CQC report explained · a nursing home
What the CQC found at Casterbridge Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found kind care but serious weaknesses in safety checks and management oversight.
Inspectors visited without notice on 20 December 2022 and 24 January 2023. They spoke with people, relatives and staff, observed care, and checked care records, medicines, recruitment files and management audits.
People and relatives were positive about the care and staff were described as kind. There were enough staff, medicines were managed safely, safeguarding procedures were understood, and people’s legal rights were supported.
However, inspectors found fire doors propped open, an unsecured entrance, missing risk assessments and poor monitoring of some people’s fluid intake. Recruitment checks were also not always complete. The home acted quickly on many issues, but inspectors could not confirm that all changes had become established.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The breaches concerned safe care and treatment and good governance.
Kind staff
People and relatives were positive about the staff and the care they received. Inspectors also observed a person with dementia responding positively to staff support.
“People and their relatives were positive about the home and the way staff cared for people.” from the report
Safe medicines
Medicines were administered by trained staff whose competence had been checked. Records, storage, fridge temperatures and audits were all described as safe.
“Medicines were safely managed.” from the report
Enough staff
Inspectors found enough staff to meet people’s needs, although there were short periods when no staff were seen in one communal area.
“There were enough staff deployed in the home to meet people's needs” from the report
Responsive management
The registered manager and senior team acted quickly during the inspection. They changed risk assessments, fluid monitoring and oversight arrangements in response to concerns.
“The registered manager and senior team were very responsive and acted immediately to ensure improvement in response to feedback.” from the report
Safeguarding awareness
Staff had completed safeguarding training and understood how to identify and report concerns.
“Staff had completed safeguarding training.” from the report
Fire and building safety
seriousInspectors entered through an open door and found fire doors held open. One fire door was still held open on the second visit because its battery needed replacing.
“During our first visit we arrived at 6:40am and were able to access the building through an open door and find our way into areas where people were sleeping without meeting any staff.” from the report
Incomplete risk checks
seriousTwo people had bed rails without recorded risk assessments. Another person did not have a clear care plan for a catheter that was not always working effectively.
“We identified that 2 people had bed rails in place without the risks being assessed.” from the report
Poor fluid monitoring
seriousThree of five fluid records were not being totalled. Two records showed drinks were often given only during part of the day, and this had not been identified by staff reviewing the records.
“3 were not being tallied and this meant staff were not using the records to help them plan the care and support people received.” from the report
Weak management checks
seriousMonthly audits and daily checks did not identify all the problems found by inspectors. The home also had not fully applied learning from another home run by the provider.
“The provider had failed to ensure robust quality assurance systems were established and operated effectively to continually assess, monitor and improve the quality and safety provided.” from the report
Recruitment records
needs fixingTwo of three staff files had gaps in employment history. References in two files did not clearly show the previous job or the referee’s role.
“Improvements were needed to ensure new staff were recruited safely.” from the report
Mealtime experience
needs fixingIn one communal area, people faced a loud television, staff walking through and too few tables. There was no choice of another place to eat at the time observed.
“We observed people did not have a positive mealtime experience in one communal area” from the report
- 01What has been done to ensure all fire doors close safely, their batteries are checked, and emergency information is kept up to date?
- 02How are bed rails, catheters and other risks now assessed and reviewed for each person?
- 03How do staff now record and review drinks so that people at risk of dehydration receive enough support throughout the day?
- 04What independent or senior checks are now in place to make sure the problems found by inspectors are identified promptly?
- 05What changes have been made to recruitment checks, including employment gaps and references?
This was an unannounced inspection that looked at the overall service, but the report gives ratings only for Safe and Well-led; the other three key questions were not separately rated. This explanation was written from the published report of 3 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 2022
Casterbridge Manor was inspected but not rated; inspectors found good infection controls, with some environmental improvements still needed.
This was an unannounced, targeted inspection on 12 January 2022. Inspectors were responding to concerns about infection prevention and control. They also asked about staffing pressures and whether these affected care.
Inspectors were assured about visitor controls, safe admissions, testing, personal protective equipment, vaccination checks and managing infection outbreaks. People appeared comfortable and said they felt safe. Staff said they were well supported.
The home was only inspected, not rated. Inspectors were somewhat assured about the layout and hygiene of the premises because an environmental improvement plan was still being worked on. The report does not give ratings for the other four areas.
Infection controls
Visitors were expected to have a negative lateral flow test before entering, and protective equipment was available. The home also had procedures for admitting new people safely.
“Measures were in place to prevent the spread of infection by visitors to the service.” from the report
Testing and vaccination
Regular COVID-19 testing was carried out for staff and people living in the home. Non-exempt staff and visiting professionals were checked as vaccinated before entry.
“Regular COVID testing was carried out at the service for both staff and people living there.” from the report
Communication with families
The manager kept people and families updated by email and telephone and facilitated visits in line with current guidance.
“The registered manager kept people and families up-to-date with the current situation through regular emails and phone calls.” from the report
People felt safe
People appeared relaxed and comfortable. Those spoken with said they felt safe and content, and activities were continuing.
“People we spoke with understood the need for the extra precautions and said they felt safe at the service.” from the report
Staff support
Staff said they received support from the management team, provider and colleagues, and that teamwork was good.
“Staff felt well supported by the management team, the provider and their colleagues.” from the report
Mask use
minorMost staff were seen wearing protective equipment correctly, but a small number needed reminders about mask position.
“A couple of staff had to be reminded about the position of their mask.” from the report
- 01What environmental improvements were included in the improvement plan, and which ones have now been completed?
- 02How do you check that staff wear masks and other protective equipment correctly throughout their shifts?
- 03How would staffing pressures affect the care and support provided to my relative?
- 04How are families kept informed if there is an infection outbreak or a change to visiting arrangements?
- 05What ratings did the home receive at its previous full inspection?
This was an unannounced targeted inspection of infection prevention and control and staffing pressures; the other four question areas were not inspected or rated. This explanation was written from the published report of 28 January 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.
Every inspection of Casterbridge Manor
4 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022Inspected but not ratedSafe: Inspected but not rated
- January 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Inadequate
- September 2016Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- January 2016
Registered with the Care Quality Commission on 13 January 2016.
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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