CQC report explained · a residential care home
What the CQC found at Conifers Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were stored, administered and recorded safely. They also found suitable risk assessments, staffing, recruitment checks, infection control and systems for learning from incidents.
- Effective?
- Good
- This key question was not inspected during this focused visit.
- Caring?
- Good
- This key question was not inspected during this focused visit.
- Responsive?
- Good
- This key question was not inspected during this focused visit.
- Well-led?
- Good
- Inspectors found effective governance, clear management responsibilities and improvements to quality assurance. People, relatives and staff described a positive culture and good communication.
What inspectors found, July 2022
Conifers Care Home is rated Good; inspectors found safe care and stronger management after earlier concerns.
This was an unannounced, focused inspection on 10 June 2022. One inspector spoke with people, relatives, staff and a health professional. They observed care, checked the home, medicines, care records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found medicines were managed safely, risks were recorded, staffing was suitable and infection control arrangements were effective. People were protected from abuse and avoidable harm.
The overall rating improved from Requires Improvement at the previous inspection. The provider had completed an action plan, and inspectors found improvements meant the home was no longer breaching regulations.
This report only covers Safe and Well-led. The other areas were not inspected during this visit, so their previous ratings were carried forward when calculating the overall rating.
Medicines were managed safely
Inspectors found secure storage, correct temperatures, clear administration records and suitable guidance for medicines taken occasionally.
“Medicines were managed safely and stored securely at the correct temperatures.” from the report
People were protected from harm
The home had systems for reporting abuse, assessing risks and responding to emergencies. Staff knew what action to take if they suspected abuse.
“The registered manager had systems to record, report and analyse any allegations of abuse.” from the report
Good infection control
Inspectors were assured about infection prevention, visitors' arrangements, protective equipment, testing, hygiene and outbreak management.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Positive culture
People, relatives and staff described the home as supportive and person-centred. Relatives also praised communication with staff.
“People and relatives reported a positive culture that was enabling, supportive and helped to ensure they [people] felt valued.” from the report
Stronger oversight
Management responsibilities were clear and governance systems were embedded. The home had acted on the previous recommendation about quality assurance.
“Effective and continuous governance was well embedded into the running of the service with a strong framework of accountability.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you keep the medicines checks and records accurate for my relative?
- 02What individual risks have you identified for my relative, and how are these recorded and reviewed?
- 03How do you maintain staffing levels when people's needs change?
- 04How do you collect and act on feedback from residents and relatives?
- 05What evidence can you show that the improvements made after the previous inspection have been maintained?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 7 July 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.
What inspectors found, May 2021
Rated Requires Improvement; inspectors found serious medicines recording gaps, although people felt safe and staff provided kind support.
Inspectors visited on 27 January 2021 and again in February 2021. The first visit was unannounced and the second was announced. They spoke with people, relatives, staff and managers, checked five medicines records, observed medicines being given, and reviewed care and management records.
The main problem was medicines safety. Records did not always show that medicines had been given as prescribed. Controlled drugs records were incomplete, and audits had not found all the errors. The report says no harm was found, but people were put at risk.
There were also some repair issues, including an unsafe toilet seat and a bath hoist that was not working effectively. Inspectors found good infection control, enough protective equipment, safe recruitment, attentive staff and positive relationships.
The overall rating fell from Good to Requires Improvement. Safe was rated Requires Improvement. Well-led remained Requires Improvement. The other three areas were not inspected at this visit, so their previous ratings were used in the overall rating.
Positive relationships
People and relatives described positive relationships with staff. People said they felt safe and able to speak with the provider.
“People gave positive feedback about their relationship with staff and said they trusted them.” from the report
Staffing and recruitment
There were enough staff to support people, and recruitment checks were completed before staff started work.
“Staff continued to be recruited safely.” from the report
Infection control
Inspectors found enough protective equipment and saw staff using it correctly. The home had remained free of COVID-19 since the beginning of the pandemic.
“We checked personal protective equipment (PPE) and found sufficient stocks available and staff confirmed they were not short of equipment.” from the report
Management action
The management team generally acted on findings from audits and introduced new medicines systems after the inspection to identify discrepancies.
“Following the inspection visits the management team had introduced new medication systems to ensure any discrepancies would be found and improvements made.” from the report
Medicines records
seriousRecords did not always prove that medicines were given as prescribed. Some variable doses and reasons for non-administration were not recorded clearly.
“Medicines records did not always support and evidence that people medicines had been administered correctly.” from the report
Controlled drugs
seriousControlled drugs records included duplicate and missing administration entries. Some medicines were not given as often as prescribed, and not all were entered in the register.
“We also found examples where doses were not administered as frequently as prescribed.” from the report
Audits did not find errors
needs fixingThe medicines audits did not identify all the problems found by inspectors. This meant the management systems did not give enough assurance about medicines safety.
“However, audit processes had not identified issues that we had highlighted during this inspection.” from the report
Repair issues
needs fixingA toilet seat moved when used and a bath hoist was not working effectively. Inspectors said these could pose a safety risk.
“A toilet seat was in need of repair it moved when it was sat upon and a bath hoist wasn't working effectively.” from the report
Training assurance
needs fixingInspectors were not fully assured that medicines knowledge, skills and competency had been reviewed annually as national guidance recommended.
“We were not fully assured that an annual review of knowledge, skills, competencies and accredited training had been carried out as per national guidance.” from the report
- 01What changes have been made to medicines records since the inspection, and how do you check that medicines are given as prescribed?
- 02How are controlled drugs now recorded, checked and reconciled?
- 03What evidence can you show that medicines audits now identify errors promptly?
- 04Have the toilet seat and bath hoist repairs been completed, and how are other equipment risks checked?
- 05How do you check staff medicines knowledge, skills and competency each year?
This was a focused inspection of Safe and Well-led after concerns about medicines, the environment, meals and care; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 5 May 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 Conifers Care Home
4 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2018Goodstayed GoodSafe: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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