CQC report explained · a residential care home
What the CQC found at Inwood House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines, risk assessments, recruitment, safeguarding systems and infection control were found to be managed safely. Inspectors said staff deployment needed to improve during busy periods.
- Effective?
- Good
- Staff had induction and training, and people were supported with food, drink and access to health services. Staff appraisals and the lunchtime environment were areas still being improved.
- Caring?
- Good
- This key question was not inspected during this focused inspection.
- Responsive?
- Good
- This key question was not inspected during this focused inspection.
- Well-led?
- Good
- Inspectors found effective quality checks, relevant policies and improved management. Meetings for staff, residents and relatives were being developed.
What inspectors found, August 2022
Inwood House was rated Good after inspectors found clear improvements, with some concerns about staff deployment and the dining experience.
This was an unannounced focused inspection. Inspectors visited on 13 and 14 July 2022, spoke with a person living at the home, relatives and staff, observed daily life and lunch, and checked care, staff and management records.
The home was rated Good overall for the areas inspected: Safe, Effective and Well-led. Inspectors found safe medicine systems, suitable staff recruitment, good support with food and health care, and better management and quality checks.
There were still some areas to improve. Staff were not always deployed effectively at busy times, the lunch setting was noisy and not fully prepared, and staff appraisal and meetings arrangements were still developing.
The previous rating was Requires Improvement, published on 31 December 2021. The provider had previously breached regulations about safe care and treatment and good governance, but inspectors found enough improvement for the home to be no longer in breach.
Medicines managed safely
Medicines were stored, given and disposed of properly. Records were completed appropriately and staff had their medicines skills checked.
“Medicines were stored safely and securely, administrated as prescribed and disposed of properly.” from the report
Risks were monitored
The home used risk assessments, monitored nutrition risks and recorded accidents and learning. Safety checks and fire arrangements were also in place.
“Where risks to a person had been identified there was an associated risk assessment with clear guidance for staff.” from the report
Support with health and nutrition
People enjoyed the food, had their dietary needs catered for and were supported to access health and social care services.
“People were supported to maintain good health and have access to health and social care services as required.” from the report
Improved management
Inspectors found stronger governance and quality monitoring than at the previous inspection. Relatives and staff also described improvements in management and morale.
“There were effective quality assurance and governance systems in place to assess the safety and quality of the service.” from the report
Staff cover at busy times
needs fixingAlthough there were enough staff overall, staff were not always placed where they were most needed. Some shifts ended at 1pm during the busy lunchtime period.
“However, we found improvements were needed to how staff were deployed throughout the home during busier periods of time.” from the report
Noisy lunchtime setting
needs fixingLunch was described as busy and noisy, with music, fans and staff having to raise their voices. Tables were not always set up in advance.
“The environment was not as relaxed as it could have been.” from the report
Staff appraisals
minorThere were no records of yearly appraisals. Newer supervision arrangements were more supportive, but these were still being put in place.
“There were no records of staff having yearly appraisals.” from the report
Infrequent meetings
minorMeetings for staff were infrequent, while regular meetings for residents and relatives were being introduced. Some relatives also wanted newsletters more often.
“There were records of meetings taking place with all staff, but these were infrequent.” from the report
- 01How do you make sure enough staff are available during lunch and other busy periods?
- 02What has changed to make lunchtime quieter, calmer and better prepared?
- 03How are staff appraisals and supportive supervision being completed now?
- 04How often will meetings be held for residents, relatives and staff?
- 05What were the results of the latest checks on medicines, risks and care quality?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 5 August 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, December 2021
Rated Requires Improvement; inspectors found unsafe medicines, staffing concerns and inadequate leadership.
This was an unannounced focused inspection on 31 August 2021. Inspectors looked at Safe, Effective and Well-led, following concerns about medicines and infection control. They spoke with people and staff and checked care, medicines, training and management records.
Medicines were not always managed safely. Staff did not consistently record creams, and protocols for medicines given when needed were not in place. Records did not always show that risks such as poor fluid intake or missed repositioning had been managed. People and staff also reported too few staff, and some people waited for support.
The home’s leadership and checking systems were rated Inadequate. Previous problems had not been fixed, and the provider’s checks had not found issues identified by inspectors. There were some positive findings: people said they felt safe, staff were caring, infection control measures were mostly in place, and people spoke positively about the food.
The overall rating was Requires Improvement. This was the home’s third consecutive Requires Improvement rating. The rating means inspectors found important shortfalls and limited assurance that care was consistently safe and well managed.
People felt safe
People told inspectors they felt safe, and staff could describe how to recognise and report abuse or neglect.
“People felt safe. Comments included: "I prefer to stay in my bedroom, staff bring me my meals. I feel safe because I know its only staff that can get into my bedroom” from the report
Kind and respectful care
Inspectors observed staff being caring and giving people choices. The home’s policies supported people to have choice and receive the least restrictive care possible.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Food and dietary support
People spoke positively about the food. The cook understood people’s dietary needs, and weight loss was followed up with support and referrals where needed.
“The food is always nice, we have a choice, or I can always have something else if it's not on the menu” from the report
Infection control measures
Inspectors were assured about most infection prevention measures, including PPE, testing, visiting arrangements and social distancing.
“We were assured the provider was using PPE effectively and safely.” from the report
Medicines were not consistently safe
seriousMedicines given when needed did not have the required protocols. Creams were not always recorded, and some medicine records had not transferred correctly to a new system. This was a repeated breach.
“We found no evidence people had been harmed, however systems were either not in place or robust enough to demonstrate medicines were managed safely.” from the report
Risks were not always managed
seriousRecords did not reliably show that people received the required fluids or were repositioned as set out in their care plans. This was a repeated breach.
“For example, for one person staff had only offered the required amount of fluid for one out of eight days.” from the report
Staffing pressures
needs fixingPeople and staff reported low staffing levels, frequent staff changes and delays. Inspectors saw that medicines rounds could take up a senior worker’s whole shift and that people did not always receive timely help at mealtimes.
“Without exception people and staff expressed concerns about staffing numbers in the home.” from the report
Training and supervision gaps
needs fixingSome staff had not completed all mandatory training or received regular supervision. Inspectors were told that some staff had not been trained to use the hoist.
“Not all staff were compliant with all mandatory training.” from the report
Weak leadership and checks
seriousThe provider’s governance systems did not identify or resolve important problems. This was a continued breach, and the well-led rating fell from Requires Improvement to Inadequate.
“The provider has failed to be compliant with regulations at the last three inspections.” from the report
- 01What has changed to make sure medicines given when needed have written protocols and all creams and other medicines are recorded correctly?
- 02How do you now check that people receive the fluids and repositioning set out in their care plans?
- 03What staffing levels and skill mix are provided on weekdays and weekends, and how do you cover sickness and vacancies?
- 04How do you check that every staff member has completed the required training, including training to use the hoist, before providing care?
- 05What evidence can you show that the action plan from the previous inspection has been completed and that your audits now find problems promptly?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 31 December 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 Inwood House
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- August 2021Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Requires improvementEffective: Inspected but not ratedWell-led: Requires improvement
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2019
Registered with the Care Quality Commission on 9 April 2019.
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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