CQC report explained · a residential care home
What the CQC found at Caldwell Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable risk assessments, safe medicines systems, trained staff and enough staff to meet people's needs. Equipment, fire safety arrangements and infection control were also checked and found satisfactory.
- Effective?
- Good
- People's needs were assessed before they moved in, and staff received training and support. People were offered food and drink choices, had access to healthcare, and consent and best-interest decisions were handled in line with the law.
- Caring?
- Good
- People and relatives described the care as very good. Staff were seen treating people kindly, protecting their dignity and involving them in everyday decisions.
- Responsive?
- Good
- Care plans contained detailed information about people's needs and preferences. The home provided activities, communication support and personalised end of life care, and relatives said staff were available and responsive.
- Well-led?
- Outstanding
- Inspectors found exceptional leadership and a strong culture of improvement. The registered manager involved people, relatives and staff, used audits to improve care, and worked closely with healthcare professionals.
What inspectors found, May 2019
Rated Good overall, with Outstanding leadership; inspectors found kind, safe and personalised care.
This was an unannounced planned inspection on 30 April and 1 May 2019. Inspectors spoke with people living at the home, relatives, staff and healthcare professionals. They also observed care and checked care plans, medicines records, complaints records and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found people were protected from avoidable harm, staff were trained, care was personalised, and people and relatives were involved in decisions. The home also supported people with dementia and worked with healthcare professionals to provide end of life care where possible.
The home was rated Outstanding for Well-led. Inspectors found strong leadership, good partnership working and a culture focused on improving people's lives. The overall rating stayed Good, but the Well-led rating improved from Good at the previous comprehensive inspection in 2016.
Strong leadership
The registered manager and staff team were focused on improving people's experience and involving them in how the home was run.
“There was an exceptionally high level of satisfaction with the quality of the services received.” from the report
Kind and dignified care
Inspectors saw positive interactions and found that staff supported people's privacy, dignity, independence and choices.
“Staff were consistently conscious of maintaining people's dignity when helping them mobilise, transfer using a hoist, knocking on bedroom doors and providing cloth aprons at mealtimes.” from the report
Personalised support
Care plans included detailed information about people's individual needs and preferences. Staff used creative approaches to support communication and reduce isolation.
“People had care plans which highlighted individual needs and preferences and included detailed person- centred information.” from the report
End of life care
The home worked with visiting healthcare professionals so some people with complex end of life needs could remain in familiar surroundings.
“This innovative collaborative working meant visiting nurse practitioners undertook clinical interventions required during a person's end of life care” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs, with recruitment checks, medicines training and completed medicines records.
“Throughout our inspection visit, people's needs were met in a timely way.” from the report
Meeting attendance
minorThe registered manager said attendance at resident and relative meetings was low and planned to introduce themed meetings to encourage more people to attend.
“The registered manager wished to increase attendance at the home' s 'resident and relative meetings'.” from the report
- 01How are residents and relatives currently involved in care planning and decisions about the home?
- 02How do you make sure people who stay in their bedrooms receive regular contact and meaningful activities?
- 03How would you support my relative if they wanted end of life care at the home?
- 04How do you check current staffing levels against each person's needs?
- 05How are resident and relative meetings arranged now, and how can families give feedback if they cannot attend?
This was a planned unannounced comprehensive inspection covering all five CQC questions; the previous comprehensive inspection in 2016 rated the home Good overall. This explanation was written from the published report of 25 May 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.
What inspectors found, October 2017
Rated Good; inspectors found effective, well-managed care, but delays from some GPs and staffing pressures were concerns.
The unannounced inspection took place on 17 August 2017. It was arranged after concerns about people's diets and access to healthcare. The inspectors only checked whether the home remained effective and well-led.
Inspectors found that staff supported people with food, drinks and specialist diets. They monitored weight and fluid intake and referred people to healthcare professionals when needed. However, some GPs were slow to visit, provide advice or send prescriptions.
Staff had relevant training and understood their responsibilities around consent and restrictions on people's freedom. The registered manager carried out audits, monitored care and worked alongside staff. Inspectors also noted staffing gaps, agency cover and some staff working extra hours.
The home was rated Good overall, as it had been at the previous inspection in October 2016. This report does not give new ratings for safe, caring or responsive care because those areas were not checked during this focused inspection.
Nutrition and hydration
Staff monitored people's food, drinks and weight. They offered choices, alternatives and help at mealtimes, including support for specialist diets.
“People were supported to eat a balanced diet that met their needs.” from the report
Healthcare monitoring
The home arranged regular appointments and referrals when people's health changed. The manager also kept records of healthcare requests and delays.
“The registered manager and staff took all the actions they could take to support people to access healthcare services when their health conditions changed.” from the report
Skilled staff
Staff received training linked to people's needs, including dementia care, food and nutrition. The manager also worked alongside staff to observe practice.
“People were cared for and supported by staff who had the relevant training and skills for their roles.” from the report
Management oversight
The manager used audits, observations and meetings to check the quality of care and identify improvements.
“Their quality monitoring system included checking people received an effective, good quality service that met their needs.” from the report
Delays from some GPs
needs fixingSome GPs did not visit promptly and did not always send prescriptions quickly. This meant some people waited for medical advice or treatment.
“some GPs did not visit as promptly as requested by staff and did not always send their prescriptions to the pharmacy promptly.” from the report
Staffing pressure
needs fixingThe home had gaps caused by sickness, holidays and staff leaving. Agency cover and extra hours were used, and some staff said they felt exhausted.
“Several staff reported feeing 'exhausted' from working more hours than usual to cover gaps in the rota.” from the report
Safeguarding matter
seriousA potential safeguarding concern was reported after the inspection visit. The report says this was still being investigated and the outcome would be reviewed.
“Following this inspection visit, we were alerted a potential safeguarding concern. This is currently being investigated” from the report
- 01What was the outcome of the potential safeguarding investigation mentioned after the inspection?
- 02How do you make sure people receive prompt medical advice when their GP does not attend quickly?
- 03How do you prevent delays in prescriptions reaching the pharmacy?
- 04What are the current staffing levels, and how are sickness and holiday cover arranged?
- 05How do you make sure people have familiar staff supporting them when agency workers are used?
This was an unannounced focused inspection of Effective and Well-led only; the other areas were not reassessed in this report and the previous overall Good rating carried forward. This explanation was written from the published report of 3 October 2017 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 Caldwell Grange
3 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- October 2017Goodstayed GoodEffective: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 10 December 2012.
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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At least 100 live-in carers within about an hour of Warwickshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
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