CQC report explained · a nursing home
What the CQC found at Guys Cross Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough suitably trained staff, safe medicines systems, appropriate safeguarding and well-managed risks to people's health and wellbeing. They also found infection prevention arrangements were effective.
- Effective?
- Good
- People's needs were assessed, staff were trained and healthcare professionals worked with the home. People had choices about food and care, although formal mental capacity assessments had not always been completed.
- Caring?
- Outstanding
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found effective quality checks, a positive culture and management that worked openly with people and outside organisations. Some regulatory notifications were sent after the inspection.
What inspectors found, February 2023
Guys Cross Nursing Home was rated Good; inspectors found safe, effective and well-led care, with some records and fire safety work needing attention.
This was an unannounced, focused inspection on 26 January 2023. Inspectors looked at Safe, Effective and Well-led. They observed staff, spoke with people, relatives and staff, and checked care, medicines, recruitment and quality records.
People told inspectors they felt safe and comfortable with staff. Inspectors found enough trained staff, safe medicines systems, well-managed health risks and appropriate safeguarding arrangements. People had choices about their care, food and daily routines.
The home worked with healthcare professionals and had systems to check the quality of care. Inspectors found a positive culture and people and relatives said the home was well-led. However, formal mental capacity assessments were not always completed, and a fire risk assessment review was needed.
The overall rating remained Good, as did the ratings for Safe, Effective and Well-led. Caring and Responsive were not inspected during this visit, so the report used their previous ratings when calculating the overall rating.
People felt safe
People told inspectors they felt safe and staff interacted with them in a relaxed and friendly way.
“People were comfortable in the presence of staff who interacted with people in a relaxed and friendly manner.” from the report
Enough trained staff
Staffing levels and recruitment checks were judged suitable. Staff said they had time to support people's emotional wellbeing.
“There were enough staff to meet people's needs safely and effectively.” from the report
Safe medicines
Medicines were ordered, stored, given, recorded and disposed of safely. People received medicines from appropriately trained staff.
“Systems and processes ensured medicines were managed safely.” from the report
Good healthcare support
The home worked with GPs, physiotherapists and psychiatric services to support people's mental and physical health.
“Staff worked collaboratively with other healthcare professionals to ensure a successful transition between services.” from the report
Positive leadership
Inspectors found an active management presence, good quality checks and a positive culture focused on people's wishes.
“There was a positive culture within the home and staff understood the ethos and values the provider promoted.” from the report
Mental capacity records
needs fixingFormal mental capacity assessments had not always been completed. Inspectors noted that applications had been made where restrictions on liberty were involved.
“However, formal mental capacity assessments had not always been completed.” from the report
Fire risk assessment review
needs fixingThe person who had completed the fire risk assessment had not refreshed their training recently. The manager arranged an external review during the inspection.
“Whilst the quality manager had previously had training in this area, they acknowledged this had not been refreshed recently.” from the report
Regulatory notifications
minorMost required notifications had been submitted, but the manager did not know that renewed DoLS authorisations also needed to be reported. These notifications were sent after the inspection.
“These were sent to us immediately after our inspection.” from the report
- 01Has the external provider completed the review of the fire risk assessment, and what actions resulted from it?
- 02How do you now make sure formal mental capacity assessments are completed whenever they are needed?
- 03What is the current position on the safeguarding concern about management of people's finances?
- 04How do you make sure renewed DoLS authorisations are reported to the CQC on time?
- 05What evidence can you provide about the home's Caring and Responsive ratings, which were not inspected on this visit?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 15 February 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, November 2017
Rated Good overall, with Outstanding caring and strong support for people's independence, although some decision-making records needed improvement.
This was an unannounced, comprehensive inspection on 25 October 2017. Inspectors spoke with people living at the home, staff and healthcare professionals. They observed care and reviewed care plans, daily records, medicines records, staff recruitment and quality checks.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were also rated Good. Caring was rated Outstanding, which was an improvement from the previous Good rating.
Inspectors found enough staff, safe medicines practice and good support for people's health, choices and daily lives. They found warm, respectful relationships between staff and people, with a strong sense of companionship.
There was a shortfall in recording some decisions about whether people had the ability to make particular choices. The manager said this would be reviewed and provided an assessment form after the inspection.
Kind and respectful care
Inspectors saw a calm home where staff understood people's moods, backgrounds and individual needs. They described the relationships between staff and people as unusually strong.
“There was a real sense of integration and companionship between the staff and the people who lived at the home.” from the report
People control their care
People helped write their care plans and were supported to make decisions and remain independent. Their wishes were respected, including when they chose not to record their thoughts.
“People had ownership of their care plans which were developed with them and built around what they wanted to achieve in their lives.” from the report
Safe medicines and staffing
The report found enough regular staff who knew people well. Medicines were stored securely, given as prescribed and recorded on medicines charts.
“People received their medicines in line with nationally recognised standards for safe medicines management.” from the report
Activities and community life
People could choose from daily activities and were supported to maintain friendships and go out into the local community, either alone or with staff.
“People told us they did different activities each day and that it was up to them to choose what they wished to do.” from the report
Some decision records were incomplete
needs fixingInspectors found that good practice in supporting people's decisions was not always backed up by written evidence. One decision about resuscitation did not have a formal recorded assessment of the person's ability to make that decision.
“However, whilst we were confident managers and staff were working within the principles of the MCA, we found the good practice around supporting people to make their own decisions and choices was not always supported by documentation.” from the report
Capacity checks before applications
needs fixingApplications about restrictions on people's freedom had been made before formal capacity assessments were completed. The manager said they had assumed another assessor would complete them.
“The registered manager acknowledged that capacity assessments had not been completed prior to the submission of the applications as they assumed the mental health assessor would complete the assessments as part of the DoLS process.” from the report
- 01How do you now record assessments when there is doubt about a person's ability to make a particular decision?
- 02How do you make sure applications about restrictions on a person's freedom are supported by the right assessments first?
- 03How would my relative help create and review their recovery plan and care plan?
- 04What activities and trips into the community would be available for my relative?
- 05How would you support my relative to keep in touch with family and friends?
This was an unannounced comprehensive inspection covering all five quality areas, with ratings compared with the previous inspection on 2 November 2015. This explanation was written from the published report of 25 November 2017 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 Guys Cross Nursing Home
3 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2017Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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