CQC report explained · a nursing home
What the CQC found at Great Wheatley Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and updated, staff recruitment checks were completed, infection controls were in place and medicines were administered by trained staff. Medicine auditing had needed improvement, but a more robust system was introduced after the inspection.
- Effective?
- Good
- People had individual care plans, trained staff and support from health professionals when needed. Food, drink, weights and special diets were monitored.
- Caring?
- Good
- People and relatives described staff as kind and helpful. Inspectors observed that staff respected privacy, dignity and people's choices.
- Responsive?
- Good
- Care plans reflected people's preferences and were reviewed. People were offered activities, complaints were handled promptly and end-of-life wishes were recorded where appropriate.
- Well-led?
- Good
- Inspectors found a positive culture, clear management arrangements and monitoring systems. The home had improved its governance since the previous inspection and was no longer in breach.
What inspectors found, April 2023
Rated Good; inspectors found safe, kind and personalised care, with earlier problems improved but some records still needing attention.
This was an unannounced inspection on 4 April 2023. Two inspectors spoke with 7 people, 3 relatives and 6 staff. They reviewed care, medicines, recruitment and management records, as well as the premises.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives gave positive feedback. Inspectors found suitable risk assessments, trained staff, safe medicine administration, good food and healthcare support, activities, and respectful care.
The home had previously been rated Requires Improvement, published in April 2022. At that inspection it breached rules about safe care and treatment and good governance. Inspectors found improvements had been made and said the home was no longer in breach.
Positive experiences
People and relatives gave positive feedback about the care. People said they felt safe and well looked after.
“People and their relatives gave us positive feedback on their experience of using the service.” from the report
Personalised care
Care plans were individual and included information about what mattered to each person. Staff used this information to support people's preferences.
“Care planning documentation contained 'This is me' and preferred priorities of care so that staff could really get to know and understand how people wished their care to be delivered.” from the report
Kind and respectful staff
Inspectors found that staff treated people with dignity and respected their privacy. People's views were included in care planning.
“Staff treated people with dignity and respect. We observed staff closed doors and pulled curtains when supporting people with personal care.” from the report
Improved leadership
The home had introduced monitoring systems and made improvements after the previous inspection. Staff said they felt supported.
“The registered manager had been successful in driving improvements at the service.” from the report
Activities and healthcare support
People received one-to-one activities suited to their health and interests. The home worked with GPs and other health professionals when needed.
“Due to people's health conditions, they mostly stayed in bed or in their rooms and the activity person did one to one activity with them.” from the report
Medicine audit records
needs fixingInspectors said the systems for auditing medicines needed to be improved. The registered manager showed them a new, more robust system after the inspection.
“systems in place to audit the use of medicines to ensure all medicines could be accounted for needed to be improved.” from the report
One resuscitation record
needs fixingOne person's do-not-resuscitate documentation had not been updated after they returned from hospital. The registered manager said this would be updated by the GP.
“We did note that do not resuscitate documentation for one person had not been updated since their return from hospital.” from the report
- 01How do you now check that all medicines are recorded and accounted for?
- 02How quickly are do-not-resuscitate records reviewed after someone returns from hospital?
- 03How are care plans and risk assessments updated when a person's needs change?
- 04What one-to-one activities are available for people who mostly stay in bed or in their rooms?
- 05How are relatives involved in reviewing care plans and giving feedback?
This was an unannounced inspection that assessed all five CQC key questions, with infection prevention and control also checked under Safe. This explanation was written from the published report of 27 April 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, April 2022
Rated Requires Improvement; inspectors found kind care and safe medicines, but gaps in records, infection control and quality checks created risks.
This was an unannounced inspection over three visits. Inspectors spoke with four people, 12 relatives and eight staff. They reviewed care records, medicines records, staff files and management records.
People generally felt safe. There were enough staff, medicines were administered safely, the home was clean and staff were kind and respectful. People were supported with food, drink, healthcare and contact with family.
However, infection control guidance was not always followed. Some care plans and risk assessments were out of date, and decisions about care were not always recorded. There were no organised activities, so inspectors recommended that the activity programme be reviewed.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement. Caring was rated Good. The previous overall rating was Good, published on 4 April 2018.
Kind and respectful care
Inspectors saw staff treating people as individuals, protecting their privacy and asking permission before providing support.
“We observed staff speaking kindly to people, asking their permission to support them and using people's names when exchanging information with each other.” from the report
Enough skilled staff
There was always a registered nurse on duty. Recruitment checks, training and staff experience helped support people's safety.
“There were enough staff to meet people's needs and staff demonstrated they were sufficiently skilled and experienced.” from the report
Medicines managed safely
Trained staff administered medicines safely. Records were completed accurately and regular checks were carried out.
“Medicines were administered safely by staff who were trained and assessed as competent to do so.” from the report
Food and drink support
Staff supported people with eating and drinking throughout the day. People were offered a balanced diet and relatives gave positive feedback about the food.
“People were supported to eat and drink a balanced diet.” from the report
Infection control gaps
seriousSome staff did not know the correct visitor testing or vaccination-check guidance. Inspectors said this could increase the risk of infectious diseases.
“Not all staff knew how long visitors had to wait for the result of a lateral flow test.” from the report
Out-of-date care records
seriousSome care plans and risk assessments did not match people's current needs. One person's catheter care arrangements had not been documented.
“People's care plans and risk assessment were not always reflective of their current needs.” from the report
Weak management checks
seriousAudits did not identify problems with infection control, risks and record keeping. The report says the systems were not robust enough to show that safety was properly managed.
“Systems were either not in place or robust enough to demonstrate good governance.” from the report
Few meaningful activities
needs fixingThere were no organised activities because the activities co-ordinator had left. Inspectors recommended reviewing the activity programme so people could be more engaged.
“People did not have access to any organised activities.” from the report
Maintenance and dementia-friendly design
needs fixingSome radiator covers were damaged or loose, and a chest of drawers was damaged. The home also lacked features such as coloured doors and clear signs to help people with dementia find their way.
“The home was purpose built but was in need of some maintenance.” from the report
- 01What has been changed to make sure care plans and risk assessments are updated whenever a person's needs change?
- 02How do you now check that staff understand visitor lateral flow testing and vaccination guidance?
- 03What organised or one-to-one activities are currently available for people who spend much of their time in bed?
- 04How are audits now checking infection control, risk assessments and care records?
- 05What repairs and dementia-friendly changes have been completed since the inspection?
This was a comprehensive inspection covering all five key questions, including infection prevention and control; the previous overall rating was Good and had been published on 4 April 2018. This explanation was written from the published report of 22 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.
Every inspection of Great Wheatley Nursing Home
5 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- June 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2020
Registered with the Care Quality Commission on 2 April 2020.
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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