CQC report explained · a nursing home
What the CQC found at London Road Specialist Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines were managed safely, risks were assessed and reviewed, staff had suitable training, and infection control arrangements were in place.
- Effective?
- Good
- This area was not looked at during this focused inspection.
- Caring?
- Good
- This area was not looked at during this focused inspection.
- Responsive?
- Good
- This area was not looked at during this focused inspection.
- Well-led?
- Good
- Inspectors found open communication, regular staff support and meetings, and systems for monitoring quality and acting on improvements.
What inspectors found, May 2021
Rated Good; inspectors found safe medicines, supportive management and clear communication, following improvements since the previous inspection.
This was a focused inspection on 13 April 2021. Inspectors checked Safe and Well-led, including medicines, risks, staffing, infection control and how the home was managed. They spoke with management, staff and relatives, and reviewed care records, medicine records, staff files, audits and other documents.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed and reviewed, staff were trained, medicines were managed safely and infection control arrangements were in place. Relatives and staff described good communication with the management team.
The previous inspection had rated the home Requires improvement and found a breach involving medicines. Inspectors found that enough improvement had been made and that the home was no longer in breach. The overall rating changed to Good, but the other three areas were not inspected at this visit and their previous ratings were carried forward.
Safer medicines
Medicine policies and personalised plans had been improved. Records showed medicines were given when needed, stored correctly and checked through regular audits.
“Records were kept of medicines prescribed for and given to people. These showed that people who used the service received their medicines at the times they needed them.” from the report
Risks were reviewed
The home assessed risks such as choking, dehydration, malnutrition and skin damage. Care records explained what staff should do to reduce these risks.
“Potential risks to people were assessed, were regularly reviewed, and covered a range of areas which included the risk of malnutrition, dehydration, choking or aspiration and skin integrity.” from the report
Open communication
Relatives and staff said they were kept informed and involved in decisions about people's care. Inspectors also found that managers communicated openly with outside organisations.
“Relatives told us there was open communication between them and the service, and that they were kept informed of any changes and consulted about any decision related to their family members care.” from the report
Supportive management
Staff received supervision, training and competency checks. The management team used audits, meetings and action plans to monitor the service.
“Staff performance was monitored through quality monitoring, including the auditing of records, staff supervision, observed practice and competency assessments.” from the report
Inspectors raised no specific concerns in this report.
- 01How are medicines given through feeding tubes, and how do you check staff remain competent to give them?
- 02How are individual plans used before antibiotics or other medicines are given when needed?
- 03How are risks such as choking, aspiration, dehydration and skin damage reviewed for my relative?
- 04How will you keep me informed about changes in my relative's health and involve me in care decisions?
- 05What arrangements are currently in place for visiting and infection control?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not assessed and their previous ratings were carried forward. This explanation was written from the published report of 7 May 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.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found kind, personalised care, but medicines were not always managed safely.
Inspectors visited the home without warning on 16 and 17 September 2019. They spoke with a person living there, family members, staff and health professionals. They also checked care records, medicines records, staff files and management records.
The home provided nursing and personal care for 22 people with brain injuries, degenerative conditions, stroke or cardiac conditions. Inspectors found enough suitably skilled staff, good infection control, clean surroundings and care that was kind, respectful and tailored to people.
The main problem was medicines safety. Staff did not always follow the provider's medicine procedures. Some medicine guidance and records were incomplete, and medicine staff had not had suitable training or competency checks for three years. The home breached Regulation 12.
The overall rating changed from Good at the previous inspection to Requires Improvement. Effective, Caring and Responsive remained Good. Safe remained Requires Improvement, while Well-led fell from Good to Requires Improvement.
Kind and respectful care
Family members spoke very positively about the kindness and compassion shown by staff. Staff explained care before providing it and promoted people's dignity.
“Family members were consistently positive about the kind and caring approach of all staff towards their relative in the delivery of care.” from the report
Personalised support
Staff understood how people communicated, including through gestures and changes in behaviour. Care was adjusted to support independence, pain management and changing health needs.
“Staff were committed to providing people with highly personalised care, based on their knowledge and understanding of their needs.” from the report
Risk management
Most risks, including choking, dehydration, malnutrition and skin damage, were assessed and reviewed. Staff followed guidance and used suitable equipment to reduce these risks.
“Potential risks to people were assessed, were regularly reviewed, and covered a range of areas” from the report
Good family involvement
Families were involved in assessments, care planning and best-interest decisions. They were also kept informed about changes in their relative's health.
“Family members told us they had been fully involved in the assessment of their relative” from the report
Medicine guidance was incomplete
seriousStaff lacked information about giving medicines through feeding tubes. There was also no clear record of how to identify when some people needed as-needed medicines if they could not communicate verbally.
“Staff did not have the information available on how to prepare and administer medicines given via a feeding tube safely.” from the report
Medicine procedures were not followed
seriousInspectors saw a medicine record signed after another person's medicine had been given. Antibiotics were also given without first consulting a doctor or checking individual guidance.
“We saw a nurse sign two medicine administration record (MAR) charts after they had administered somebody else's medicine.” from the report
Medicine staff lacked recent checks
seriousStaff giving medicines had not received training or an appropriate competency assessment in the previous three years. This was part of the breach of Regulation 12.
“Staff that were giving people their medicines had not received training or an appropriate competency assessment around this role in the last three years.” from the report
Quality checks were inconsistent
needs fixingThe home's system for checking staff competence did not cover nursing staff consistently. The report specifically identified that medicine competence was not kept under review.
“The provider's system to keep under review the day to day culture of the service, was not consistently implemented for all staff.” from the report
- 01Have all staff who administer medicines now completed training and a documented competency assessment?
- 02What written guidance is now available for medicines given through feeding tubes?
- 03How do staff identify and record when a person who cannot speak needs an as-needed medicine?
- 04How are medicinal patches recorded so staff can show where and when each patch was applied?
- 05How does management now check nursing staff's medicine practice and follow up any problems?
This was an unannounced planned inspection covering all five CQC questions, with checks of the premises, care, medicines, staff and management systems. This explanation was written from the published report of 23 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.
Every inspection of London Road Specialist Nursing Home
4 rated inspections over 6 years: the service has held its Good rating throughout.
- May 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at London Road Specialist Nursing Home →
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at London Road Specialist Nursing Home →
- March 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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