CQC report explained · a nursing home
What the CQC found at Inglefield Nursing & Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2019
Rated Good overall; inspectors found kind, safe and well-organised care, but the Effective rating Requires Improvement.
This was an unannounced inspection on 8 and 11 October 2019. Inspectors spoke with 12 people, five relatives, 12 staff and one health professional. They observed care and checked care plans, medicines records, staff files and management records.
People told inspectors they felt safe and were treated with kindness and respect. Staff understood people's preferences, medicines were given safely, staffing levels were sufficient, and the home was clean. People had personalised activities and could access health professionals when needed.
The main shortfalls were in the information collected when people first moved in, food and fluid monitoring charts, and bedroom doors that were hard to identify. The home was rated Good overall, with Good ratings for Safe, Caring, Responsive and Well-led. Effective remained Requires Improvement.
The previous overall rating was Requires Improvement, published in October 2018. Inspectors found that improvements had been made, raising the overall rating to Good.
Kind and respectful care
People described staff as kind and caring. Inspectors saw staff offer choices, gain consent and support people in a gentle and respectful way.
“People were supported by staff who were kind, compassionate and caring and who understood their likes, dislikes and preferences.” from the report
Safe medicines and staffing
Inspectors found safe systems for storing, administering and checking medicines. Staffing levels were considered sufficient for people's needs.
“People were protected from avoidable harm, received their medicines as prescribed and infection control risks were managed appropriately.” from the report
Personalised activities
The home offered group and individual activities, adjusted them to people's preferences and supported people who could not join group activities.
“The service had a strong focus on inclusion and the prevention of social isolation and offered people a range of personalised activities.” from the report
Good management oversight
The management team was open and transparent. Audits, complaints and incidents were reviewed, with action plans used where needed.
“There were effective governance systems in place to identify concerns in the service and drive improvement.” from the report
Limited information at admission
needs fixingInformation collected when people first moved in was minimal and further details about their needs were not always recorded promptly. The manager said action would be taken.
“However, information captured was minimal and further information about people's needs was not gathered and recorded promptly.” from the report
Bedroom identification
minorAll bedroom doors were the same colour and had no identifying features. Inspectors said this might not support people living with dementia or poor vision to find their rooms.
“There were no identifying features on doors, which would support people living with dementia or poor vision to identify their rooms.” from the report
- 01How do you now collect and record a detailed assessment of someone's needs when they first move in?
- 02How do you check that food and fluid charts accurately show what was offered, taken or declined?
- 03What identifying features are available to help a person with dementia or poor vision find their bedroom?
- 04How would you support my relative if they need monitoring for poor nutrition, dehydration, choking or pressure injuries?
- 05How will you make sure care plans reflect my relative's preferences and changing needs from the start?
This was an unannounced planned inspection that assessed all five key questions, with the previous overall Requires Improvement rating reviewed after improvements were made. This explanation was written from the published report of 31 October 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 2018
Rated Requires Improvement; inspectors found kind care and good activities, but concerns about medicines, staffing, records and management systems.
This was an unannounced inspection on 15 and 16 August 2018. Inspectors spoke with people, families, staff and healthcare professionals. They reviewed care plans, medicines, recruitment, training, complaints, incidents and quality checks, and observed care.
People were treated kindly and respectfully. Their food, drinks, healthcare and activities were generally well supported. Staff understood people's needs and helped them remain as independent as possible.
However, medicines records were incomplete, some medicines could not be accounted for, and guidance for giving medicines when needed was lacking. Recruitment checks were not always completed, some training was out of date, and call bells might not always have been answered quickly.
The overall rating and four of the five question ratings were Requires Improvement. Caring was rated Good. The home had acted on the two breaches found in July 2017, and there were no breaches at this inspection, but the new quality systems still needed time to become reliable.
Kind and respectful care
People and families consistently described staff as kind. Inspectors observed gentle, patient and dignified support.
“People consistently told us they were treated in a kind and compassionate way by staff.” from the report
Safeguarding
People said they felt safe. Staff knew how to report concerns, and safeguarding incidents had been notified and investigated.
“The provider had effective systems and processes in place to protect people at risk of abuse.” from the report
Food and hydration
People's dietary needs were assessed and special meals were provided. Staff monitored people at risk of poor nutrition or dehydration.
“People's nutrition and hydration needs were met and people were satisfied with the quality of their meals.” from the report
Activities
The home offered group activities and one-to-one options based on people's interests and abilities.
“People had access to a range of activities based on their individual interests, including on a one-to-one basis.” from the report
Medicines records and instructions
seriousMedication administration records had gaps, some stock could not be accounted for, and instructions for medicines given when needed were incomplete. This could lead to inconsistent or unsafe administration, particularly by agency staff.
“Medicines were generally managed safely, although medication administration records had not been completed fully, some medicines could not be accounted for” from the report
Recruitment checks
seriousThe home did not consistently check full employment histories or obtain further references. It therefore could not confirm that every member of staff was suitable.
“Recruitment procedures were not followed consistently, so the provider was unable to confirm that all staff employed were suitable.” from the report
Liberty safeguards
seriousThere was no reliable process to renew legal authorisations before they expired. Staff were also unclear about which people were subject to these restrictions.
“This posed a risk that people could be subject to restrictions not authorised in law.” from the report
Care plans
needs fixingSome plans did not explain how to support people who became agitated or declined personal care. End of life wishes and preferences had not been recorded for people approaching the end of life.
“However, end of life care plans had not been developed for them, to include information about their end of life wishes and preferences.” from the report
Staff training
needs fixingSome required refresher training was overdue, including fire safety, safeguarding, infection control and moving and positioning. Only 10 of 30 staff supporting people to eat had completed food hygiene training.
“However, we found a nurse who was responsible for taking charge of fire safety procedures in an emergency was overdue fire safety training by four months” from the report
Call bell response
needs fixingPeople and staff gave mixed views about staffing. Although essential needs were met, some people said they sometimes waited a long time for call bells to be answered, and the home had not yet analysed response times.
“we could not be assured that people's call bells were always responded to in a timely way.” from the report
- 01What changes have been made to ensure every medicine administration record is completed and all medicine stock is accounted for?
- 02How are 'as required' medicines now recorded, including the reason for giving them and the gap between doses?
- 03How do you check that all staff have completed the required recruitment checks and current essential training?
- 04How do you monitor call bell response times, especially during evening shifts and when staff are absent?
- 05Have care plans now recorded each person's behaviour support needs and end of life wishes and preferences?
This was an unannounced inspection of all five quality areas, including care, records, staffing, medicines and how the home was managed; the report also compares the findings with the previous inspection in July 2017. This explanation was written from the published report of 2 October 2018 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 Inglefield Nursing & Residential Home
4 rated inspections over 4 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Inglefield Nursing & Residential Home →
- October 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Inglefield Nursing & Residential Home →
- August 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 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 18 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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