CQC report explained · a nursing home
What the CQC found at Hoar Cross Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, safe recruitment, suitable risk plans, safe medicines practice and good infection control.
- Effective?
- Good
- Staff had suitable training and people had access to health professionals. People were supported with food, drink, health needs and decision-making, although older mental capacity assessments were recommended for review.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in decisions and supported to remain as independent as possible.
- Responsive?
- Good
- Care was personalised and activities were available. Complaints were recorded and investigated, but inspectors recommended more personalised written plans for end of life wishes.
- Well-led?
- Good
- Inspectors found approachable leadership, good teamwork and effective quality checks. The home used feedback, audits and learning from incidents to improve care.
What inspectors found, May 2019
Rated Good; inspectors found kind, personalised care, with recommendations about older capacity assessments and end of life plans.
Inspectors visited without notice on 16 and 17 April 2019. They spoke with people living in the home, relatives, staff and managers. They reviewed care files, medicines records, recruitment checks, audits and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough safely recruited staff, safe medicines management, kind care, personalised support and effective checks on quality.
There were two recommendations rather than legal breaches. The home was asked to review older mental capacity assessments and consider making end of life plans more personal.
Kind and respectful care
People and relatives said staff were caring, patient and respectful. Inspectors observed warm and positive relationships between people, relatives, staff and managers.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans reflected people's needs and preferences. Staff knew people well and supported choices about personal care, activities and communication.
“Staff knew people well and people had plans that detailed how they liked to be supported.” from the report
Safe care
Inspectors found suitable risk assessments, safe medicines management, appropriate staffing and effective infection control.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Strong quality checks
The home used regular audits, feedback and incident reviews to identify improvements. Inspectors found leadership visible and staff working well together.
“There was a clear quality assurance system in place which held staff to account.” from the report
Support for independence
The home used equipment and technology to help people remain independent and communicate with others.
“The service helped people to remain independent.” from the report
Older capacity assessments
needs fixingThe computer system for mental capacity assessments had changed. Inspectors recommended reviewing assessments completed using the previous version to make sure they covered the main legal principles.
“We recommend assessments carried out on the previous versions are reviewed to ensure they cover the main principles of the MCA.” from the report
End of life plans
needs fixingSome people nearing the end of life did not have detailed written plans setting out their personal wishes. Inspectors recommended making these plans more personalised.
“We recommend that the service seek advice and guidance from a reputable source, about the development of personalised end of life care plans.” from the report
- 01Have all mental capacity assessments completed on the previous system now been reviewed?
- 02How do you record a person's individual end of life wishes, including spiritual support, music and clothing?
- 03How do you check that staffing levels remain enough at busy times and overnight?
- 04How are medicines errors, falls and other incidents reviewed to prevent them happening again?
- 05How will you involve our relative and family in reviewing their care plan and activities?
This was an unannounced routine inspection covering all five CQC questions, including the care provided and the care home premises. This explanation was written from the published report of 22 May 2019 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 2016
Rated Good overall; inspectors found safe, kind and responsive care, but the effective rating Requires Improvement because some capacity assessments were missing.
This was an unannounced inspection on 8 September 2016. Inspectors spoke with people living in the home, relatives, staff, the manager and the provider. They observed care and reviewed care records, recruitment records and quality checks.
Overall, the home was rated Good. Inspectors found enough staff, safe medicines systems and suitable checks on risks, accidents and the environment. People were treated kindly and with dignity. They could choose how to spend their time, take part in activities and raise concerns.
The effective rating was Requires Improvement. Some people who may have lacked capacity had restrictions or needed help with important decisions, but capacity assessments had not always been completed first. Staff had received training but did not fully understand how to apply the Mental Capacity Act and Deprivation of Liberty Safeguards.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs. Medicines were ordered, stored, given and checked safely.
“People received their medicines at the right time and systems were in place to ensure medicines were managed safely.” from the report
Kind and respectful care
People described good relationships with staff. Inspectors saw staff protecting privacy, dignity and independence.
“People were treated with dignity and respect by kind and friendly staff and were encouraged to maintain their independence.” from the report
Activities and choice
People could choose how to spend their day and took part in activities in the home and the community. Activities were planned around their interests.
“A range of different activities took place each day with dedicated activity staff.” from the report
Open management and checks
Staff said managers listened to concerns and supported them. Audits and reviews were used to monitor care and reduce risks.
“Quality assurance systems were in place to monitor the service and to help improve standards of service.” from the report
Capacity assessments
needs fixingSome capacity assessments had not been completed to show whether people could make decisions for themselves. This meant restrictions and decisions could not always be shown to follow the correct process.
“capacity assessments had not been completed to identify if people could make these decisions themselves.” from the report
Understanding of legal safeguards
needs fixingStaff had training on capacity and liberty safeguards but did not fully understand how to put this into practice. This was the reason the effective rating required improvement.
“The staff had received training for MCA and DoLS but had not understood how to implement this.” from the report
- 01How do you assess whether a person can make each specific care decision for themselves?
- 02How do you make sure capacity assessments are completed before applying for liberty restrictions?
- 03What training and checks do staff now receive on the Mental Capacity Act and Deprivation of Liberty Safeguards?
- 04How will you involve relatives in care reviews and decisions when a person may lack capacity?
- 05How do you monitor that care plans are updated when people's needs change?
This was an unannounced inspection of all five key questions, including observations, discussions with people, relatives and staff, and reviews of care and management records. This explanation was written from the published report of 21 October 2016 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 Hoar Cross Nursing Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- November 2013
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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