelled, stored and discarded on time?
- 02How do you check that medicines are always available and that missed doses are reported and investigated?
- 03Have all staff now had their manual handling competency reassessed for every item of equipment they use?
- 04Can you show how the induction process is recorded for new staff?
- 05How will you keep families informed about any further improvements following the medicines recommendation?
This was a planned, unannounced inspection covering all five CQC questions; Safe and Well-led improved from Requires Improvement, while Effective, Caring and Responsive remained Good. This explanation was written from the published report of 7 April 2020 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.
What inspectors found, January 2019
1 Sewardstone Close was rated Requires Improvement because medicines records and quality checks were not consistently reliable, although care was kind and responsive.
This was an unannounced inspection on 6 November 2018. Inspectors spoke with people living in the home, staff, relatives and managers. They reviewed care plans, care records, staff support records, medicines arrangements, complaints and quality checks.
The home supported 21 people and could care for up to 29 people with neurological conditions. Inspectors found suitable staffing, safe recruitment, good infection control and appropriate arrangements for managing risks. However, medicines were not always recorded correctly, and one person's stock records suggested they may not have received all prescribed medicine.
Care was rated Good in the areas of effective, caring and responsive. People were treated with kindness and dignity, received support suited to their needs, enjoyed activities and had access to healthcare. Safe and well-led were rated Requires Improvement because of medicines practice, overdue staff supervision and appraisals, and weak records showing how identified problems would be fixed.
The overall rating Requires Improvement means the home was not consistently meeting the expected standard at the time of this inspection. The report made recommendations about medicines management and quality assurance.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff understood how people communicated and supported their independence and choices.
“Staff were friendly, kind and caring towards the people they supported.” from the report
Personalised support
Care plans covered individual needs, routines and preferences. Staff were aware of changes and passed information on through handovers and discussions.
“People's care plans were detailed to enable staff to deliver care and therapies that met people's individual needs.” from the report
Staffing and risk management
Inspectors found enough staff to meet people's needs. Staff understood risks such as choking, PEG tubes and distress, and knew how to manage them.
“There were sufficient numbers of suitably recruited staff available to meet people's care and support needs.” from the report
Activities and healthcare
People had access to activities such as gardening, exercise, brunch club, community visits and arts and crafts. The home worked with a range of healthcare professionals.
“The service worked with other organisations to ensure they delivered joined-up care and support.” from the report
Medicines records
seriousSix of 10 medicine records checked had unexplained gaps where staff had not initialled the record. One person's stock discrepancy suggested not all prescribed medicine may have been received.
“The service was not consistently safe.” from the report
Weak action tracking
needs fixingAudits identified problems with medicines, care plans, supervision and appraisals, but action plans were not routinely completed. This made it difficult to show what had been done to correct the problems.
“Action plans were not routinely in place to evidence the actions undertaken or commenced to address the identified shortfalls.” from the report
Care plan detail
minorThe manager acknowledged that care plans were not as person-centred as they should be. This was an area needing improvement, although inspectors found they covered people's care needs and were reviewed.
“There was an acknowledgement from the registered manager that the care plans were not as person-centred as they should be and improvements were required.” from the report
- 01What changes have been made to medicine recording since the inspection, and how do you check that every dose and topical cream application is recorded?
- 02How was the issue involving missing medicine stock investigated, and what safeguards are now in place?
- 03Have all staff received regular supervision and an annual appraisal, and how is this tracked now?
- 04What action plans are used when audits, meetings or family feedback identify problems?
- 05How have care plans been made more person-centred since the inspection?
This was an unannounced inspection covering all five CQC questions, with the overall rating and each question rating assessed during the visit. This explanation was written from the published report of 8 January 2019 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.
Every inspection of 1 Sewardstone Close
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 21 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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