CQC report explained · a nursing home
What the CQC found at GHC Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2022
Rated Requires Improvement; medicines and safety improved, but management systems and communication with relatives were not yet reliable.
This was an unannounced focused inspection on 9 March 2022. Inspectors checked whether earlier problems with medicines and governance had been fixed. They spoke with people, staff, relatives and healthcare professionals, and reviewed care, medicines, staff and management records.
The home was rated Good for Safe. Inspectors found medicines were managed safely, risk assessments were detailed and regularly reviewed, staffing levels were appropriate, and infection control arrangements were suitable.
The home was rated Requires Improvement for Well-led. There were better audits and records, but inspectors could not yet be sure the improvements would last. They also found weaknesses in management cover, staff supervision and communication with relatives.
The overall rating stayed Requires Improvement. The inspection only covered Safe and Well-led. The other ratings were carried forward from the previous inspection.
Safer medicines
Medicines were stored and managed appropriately. Records showed how people preferred to receive them.
“At this inspection we found medicines were appropriately managed which meant people were protected from unnecessary risks and harm.” from the report
Risk management
Risk assessments were personal to each person, proportionate and regularly reviewed. Staff also discussed changing risks during handovers.
“Risk assessments were person centred, proportionate and reviewed regularly.” from the report
Safeguarding
Staff understood the safeguarding process and inspectors saw evidence that management acted to protect people when incidents occurred.
“Staff were able to demonstrate a thorough understanding of this and told us they received support and feedback from management when concerns were raised.” from the report
Respectful care
People were treated with dignity and respect. Inspectors found that care was person-centred and aimed at positive outcomes.
“People received care from staff that was person-centred with the aim of providing positive outcomes.” from the report
Management cover
needs fixingThe systems for maintaining governance when the registered manager was absent were not fully effective. Inspectors could not review medicine audits and said this increased the risk that errors would not be identified quickly.
“We were unable to review medicine audits completed by management in the absence of the registered manager.” from the report
Checks not yet established
needs fixingNew audits and quality checks had been introduced, but they needed more time to show that they were robust and consistently identified problems.
“However, more time was needed to ensure these checks were robust and identified issues.” from the report
Irregular updates for relatives
needs fixingSome relatives said communication was irregular and that they were not always included in care planning. They were also unclear about who the registered manager was and how to contact them.
“Relatives told us they received irregular communication and updates.” from the report
Staff supervision
minorStaff did not receive formal supervision as often as the home's policy required. This meant feedback was not always recorded and shared promptly.
“Staff did not receive regular formal supervisions in line with the providers policy which meant that feedback was not always documented and communicated in timely manner.” from the report
- 01How are medicine audits completed and checked when the registered manager is absent?
- 02What evidence can you show that the new audits are now identifying and resolving problems consistently?
- 03How often will staff receive formal supervision, and how will this be recorded?
- 04Who is the current registered manager, and how can relatives contact them?
- 05How will relatives be included in care planning and kept informed about smaller changes in their relative's care?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 5 April 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
Rated Requires Improvement; inspectors found kind care and enough staff, but serious problems with medicines, risk management and governance.
This was an unannounced comprehensive inspection on 26 and 31 August 2021. Inspectors spoke with people, staff and partner professionals. They reviewed care records, medicines records, staff files, audits and other management records.
The main concerns were that medicines were not always managed safely, risks were not consistently assessed, and care plans did not always give staff enough guidance. Records and audits were not always accurate or effective. The home also did not always support people in line with the Mental Capacity Act.
Inspectors found enough staff, suitable recruitment checks, infection control measures and caring interactions. People’s privacy, dignity and independence were respected. Meals, activities, visitors and complaints arrangements were also viewed positively.
The overall rating and four of the five question ratings were Requires Improvement. Caring was rated Good. The rating means the home was not consistently safe, effective, responsive or well-led, and inspectors found an increased risk that people could be harmed.
Enough staff
Inspectors found enough staff to provide timely care. Staff responded quickly to call bells and supported people safely when equipment was used.
“Enough staff were available to provide safe care to people.” from the report
Kind and respectful care
Staff respected people’s privacy, dignity and choices. They helped people keep everyday skills and supported them to personalise their rooms.
“We observed staff enabling people to retain their everyday living skills and abilities.” from the report
Infection control
Inspectors were assured that infection prevention measures, including PPE, testing and visiting arrangements, were being followed.
“People were protected from the risks associated with infection.” from the report
Food and activities
People were offered varied meals that met dietary needs, and inspectors saw people enjoying activities and time with friendship groups.
“People told us they enjoyed their meals and we saw staff created an enjoyable dining experience.” from the report
Medicines were not reliably safe
seriousTablets were found on the dining room floor, and medicine stocks did not always match the records. The home could not show that everyone had received medicines as prescribed.
“Medicines were not always managed safely, and people did not always receive their medicines as prescribed.” from the report
Risks and care plans were incomplete
seriousSome risks, including falls, bed rails and moving equipment, were not properly assessed or reviewed. Important care plans were missing or did not give staff enough detail.
“People were placed at risk as care plans were not in place to ensure safe and consistent care.” from the report
Weak management checks
seriousAudits did not identify important problems with medicines, records, training or incidents. The home also had difficulties maintaining effective governance when the registered manager was absent.
“Systems and processes designed to assess, monitor and improve the quality and safety of services and reduce risks had not been operated effectively.” from the report
Incomplete legal decision records
needs fixingRecords did not always show people’s consent or mental capacity assessments for important decisions. DoLS-related information was not consistently reflected in care plans.
“We found no record to show consent had been gained, or a mental capacity assessment completed for important decisions regarding one person's care.” from the report
Unclear end of life wishes
needs fixingSome care plans contained contradictory information about resuscitation wishes. Inspectors were concerned this could cause problems during a medical emergency.
“Care plans were not always clear on people's resuscitation wishes and at times contained contradictory information.” from the report
- 01What changes have been made to ensure every medicine is given as prescribed and that stock records are accurate?
- 02How are falls, bed rails and moving equipment now assessed, recorded and reviewed after an incident?
- 03How do you check that care plans contain enough detail for staff to provide consistent care?
- 04How do you track staff training and medicine competence, including for agency nurses?
- 05How are consent, mental capacity, DoLS and resuscitation decisions recorded and kept up to date?
This was an unannounced responsive comprehensive inspection covering all five key questions, including infection prevention and control; it was the first inspection under the home’s current registration. This explanation was written from the published report of 23 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 GHC Nursing Home
10 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- April 2022Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2019Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- March 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2021
Registered with the Care Quality Commission on 21 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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