CQC report explained · a nursing home
What the CQC found at Cherwood House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff with the right skills, safe recruitment, effective risk management and safe medicines practice. People told inspectors they felt safe.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff had relevant training. People were supported with nutrition, hydration and healthcare, but mental capacity records needed improvement.
- Caring?
- Good
- People said staff were caring. Inspectors saw respectful interactions, and found that staff knew people well and supported their privacy, dignity and independence.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and routines and were regularly updated. Inspectors found some contradictory information in care plans, although the management team was working through an action plan.
- Well-led?
- Good
- The home had a clear management structure, good teamwork and systems to monitor quality and safety. Managers had identified improvements and were addressing some shortfalls.
What inspectors found, May 2019
Cherwood House Care Centre was rated Good; inspectors found safe, kind care but records about mental capacity needed improvement.
Inspectors visited on 14 May 2019. They spoke with 28 people, nine relatives and staff, reviewed care and medicines records, and checked accidents, complaints, recruitment and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were treated kindly. Inspectors found enough suitably skilled staff, safe medicines practice, good support with food and health, and a varied activities programme.
There were some recording problems. Mental capacity assessments sometimes contradicted other records, and the home did not always have clear evidence that a family member had legal power of attorney. Some care plans also contained contradictory information. The CQC made a recommendation to improve mental capacity records.
The overall Good rating means inspectors found consistently good care and that legal requirements were met in the areas assessed. This was an improvement from Requires Improvement at the previous inspection, published on 25 May 2018.
Safe staffing and medicines
Inspectors found enough staff with the right skills. Medicines were stored, given and recorded safely.
“The home had enough staff on duty with the right skill mix to keep people safe.” from the report
Kind and respectful care
People spoke positively about staff. Inspectors observed polite and respectful interactions, with support for privacy and independence.
“We observed staff talking to people in a polite and respectful manner.” from the report
Activities and community links
People could take part in activities in the home, one-to-one sessions and trips into the local community. The home also maintained links with local churches and other community groups.
“People had access to a full programme of activities which included in-house, days out and one to one activities.” from the report
Improved management
The home had a clear management structure and staff worked well together. A new manager had introduced positive changes and was working through an improvement plan.
“The new manager had quickly identified areas that needed immediate improvement and were working through an action plan to address the shortfalls identified.” from the report
Mental capacity records
needs fixingSome mental capacity records were unclear or contradicted other information. The home also did not always have evidence of a claimed power of attorney.
“We also found records around people's capacity assessments needed reviewing as some of them had contradicting information.” from the report
Contradictory care plan information
needs fixingSome care plans contained information that did not fit together, including information about a person's ability to communicate and consent. The home had identified these concerns and was working through an action plan.
“However, some care plans had contradictory information.” from the report
- 01How have you improved the recording of mental capacity assessments since the inspection?
- 02How do you check and record that a family member has legal power of attorney before relying on their consent?
- 03How have you checked that care plans no longer contain contradictory information?
- 04How do you make sure changes in a person's health, equipment or medicines are reflected promptly in their care plan?
- 05How do you use audits and staff feedback to check that the improvements in the action plan have been completed?
This was a planned inspection of the overall service, covering all five CQC questions and providing an overall rating. This explanation was written from the published report of 29 May 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.
What inspectors found, May 2018
Requires Improvement; inspectors found caring and responsive support, but serious legionella safety checks and some management records were not in place.
Inspectors visited the home without warning on 10 April 2018. They spoke with people, relatives, staff and health professionals. They observed care, checked records and medicines, and reviewed how the home was managed.
There had been clear improvements since the previous inspection. Staffing, medicines, risk assessments, dignity, staff training and support for people's choices had improved. People generally said they felt safe and were treated kindly.
However, the home had no system to assess or manage the risk of legionella. Some care records were not updated when people's needs changed, and quality checks did not always find these problems. This led to a breach of Regulation 12 and an overall rating of Requires Improvement.
Kind and respectful care
Inspectors saw staff treating people patiently and respectfully. People were given choices, privacy and support to do things for themselves.
“People told us staff treated them respectfully and maintained their privacy and dignity.” from the report
Improved staffing
Staffing levels had improved since the previous inspection. Inspectors saw enough staff to meet people's needs, with call bells answered promptly.
“On the day of the inspection we saw the home had enough staff to meet people's needs and keep them safe.” from the report
Medicines managed safely
People received their medicines as prescribed. Records showed medicines given, refused or not taken were recorded accurately.
“People received their medicines as prescribed and the home had safe medicine storage systems in place.” from the report
Personalised activities and care
Care records included people's histories, preferences and interests. People could join group or one-to-one activities, including trips and community visits.
“People had access to a range of activities which they could be involved with, including group and one to one activities.” from the report
No legionella risk controls
seriousThe home had not assessed or managed potential legionella risks. Inspectors found no evidence of water checks or regular flushing of frequently used outlets.
“There were no Legionella risk assessments or risk management plans in place.” from the report
Care records not always updated
needs fixingSome records did not show actions taken after people's needs changed. The report gives an example involving weight loss where the care plan had not been updated.
“Where people's needs had changed, the changes had been implemented, however, this was not always documented.” from the report
Quality checks missed problems
needs fixingThe home's audits had improved but did not always identify gaps in care records. Accident and incident records on one unit did not clearly show whether patterns had been found or referrals made.
“However, further improvement was still required to ensure these were used to drive improvement.” from the report
Mental Capacity Act recording
minorStaff followed the correct process for decisions about covert medicines, but records did not always show that each specific decision had been assessed.
“However, we found the records around MCA needed further improvement as we identified people's capacity assessments around specific decisions did not always reflect all decisions people were assessed for.” from the report
- 01What legionella risk assessment, water testing and outlet-flushing arrangements are now in place?
- 02How do you check that care plans are updated promptly when a person's needs or health changes?
- 03How are accidents and incidents reviewed for patterns, particularly on the residential unit?
- 04How do you record and review residents' concerns raised in meetings?
- 05How are Mental Capacity Act assessments recorded for specific decisions, including covert medicines?
This was an unannounced inspection covering the overall service and all five key questions, with particular follow-up on concerns from the September 2017 inspection. This explanation was written from the published report of 25 May 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 Cherwood House Care Centre
4 rated inspections over 4 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- March 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 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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