CQC report explained · a residential care home
What the CQC found at Phillippines Close
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2023
HF Trust - Phillippines Close is rated Good; inspectors found safe, effective and well-led care, with some recording and campus-design issues.
This was an unannounced focused inspection. Inspectors spoke with people using the home, relatives, staff and managers. They reviewed care records, staff files and management records, and checked infection control.
The home was rated Good overall, with Good ratings for Safe, Effective and Well-led. People and relatives said people felt safe. Inspectors found enough staff, safe recruitment, suitable training, clean surroundings and generally safe medicines management.
Inspectors found that care was person-centred. People were supported to make choices, take part in activities, access the community and eat food suited to their needs. Staff worked with health professionals when people needed extra support.
The rating improved from Requires Improvement at the previous inspection. The home had improved its governance and pressure-care arrangements and was no longer in breach of regulations. However, the campus-style layout was still not in line with best practice guidance, and some PRN medicines records needed improvement.
People felt safe
People and relatives told inspectors they felt safe. Staff understood how to recognise and report abuse.
“People and their relatives told us they felt safe using the service.” from the report
Support for independence
People were supported to go into the local community, use public transport and take part in activities according to their choices.
“People were encouraged to walk into the local town and one person done this alone daily.” from the report
Trained staff
Staff had training suited to people's needs, including training on epilepsy medicines. Relatives said staff were well trained.
“Staff had received a variety of training suitable to meet peoples needs.” from the report
Improved leadership
Inspectors found a noticeable improvement in the culture and management of the home. Staff and relatives spoke positively about the new leadership.
“Since our last inspection a registered manager had been appointed and had been in post about a year.” from the report
Personalised food and healthcare
People helped choose menus and prepare meals. Modified diets were followed, and staff worked with health professionals to support people's specific needs.
“People who needed support with modified diets were supported.” from the report
Campus-style setting
minorThe home was spread across several buildings in a campus-style arrangement. Inspectors said this did not meet best practice guidance, although staff used the arrangement to support people's independence and create a community.
“The model of care was not in keeping with the principle of right support.” from the report
PRN medicines records
needs fixingRecords did not always explain why medicines given when needed had been used or whether they had the desired effect. The manager acted promptly to address this.
“Some improvements were needed in the recording of people's PRN medicines” from the report
- 01How do you support people to be independent and access the local community within the campus-style setting?
- 02How do you record why PRN medicines are given and whether they have the desired effect?
- 03What changes have been made since the previous Requires Improvement rating and the Regulation 17 breach?
- 04How will you support my relative's specific health needs, including any modified diet, epilepsy or pressure-care needs?
- 05How are people and relatives involved in menu choices, activities, care planning and decisions about the home?
This was an unannounced focused inspection checking Safe, Effective and Well-led, so Caring and Responsive were not assessed in this report and their previous ratings carry over. This explanation was written from the published report of 6 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, July 2021
HF Trust - Phillippines Close was rated Requires Improvement; care was safe and kind, but leadership, quality checks and some aspects of people's support needed improvement.
This was an unannounced focused inspection on 26 and 27 May 2021. Inspectors spoke with people, staff and relatives, observed care, and checked medicines, care records, training, employment records and quality checks.
The home was rated Good for Safe. Inspectors found enough staff, safe medicines practice, individual risk assessments and improvements after incidents between people. Some infection control checks were missing during the visit, but the provider took action afterwards.
Effective and Well-led were rated Requires Improvement. Inspectors found that best-practice tools were not always used to reduce the risk of skin damage or poor nutrition. There was no registered manager, staff were worried about repeated management changes, and quality systems had not found or acted on important shortfalls.
The overall rating remained Requires Improvement. This was the second consecutive inspection with that rating. The inspection found a continued breach of Regulation 17, relating to good governance, and the provider was asked to submit an action plan.
Safe staffing
Staffing levels had increased and inspectors found there were enough staff to meet people's needs, including one-to-one support.
“There were enough staff to meet people's needs and people were receiving their one to one time effectively.” from the report
Person-centred care
Inspectors found that care respected people's dignity, privacy and human rights.
“Care that was provided was person-centred and promoted people's dignity, privacy and human rights” from the report
Safe medicines
Medicines were stored securely, and trained staff followed procedures when giving them.
“Correct procedures were followed to ensure the safe handling of medicines.” from the report
Good teamwork
Staff knew people well, worked with health professionals and supported people to take part in daily activities and decisions.
“Staff had experience and knew people they were caring for well.” from the report
Improvements after incidents
Changes to accommodation and staff support reduced altercations between people.
“This move had been successful and less altercations occurred.” from the report
No stable manager
needs fixingThere had been no registered manager since September 2020. A newly appointed manager had also left just before the inspection, leaving interim arrangements.
“The service did not have a registered manager in post.” from the report
Weak quality checks
seriousThe home's monitoring systems did not identify important problems. Hot water checks were still incomplete, creating an increased risk of harm.
“At our last inspection we identified hot water checks had not been completed.” from the report
Medicine errors not analysed
seriousNine medicine errors were recorded in May 2021, but the provider had not analysed them for patterns or repeat risks.
“For example, nine medicine errors were logged in May 2021 and although no harm occurred as a result of these errors, the lack of management oversight put people at continued risk of harm of incidents reoccurring.” from the report
Limited community access
needs fixingThe campus-style layout and closed day services meant people were isolated from the community and relied heavily on staff for access.
“People were very secluded in an industrial style facility and relied heavily on staff support to have access to the community.” from the report
Care planning tools
needs fixingBest-practice tools were not always used to monitor weight, nutrition risks or the risk of skin breakdown.
“Tools were not used regularly to review and reduce the risk of skin breakdown for people.” from the report
- 01Who is currently responsible for managing the home, and what is the timetable for appointing a registered manager?
- 02What has been done to complete and independently check hot water safety checks?
- 03How are medicine errors now reviewed for patterns, and what changes were made after the nine errors recorded in May 2021?
- 04How are weight, nutrition and skin-breakdown risks assessed and reviewed for each person?
- 05What opportunities do people now have to use day services and access the wider community?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed and their previous ratings were carried forward when calculating the overall rating. This explanation was written from the published report of 8 July 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 Phillippines Close
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2021Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- December 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2020Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2016
Registered with the Care Quality Commission on 20 October 2016.
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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