CQC report explained · a nursing home
What the CQC found at Hayes Cottage Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found risk assessments, safeguarding arrangements, staffing, medicines systems and infection control were generally effective. They asked the home to address unlocked doors, stained pill crushers and some care records that needed signatures or clearer information.
- Effective?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- Care plans were personalised and covered communication, activities, food and end-of-life preferences. Complaints were handled appropriately, although some end-of-life information was missing from the digital care plan and some relatives wanted more regular updates.
- Well-led?
- Good
- The home had audits, meetings and improvement plans, and inspectors found management had improved. However, there was no registered manager in post, the new digital records system was still being embedded, and some telephone communication had previously been difficult.
What inspectors found, September 2022
Rated Good; inspectors found safe, kind and personalised care, but some care records and family communication needed improvement.
This was an unannounced focused inspection. Inspectors visited on 27 July 2022, spoke with people, relatives, staff and professionals, observed care, and checked care, medicines, staffing, risk and management records.
The home was rated Good overall. Safe, Responsive and Well-led were also rated Good. Inspectors found enough staff, suitable safeguarding and medicines systems, good infection control, personalised care plans, activities and appropriate end-of-life support.
The inspection followed concerns about support with people's skin care. Inspectors found no evidence that people were at risk of harm from this concern during the visit. They did identify some records that were not complete or easy to find, and some communication issues.
Enough staff
Inspectors saw staff respond promptly to people's needs and call bells. Staff also said staffing levels were sufficient.
“We observed staff respond to people's support needs in a timely manner and answer call bells promptly.” from the report
Personalised care
Care plans included detailed preferences and routines, such as bedtime arrangements and personal care choices. Staff used this information to support people.
“Plans were personalised to each person and reflected their preferences.” from the report
Activities and relationships
People were offered group and individual activities, including singing, drawing, reading and reminiscence work. The home also supported emotional needs and family celebrations.
“We observed people enjoying a variety of things during our visit.” from the report
Improved leadership
The leadership rating improved from Requires Improvement at the previous inspection to Good. The home had audits, meetings and plans for further improvement.
“At this inspection we have rated this key question good.” from the report
End-of-life support
The home worked with palliative care professionals and planned people's end-of-life care. A professional felt people would receive good palliative care.
“I feel able to tell people they will get good palliative care.” from the report
Some records needed completing
needs fixingSome decisions about supporting very ill people had not been signed by the appropriate clinician. The home was asked to address this with healthcare partners.
“These had been devised by but not always signed by the appropriate clinician.” from the report
Family updates
needs fixingMost relatives felt informed, but some said they were updated only when they called or asked staff. Some relatives and a professional had also found it difficult to contact staff promptly by telephone.
“Some relatives told us they felt they were only updated when they called or asked staff.” from the report
No registered manager
minorThere was no registered manager in post during the inspection. The manager had been promoted in May 2022 and planned to register.
“At the time of our inspection there was not a registered manager in post.” from the report
Past delays in skin care referrals
needs fixingA professional said tissue viability referrals had not always been made promptly in the past. The home had since provided pressure care training and had further training planned.
“In the past this could have been done in a timelier manner on some occasions.” from the report
- 01How will you make sure end-of-life wishes and advance directives are recorded clearly in the digital care plan?
- 02How are you checking that decisions about support for very ill people are signed by the appropriate clinician?
- 03How will you keep relatives updated regularly without them needing to call first?
- 04Who is currently responsible for management, and when does the manager expect to register with the CQC?
- 05What further action has been taken to make sure skin care referrals are made promptly when needed?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and previous ratings were used when calculating the overall rating. This explanation was written from the published report of 24 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, April 2020
Rated Good overall; inspectors found safe, caring and responsive care, but the well-led rating Requires Improvement because some records were not kept up to date.
This was an unannounced inspection on 5 and 6 February 2020. Inspectors spoke with people, relatives, staff and health and social care professionals. They observed care and checked care records, medicines records, staffing records and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines arrangements, kind and respectful care, personalised support, activities and good links with health professionals. People were supported with end of life care and could make choices about their daily lives.
The Well-led rating fell from Good to Requires Improvement. Some fluid intake, turning and staff allocation records were incomplete or out of date. The home's checks had not identified all these problems. Inspectors made recommendations about recording care and supporting people at risk of poor nutrition or dehydration.
Kind and respectful staff
People and relatives described staff positively. Inspectors saw staff protecting people's privacy and dignity and responding to distress promptly.
“People were treated by staff in a caring manner.” from the report
Enough regular staff
Staffing rotas showed sufficient nursing, care and domestic staff. The home mainly used regular bank staff rather than temporary agency staff, supporting continuity.
“The provider arranged for enough staff to be on shift to support people to stay safe.” from the report
Activities and personal choices
People could join a range of activities and choose how to spend their time. Staff also supported communication needs, including the use of pictures.
“Two activities coordinators arranged a weekly timetable of sessions for people, with several taking place each day.” from the report
End of life care
The home worked with a local hospice and recorded people's end of life preferences. Professionals said staff aimed to provide a comfortable and dignified death in the person's chosen place where possible.
“Staff supported people at the end of their life to experience a comfortable and dignified death.” from the report
Fluid monitoring records
needs fixingSome records did not show how much people needed to drink, how much they had taken, or what action was needed when intake was low. Inspectors recommended reviewing current guidance and updating practice.
“The provider did not always ensure there were clear arrangements in place to manage the risks associated with poor hydration some people may experience.” from the report
Incomplete care records
needs fixingSome turning charts and daily records were incomplete. In one unit, staff allocations had not been recorded on more than half of the 36 days checked.
“The provider had not always kept up to date some records regarding the management of the service.” from the report
Quality checks missed problems
needs fixingThe home had several audits, but they had not found and corrected the record-keeping issues identified during the inspection.
“These had not always been effective as they had not identified and addressed the issues we found regarding maintaining records appropriately.” from the report
- 01How have you improved records showing people's daily fluid targets, actual intake and any action taken when intake is low?
- 02How do you now make sure turning charts record the required frequency for each person?
- 03How do you record staff allocations and handovers on every shift?
- 04What changes have you made to quality checks so incomplete care records are found and corrected promptly?
- 05How will you make sure care plans consistently record each person's preferences, including food choices and things they do not like?
This was an unannounced planned inspection covering all five CQC questions, the care provided and the premises; the previous overall rating was Good, published on 9 August 2017. This explanation was written from the published report of 2 April 2020 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 Hayes Cottage Care Centre
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- September 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2020Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015Goodup from Requires improvementSafe: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Requires improvementSafe: InadequateEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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