CQC report explained · a nursing home
What the CQC found at Cypress Court
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- There were enough staff, risks were assessed and safety checks were completed. Medicines were given as prescribed, although some liquid and topical medicines were not dated when opened.
- Effective?
- Requires improvement
- People were supported with food, drink, healthcare and consent, and staff had suitable training. However, fluid charts were not always completed accurately and further dementia-friendly orientation aids were recommended.
- Caring?
- Good
- Staff respected people's privacy, dignity, independence and choices. Inspectors saw warm and compassionate interactions, and people and relatives were involved in care planning.
- Responsive?
- Requires improvement
- Care plans were personalised and complaints were followed up. However, some people found staff communication difficult, and activities attracted limited interest.
- Well-led?
- Good
- Management and quality monitoring had improved. People, relatives and staff were involved in the service, and the home showed evidence of acting on feedback and previous inspection findings.
What inspectors found, October 2023
Rated Requires Improvement; inspectors found safer, kinder and better-led care, but communication, activities and some records still need improvement.
This was an unannounced follow-up inspection after the home had previously been rated Inadequate and placed in special measures. Inspectors visited on 22, 24 and 25 August 2023, and reviewed records, medicines, staffing, care plans and audits. They also spoke with people, relatives, staff and visiting professionals.
The home had made important improvements. There were enough staff, medicines were given as prescribed, risks were assessed, and people were treated with kindness and respect. Care plans, staff training and quality checks had also improved.
Some areas were still inconsistent. Liquid and topical medicines were not always dated when opened, fluid records were sometimes incomplete, and there were limited dementia-friendly signs. Some people found communication difficult and showed little interest in the activities offered.
The overall rating was Requires Improvement. Safe, Caring and Well-led were rated Good. Effective and Responsive remained Requires Improvement. The home was no longer in breach of regulations and was no longer in special measures.
Staffing improved
The home had recruited a more stable staff team and inspectors found enough staff to support people safely. People were supported by staff who knew their needs.
“The home had recruited a stable and consistent staff team, with limited use of agency staff or nurses.” from the report
Kind and respectful care
Staff protected people's privacy and dignity and encouraged independence. Inspectors saw compassionate interactions and found that people and relatives were involved in care decisions.
“We observed warm, compassionate and considerate interactions between staff and people during the inspection.” from the report
Better management checks
Audits and action plans had become more robust. The management team acted on issues from the previous inspection and recorded improvements.
“The management team completed a range of audits and quality monitoring processes in the areas of medicines management, health and safety, infection prevention and control, care plans and people's dining experiences.” from the report
Safer care planning
People's needs, choices and risks were recorded in detailed care plans. These were reviewed and updated when people's needs changed.
“People's needs and choices were assessed and detailed in their care plans.” from the report
Medicine opening dates
minorSome liquid and topical medicines were not marked with their opening date. Inspectors recommended that the home follow current guidance on managing these medicines.
“However, not all topical treatments or liquid medicines were marked with a date of opening.” from the report
Fluid records
needs fixingFluid charts were not always accurate because drinks given during visits from relatives were not always recorded. The manager took immediate action to address this.
“However, fluid charts were not always completed accurately.” from the report
Communication
needs fixingSome people said they could not always understand staff, and one person felt uncomfortable when staff spoke to each other in another language. The home was asked to review how staff communicate.
“The staff are kind but they don't always understand you” from the report
Activities
needs fixingActivities were happening more often, but people showed limited interest and some said they were bored. The home was reviewing the programme and looking for transport for community activities.
“I'm so bored, I'd like to go out more” from the report
Dementia-friendly signs
needs fixingThere were some signs and colour-coded equipment, but inspectors found that more orientation aids were needed to help people living with dementia move around the home.
“However, people living with dementia would benefit from further implementation of dementia friendly orientation aids to enable them to navigate the home environment more effectively.” from the report
- 01How do you make sure liquid and topical medicines are dated when they are opened?
- 02How will you ensure fluid charts are completed when relatives are visiting?
- 03What are you doing to help people understand staff and communicate their needs?
- 04What new activities and community outings are planned for people who are bored or not interested in the current programme?
- 05What additional dementia-friendly signs or orientation aids have been introduced since the inspection?
This was an unannounced follow-up inspection checking action from the previous inspection, with infection prevention and control also reviewed; all five key questions were rated. This explanation was written from the published report of 5 October 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, June 2023
Rated Inadequate and placed in special measures; inspectors found serious problems with safety, staffing, medicines and management.
This was an unannounced inspection on 27 February and 2 March 2023. Inspectors spoke with people living in the home, relatives, staff and outside professionals. They reviewed care records, medicines records, recruitment files and management systems.
Inspectors found people were sometimes left waiting for personal care, meals, drinks and responses to call bells. They found risks were not always properly assessed, care plans were out of date, medicines checks were not strong enough, and some areas and equipment were not clean or suitable.
People were not always involved in decisions about their care. Inspectors also found limited activities, poor recording of care, and staff who did not always have enough time or experience to meet people's needs.
The overall rating was Inadequate. Safe and well-led were rated Inadequate. Effective, caring and responsive were rated Requires Improvement. The home was placed in special measures, meaning CQC planned to keep it under review and usually re-inspect within six months.
Health and safety checks
Inspectors found that health and safety checks were in place and being monitored.
“Health and safety checks were in place and were being monitored.” from the report
Secure medicine storage
The clinic room was tidy, medicines were securely stored and stocks were sufficient.
“The clinic room was tidy, and people had sufficient stocks of medication which was securely stored.” from the report
Staffing delays
seriousStaffing levels and deployment did not allow care to be delivered promptly. People waited for personal care, meals and help with eating and drinking.
“We found evidence the service did not provide adequate staffing levels to ensure care was carried out in a safe and effective way.” from the report
Risks and medicines
seriousRisk assessments and care plans were incomplete or out of date. Inspectors also found weaknesses in allergy records, as-needed medicines, medicine storage temperatures and administration records.
“The oversight of medicine was not robust enough to ensure people where safely given their medicines.” from the report
Food and drinks
seriousSome people did not have drinks within reach and had to wait for food or drinks. Mealtime support and choking risk arrangements were not always followed.
“Effective systems were not in place to ensure people received support with their nutritional intake. This placed people at risk of harm.” from the report
Cleanliness and equipment
needs fixingInspectors found unpleasant smells, unclean bedding, toiletries in shared bathrooms and damaged bedrails. Equipment was not always suitable or safely available.
“We found peoples bed linen was not always clean and some people's bedrooms and areas of the corridors had unpleasant smells.” from the report
Choice and person-centred care
seriousPeople were not always involved in care planning or given choices about bathing, personal care and how their needs were met. Care was often task focused.
“The support people received was not person centred, did not consider people's individual needs, or promote choice and control.” from the report
Weak management oversight
seriousAudits and feedback systems did not lead to lasting improvements. Records did not reliably show what care people had received.
“The provider's quality assurance systems and processes were not effective and had not enabled them to assess, monitor and improve the quality and safety of the service.” from the report
- 01How many staff are now on each shift, and how do you make sure people do not wait for personal care, meals or call bell responses?
- 02What has changed in the checking and administration of medicines, including allergies, as-needed medicines and time-sensitive doses?
- 03How do you now make sure risk assessments and care plans are current and followed by staff?
- 04How are people and their relatives involved in care planning and decisions about bathing, personal care and preferred staff gender?
- 05What activities and regular social contact are now available, especially for people who are cared for in bed?
This was an unannounced inspection covering all five CQC questions and infection prevention and control; it was the first inspection under the current registration, while the previous provider had been rated Requires Improvement in 2020. This explanation was written from the published report of 7 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.
Every inspection of Cypress Court
2 rated inspections over a year: the service has improved, from Inadequate to Requires improvement.
- October 2023Requires improvementcurrent ratingup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2023InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2022Inspected but not ratedSafe: GoodWell-led: Requires improvement
- May 2022
Registered with the Care Quality Commission on 3 May 2022.
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 Cheshire East
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 £1,260 a week. 88 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.