CQC report explained · a nursing home
What the CQC found at Crescent Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always administered safely, and medicine records and guidance were sometimes inaccurate or incomplete. Staffing, recruitment, risk management, infection control and safeguarding were otherwise found to be suitable.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- People's needs were generally met, and they were supported with communication, activities, relationships and complaints. Some care and end-of-life records were not sufficiently person-centred.
- Well-led?
- Requires improvement
- Management systems did not reliably identify or address problems in medicines, care records and maintenance records. Inspectors nevertheless found an open culture and approachable management.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found kind care and enough staff, but medicines were not always safe and oversight was not strong enough.
This was an unannounced focused inspection. Inspectors visited on 25 October 2023, and the medicines team visited on 9 November 2023. They spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
The home was rated Requires Improvement overall. Safe and Well-led were rated Requires Improvement. Inspectors found medicines records and guidance were not always accurate, and checks by managers had not picked up these problems. The home was rated Good for Responsive care.
There were also positive findings. Staffing levels were suitable, staff were trained, people were treated with dignity, and relatives and professionals spoke positively about the service. However, the rating had fallen from Outstanding at the previous inspection in 2017.
Enough suitable staff
The provider used a dependency tool to set staffing levels. Inspectors found enough staff and suitable recruitment checks.
“The provider ensured there were sufficient numbers of suitable staff.” from the report
Respectful care
Staff were described as positive and motivated. Inspectors found that they understood the importance of dignity, respect and independence.
“Staff were passionate about the people they cared for and understood the importance of providing care, which was dignified, respectful and which enabled independence.” from the report
Support with relationships and activities
People were supported to maintain friendships, spend time in the community and take part in activities linked to their interests.
“People were supported to maintain relationships, follow their interests and take part in activities that were relevant to them.” from the report
Complaints were heard
People and relatives were given information about raising concerns. Inspectors found complaints were listened to and used to improve care.
“People's concerns and complaints were listened to, responded to and used to improve the quality of care.” from the report
Medicines were not always safe
seriousRecords showed that prescribed medicines were not always applied or recorded correctly. The home also used a medicine that was not prescribed when it had run out of the prescribed stock.
“People did not always receive their medicines safely. This was a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Management checks missed problems
seriousMedicine audits and other quality checks did not identify issues found by inspectors. Some care records and maintenance entries were also unclear or incomplete.
“The provider failed to ensure the quality assurance systems in place were effective. This was a breach of regulation 17” from the report
Some records were not personal enough
needs fixingSome risk, care, behaviour and end-of-life records did not give enough person-centred information or clear guidance for staff.
“Not all of the records contained person centred information.” from the report
- 01What has been done to make sure every medicine is prescribed, available, administered correctly and recorded accurately?
- 02How are staff given clear, person-centred instructions for medicines taken when needed, seizure medicines and anticoagulants?
- 03What changes have been made to medicine audits so that they find problems before they put people at risk?
- 04Have care records, behaviour guidance and end-of-life plans been reviewed to make them more personal and useful to staff?
- 05What action has been taken on unclear maintenance requests, including the kitchen trolley temperature control?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 19 January 2024 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, February 2022
Inspected but not rated; inspectors were assured that infection control, visiting arrangements and PPE use were being managed safely.
This was an announced, targeted inspection on 27 January 2022. Inspectors looked at infection prevention and control, visiting arrangements and staffing pressures linked to COVID-19. The home was given 24 hours' notice.
Inspectors found that visitors could be nominated and that an essential care giver role was available. Visitors and most professionals needed to show vaccination status where required, take a rapid COVID-19 test and complete health checks.
Staff monitored people's health and used a clinical system to raise concerns with health professionals. PPE was available and used correctly. The home was visibly clean, with enhanced cleaning of frequently touched areas.
The home was inspected but not rated. This was not a full assessment of all five CQC areas, so the report does not provide an overall quality rating.
Visiting arrangements
People could nominate three visitors, and an essential care giver role was available as well. Visitors had to complete testing and health checks.
“People could nominate three named visitors, and the essential care giver role was available in addition to this.” from the report
Health monitoring
Staff monitored people for changes in their health. A new clinical system helped staff raise concerns directly with health professionals for prompt review.
“People were regularly monitored by staff for health changes, and a new clinical system had been implemented at the care home.” from the report
Safe PPE use
PPE was available, guidance was displayed and staff were seen using it correctly. Staff training and checks supported safe use.
“Staff were observed to wear PPE correctly, and wore uniforms whilst at work.” from the report
Clean environment
The home was visibly clean and hygienic. Cleaning schedules set out which products to use and how often areas should be cleaned.
“The care home was visibly clean and hygienic.” from the report
Inspectors raised no specific concerns in this report.
- 01How many named visitors can a resident currently have, and is the essential care giver role still available?
- 02What are the current testing and health-check requirements for visitors and visiting professionals?
- 03What staffing pressures are there now, and what measures are in place to manage them?
- 04How is the clinical system used to identify and escalate changes in a resident's health?
- 05How often are staff checked and trained on PPE use and infection control?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated overall. This explanation was written from the published report of 11 February 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 Crescent Nursing Home
4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- November 2017Outstandingup from GoodSafe: GoodResponsive: OutstandingWell-led: Outstanding
- September 2015Goodstayed GoodSafe: Requires improvement
- May 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 5 November 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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