CQC report explained · a nursing home
What the CQC found at Margaret Roper House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks were not always assessed or managed accurately. Medicines records and staff competency checks were incomplete, and the premises had fire safety, equipment, cleanliness and repair concerns.
- Effective?
- Requires improvement
- Consent records did not always follow the Mental Capacity Act. Care plans did not always give enough guidance about diets or show that professional advice had been followed, and some staff refresher training was overdue.
- Caring?
- Good
- Caring was not inspected during this focused inspection, so no new rating was given. People said staff treated and supported them well.
- Responsive?
- Good
- Responsive was not inspected during this focused inspection, so no new rating was given.
- Well-led?
- Requires improvement
- Quality checks and action plans were not reliable enough, and records were not always accurate. The home had no registered manager in post and had been without one for over 12 months.
What inspectors found, January 2024
Requires Improvement; inspectors found risks with care records, medicines, premises and management systems.
This was an unannounced focused inspection on 13 November 2023. Inspectors looked only at Safe, Effective and Well-led. They spoke with five people, staff and managers, and checked care records, medicines, staff files and quality records.
The home was not always safe or effective. Risk assessments and care plans were incomplete or inconsistent. Medicines checks and records were not always reliable. Some fire safety checks, equipment checks and cleaning arrangements were not adequate. Staff training and consent records also needed improvement.
Management oversight was not strong enough. The home had been without a registered manager for more than 12 months, and audits had not always led to action. The overall rating changed from Good at the previous inspection in 2017 to Requires Improvement. The provider had started work on some problems, but CQC will monitor progress.
Kind staff
People gave positive feedback about how staff treated and supported them. People appeared calm and at ease in the home.
“People told us they were treated and supported well and enjoyed living at the home.” from the report
People felt safe
People said they felt safe and knew they could speak to staff if they were unhappy.
“People told us they felt safe living at the service.” from the report
Safe recruitment
The recruitment records checked by inspectors included the required pre-employment checks.
“Recruitment of new staff was safe. Pre-employment checks were completed to help ensure staff members were safe to work with vulnerable people.” from the report
Action had started
The provider responded positively to the inspection and had begun work on some problems, including fire door repairs and changes to pharmacy support.
“Both the provider and quality compliance team responded in a positive and proactive way to the findings at our inspection” from the report
Risk records were unreliable
seriousCare plans and risk assessments did not always explain how risks should be reduced. Some risk ratings were inconsistent or had not been reviewed.
“Risks were not always managed safely. Care plans and risk assessments did not always evidence people received planned care that met their needs.” from the report
Medicines safety
seriousRecords did not always show the care people needed or received for medicines. Some staff were not up to date with training or competency checks, and medicines policies lacked enough guidance.
“The provider failed to ensure medicines were managed safely, this was a breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Premises and cleanliness
seriousSome internal doors were not fire safety compliant. Inspectors also found dirty communal toilets, damaged bathrooms and incomplete cleaning or safety checks.
“The provider failed to ensure the premises were safe to use by people, this was a breach of regulation 12” from the report
Consent was not always recorded
seriousRecords did not always show that people had agreed to their care plans. Mental capacity assessments were not always completed when there were concerns about a person's ability to consent.
“Failure to assess mental capacity and ensure consent was sought in line with the principles of the MCA, is a breach of Regulation 11” from the report
Weak management oversight
seriousAudits did not always identify problems or lead to timely action. The home had no registered manager and had been without one for over 12 months.
“The provider failed to operate effective systems to assess, monitor and improve the quality and safety of the service” from the report
Training and diet records
needs fixingSome refresher training was overdue. Care plans and daily records did not always give or record the support people needed with specific diets and fluids.
“We recommend the provider ensures systems in place to train and support staff are more effective and refresher training is provided in line with best practice guidance.” from the report
- 01What has been done to make the internal doors fire safety compliant, and has this work been checked?
- 02How are medicines now checked, and are all staff who administer them up to date with training and competency assessments?
- 03How will you make sure every person's risk assessment and care plan is accurate, current and clear for staff to follow?
- 04How do you record people's consent and complete mental capacity assessments when needed?
- 05When will a registered manager be in post, and how will the provider check that the action plan is working?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected, and the overall rating used the previous ratings for the questions not inspected. This explanation was written from the published report of 11 January 2024 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 2021
Inspected but not rated; inspectors found strong infection control and support for people during lockdown.
Inspectors made an unannounced visit on 15 February 2021. This was a targeted inspection of infection prevention and control during the coronavirus outbreak.
They found the home was clean and hygienic. There were effective measures for visitors, social distancing, personal protective equipment, testing, safe admissions and managing outbreaks.
People said they were comfortable and had what they needed. Staff had also prepared diaries, games and other resource packs to support people's wellbeing during lockdown.
The home was inspected but not rated. This means the visit checked infection control practices only, rather than giving a full rating for the home's overall quality.
Infection control
The home had effective measures to reduce the risk of infection entering and spreading. Inspectors found the infection prevention and control policy was up to date.
“The service had effective measures in place to reduce the risk of people spreading infection on entering the premises.” from the report
Clean environment
Inspectors found the home was clean and hygienic, with safety supported by the layout and cleaning practices.
“The service was clean and hygienic.” from the report
Testing
People living at the home and staff were tested regularly for COVID-19, at the frequency required by current guidance.
“Staff and people at the service were tested regularly for COVID-19.” from the report
Wellbeing support
Staff created packs with diaries and games to help people during lockdown.
“Staff had developed resource packs for people to use. The packs included diaries and games to help people's wellbeing during lockdown guidance.” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors currently prevented from bringing infections into the home?
- 02How often are people living here and staff tested for COVID-19 now?
- 03How is personal protective equipment used and monitored in the home?
- 04What procedures are followed when someone is admitted to the home?
- 05What activities and support are now available to protect residents' wellbeing?
This was a targeted inspection of infection prevention and control practices only; the service was inspected but not rated overall. This explanation was written from the published report of 26 February 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 Margaret Roper House
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- December 2017Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2016Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Goodstayed GoodSafe: Requires improvement
- January 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- August 2011
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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38 live-in carers within about an hour of Sefton
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,270 a week. 34 can care for a couple. 11 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.