CQC report explained · a residential care home
What the CQC found at Cressington Court Care Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, June 2023
Requires Improvement; inspectors found kind care but serious concerns about risk management, medicines and service oversight.
This was an unannounced focused inspection on 11 and 15 May 2023. Three inspectors spoke with people, relatives and staff. They reviewed four care records, seven medicines records, staff recruitment files and management records.
The home was rated Requires Improvement overall. Safe, Effective, Responsive and Well-led were also rated Requires Improvement. Caring was rated Good. Inspectors found concerns with risk assessments, care plans, medicines and quality checks.
People and relatives generally described staff as kind, respectful and caring. The home was clean, people had support from health professionals and complaints were recorded. However, the provider remained in breach of regulations 12 and 17, and CQC said it would monitor an action plan.
Kind and respectful staff
People and relatives generally spoke positively about staff. Inspectors observed caring relationships and respectful support for people's privacy, dignity and independence.
“People were treated well, and their equality and diversity was respected.” from the report
Support from health professionals
People received support from a range of health and social care professionals, including when managing health conditions and end-of-life care.
“People received support from a range of health and social care professionals including dieticians; social workers, community nurses, community mental health teams, speech and language therapy and their local GP.” from the report
Clean environment
The home was generally clean and hygienic. Inspectors found suitable supplies of gloves and aprons, although hand gel was missing from wall-mounted dispensers.
“The home was generally clean and hygienic throughout.” from the report
Open response from management
The provider and manager discussed the problems openly and acted immediately on findings raised during the inspection.
“The provider and manager were responsive to feedback given throughout the inspection and immediately acted on the findings.” from the report
Risks and care plans
seriousCare plans and risk assessments were not always reviewed after people's needs changed or after professional advice. Some people at risk of weight loss were weighed monthly instead of weekly.
“Care plans reviewed were not updated following reviews by professionals and changes to peoples care needs.” from the report
Medicines safety
seriousThere was a high number of reported medication errors and quality checks had not found all the problems. One person's hidden medication was given in a way that did not follow the medication record or care plan.
“Systems had not been fully established to ensure safe and effective administration of medicines. This placed people at risk of harm.” from the report
Weak oversight and records
seriousSome audits were missing or ineffective, and records were not always complete, accurate or up to date. The medicines and environment audits failed to identify issues found by inspectors.
“The governance arrangements in place were not robust and records were not always adequately maintained.” from the report
Activities and information
needs fixingPeople did not always have menus or signage to help them make choices. Records showed many activities had been declined, and a relative said the wider programme of activities had stopped over the previous six months.
“There used to be a range of activities in place with external and internal events, over the past six months this has stopped” from the report
- 01What has changed to make sure medicines, including hidden medicines, are administered and recorded safely?
- 02How often are residents' risk assessments and care plans now reviewed after a change in need or professional advice?
- 03How are you checking that audits identify problems with medicines, room temperatures, care plans and infection control?
- 04How are relatives involved in care plan reviews now?
- 05What activities, menus and signs are currently available to help residents make choices and take part in daily life?
This was an unannounced focused inspection covering all five key questions and infection prevention and control; the report says the previous comprehensive inspection report should be read for more detail. This explanation was written from the published report of 15 June 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, October 2022
Rated Requires Improvement; inspectors found major progress since an Inadequate rating, but medicines and management systems were still unsafe.
This was an unannounced follow-up inspection on 10 and 12 August 2022. One inspector and one medicines inspector spoke with people, relatives and staff, observed care, and checked care, medicines, staffing and management records.
The home had improved since the previous inspection. There were enough staff, the building was safer, infection control was followed, and care plans were more person-centred. Staff knew people well and were described as kind and patient.
Important problems remained. Medicines were not always given as prescribed, including doses given too close together. Audits had not found these problems. Some risk, care and food records were incomplete or out of date, and incident reviews did not fully identify patterns.
All five areas were rated Requires Improvement. The previous overall rating was Inadequate, and the home is no longer in Special Measures. However, the home remained in breach of two regulations and CQC said it would continue to monitor progress.
Enough staff
Inspectors found enough suitably qualified staff to meet people's needs safely. Recruitment procedures had also improved.
“There were enough suitably qualified staff to support people.” from the report
Cleaner and safer home
The home was clean, infection control procedures were followed, and the building had become safer since the previous inspection.
“The home was clean throughout and cleaning schedules had been updated to reflect current guidance.” from the report
Kind staff
Staff understood people well and were observed to respond patiently and kindly. People's independence was respected.
“Staff were kind in their response to people and their approach was observed to be patient.” from the report
Medicines were not always safe
seriousOne person received paracetamol doses too close together on seven occasions, creating a risk of overdose. Another person received the same medicine twice because staff used a duplicate medicines record.
“One person had been given doses of paracetamol too close together without leaving a four-hour gap on seven occasions.” from the report
Management checks missed problems
seriousAudits did not identify the medicine concerns. Records about care and treatment were also not always accurate, complete or updated promptly.
“The provider failed to ensure governance procedures were always effective to monitor and improve the quality and safety of the service.” from the report
Care and risk records needed updating
needs fixingSome risk assessments were scored incorrectly, and care plans did not always contain enough personal information. Some diet, oral health and DoLS information was also not reflected in care plans.
“Risk assessments were completed but they did not always reflect people's current risks accurately as they had been scored incorrectly.” from the report
Incident learning was incomplete
needs fixingIncidents were recorded and reviewed, but reviews did not fully identify patterns or trends. This meant opportunities to improve safety could be missed.
“Although regular reviews of incidents had been put in place since the last inspection, these reviews did not fully identify patterns, trends or themes.” from the report
- 01What changes have been made to prevent medicines being given too close together or recorded on duplicate MARs?
- 02How are managers checking that medicines audits now identify errors promptly?
- 03How often are care plans and risk assessments reviewed and updated when people's needs change?
- 04How are incidents analysed for patterns and trends, and what improvements have resulted?
- 05What is the current process for accepting new residents, given the CQC restriction on admissions and the decision not to admit people with nursing needs?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also checked under Safe. This explanation was written from the published report of 7 October 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 Cressington Court Care Home
5 rated inspections over 4 years: the service has improved, from Inadequate to Requires improvement.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2022Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2022InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- March 2022Inspected but not ratedSafe: Inspected but not rated
- November 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- March 2019InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- March 2018
Registered with the Care Quality Commission on 19 March 2018.
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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