CQC report explained · a nursing home
What the CQC found at Dean Wood Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and inspectors found enough staff, safe recruitment, good infection control and appropriate risk assessments. Some recording issues with medicines were found and addressed during the inspection.
- Effective?
- Good
- Staff had training and support, people's healthcare needs were met, and people had suitable food, drinks and snacks. Staff supported people with consent and least restrictive care.
- Caring?
- Good
- Inspectors observed patient and respectful care. People and relatives said staff were kind, caring and attentive to privacy, dignity and independence.
- Responsive?
- Good
- Care plans included people's preferences, communication needs and life histories. The home provided individual and group activities, involved relatives and handled complaints through its stated process.
- Well-led?
- Good
- The home had regular audits, improvement plans and meetings to identify concerns and share learning. People, relatives and staff spoke positively about the management and communication.
What inspectors found, August 2022
Rated Good; inspectors found safe, kind and personalised care, with some medicines recording issues fixed during the inspection.
This was the first full ratings inspection since the home changed from a partnership to a limited company. Inspectors visited on 30 June and 1 July 2022, and reviewed further information until 27 July. They spoke with people living at the home, relatives, staff and a visiting medical professional. They also checked care records, risk assessments, medicines and quality records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, good infection control and suitable risk checks. People were supported with healthcare, food, communication, activities and decisions about their care.
People and relatives described staff as kind, respectful and responsive. Care plans recorded people's needs and preferences, and relatives were involved in reviews. The home had systems for complaints, audits and improvement. Some medicines records were not always clear, but the home acted promptly during the inspection.
Kind and respectful care
People were treated with dignity and staff were patient, friendly and empathetic. Inspectors observed people appearing comfortable with staff.
“People were treated with dignity and respect by staff who knew them well.” from the report
Personalised support
Care plans recorded people's likes, dislikes, interests, life histories and communication needs. People and relatives were involved in care planning and reviews.
“Care plans viewed on inspection contained a range of personalised information about people's likes, dislikes, interests and life histories” from the report
Safe staffing and environment
People and relatives said there were enough staff and that requests for help were answered promptly. The home was clean and safety checks were completed.
“Enough staff were deployed to keep people safe and meet needs.” from the report
Good support at the end of life
Staff were trained in end of life care and worked with the local hospice. Inspectors found examples of staff helping someone receive care in line with their wishes.
“Staff took it in turns to visit when not on shift, to ensure this person always had someone with her.” from the report
Improved management
Audits, daily meetings and an improvement plan were used to track issues and share learning. The previous Well-led rating improved from Requires Improvement to Good.
“The improvement plan was formally reviewed weekly and updated with progress made.” from the report
Medicines recording
needs fixingStaff did not always record whether medicines given when needed had worked. Records for medicines in patch form were unclear, so the home temporarily returned to paper records while the electronic system was adapted.
“Staff had not always documented on care notes if PRN medicines had been effective.” from the report
Staff allocation
minorSome staff felt that the distribution of staff across different areas of the home could be reviewed because some areas were busier than others.
“Some felt allocation of staff across the home could be looked at, as some areas were busier than others.” from the report
Staff support meetings
minorCompetency supervision took place, but broader meetings for staff to discuss how things were going, goals and support needs were not currently held. The provider was reviewing this process.
“Support orientated meetings, where staff were able to talk about how things were going, discuss goals and needs and so on, were not currently held.” from the report
- 01How do you now check that medicines given when needed have worked and are recorded clearly?
- 02What system do you use for recording medicines in patch form, and how will you prevent unclear records?
- 03How do you decide how many staff are placed in each area during busy periods?
- 04What broader support meetings are now available for staff to discuss their goals and support needs?
- 05How will relatives be involved in reviewing their family member's care plan and communication needs?
This was the first full ratings inspection of the newly registered service and covered all five key questions; inspectors visited on 30 June and 1 July 2022, with inspection activity continuing until 27 July for further evidence. This explanation was written from the published report of 5 August 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 2021
Inspected but not rated overall; inspectors found unsafe medicines management and weak checks, while people said they felt safe and supported.
This was a focused inspection on 5 and 25 August 2021. Inspectors looked only at Safe and Well-led, including infection control, medicines, care records, staffing and management checks. They spoke with people, relatives and staff, and reviewed care, medicine and quality records.
The home was rated Requires Improvement for Safe. Medicines were not always managed safely. Some doses were missed, records were inaccurate, and staff did not always have enough guidance. Care records also contained conflicting or incorrect information. Inspectors found no evidence that anyone had been harmed by these medicine problems.
The home was rated Requires Improvement for Well-led. Its audits had not found the medicines and record-keeping problems, and some improvement actions were not updated. There were also positive findings, including enough staff, safe recruitment, safeguarding training, infection control and positive feedback from people and relatives.
There was no overall rating because this inspection only covered two areas. The previous rating under the former provider was Requires Improvement, published on 12 January 2021.
People felt safe
People and relatives told inspectors they felt safe and were positive about the care and support provided.
“People told us they felt safe living at Dean Wood Manor and were happy with the care and support they received.” from the report
Infection control
Inspectors found robust cleaning and infection control arrangements, including measures introduced during the COVID-19 pandemic.
“The home had robust cleaning and infection control processes in place.” from the report
Staffing and recruitment
Inspectors found enough staff were deployed and the required recruitment checks had been completed.
“Enough staff had been deployed to meet people's needs.” from the report
Safeguarding
Staff had safeguarding training and knew how to report concerns. Safeguarding referrals were recorded and followed up.
“Staff had received training in safeguarding and knew how to report concerns.” from the report
Positive feedback
People, relatives and staff spoke positively about the home and said management had made improvements.
“People, staff and relatives spoke positively about the home and support provided.” from the report
Medicines were not always safe
seriousSome prescribed doses were missed because stock was not managed effectively. Records showed medicines had been given when this was not accurate, and guidance for some medicines was missing or unclear.
“People missed some doses of their prescribed medicines because stock had not been managed effectively.” from the report
Medicine storage and guidance
seriousSome medicines were stored outside recommended conditions. Staff also lacked enough information about medicines given when needed, variable doses and covert medicines.
“Information was missing to help staff give covert medicines safely.” from the report
Inaccurate care records
needs fixingCare records included conflicting information about diets, falls, safety checks, weight ranges and body mass index. This could make it harder for staff to follow the right care arrangements.
“We identified a number of inaccuracies and contradictory information within people's electronic care records.” from the report
Checks did not find problems
seriousThe home's audits had not identified the medicines and care-record issues found by inspectors. Some improvement actions had no recorded update.
“Systems and processes to monitor the safety and quality of service provision and ensure actions were addressed timely, were not robust.” from the report
- 01What action has been taken to stop missed medicine doses and improve medicine stock control?
- 02How are fridge temperatures, unwanted medicines and medicines removed from their original packaging now checked?
- 03What written guidance is available for medicines given when needed, variable doses and covert medicines?
- 04How are inaccurate or conflicting care records identified and corrected promptly?
- 05What evidence can you show that the improvement plan actions are now updated and completed?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not assessed and no overall rating was awarded. This explanation was written from the published report of 8 October 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 Dean Wood Manor
8 rated inspections over 6 years: the service has improved, from Inadequate to Good.
- August 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2021Inspected but not ratedSafe: Requires improvementWell-led: Requires improvement
- January 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016Inadequatestayed InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2016InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- July 2021
Registered with the Care Quality Commission on 19 July 2021.
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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At least 100 live-in carers within about an hour of Wigan
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. 92 can care for a couple. 11 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“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.