CQC report explained · a nursing home
What the CQC found at Cartmel Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2022
Cartmel Grange was rated Requires Improvement; inspectors found gaps in risk management, medicines records and quality checks, although people spoke warmly about the care.
Inspectors made an unannounced visit on 14 July 2022. They spoke with people, relatives, staff and a health professional. They observed care, checked medicines, reviewed care and recruitment records, and looked at how the home was managed.
The home was not always safe. Some care plans did not explain how to reduce known risks. Staff did not always have the right training, some medicine checks and records were incomplete, and some recruitment records lacked full employment histories. Infection control was generally satisfactory, but COVID-19 precautions were not followed consistently during staff breaks and testing.
The home was also not always well-led. Audits had failed to find some of the problems inspectors identified. However, people and relatives generally described staff as kind and respectful. Inspectors found safeguarding systems, support for people's legal rights, infection control arrangements and partnership working with health professionals.
Kind and respectful staff
People, relatives and staff shared positive comments about the care. People said staff were respectful and that they could not have been treated better.
“People, relatives and staff shared positive comments about their experiences with staff at Cartmel Grange.” from the report
Safeguarding systems
The home had systems for recording and reporting possible abuse. Staff had training and knew what action to take.
“The registered manager had systems to record, report and analyse any allegations of abuse.” from the report
Infection control arrangements
Inspectors were assured about the home's arrangements for preventing and managing infections, including safe admissions, testing and visiting safeguards.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Working with health professionals
Inspectors found positive working relationships with health and social care professionals to meet people's needs.
“The management team and staff had positive and productive working relationships with health and social care professionals to meet people's needs.” from the report
Risk information and training
seriousSome people had not had their needs fully assessed. Care plans did not always tell staff how to manage known risks, and staff did not always have the training needed for safe care.
“Some care plans did not have information to guide staff on how to support people safely.” from the report
Medicines management
seriousSome thickening powders were not safely stored or risk assessed. Medicine temperature records and some administration signatures were also incomplete or unreliable.
“Some prescribed medicines were signed as given by trained staff who did not witness the person being given or swallowing the medicine.” from the report
Quality checks
needs fixingThe home's audits had not identified several of the problems found during the inspection. CQC recommended that governance processes be followed and embedded effectively.
“The auditing processes had not identified the issues we had found during the inspection.” from the report
Staffing and recruitment records
needs fixingSome people and relatives reported staff shortages and high turnover. Not all application forms contained a full employment history, and there was no evidence this had been discussed with the applicant.
“A family member commented, "I do feel staffing levels are low which does raise questions about safety.” from the report
COVID-19 precautions
needs fixingStaff were seen sitting close together without PPE during a break, and not all staff had confirmed a negative daily test before supporting people.
“Good practice measures to manage the risk of COVID-19 were not consistently followed.” from the report
- 01What has changed in the care plans and staff training for people whose risks were not fully assessed?
- 02How do you now check that thickening powders and other medicines are risk assessed, stored safely and recorded correctly?
- 03How do you check that audits identify problems before they affect people's safety?
- 04What are the current staffing levels, and how are shortages or staff turnover managed?
- 05What action has been completed in response to the Regulation 12 breach and the CQC action plan?
This was an unannounced focused inspection covering Safe and Well-led; the other three key questions were not rated in this report. This explanation was written from the published report of 1 September 2022 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, February 2018
Cartmel Grange was rated Good overall, with Outstanding caring and improved recruitment practices.
This was an unannounced, comprehensive inspection on 19 December 2017. Inspectors spoke with people living at the home, relatives, staff and visiting healthcare professionals. They observed care and checked care records, medicines, staff files, training, staffing, meals, the building and management records.
The home was rated Good for Safe, Effective, Responsive and Well-led. It was rated Outstanding for Caring. Inspectors found kind and respectful staff, personalised care, safe medicines practice, enough staff, suitable training, good meals and regular activities.
At the previous inspection, recruitment needed improvement. Inspectors found this had improved and that safe recruitment checks were now in place. The home remained Good overall, with the Outstanding caring rating maintained.
Kind and respectful care
Inspectors observed staff treating people with compassion, respect and dignity. People and relatives spoke very positively about the care.
“We observed staff demonstrated compassion towards people in their care and treated them with respect.” from the report
Personalised support
Care plans included people's needs, likes, dislikes, hobbies and interests. People and, where appropriate, relatives were involved in reviewing them.
“We saw care plans included people's care needs, likes and dislikes, hobbies and interests.” from the report
Safe medicines
Medicines were ordered, stored, given and recorded correctly in the sample checked. Inspectors also saw staff follow safe procedures when administering medicines.
“People received their medicines as prescribed and when needed and appropriate records had been completed.” from the report
Enough trained staff
Staffing levels were sufficient, and staff responded quickly when people needed help. Recruitment checks, training, supervision and appraisals were in place.
“There were sufficient staffing levels in place to provide support people required.” from the report
Activities and relationships
People could choose from varied activities and were supported to maintain contact with family and friends. The home also supported end of life care where possible.
“People who lived at the home and their visitors told us they enjoyed a variety of meaningful activities in the home and in the local community.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you check that staffing levels remain sufficient when people's needs change or more staff are needed?
- 02How often are care plans reviewed, and how will you record my relative's likes, dislikes, routines and future care wishes?
- 03What activities are available at weekends, as well as during the week, and how do you adapt them for people with different abilities?
- 04How do you make sure medicines are given on time and that records are complete?
- 05How would you support my relative to remain at the home for end of life care, if that is their wish?
This was a comprehensive inspection covering all five CQC questions, including the premises and the care provided. This explanation was written from the published report of 22 February 2018 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 Cartmel Grange
4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- February 2018Goodstayed GoodSafe: GoodWell-led: Good
- August 2015Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 January 2011.
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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9 live-in carers within about an hour of Westmorland and Furness
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.
8 can care for a couple. 10 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.