CQC report explained · a nursing home
What the CQC found at John Sturrock
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were generally protected from abuse and avoidable harm. There was enough staff and medicines were managed safely, although some risk records and recruitment checks were not always complete.
- Effective?
- Good
- People's needs were assessed and reviewed, staff received training and support, and people had choice about their care. People enjoyed a choice of food and the home worked with other professionals.
- Caring?
- Good
- No rating is given for Caring in this report.
- Responsive?
- Good
- No rating is given for Responsive in this report.
- Well-led?
- Requires improvement
- Management was visible, approachable and respected, and feedback was welcomed. However, some governance checks did not identify risks and some care plans were inaccurate.
What inspectors found, May 2023
Rated Good overall; inspectors found safe, effective care, but leadership and records still needed improvement.
This was an unannounced follow-up inspection on 5 and 18 April 2023. Inspectors observed care, spoke with people, a relative and staff, and checked care, medicine, recruitment and management records.
The home was rated Good for Safe and Effective. Inspectors found enough staff, generally safe risk management, well-managed medicines, suitable infection control, good staff training and support, and positive healthcare and dining experiences.
The home was rated Requires Improvement for Well-led. Governance had improved, but some checks did not identify risks and some care records were inaccurate. Overall, the rating improved from Requires Improvement at the previous inspection, and the home was no longer in breach of regulations.
Enough familiar staff
Inspectors found enough competent staff to meet people's needs. The staff team was consistent, so people were cared for by staff they knew.
“The service had enough competent staff for people to stay safe.” from the report
Medicines managed safely
Medicines were administered safely, records were accurate and storage was suitable. Medicine errors were investigated and action was taken to reduce the chance of repetition.
“Medicines were administered in a safe way and administration records were accurate.” from the report
Good staff support
Staff completed required and role-specific training, received supervision and had a thorough induction. Staff told inspectors they felt supported by colleagues and managers.
“All staff received a comprehensive induction and shadowed staff until they were confident to work unsupervised.” from the report
Choice and dining
People could make everyday choices about their care and had a wide choice of food. Inspectors saw a bistro-style dining experience and food made to order.
“People enjoyed a bistro style dining experience where they had a choice of food.” from the report
Open management
The management team was described as visible, approachable and respected. The home involved people and staff and acted on feedback.
“The provider and management team were well respected, visible and approachable.” from the report
Risk records were not complete
needs fixingSome records did not show how risks were being managed, including support for one person using the community. The provider sent information showing it had addressed the identified shortfalls.
“We saw gaps where records did not show how risk was being appropriately managed.” from the report
Personal money checks
needs fixingChecks on people's personal money were not robust enough. The provider took immediate steps after inspectors raised this.
“The provider carried out checks where they supported people with personal monies, but these were not always done robustly.” from the report
Some care plans were inaccurate
needs fixingCare plans were usually detailed and person-centred, but information about some people's needs was wrong. One nutritional care plan did not match the person's dietary needs.
“However, we saw information about some people's needs was not accurate.” from the report
Recruitment records
needs fixingSome recruitment checks were not completed robustly. In one example, a character reference had been used when an employment reference was required.
“They had received character references for a recent employee even though 1 should have been an employment reference.” from the report
Medicine errors
minorInspectors found three medicine errors in March 2023. These were investigated and improvements were made to reduce the chance of the errors happening again.
“We saw staff had made three errors when giving people their medicines in March 2023.” from the report
- 01How are you now checking people's personal money and who reviews those checks?
- 02How do you make sure care plans match each person's current dietary and other care needs?
- 03What checks are now completed before staff start work, including employment references?
- 04How are risks recorded and reviewed when people use the community?
- 05What changes were made after the three medicine errors in March 2023?
This was an unannounced follow-up inspection of action from the previous inspection; the report says that any key questions not inspected used their previous ratings to calculate the overall rating. This explanation was written from the published report of 20 May 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, February 2022
Rated Requires Improvement overall; inspectors found unsafe systems, inadequate leadership, and warning notices for three breaches.
The inspection took place without notice on 22 September, 28 September and 14 October 2021. Inspectors spoke with people, relatives, staff and healthcare professionals. They observed care and checked care plans, medicines, staff files and management records.
The home was not always safe. Known risks were not managed well, medicines were not always administered safely, and some safeguarding incidents had not been identified and reported. There were also gaps in fire safety, staff training, supervision and staffing cover.
Leadership was rated Inadequate. Inspectors found widespread weaknesses in quality checks, incident reviews, complaints records and care records. They also found signs of a closed culture, including poorly recorded restrictions and care plans that did not always reflect people's views.
The overall rating was Requires Improvement. Safe remained Requires Improvement and Well-led fell from Requires Improvement to Inadequate. The other three areas were not inspected during this visit, so their previous ratings were used.
Mostly positive care feedback
People and relatives generally spoke positively about the care. Some people said they felt safe and had good relationships with staff.
“People and relatives shared mostly positive feedback about the care provided.” from the report
Partnership working
The home worked with commissioners and health and social care professionals, including social workers and GPs.
“The home maintained good working relationships with partner agencies.” from the report
Manager responded during inspection
The registered manager accepted the inspection findings and said action had been taken on some of the problems identified.
“The registered manager was receptive to the inspection process and responsive in acting on the issues found at this inspection.” from the report
Known risks and incidents
seriousRisks linked to incidents between people, nutrition and hydration, and behaviour were not always assessed or managed properly. Some incidents were not fully investigated or included in the home's reviews.
“People were not always protected from the risk of harm because there was poor management of known risks to people's care.” from the report
Medicines safety
seriousInstructions for medicines were not always followed. Records for creams, thickeners and medicines given when needed were incomplete, and some staff had not had their competence assessed.
“People's medicines were not always administered safely.” from the report
Restrictions and consent
seriousSome restrictions on people's care had not been properly assessed, recorded or reviewed. Inspectors also found that a Deprivation of Liberty Safeguard condition was not followed.
“Some people's planned care interventions included restrictions, but these had not been properly assessed, documented and reviewed to ensure the least restrictive approach was being used.” from the report
Weak management checks
seriousThe home's systems did not identify or fix repeated problems with medicines, care planning, incidents, complaints, training and records.
“Systems were either not in place or robust enough to demonstrate effective oversight and management of the service.” from the report
Closed culture concerns
seriousInspectors found signs of a developing closed culture. Behaviour was not consistently managed using positive, least restrictive approaches, and activities were not offered consistently.
“We found signs of a closed culture developing.” from the report
Staffing cover
needs fixingSome one-to-one agency shifts were not covered. Other staff had to provide the support, and one cancelled outing was linked to a behaviour incident.
“We recommend the provider reviews their staffing levels and staff deployment practices and take action to update their practice accordingly.” from the report
- 01What has changed since the inspection to make sure known risks, including risks between people, are properly assessed and reviewed?
- 02How do you check that medicines are given at the right time, with the right instructions, and only by staff whose competence has been assessed?
- 03How are restrictions on a person's care now assessed, recorded and reviewed, including any required Deprivation of Liberty Safeguards?
- 04How do you record and investigate accidents, safeguarding incidents and complaints, and how do you show that lessons have been learned?
- 05How will you make sure staffing cover is sufficient for one-to-one support, outings and activities?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 11 February 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.
Every inspection of John Sturrock
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
- August 2019Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2018
Registered with the Care Quality Commission on 14 June 2018.
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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Most charge £980 to £1,250 a week. 89 can care for a couple. 11 years' experience on average.
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