CQC report explained · a nursing home
What the CQC found at Conewood Manor Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment checks, appropriate safeguarding arrangements and safe medicines systems. They noted missing fluid targets, some gaps in staff understanding of evacuation procedures and problems with social distancing in the activity room, with actions taken to address these.
- Effective?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Inspectors did observe kind, dignified and respectful interactions.
- Responsive?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- The home had clear roles, regular audits and positive staff feedback about management and teamwork. This rating improved from Requires Improvement at the previous inspection.
What inspectors found, April 2021
Conewood Manor Nursing Home was rated Good; inspectors found people safe and kindly treated, but noted some communication, fire safety and infection control issues.
This was an unannounced focused inspection on 8 April 2021. Inspectors looked at Safe and Well-led because concerns had been raised about staff communication and the way people living with dementia were approached. They spoke with people, relatives, staff and outside professionals, and checked care, recruitment and management records.
The home was rated Good for Safe and Good for Well-led. Inspectors found enough staff, safe recruitment checks, suitable safeguarding arrangements, secure medicines and regular checks on the quality of care. People appeared safe and content, and staff treated people with kindness and respect.
Some improvements were made during or after the inspection. These included refreshing staff knowledge about evacuation, adding fluid targets to care records and providing another room to support social distancing during activities. The overall rating remained Good. The other three question ratings were carried forward from the previous comprehensive inspection because they were not inspected this time.
Kind and respectful care
People and relatives praised staff for being kind and caring. Inspectors observed pleasant interactions and found people were treated with dignity and respect.
“People and relatives praised staff for being kind and caring.” from the report
Safe staffing and recruitment
The home had enough staff to meet people's needs. Recruitment records checked by inspectors included references and criminal record checks.
“Safe and effective recruitment practices were followed to help make sure staff were of good character and suitable for their roles.” from the report
Medicines management
Medicines were stored securely and records were accurate. Audits, training and staff competency checks were in place.
“Detailed medicine audits were completed, staff training was provided, and competency assessments were undertaken.” from the report
Improved management systems
The Well-led rating improved from Requires Improvement to Good. The home had regular audits, clear responsibilities and systems for learning from incidents.
“At this inspection we found individual mental capacity assessments had been developed, dependent on people's needs for day to day decisions.” from the report
Communication with masks
minorSome people found it difficult to understand or hear staff wearing masks. Inspectors also noted that some staff members had a first language other than English, although no general communication concern was found during the visit.
“One person said, "I find it difficult to understand the staff with the masks on, but they are good.” from the report
Evacuation knowledge
needs fixingNot all staff spoken with understood what to do under the home's evacuation plan. The manager refreshed staff awareness and arranged additional fire drills.
“Not all staff we spoke with demonstrated an understanding of actions to be taken” from the report
Social distancing
needs fixingPeople using the activity room were not supported to socially distance. The manager reviewed the guidance and made another room available after the visit.
“People using the activity room were not supported to socially distance.” from the report
Contact with relatives
minorThe phone system was not adequate for keeping in touch with relatives during the pandemic. Staff used mobile phones to help, and replacement equipment had been sourced.
“However, the provider's phone system had proved to be inadequate to maintain good contact with relatives during the pandemic.” from the report
- 01How do you now make sure each person's fluid target is recorded and followed?
- 02What extra help is available for people who find it hard to hear or understand staff wearing masks?
- 03When was the latest evacuation drill, and how do you check that all staff understand the evacuation plan?
- 04How is social distancing managed during activities now?
- 05How can relatives contact the home, and has the replacement phone system been installed?
This was a focused inspection of Safe and Well-led, including infection prevention and control; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 24 April 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.
What inspectors found, November 2019
Conewood Manor Nursing Home was rated Good overall; inspectors found safe, kind and responsive care, but well-led was Requires Improvement.
This was an unannounced inspection on 3 and 11 October 2019. Inspectors spoke with people, relatives, visitors and staff. They observed care and reviewed care, medicine, training and management records.
People generally felt safe and happy. Inspectors found enough staff on duty, kind and respectful care, personalised support, good activities and appropriate help with eating, healthcare and end of life care.
The overall rating was Good. Safe, Effective, Caring and Responsive were all rated Good. Well-led fell from Good to Requires Improvement because leadership and systems did not always support high-quality, person-centred care.
Kind and respectful care
People and relatives praised staff for being kind and caring. Inspectors observed staff offering reassurance and support during everyday interactions.
“We saw caring interactions between care staff and people in the home. Staff greeted people when they passed them in corridors, offering support and reassurance where necessary.” from the report
Activities and family involvement
The home offered varied activities, community trips and individual engagement. Relatives said they were made welcome and could be involved in care.
“Occupation activities are very good. The home is busy and always something going on.” from the report
Staff development
Staff received regular training, supervision and competency checks. Additional training was provided when staff asked for it.
“Staff were supported through regular training, supervision and appraisals to develop further.” from the report
Staff communication and dignity
needs fixingInspectors saw that language barriers meant some staff did not always promote people's dignity. The home offered English classes, but this remained an area needing improvement.
“Our observations throughout the day of the inspection confirmed that some staff members due to a language barrier were not always promoting people's dignity.” from the report
Care plan involvement
needs fixingSome care plans did not show how people's life histories shaped their care or how regularly people were involved in reviews.
“Not all the care plans evidenced that people`s life histories were used to shape people`s care.” from the report
Mealtime environment
needs fixingCommunal meals were not always calm or comfortable. Tables were not prepared in advance, staff spoke loudly and limited space meant staff stood over people.
“The dining experience in the communal areas was not as peaceful.” from the report
Medicine count
needs fixingOne medicine count did not match the records, and daily nursing checks had not found the error. The provider said staff would be reminded to count medicines accurately after each administration.
“One medicine count we checked did not correspond with the records held and the physical count done by the nursing staff daily had not identified this.” from the report
- 01What has changed to make sure language barriers do not affect people's dignity?
- 02How are people and relatives now involved in care plan reviews, and how are life histories used in daily care?
- 03What changes have been made to make communal mealtimes calmer and more comfortable?
- 04How are medicine counts checked now, and what happens if the count does not match the records?
- 05How do you make sure there are enough staff when people are upstairs or taking part in activities?
This was an unannounced inspection that looked at both the premises and the care provided, and rated all five key questions. This explanation was written from the published report of 22 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 Conewood Manor Nursing Home
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- April 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015Inspected but not ratedSafe: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2014
Registered with the Care Quality Commission on 19 September 2014.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Hertfordshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 82 can care for a couple. 12 years' experience on average.
“She handled the new situation in front of her with such professionalism and I felt I could trust her 100%.”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.