CQC report explained · a nursing home
What the CQC found at Claremont Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2023
Rated Inadequate and placed in special measures; inspectors found serious safety and management failures.
This was an unannounced focused inspection on 5 January 2023. Inspectors looked at Safe and Well-led after concerns about nursing care and safeguarding. They spoke with people, relatives, staff and professionals, observed care, and checked care plans, medicines records and other documents.
Inspectors found that people were not always protected from abuse or avoidable harm. Safeguarding concerns were not always reported or investigated promptly. Risks linked to pressure ulcers, falls, dehydration and accidents were not managed well enough. Some people had to wait for support, and staff said they felt rushed.
The home had improved its medicines management and infection control, although some smaller problems remained. Staff were seen to be kind, and recruitment checks were in place. However, weak records, training gaps and ineffective audits meant the home did not have reliable oversight of people's safety and care.
The overall rating changed from Requires Improvement to Inadequate. The home was already rated Inadequate for Safe and remained in breach of earlier regulations. It was also rated Inadequate for Well-led and placed in special measures.
Kind interactions
Inspectors saw staff being kind and caring when they spoke with and supported people.
“We observed that staff were kind and caring when interacting with people.” from the report
Safer recruitment
The home had recruitment checks in place, including DBS checks for employees.
“Safe recruitment checks were in place which included the completion of Disclosure and Barring Service (DBS) checks on employees.” from the report
Medicines improvements
Medicines were stored safely, and staff giving medicines had been assessed as competent. The home was no longer in breach for medicines management.
“Enough improvement had been made and the provider was no longer in breach of regulation 12 in relation to medicines.” from the report
Infection control improvements
Inspectors found enough improvement in infection prevention and control for the home no longer to be in breach in this area.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12 in relation to infection prevention and control.” from the report
Safeguarding failures
seriousSafeguarding concerns were not always recognised, reported or investigated promptly. The local authority had 10 current alleged safeguarding incidents under investigation.
“People were not always protected from the risk of abuse.” from the report
Risks not controlled
seriousPressure ulcer, falls, hydration and accident risks were not managed reliably. Some equipment was unsuitable or was not put in place soon enough.
“Risks were not always mitigated in a timely manner.” from the report
Staffing and training
seriousStaff said they were rushed, and some people had to wait for help. Supervision and regular training were not consistently provided.
“We could not be assured that staff were supported to undertake training and learning to enable them to fulfil the requirements of their role and keep people safe.” from the report
Poor records
needs fixingCare records did not always show that people's assessed needs were being met. Some care plans and risk assessments were not readily available to staff.
“Records relating to people's care were not always completed to show care was being delivered in accordance with people's assessed needs.” from the report
Weak management oversight
seriousAudits did not identify all the problems inspectors found. The home had not fixed all earlier breaches, and management had lacked consistency.
“The provider had failed to ensure people received a well-managed service which was safe.” from the report
Medicine supply records
needs fixingSome people did not receive all their medicines because of supply delays. Staff did not always use incident procedures to ensure these issues were promptly investigated and resolved.
“For some people recent records showed they had not received all of their medicines because there had been delays in obtaining them.” from the report
- 01What immediate changes have been made to report and investigate safeguarding concerns?
- 02How are pressure ulcer risks, repositioning, hydration and falls now monitored for each resident?
- 03What staffing levels are in place, and how do you prevent people waiting for help when staff are busy or absent?
- 04Which regular training and supervision do nurses and care staff now complete?
- 05What evidence can you show that audits and care records are identifying and fixing problems promptly?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 22 February 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, March 2022
Claremont Nursing Home was rated Requires Improvement, with Safe rated Inadequate because inspectors found serious problems with medicines, risk management and infection control.
Inspectors visited on 6 and 13 January 2022. The visit began as a targeted check of infection prevention and control, then widened to a focused inspection of Safe and well-led. They reviewed five care records and multiple medicines records, and spoke with staff, relatives and professionals.
The home was not always safe. Medicines records had unexplained gaps, risk assessments and care guidance were incomplete, and food and fluid charts were not consistently filled in. Inspectors also found unclean areas, weak cleaning records and risks linked to infection control.
Staff were seen to be kind and caring, but staffing levels did not always support meaningful individual attention. The new manager had been in post for three weeks, and staff spoke positively about them. However, the management systems had not dealt with known problems quickly enough.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe was rated Inadequate and well-led was rated Requires Improvement. The other key questions were not inspected during this visit, so their previous ratings were used in calculating the overall rating.
Kind and caring staff
Inspectors saw staff being kind and caring. Relatives also confirmed this.
“Staff were observed to be kind and caring, and relatives confirmed this.” from the report
Infection testing and protective equipment
The home was using protective equipment safely and was arranging COVID-19 testing for people and staff.
“We were assured that the provider was using PPE effectively and safely.” from the report
Medicines records
seriousThere were unexplained gaps in medicines administration records, including records for creams. Staff did not always record why medicines were missed or whether they were offered again.
“MAR charts did not always indicate why medicines were not given, which was unsafe practice.” from the report
Incomplete risk and nutrition records
seriousSome health conditions and distress behaviours did not have clear risk assessments. Repositioning records were inaccurate, and food and fluid charts were not consistently completed.
“Food and fluid charts were not consistently completed. Where needed, it was not clear if people were being offered snacks between meals.” from the report
Cleaning and infection control
seriousInspectors found unclean bedrooms, communal areas and kitchens. Cleaning schedules and high-touch cleaning records did not always show that required cleaning had happened.
“Cleaning schedules were not consistently completed to evidence staff were following cleaning regimes.” from the report
Staffing levels
needs fixingThere were not always enough staff on shift. Staff said this affected activities and relatives said staff could appear rushed.
“Sufficient numbers of staff were not always provided on shift.” from the report
Weak oversight
seriousManagement audits had not identified or resolved all problems. Known concerns from late 2021 were still present during the inspection.
“Areas for improvement identified by the provider in November/December 2021, were still found to be areas of concern.” from the report
Communication and visiting
needs fixingRelatives said communication needed to improve. Some were unclear about visiting arrangements and the home did not have visiting care plans.
“Some relatives were confused about the visiting arrangements in the service.” from the report
- 01What changes have been made to prevent unexplained gaps in medicines records, including records for creams and other topical medicines?
- 02How are you now checking that risk assessments, repositioning records, and food and fluid charts are accurate and complete?
- 03What evidence can you show that bedrooms, communal areas, kitchens and high-touch surfaces are being cleaned as scheduled?
- 04How many staff are planned for each shift, and how do you cover short-notice sickness without reducing activities or individual care?
- 05What actions have been completed from the improvement plan, and how is the manager checking that previous audit concerns have been resolved?
This began as a targeted inspection of infection prevention and control and became a focused inspection of Safe and well-led; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 22 March 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 Claremont Nursing Home
4 rated inspections over 6 years: the service has slipped, from Good to Inadequate.
- February 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- March 2022Requires improvementdown from GoodSafe: InadequateWell-led: Requires improvement
- July 2019Goodstayed GoodSafe: GoodWell-led: Good
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- September 2012
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 23 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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