CQC report explained · a nursing home
What the CQC found at Catherine House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found risks that were not always assessed or managed, including unsafe pressure mattress settings, inaccessible call bells, unlocked chemicals and unsafe equipment. Medicines, infection control, staffing and cleanliness also needed improvement.
- Effective?
- Requires improvement
- People did not always receive enough support, choice or encouragement at mealtimes. Records of food and fluids were incomplete, and oral and personal care were not always delivered. Staff did support healthcare access and generally had personalised care plans.
- Caring?
- Requires improvement
- Staff were seen to be kind and respectful, but they were often too busy to spend meaningful time with people. Some people were not well presented, did not have call bells and did not always receive support with dignity or meals.
- Responsive?
- Requires improvement
- Many people spent prolonged periods in their rooms or in bed, with limited activities and social interaction. Care plans were detailed, but some daily tasks and end-of-life plans were not fully recorded.
- Well-led?
- Requires improvement
- The home's quality checks had not identified important problems with risks, medicines and infection control. Personal records were not always secure. The provider and manager responded promptly to the inspectors' feedback and made changes during the visit.
What inspectors found, August 2023
Rated Requires Improvement; inspectors found kind staff and some prompt action, but identified risks to safety, staffing, medicines, cleanliness and management.
This was the first inspection since the current provider registered the home. Inspectors visited without notice on 11 and 25 May 2023. They spoke with 18 people, five relatives and 16 staff, and reviewed care, medicines and management records.
The overall rating and all five areas were Requires Improvement. People were not always protected from harm. Inspectors found incomplete risk assessments, unsafe medicine practices, poor cleanliness in some areas, ineffective use of protective equipment and times when there were not enough trained staff.
Care was not always personal or dignified. Some people had limited support with personal care, meals, activities and social contact. Personal records were also not always kept securely, and the home's checks had failed to identify important problems.
The provider acted during the inspection. Staffing was increased, some medicine and infection control issues were addressed, and records and risk assessments were reviewed. CQC said it would continue to monitor the home.
Safeguarding
Staff had safeguarding training and knew how to raise concerns. The home was also working with the local safeguarding team.
“Staff had received safeguarding training and were confident to raise concerns.” from the report
Personalised care plans
People's care plans were generally personalised and included information about their needs, choices and health conditions.
“Care plans were personalised to each person which enabled staff to provide support to people which reflected their choices” from the report
Healthcare access
Records showed that staff sought healthcare advice when needed and supported people to attend appointments.
“Records showed that healthcare advice and support had been sought for people when necessary.” from the report
Prompt action
The provider acted quickly when inspectors raised concerns. Staffing, infection control, medicines and record keeping were improved during the inspection.
“The provider and registered manager responded promptly to our feedback during and after the inspection.” from the report
Mental capacity
Inspectors found that the home was working within the principles of the Mental Capacity Act. Capacity assessments and best-interest decisions were completed when needed.
“We found the service was working within the principles of the MCA.” from the report
Unmanaged safety risks
seriousSome risks to people's health and safety were not identified or controlled. These included pressure mattresses set incorrectly, missing call bells and unsafe areas containing chemicals.
“People did not always have detailed care plans and risk assessments in place and there was a risk they would not always be protected from harm.” from the report
Medicines and equipment
seriousInspectors found prescribed creams in the wrong rooms, inaccurate medicine instructions and unsecured oxygen equipment. Some medical equipment was dirty or had not been properly tested.
“We found these issues placed people at risk of harm. This was a breach of regulation 12 (Safe care and treatment)” from the report
Cleanliness and infection control
seriousSome areas were dirty, had unpleasant smells or were in poor repair. Staff did not always use protective equipment safely, although improvements were seen on the second day.
“We were not assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
Staffing and social contact
needs fixingThere were not always enough trained staff on the first day, particularly on the first floor. People sometimes waited for help and had little social contact, although staffing was increased during the inspection.
“There was not always sufficient, trained staff deployed to meet people's needs.” from the report
Limited activities
needs fixingMany people spent long periods without activities, occupation or meaningful interaction. One activities coordinator could not meet everyone's social needs.
“People spent prolonged periods of time without access to activity, occupation or social interaction.” from the report
Governance and privacy
seriousThe home's audits did not reliably identify problems. Personal records were found in unlocked or publicly accessible places, creating a confidentiality risk.
“Systems and processes had not been operated to ensure robust governance and oversight of the service.” from the report
- 01How are you now checking that every person has a working call bell and that risks such as pressure mattresses, radiators and chemicals are safely managed?
- 02What changes have you made to medicine checks, oxygen storage and the cleaning and testing of medical equipment?
- 03How many trained staff are now deployed on each floor at different times of day, and how do you check that people receive timely help and social contact?
- 04What activities are currently available, and how are they matched to each person's interests, abilities and communication needs?
- 05How do you now audit care, medicines, infection control and confidential records, and what evidence can you show that the improvements have lasted?
This was an unannounced first comprehensive inspection of the newly registered home, covering all five key questions, with infection prevention and control also examined under Safe. This explanation was written from the published report of 3 August 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 Catherine House Care Home
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- August 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2020Goodup from Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- July 2015Goodup from Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2021
Registered with the Care Quality Commission on 5 November 2021.
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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