CQC report explained · a nursing home
What the CQC found at Caritate Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Caritate Nursing Home was inspected but not rated; inspectors found improvements in medicines, risk management and audits, but food and drink records were not always complete and no registered manager was in post.
This was an unannounced, targeted inspection on 14 February 2023. One inspector checked whether the home had acted on a previous Warning Notice about governance. They reviewed two care plans and risk assessments, staff training and supervision, and other management records.
Inspectors found improvements in medicine records, staff training, risk assessments, weight monitoring and audits. They also found that accidents and incidents were recorded and reviewed. However, food and drink records were not always totalled each day, so it was not always clear whether people had received enough.
The home was not given a new overall rating. Its previous rating was Requires Improvement, and that rating remains in place. The well-led question was inspected but not rated because this visit did not cover the whole question.
Medicine safety
Records and checks for people who administered their own medicines had improved. Nurses had received medicine update training and competency checks.
“The recording of assessments and the monitoring and oversight by staff, of stocks of medicines, when people self-administered their own medicines was now effective.” from the report
Risk management
Care plans contained risk assessments and had been reviewed when people's needs changed. Staff received guidance about reducing identified risks.
“The management and recording of risks had improved.” from the report
Audits and learning
The home had increased its audits and used them to identify and act on improvements. Accidents and incidents were also reviewed for patterns and trends.
“There was an increased programme of audits in place. The audit process was being used effectively.” from the report
Weight monitoring
Records and care plan guidance for monitoring people's weight had become clearer, and weight records were being regularly checked.
“The process for monitoring people's weight had improved.” from the report
No registered manager
needs fixingThere was no registered manager at the time of the inspection. The provider was recruiting and managing the home with help from a deputy manager.
“At the time of our inspection there was no registered manager in post.” from the report
- 01How are food and drink records now totalled each day, and how do you identify missing records quickly?
- 02Who is responsible for managing the home while there is no registered manager in post?
- 03What progress has been made in recruiting a new registered manager?
- 04How are people who self-administer medicines reviewed to make sure this remains safe?
- 05How are audits used to check that identified improvements have been completed?
This was a targeted inspection of specific governance concerns linked to Regulation 17; it did not assess the whole well-led question or the other four key questions, so the previous overall rating of Requires Improvement remains. This explanation was written from the published report of 4 March 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.
What inspectors found, January 2023
Rated Requires Improvement, with Inadequate leadership; inspectors found medicine, consent, training and oversight problems.
This was an unannounced focused inspection on 9 November 2022. Inspectors reviewed six care plans and risk assessments, staff training and supervision records, and other management records. They spoke with people living at the home, staff and relatives.
The home was not always safe or effective. Some medicines were missed or poorly recorded. Risk information was incomplete, care plans were not always followed, and some restrictions were used without the right authorisation. Staff did not always have up-to-date training, supervision or appraisals.
The home was rated Inadequate for being well-led. Audits and improvement plans were not effective, and the registered manager did not have enough oversight of risks, records or staff support. People said they felt safe and staff were caring, but inspectors found limited activities and task-focused interactions.
The overall rating fell from Good at the previous inspection, published in November 2017, to Requires Improvement. Caring and Responsive were not inspected during this visit, so their previous ratings were used when calculating the overall rating.
Staffing levels
Inspectors found enough staff to meet people's needs. Recruitment procedures were appropriate, although agency staff were used to cover vacancies.
“There were sufficient staff employed to meet people's needs. People and relatives confirmed this.” from the report
People felt safe
People and relatives told inspectors they felt safe. Staff understood how to report safeguarding concerns.
“People told us they felt safe. Relatives were confident their loved ones were safe.” from the report
Kind and familiar staff
People appeared happy and comfortable with staff. Many staff had worked at the home for a long time and knew people well.
“People looked happy and comfortable with staff supporting them. Staff were caring.” from the report
Accessible premises
The building had suitable access for people with reduced mobility and wheelchairs. Rooms were personalised with items important to each person.
“People's rooms were personalised to their individual requirements.” from the report
Medicines were not always safe
seriousSome people did not receive medicines as prescribed. Records, stock checks and audits were not reliable, and not all nurses had recorded medicines training.
“One person did not have one of their prescribed medicines available to them. They had missed seven days of this medicine dose, according to the records.” from the report
Risks and care records
seriousCare plans did not always explain known risks or the care people needed. Monitoring charts had gaps and were not regularly checked.
“Monitoring charts were not formally checked regularly, so any gaps or concerns would not be identified in a timely manner.” from the report
Consent and restrictions
seriousCCTV monitoring and other restrictions were not always properly authorised. Some consent forms were signed by people without the legal authority to do so.
“Only one person, of the five, had the necessary documentation to demonstrate how the decision had been made, prior to the installation of CCTV in their rooms.” from the report
Staff training and support
needs fixingMany staff needed training updates, and most had not received regular supervision or appraisal. One nurse's professional registration had lapsed without the manager knowing.
“Staff did not receive regular one to one supervision or appraisal.” from the report
Weak management oversight
seriousAudits and improvement plans were not effective. The manager did not have full access to information delegated to other staff, so problems were not identified or acted on promptly.
“There was a lack of robust governance of the service provided.” from the report
Limited activities and personal support
needs fixingPeople reported boredom, and inspectors saw no activities during the inspection. Support for people with learning disabilities was not delivered in line with the guidance available to the home.
“There was no activity provided for people on the day of this inspection. People told us they were bored.” from the report
- 01What has changed to make sure every prescribed medicine is available, given correctly and recorded accurately?
- 02How are you now checking care plans, risk assessments and monitoring charts for gaps?
- 03Have all CCTV and other restrictions been assessed and legally authorised, and can you explain how families are involved?
- 04What training, supervision and appraisals have staff completed since the inspection?
- 05What activities and one-to-one support are now available for people with learning disabilities or communication difficulties?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 5 January 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.
Every inspection of Caritate Nursing Home
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Inspected but not ratedcurrent ratingWell-led: Inspected but not rated
- January 2023Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- March 2021Inspected but not ratedSafe: Inspected but not rated
- November 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodWell-led: Good
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016Requires improvementdown from GoodEffective: Requires improvementWell-led: Requires improvement
- August 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 29 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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