CQC report explained · a residential care home
What the CQC found at Deer Park Care Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2022
Rated Requires Improvement overall, with Inadequate leadership and quality checks that did not reliably keep care records and risks up to date.
This was an unannounced focused inspection on 18 August 2022. Two inspectors spoke with people living at the home, relatives and staff. They reviewed care and medicine records, recruitment files and management records.
The home had enough staff, people received medicines safely and infection control arrangements were suitable. People told inspectors they felt safe, supported and able to make choices. Environmental safety had also improved since the previous inspection.
However, some care plans and risk assessments were incomplete. Recruitment checks were not always thorough. Quality checks repeatedly failed to find these problems, and some required notifications were not sent to CQC. Safe was rated Requires Improvement and Well-led was rated Inadequate.
The overall rating remained Requires Improvement. This was the home's eighth consecutive rated inspection without achieving Good, and the provider remained in breach of regulations.
Enough staff
Inspectors saw people receiving support when they needed or wanted it. A second activities co-ordinator had also been recruited to support more outings and activities.
“There were enough staff to support people. We observed people received support from staff when they needed or wanted it.” from the report
Medicines
People received medicines safely, on time and as prescribed. Medicines were stored, ordered and disposed of safely.
“People received their medicine safely, on time and as prescribed.” from the report
Environmental safety
Checks and servicing of hot water, equipment and appliances were in place. A previously reported rotting window had been replaced.
“Environmental risks were managed. For example, regular hot water temperature checks were completed to reduce the risks of scalding.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including the use of protective equipment.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Weak quality oversight
seriousThe provider's checks repeatedly failed to identify problems with care plans, risk assessments, records and incident analysis. This was a continued breach of regulation 17.
“The provider had failed to operate an effective system to assess, monitor and improve the quality and safety of the service.” from the report
Incomplete risk information
needs fixingSome people at risk of choking did not have enough written guidance for staff. Care plans were put in place after the inspection, but still did not explain what to do if choking occurred.
“Where people were at risk of choking there was a lack of guidance for staff.” from the report
Recruitment checks
needs fixingFull employment histories were not always obtained, gaps were not always explored and some reference dates did not match application forms.
“Staff recruitment had not been consistently safe. Full employment histories had not been consistently obtained.” from the report
Missed CQC notification
seriousThe provider did not always notify CQC when required, including about a grade 3 pressure sore and a serious injury referred to in the enforcement section.
“The manager and provider had failed to ensure notifications were always sent to CQC when they were required to do so.” from the report
- 01What has been done to make sure every person at risk of choking has a complete and current risk assessment, including instructions for what staff should do if choking happens?
- 02How are you checking that care plans accurately reflect people's current needs, including oral care and skin conditions?
- 03What changes have been made to recruitment checks, including full employment histories, gaps in employment and reference dates?
- 04How are you analysing incidents involving emotional behaviour to identify triggers and prevent them happening again?
- 05What system is now in place to make sure all incidents and serious injuries that must be reported are notified to CQC on time?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection and the specific death that prompted the inspection was not examined. This explanation was written from the published report of 23 September 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, August 2021
Rated Requires Improvement; inspectors found improvements, but weaknesses in the environment, mental health training and quality checks remained.
This was an unannounced follow-up inspection on 8 July 2021. Inspectors spoke with four people, a relative, five staff members and two visiting professionals. They reviewed care, medicine, recruitment, training and management records.
The home had improved since the previous inspection. Staffing levels had increased, infection control had improved, medicines were safely managed and people said they felt safe and well cared for. Staff also worked with mental health professionals and involved people in decisions about the home.
However, some environmental risks had not been dealt with quickly. These included uneven outdoor surfaces and a damaged window. Care plans and risk assessments did not always contain enough detail, and staff lacked formal training in supporting people's mental health.
The overall rating remained Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three areas were not examined during this focused inspection, so their previous ratings were carried forward.
Safe medicines
Medicines were stored and given safely. Records had no gaps, and there was clear guidance for medicines taken when needed.
“Medicine administration charts were complete with no gaps in administration.” from the report
Improved infection control
The home was clean and earlier problems with dirty areas, rusty equipment and bathrooms had been addressed.
“At this inspection we found improvements, the service was clean, without limescale or build up in bathrooms.” from the report
People involved
People's views were sought and used, including when bathrooms were improved and through regular resident meetings.
“People had been actively engaged in the service, and their opinions sought and acted on.” from the report
Safer staffing
Night staffing had increased since the last inspection. The manager was also using a dependency tool to help decide staffing levels.
“At this inspection we found that the registered manager was using a dependency tool to assess people's needs and help to inform how many staff were needed on each shift.” from the report
Environmental risks
seriousUneven outdoor surfaces created a potential trip hazard. A first-floor window had a single pane of glass and a rotting frame, and replacement had not been prioritised quickly enough.
“This caused a potential trip hazard to people, which had not been identified and acted on.” from the report
Weak quality checks
seriousThe home's audits did not identify important problems with the environment, care records, risk assessments, incident analysis or staff training. This was a continued breach of Regulation 17.
“The provider had failed to operate an effective system to assess, monitor and improve the quality and safety of all areas of the service.” from the report
Mental health training
needs fixingThere was no formal mental health training, and some staff did not understand people's individual diagnoses well enough. Guidance for supporting people if their mental health worsened also needed more detail.
“Some staff we spoke with lacked understanding on people's individual diagnosis and would benefit from further training around this.” from the report
Incomplete care guidance
needs fixingSome care plans and risk assessments did not clearly record the support already being provided. Constipation care plans needed more information about risks and what to do if someone's mental health deteriorated.
“Constipation care plans needed more detail, including how to identify risks to people if their mental health deteriorated and clearer outlines of risks associated with constipation.” from the report
- 01Has the first-floor window been replaced, and when were the uneven outdoor surfaces repaired?
- 02What formal training do staff now receive about supporting people with mental health conditions?
- 03How do you check that care plans and risk assessments contain enough detail for new staff to follow safely?
- 04How are incidents such as falls analysed for patterns, including the time and circumstances of each incident?
- 05What action has been taken to meet the continued Regulation 17 breach, and how is progress checked?
This was an unannounced focused follow-up inspection of Safe and Well-led; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 6 August 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 Deer Park Care Centre
8 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- August 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Inspected but not rated
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2016Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
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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