CQC report explained · a nursing home
What the CQC found at Cathedral View House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe medicine systems, risk assessments, safeguarding arrangements, suitable staffing and effective infection-control measures. They also found that equipment and emergency arrangements were checked.
- Effective?
- Good
- No rating was given for Effective in this report.
- Caring?
- Good
- No rating was given for Caring in this report.
- Responsive?
- Good
- No rating was given for Responsive in this report.
- Well-led?
- Good
- Inspectors found clearer management responsibility, improved audits and accurate records. The home had acted on all breaches found at the previous inspection.
What inspectors found, May 2022
Cathedral View House was rated Good; inspectors found that earlier problems with medicines, care records, risk monitoring, infection control and management had been improved.
The inspection took place on 23 April 2022. One inspector visited the home, spoke with people, relatives and staff, checked care and medicine records, reviewed recruitment files and looked around both units.
The home was rated Good for Safe and Well-led. Inspectors found that people received medicines safely, risks were monitored, staffing was sufficient and safeguarding systems were in place. Staff were described as supportive, and people and relatives said they felt safe and well cared for.
The previous inspection, published on 8 November 2019, rated the home Requires Improvement and found breaches involving medicines, risk management, infection control, people's money and governance. This inspection found enough improvement had been made and that the home was no longer in breach of those regulations.
Medicines
Medicine systems had improved. Staff had training and competency checks, and people received medicines as prescribed.
“People received their medicines in a safe way, as prescribed for them.” from the report
Risk management
Care plans and risk assessments were current. Staff monitored nutrition, falls, fluid intake and equipment such as pressure-relieving mattresses.
“At this inspection we found improvements had been made and care planning, reviews and staff understanding of people's needs were current.” from the report
Staffing
Inspectors found enough staff to meet people's assessed needs. Staff were said to respond quickly and not take shortcuts when people needed more time.
“There were sufficient numbers of staff employed and on duty to meet people's assessed needs.” from the report
Management
Management oversight, audits and records had improved. Staff said managers were available and that changes had made the service better.
“The service's quality assurance systems were effective, and action had been taken to address and resolve the breaches of the regulations identified at our last inspection.” from the report
Infection-control audits
minorThe report says regular audits were not taking place to check that infection-control systems were safe and effective. Ask how this gap has been addressed.
“Regular audits were no taking place to ensure infection control systems were safe and effective.” from the report
- 01How do you now make sure regular infection-control audits are completed and any problems are acted on?
- 02How are pressure-relieving mattresses checked and monitored for each person?
- 03How do you keep medicine competency checks and medicine records up to date?
- 04How are relatives involved in care-plan reviews when a person's needs change?
- 05What checks do managers currently use to make sure care records and staff supervision records remain accurate?
This inspection was carried out to check whether previous breaches had been met; it rated Safe and Well-led only, and did not give new ratings for Effective, Caring or Responsive. This explanation was written from the published report of 20 May 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, November 2019
Cathedral View House was rated Requires Improvement; inspectors found kind, responsive care, but medicines, risk controls and management oversight were not reliable.
This was an unannounced inspection on 21 October 2019. Inspectors spoke with people living at the home, relatives, staff and healthcare professionals. They reviewed care records, medicines records, staff files and quality checks.
The home was rated Requires Improvement overall. Safe and well-led were rated Requires Improvement. Inspectors found problems with medicines, infection control, risk monitoring, record accuracy and the way quality was checked. They found no evidence that anyone had been harmed during the inspection.
Effective, caring and responsive were rated Good. People were generally treated kindly, supported to access healthcare and given personalised care. The home had previously been rated Good overall, while caring had previously been rated Outstanding.
Kind and respectful care
Inspectors saw many caring interactions. People said staff treated them well, chatted with them and respected their choices.
“We observed many kind and caring interactions between people and staff.” from the report
Staff skills and training
Staff received training, induction and regular opportunities to discuss their work and development. Relatives and healthcare professionals were positive about staff skills.
“Records showed training was regularly updated to ensure staff had the skills necessary to meet people's support needs.” from the report
Personalised care
Care plans described people's needs, preferences and routines, and were regularly reviewed. Staff knew people well.
“Care plans described people's individual needs, preferences and routines.” from the report
Access to healthcare
Staff recognised changes in people's health and sought professional advice. Care records included visits from healthcare professionals.
“People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.” from the report
Safe recruitment and staffing
There had been staff vacancies and recruitment had been difficult, but inspectors found enough staff to meet people's needs during the visit. Recruitment checks had been completed.
“Staff had been recruited safely. All pre-employment checks had been carried out before staff started work, such as criminal record checks and references.” from the report
Medicines were not reliably managed
seriousThere were gaps in medicine records, no medicines audits and no process for recording medicine incidents. Some creams were out of date, and staff competencies were not checked regularly.
“Medicine systems and processes were not robust. We were not assured that people always received their medicines as prescribed.” from the report
Risks were not always controlled
seriousSome fluid intake records were unclear, pressure-relieving mattresses were not always set to the correct weight, and repositioning was not always recorded as required.
“Staff did not always follow the guidance provided in care plans.” from the report
Infection control weaknesses
seriousThe residential unit had no working sluice and no clear cleaning system for equipment. Inspectors also saw the same gloves being used in several rooms and bathrooms.
“People were not always protected from the risk of cross infection.” from the report
Weak quality checks and records
seriousThe provider did not carry out regular audits of care, medicines or infection control. Some records were inaccurate or out of date, so problems had not been found before the inspection.
“The failure of the provider to ensure robust oversight of the service, maintain accurate records and support the registered manager to keep up to date with nationally recognised guidance is a breach of Regulation 17” from the report
Limited access to the local community
needs fixingActivities were available inside the home, but there was no suitable transport to support people to go out. Inspectors found no clear plan to address this.
“There was no opportunity for people to be supported to go outside in to the local community as the service did not have suitable transport available.” from the report
- 01What changes have been made to medicines audits, medicine incident records, MAR checks and staff competency checks?
- 02How are pressure-relieving mattresses, fluid intake and repositioning now checked and recorded?
- 03What has been done to provide a working sluice and a clear system for cleaning shared equipment?
- 04What regular audits does the provider now carry out, and how are inaccurate or out-of-date care records identified?
- 05Has suitable transport been arranged so people can be supported to visit the local community?
This was a scheduled, unannounced comprehensive inspection covering all five CQC questions, including both the premises and the care provided. This explanation was written from the published report of 8 November 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 Cathedral View House
4 rated inspections over 7 years: the service has held its Good rating throughout.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 1 December 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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Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
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