CQC report explained · a nursing home
What the CQC found at Calway House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2021
Rated Good after improvements; inspectors found safe, kind care, but records for some creams were not always complete.
This was an unannounced focused inspection on 14 April 2021. Inspectors checked whether the home had fixed problems found at the previous inspection, and also checked infection prevention and control.
The home was rated Good overall, with Safe, Effective and Well-led all rated Good. Inspectors found enough trained staff, personalised care plans, improved support with meals, safe infection control and stronger checks on the quality of care.
The previous inspection, published in September 2019, rated the home Requires Improvement and found two breaches. At this inspection, inspectors found the improvements had been made and the home was no longer in breach of those regulations.
There was one remaining shortfall. Records showing when some prescribed creams and lotions had been applied were not completed well, so their effectiveness could not be monitored.
Personalised mealtimes
People were offered choices and received support based on their care plans. Inspectors found mealtimes were calm and pleasant, and people's weights were gradually increasing after earlier weight loss.
“Lunch time was a pleasant experience. There was a nice atmosphere with staff chatting as they helped people.” from the report
Enough trained staff
Inspectors found enough staff to meet people's needs safely and promptly. Recruitment checks were in place, and staff had training for people's particular care needs.
“People were supported by adequate numbers of staff to meet their needs and ensure their safety.” from the report
Better care records
Care plans gave staff clearer information about people's needs, preferences and risks. Audits and observations had helped make care more consistent and personalised.
“regular care plan audits had led to more person-centred care plans.” from the report
Respect for choices
Staff asked for consent and respected people's choices. Inspectors found best-interest decisions were recorded when people could not make particular decisions themselves.
“We saw staff asking people if they were happy to be helped and respecting people's choices.” from the report
Cream application records
needs fixingRecords for some prescribed creams and lotions were not completed well. This meant the home could not monitor how effective the treatment was.
“There were pictorial instructions for where these creams should be applied but records relating to their application were not well completed.” from the report
- 01How are you checking that records for prescribed creams and lotions are completed properly now?
- 02What changes have been made since the inspection to monitor the effectiveness of creams and lotions?
- 03How will you make sure my relative's care plan includes their personal needs, preferences and risks?
- 04How do you involve relatives and health professionals in best-interest decisions if a person cannot make a particular decision?
- 05What were the previous ratings for Caring and Responsive, which were carried forward in this inspection?
This was a focused inspection of Safe, Effective and Well-led, including infection prevention and control; Caring and Responsive were not looked at and their previous ratings carried over. This explanation was written from the published report of 28 April 2021 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, September 2019
Rated Requires Improvement; inspectors found kind care, but gaps in personalised support, meals and quality checks created risks.
This was an unannounced planned inspection over three days. Inspectors spoke with people, visitors and staff, observed care and meals, and checked care plans, medicines records, safety records and staff meeting records.
People generally felt safe and said staff were kind, respectful and available. The home was clean and well maintained. Medicines were usually given safely, and people were supported to make choices and give consent.
However, care plans did not always give staff clear instructions. Mealtimes could be disorganised, people did not always get the help they needed to eat, and some people had too little social activity or support with their interests. The home's checks did not always find or follow up these problems.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement. Caring was rated Good. All five ratings had fallen from Good at the previous inspection, except Caring, which stayed Good.
Kind and respectful staff
People and visitors said staff were kind, friendly and respectful. Inspectors saw staff supporting people gently and at their own pace.
“People told us they were supported by kind and caring staff.” from the report
People felt safe
People said they felt safe with staff. Staffing levels were considered adequate, and visitors said they did not have to wait long for support.
“There were adequate numbers of staff on duty to keep people safe and meet their physical needs.” from the report
Clean and maintained home
The home was clean and well maintained. Safety checks included fire systems, water temperatures and lifting equipment.
“People lived in a clean environment. All areas of the home were clean and well maintained by a dedicated housekeeping team.” from the report
Choice and consent
Staff asked people for consent before helping them. Records showed that best-interest decisions involved family members where people lacked capacity for specific decisions.
“We saw people were asked for their consent before staff assisted them with tasks and made sure they were happy to be helped.” from the report
End of life support
The home had arrangements for end of life care, including plans about where people wished to be cared for and support from trained nurses.
“Calway House was a 'Platinum home' which means they had been re accredited after a three-year period” from the report
Unclear care plans
seriousCare plans did not always explain clearly how staff should support people, including with repositioning, eating and distress. This increased the risk of inconsistent care.
“Risks to people were assessed but we found there was not always clear guidance for staff to follow to minimise risks.” from the report
Poor mealtime support
needs fixingSome meals were served late or in a disorganised way. People were not always offered the help, positioning or choices they needed to eat with dignity.
“In some areas the serving of meals was disorganised meaning people sitting together did not receive their food at the same time” from the report
Too little activity and stimulation
needs fixingSome people spent long periods sitting or sleeping without meaningful activity. Staff did not consistently support hobbies or work together to help people living with dementia stay engaged.
“There was limited social stimulation for people who were unable to occupy themselves and a number of opportunities to engage people in conversation were ignored or missed.” from the report
Weak quality checks
seriousAudits were carried out, but they did not always identify problems or show that agreed actions had been completed. This meant issues could continue without being dealt with promptly.
“Systems to assess, monitor and improve the quality and safety of the service provided to people were not robust enough to demonstrate good governance.” from the report
No registered manager
minorThere was no manager registered with CQC during the inspection. A manager had applied to become registered and was being supported by other managers.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01What has changed since the inspection to make sure care plans give clear instructions about eating, repositioning and supporting distress?
- 02How do you make sure people receive the right support, equipment and food consistency when they move between suites?
- 03What activities and support are available for someone who has a particular hobby or spends a lot of time alone?
- 04How are mealtimes now organised, and how do staff make sure people are offered help, choices and suitable positioning?
- 05What checks are now in place to make sure problems are identified, acted on and followed up?
This was an unannounced planned inspection covering all five key questions; the report says Safe, Effective, Responsive and Well-led had fallen from Good, while Caring remained Good. This explanation was written from the published report of 17 September 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 Calway House
4 rated inspections over 6 years: the service has held its Good rating throughout.
- April 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2010
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 15 November 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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