CQC report explained · a nursing home
What the CQC found at Cromwell Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with risk assessments, medicines systems, staffing checks and safeguarding procedures in place. Some records were not completed thoroughly, and enhanced cleaning records were missing at the inspection.
- Effective?
- Good
- People's needs and choices were assessed and supported. Staff training, food and drink support, healthcare arrangements and consent procedures were found to be effective.
- Caring?
- Good
- Inspectors saw kind and respectful care. People were involved in decisions and supported to maintain their dignity, privacy, independence and personal choices.
- Responsive?
- Good
- Care was personalised and communication needs were supported. People had access to activities, complaints processes and end of life planning, although some care records needed more personal life-history information.
- Well-led?
- Requires improvement
- The home had an open and person-centred culture, but its quality checks did not always identify gaps in records. The provider was asked to strengthen its governance and quality assurance arrangements.
What inspectors found, January 2022
Rated Good overall; inspectors found safe, kind and personalised care, but the home’s leadership and record checks require improvement.
This was an unannounced comprehensive inspection on 3 and 8 December 2021. Inspectors spoke with people living at the home, relatives, staff and an external healthcare professional. They also reviewed care records, medicines records, staff recruitment files and management information.
The home was rated Good for Safe, Effective, Caring and Responsive. People were generally safe, medicines were managed properly, staff understood people's needs, and care was described as kind and respectful. People were supported with meals, healthcare, activities, communication and end of life care.
Well-led was rated Requires Improvement. The home had improved since earlier inspections, but quality checks did not always find incomplete or inaccurate records. The report says the provider was no longer breaching regulations, but governance arrangements still needed strengthening.
Safe medicines support
Medicines were ordered, stored and given safely. Staff were trained and records and audits were in place.
“Medication ordering, storage and administration was in line with best practice, guidance and policy.” from the report
Kind and respectful care
People and relatives described staff as kind, caring and respectful. Inspectors also observed respectful interactions.
“We observed staff engaging with people in a kind, caring and respectful manner.” from the report
Personalised support
Care plans included people's preferences and staff knew the people they supported. People were offered choice and control.
“People received personalised care and support that was centred around their needs, wants and preferences.” from the report
Activities and relationships
The home offered group and one-to-one activities, helped people maintain relationships and supported personal interests.
“Positive relationships were maintained and people were supported to engage in a variety of different activities to keep them stimulated and occupied.” from the report
Quality checks did not find all record gaps
needs fixingThe home’s monitoring systems did not always identify incomplete or inaccurate records. Inspectors recommended that governance measures be strengthened.
“However, not all quality assurance measures were identifying some of the gaps that were identified during the inspection.” from the report
Some records needed improvement
minorNot all records were completed thoroughly. Some care records also needed more information about people's life history and identity.
“However, we did note that some care records needed additional 'life history' and 'who I am' information contained in them.” from the report
Enhanced cleaning records were missing
needs fixingThe home was clean and hygienic, but inspectors found that enhanced cleaning schedule records were not in place. The home responded immediately after the inspection.
“The home was clean, hygienic and well-maintained although enhanced cleaning records were not in place.” from the report
- 01What checks are now in place to make sure care records are complete and accurate?
- 02How do you record and review enhanced cleaning schedules?
- 03How will you add and keep up-to-date information about each person’s life history and ‘who I am’?
- 04What improvements have been made since the previous inspection, and how do you check that they remain effective?
- 05How are people and relatives involved in reviewing care plans and giving feedback?
This was an unannounced comprehensive inspection covering all five key questions, following earlier focused inspections that identified a breach of safe care and treatment. This explanation was written from the published report of 12 January 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, October 2020
Inspected but not rated; inspectors found risks in care records, medicines and environmental safety, and a breach of safe care and treatment.
This was a focused inspection on 21 September 2020. Inspectors looked only at Safe and Well-led, partly because of concerns about management and leadership during the COVID-19 pandemic. The home was not given an overall rating.
Inspectors found that risk assessments and care plans did not always contain current information. Some people did not always have access to call bells. Medicines procedures, including hidden medicines, were not always followed safely. These findings led to a breach of Regulation 12, safe care and treatment.
There were positive findings too. Staff knew how to report safeguarding concerns, staffing levels were reviewed, recruitment checks were carried out, and infection control measures were in place. Inspectors also found a caring and positive culture, but said governance and quality checks needed more development.
Infection control
Inspectors found that COVID-19 infection control measures, including protective equipment, testing and outbreak arrangements, were in place.
“We were assured that the provider was using 'personal protective equipment' (PPE) effectively and safely and infection prevention and control policies were up to date.” from the report
Staff suitability
The home followed recruitment checks, and staffing levels were reviewed against people's dependency needs.
“Safe recruitment practices were followed; people received support by staff who were deemed suitable to work in adult social care environments.” from the report
Positive care culture
Inspectors found that staff understood their roles and promoted a compassionate, person-centred culture. Relatives also gave positive feedback about the care.
“The manager was aware of their legal and regulatory responsibilities; the staff team were also clear about their roles and promoted a positive, compassionate and person-centred culture.” from the report
Safeguarding
Staff knew how to report safeguarding concerns, and safeguarding incidents were referred to the local authority and CQC.
“Staff knew how to report any safeguarding concerns and the importance of keeping people safe.” from the report
Incomplete risk information
seriousCare plans and risk assessments were not always current or complete. Important details such as repositioning times and weight reviews were sometimes missing.
“Risk assessment and support tools were not always completed, and some significant information about people's support needs were not always in place.” from the report
Medicines not always managed safely
seriousStaff did not always follow medicines policies. This included problems with medicine returns and hidden medicines not being given according to instructions.
“Medication administration policies were not always followed. Medication administration processes and medication returns were not always safely managed.” from the report
Access to call bells
seriousSome people did not always have access to a call bell. One person said they had to use a pressure mat to get staff's attention.
“People did not always have access to call bells. For instance, one person told us that they had to activate their pressure mat to get a response from staff.” from the report
Weaknesses in quality checks
needs fixingThe home's audits did not always identify environmental risks. CQC recommended stronger governance and quality assurance arrangements.
“Quality audits were not always identifying potential environmental risks that people were exposed to.” from the report
Incomplete post-fall records
needs fixingAlthough accident and incident systems were in place, post-fall documentation was not always completed.
“Staff were familiar with reporting procedures although we noted that 'post -falls' documentation was not always completed.” from the report
- 01What has been done to make sure every care plan and risk assessment contains current information, including repositioning times and weight reviews?
- 02How are medicines, medicine returns and hidden medicines now checked to make sure staff follow the correct instructions?
- 03Can every resident reach a call bell, and what checks are carried out to confirm this?
- 04What environmental risks did the inspection identify, and how have they been fixed?
- 05What was included in the action plan requested by CQC, and what progress has been made?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and the service was therefore not given an overall rating. This explanation was written from the published report of 24 October 2020 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 Cromwell Court
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- January 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2020Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- September 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2020
Registered with the Care Quality Commission on 10 March 2020.
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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