CQC report explained · a residential care home
What the CQC found at Catherine Miller House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, improved risk assessments, safe medicines management and suitable infection prevention measures. People said they felt safe, and staff knew how to respond to concerns about abuse or harm.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Requires improvement
- The management team was visible and supportive, and quality checks had improved. However, records did not always clearly show trends or concerns, and some handwriting was difficult to read.
What inspectors found, May 2023
Catherine Miller House is rated Good overall; inspectors found safe, kind care, but management records needed improvement.
This was an unannounced focused inspection. Inspectors visited on 12 April 2023 and reviewed information, care and medicines records, recruitment files, and quality checks. They spoke with four people, one relative, three staff members and the registered manager.
The home was rated Good for Safe. Inspectors found enough staff, improved risk assessments, safe medicines systems, suitable infection control, and staff who knew how to protect people from harm. People said they felt safe and staff were kind and respectful.
The home was rated Requires Improvement for Well-led. Audits and other management records did not always clearly show trends or concerns, and some handwriting was difficult to read. The provider was no longer breaching regulations, but CQC recommended improving the recording systems.
This inspection only checked Safe and Well-led. The other ratings were carried forward from the previous inspection. The overall rating changed from Requires Improvement to Good because enough improvement had been made.
People felt safe
People told inspectors they felt safe. Staff knew people well and understood how to protect them from harm.
“People were protected from the risk of abuse and told us they felt safe.” from the report
Enough staff
Inspectors found enough staff to support people safely and meet their needs. Recruitment checks had also been improved.
“There were enough staff available to support people to stay safe and meet their needs.” from the report
Medicines managed safely
People received their medicines as prescribed. The records checked were complete, and staff had medicines training and competency checks.
“Two medicine administration records (MAR) were viewed, and these were completed correctly.” from the report
Kind and person-centred care
Staff were described as kind, friendly and caring. Inspectors saw people being supported to make choices and decisions.
“We saw staff being kind, chatty, and engaging with people, allowing them to make choices and decisions.” from the report
Improved working practices
The home had improved its recruitment checks, staff training oversight and learning from accidents and incidents since the previous inspection.
“Quality assurance and governance arrangements at the service had improved since the last inspection” from the report
Management records were not clear enough
needs fixingAudits were being completed, but it was difficult to identify trends and concerns over time. CQC recommended reviewing the recording systems.
“However, it was difficult to see trends and concerns over a period of time in the way the information was recorded, for example lack of clear analysis and hand writing was not always legible.” from the report
Infection control policy being updated
minorThe infection prevention and control policy was still being updated to reflect current guidance at the time of inspection.
“The providers infection prevention and control policy was in the process of being updated to reflect current guidelines.” from the report
- 01What electronic or other recording system will you use to make audits clearer and easier to review over time?
- 02How will you check that accident and incident records are clear, readable and used to identify patterns?
- 03What progress has been made in updating the infection prevention and control policy?
- 04How do you make sure staffing levels remain sufficient when people’s needs change or staff are absent?
- 05How will you gather and act on people’s formal feedback once the planned survey is introduced?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 13 May 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, November 2021
Rated Requires Improvement; inspectors found people were generally safe and cared for, but risk records, recruitment and management checks were not reliable enough.
This was an unannounced focused inspection on 22 September 2021. One inspector spoke with people, staff, the manager and relatives, observed care, and checked care, medicine, staff and management records.
The home had enough staff, medicines were given as prescribed, and infection control arrangements were generally suitable. People and relatives said they felt safe. Staff were seen supporting people in a relaxed and comfortable way.
However, some risks were not recorded accurately or followed by clear plans. Fire checks and drills were not properly evidenced. Recruitment records were incomplete, and some staff training and induction records were not up to date.
The overall rating stayed Requires Improvement. Safe and Well-led were both rated Requires Improvement. The same rating had applied at the previous two inspections, and the home remained in breach of Regulations 12 and 17.
Enough staff
Inspectors found staffing levels were appropriate and call alarms were answered promptly.
“The deployment of staff was appropriate and there were enough staff to meet people's needs.” from the report
Medicines managed safely
The medicine records checked were in good order, and staff administering medicines had suitable training and competency checks.
“These were in good order, provided an account of medicines used and demonstrated people were given their medicines as prescribed.” from the report
People felt safe
People and relatives told inspectors they had no safety concerns. Staff interactions with people were relaxed and comfortable.
“People told us they felt safe and relatives confirmed they had no concerns relating to the safety of their family members.” from the report
Infection control
Inspectors were assured about visiting arrangements, personal protective equipment, cleaning arrangements and infection control policies.
“We were assured the provider was using Personal Protective Equipment [PPE] effectively and safely; and promoting safety through the layout and hygiene practices of the premises.” from the report
Risk records were inaccurate
seriousSome people's risks were not recorded correctly or did not explain how harm would be reduced. This included skin damage, a hot liquid incident and falls information.
“Although there was no impact for people using the service, not all risks to people's safety and wellbeing were recorded or accurate.” from the report
Fire safety evidence
seriousThere was no evidence of fire drills for night staff. Some weekly fire checks appeared to have been signed in advance, so inspectors could not be assured they had happened properly.
“There was no evidence of fire drills having taken place for night staff employed at Catherine Miller House.” from the report
Recruitment records
needs fixingSome recruitment checks and records were incomplete, including references, identification, reasons for leaving and interview records.
“There was no proof of identification, the reason for leaving employment was not recorded or a record maintained of the interview process for one member of staff.” from the report
Management checks missed problems
seriousThe home's audits did not identify the safety and recruitment issues found during the inspection. Some records were disorganised and staff training information was not up to date.
“The provider's governance arrangements were not reliable or effective in identifying shortfalls in the service.” from the report
Limited activities
needs fixingInspectors observed that people were not supported to take part in meaningful leisure interests. Relatives had raised concerns about boredom, but there was no action plan.
“Our observations during the inspection confirmed people were not supported to participate in meaningful leisure interests.” from the report
- 01What has been done to make sure every person's risk assessment is accurate and explains how risks will be reduced?
- 02How are fire drills for night staff and weekly fire checks now recorded and checked?
- 03What recruitment checks and records are completed before each staff member starts work?
- 04How do you now monitor staff induction, training and the manager's induction?
- 05What activities are now available to prevent people becoming bored, and how do you check that people can take part?
This was a focused inspection of Safe and Well-led, including infection control under Safe; it did not cover the other key questions. This explanation was written from the published report of 12 November 2021 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 Miller House
6 rated inspections over 8 years: the service has held its Good rating throughout.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- February 2011
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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