CQC report explained · a residential care home
What the CQC found at Gedling Village Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks, staffing and infection control had improved, but opened creams and eye drops were not always dated and medicine competency training was incomplete.
- Effective?
- Requires improvement
- This key question was not assessed during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were involved in decisions about their care and their wishes were respected.
- Responsive?
- Good
- Care plans and support had become more person-centred. People's communication needs, interests, activities and end of life wishes were recorded and supported.
- Well-led?
- Requires improvement
- The new manager had improved the culture and introduced action plans, but quality checks and investigations were not always detailed or consistent.
What inspectors found, June 2021
Rated Requires Improvement and no longer in special measures; inspectors found kind, responsive care but ongoing medicine and management weaknesses.
This was an unannounced focused inspection on 27 April and 11 May 2021. Inspectors spoke with people, staff, relatives and a professional visitor. They observed care and checked medicines, care plans, staff records, rotas and management records.
The home had improved since its previous inadequate rating. Staff numbers had increased, risks were assessed more carefully, and people were treated with kindness and respect. People had choices about their care and activities, and complaints were acted on.
Some important work was not finished. Prescribed creams and eye drops were not always dated when opened, medicine training was incomplete, and quality checks had missed some problems. The home was no longer in breach of regulations and had left special measures, but CQC said further work was needed to make improvements consistent and lasting.
Kind and respectful care
Inspectors saw staff treating people with kindness and maintaining their dignity. People were supported to make choices and remain as independent as possible.
“People were treated with care, respect and compassion.” from the report
Improved staffing
There were enough staff during the inspection, and staffing levels had been adjusted when people's needs changed. People were no longer left waiting for long periods.
“There were enough staff and they were suitably deployed to safely meet people's needs.” from the report
Person-centred support
Care plans were being updated to reflect people's needs and preferences. Activities were linked to people's interests, and people were not woken against their wishes.
“Care and support was now delivered in a person-centred way.” from the report
More open management
The new manager had improved the culture and encouraged people, relatives and staff to raise concerns. Action plans had been created after the previous inspection.
“The culture within the home had improved and the service was more open and inclusive.” from the report
Quality checks
needs fixingThe home's audits had not identified the medicine problems found by inspectors. This suggests the checking systems were not yet reliable enough.
“Medication audits were in place but had not picked up the issues we found.” from the report
Management consistency
needs fixingThe home was going through changes, but inspectors found that some improvements still needed to be embedded and sustained. Staff said things could slip when the manager was not present.
“However, further work was needed to embed and sustain these changes.” from the report
- 01How are you now making sure every prescribed cream and eye drop is dated when opened?
- 02Has all medicine competency training now been completed, and how is it checked?
- 03How do you make sure safeguarding investigations are detailed enough to prevent incidents happening again?
- 04What checks now confirm that improvements continue when the manager is not present?
- 05How are you monitoring the action plan from the previous inspection and sharing progress with relatives?
This was a focused inspection of Safe, Caring, Responsive and Well-led, including infection control; Effective was not assessed and its previous rating was used in the overall rating. This explanation was written from the published report of 10 June 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.
What inspectors found, March 2021
Rated Inadequate and placed in special measures; inspectors found people at risk from staffing, medicines, infection control and weak management.
This was an unannounced focused inspection. Inspectors visited on 19 and 27 January 2021, spoke with people, relatives and staff, observed care, and checked records, medicines, staffing and management systems.
They found that people were not always safe. There were too few staff, long waits for help, unsafe medicines practices, repeated falls, hot radiators, poor infection control and care records with conflicting information.
Care was not always personal or responsive. Some people were woken very early for staff convenience, communication needs were missed, and some concerns were not acted on. Activities and visits with loved ones were positive areas.
The overall rating fell from Requires Improvement to Inadequate. Safe and Well-led were rated Inadequate, while Responsive remained Requires Improvement. The report says the home is in special measures and will be monitored closely.
Activities
Inspectors saw people engaged in activities, and staff spent time with people who did not want to join group activities.
“We observed activities taking place during our first day of inspection.” from the report
Family visits
The home had created a separate structure so people could see loved ones more safely during the pandemic.
“The provider had built a structure away from the home to allow for people to safely see their loved ones whilst COVID-19 was still a risk.” from the report
Vaccination programme
The registered manager worked with the GP surgery to deliver the COVID-19 vaccination programme in the home.
“The registered manager had worked with the GP's surgery to safely deliver the COVID-19 vaccination programme within the home.” from the report
Too few staff
seriousPeople were left alone and waited for help. Inspectors saw call bells ringing for long periods and staff silencing them without providing the needed support.
“During both days of our inspection we observed that there was insufficient staff.” from the report
Unsafe medicines
seriousMedicines were found on the floor, some were not identified, and medicine trolleys were left unattended. Staff knowledge and training were not checked effectively.
“Medicines were not always stored in a safe way.” from the report
Falls and other risks
seriousRisk assessments and protective measures were not reliable. People at risk of falls were left without suitable support, and incidents were repeated without effective action.
“People had experienced multiple falls and adequate action had not be taken to reduce further risk.” from the report
Infection control
seriousInspectors found that COVID-19 guidance was not consistently followed. Staff did not always use suitable protective equipment, social distancing was poor and used PPE was left on the floor.
“People were at risk of infection due to poor infection prevention and control practices.” from the report
Personalised care
seriousCare was task-led rather than based on each person's choices and current needs. Some people were woken very early for staff convenience, and care records were incomplete or contradictory.
“Staff told us people were woken to make things easier for the next shift rather than it being a person's choice.” from the report
Weak management oversight
seriousQuality checks did not identify or improve serious problems. Some staff did not feel listened to when raising concerns, and lessons were not consistently learned from incidents.
“The internal quality assurance processes had not been used to monitor the service effectively and had failed to identify and improve shortfalls in relation to falls management and staffing at the service.” from the report
- 01What staffing levels are now in place on each shift, and how do you make sure people answer call bells promptly?
- 02How are medicines stored, checked and handed out safely, including medicines left in rooms or on the floor?
- 03What changes have been made to prevent falls and make sure actions after incidents are completed?
- 04How are current care plans checked so they accurately reflect each person's mobility, diet, communication and end-of-life wishes?
- 05What evidence can you show that infection control, PPE use and social distancing now follow current guidance?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 24 March 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 Gedling Village Care Home
5 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2021Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inadequatedown from Requires improvementSafe: InadequateResponsive: Requires improvementWell-led: Inadequate
- July 2019Requires improvementdown from GoodSafe: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Registered with the Care Quality Commission on 19 November 2013.
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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