CQC report explained · a nursing home
What the CQC found at Maristow Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2020
Maristow Nursing Home was rated Good; inspectors found kind, safe care and improvements since the previous Requires Improvement rating, but guidance for some medicines was not always complete.
This was an unannounced inspection by one inspector. They spoke with seven people, two relatives, four staff members and one healthcare professional. They reviewed care records, medicine records, staff files and management records.
The home was clean and well maintained. Inspectors found enough staff, safe medicine administration, regular safety checks and detailed plans for managing risks. Staff had the training and support needed for their roles.
People were treated with kindness and respect. Care plans were personalised and kept up to date. People had choices about their care, meals and daily routines, and the home supported access to healthcare, activities and relationships.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous rating was Requires Improvement, but inspectors found enough improvement for the home to be no longer in breach of the regulations previously identified.
Kind and respectful care
People told inspectors that staff were kind and caring. Inspectors also saw people being spoken to respectfully and given choices about their care.
“People told us staff were kind and caring.” from the report
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs, including a nurse on every shift. Required checks had been completed before staff were employed.
“People were cared for by sufficient numbers of staff.” from the report
Personalised support
Care plans recorded people's preferences, routines, histories and communication needs. Staff used this information to understand and support people as individuals.
“People had their own personalised care plan which was kept up to date and reviewed regularly.” from the report
Good management and improvement
Monthly quality checks were used to identify and monitor improvements. People, relatives, staff and professionals told inspectors the home was well managed.
“Quality monitoring systems were in place and carried out monthly.” from the report
Food and healthcare
People had choices of food and drink and experienced an unhurried mealtime. Staff contacted healthcare professionals when needed and kept detailed health records.
“We observed a mealtime and saw it was unhurried.” from the report
Guidance for some medicines
needs fixingFor medicines prescribed to be taken when needed, staff did not always have enough written guidance about when and how to give them. The provider took action during and after the inspection to add more detailed protocols.
“Where people were prescribed 'as required' medicines, there was not always enough guidance in place for staff to administer this type of medicine.” from the report
- 01What detailed protocols are now in place for each medicine prescribed 'as required', and how are staff checked on using them?
- 02How do you make sure there is always a nurse available on every shift?
- 03What is the current position on the Deprivation of Liberty Safeguards applications that were awaiting local authority assessment?
- 04How are personalised activities and music therapy provided for people who have communication difficulties or prefer a quiet life?
- 05How are monthly quality checks shared with residents and relatives, and how are outstanding actions followed up?
This was an unannounced planned inspection covering all five key questions, with the home, care and records examined; the registered manager was not available during the visit. This explanation was written from the published report of 26 March 2020 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, March 2019
Rated Requires Improvement; inspectors found kind, personalised care but gaps in gas safety and quality checks.
This was an unannounced inspection on 29 January and 4 February 2019. Two inspectors spoke with people, visitors, staff and a GP. They reviewed care records, staff checks, training and management records.
The home provided kind and personalised care. People were supported to make choices, take medicines safely, eat and drink well, and access health services. The ratings for Effective, Caring and Responsive were Good.
There were important weaknesses in safety and management. The gas appliances had not received the required annual safety check, and the quality assurance systems had failed to identify this. The overall rating fell from Good at the previous inspection to Requires Improvement.
The home was told to make improvements. The gas appliances were checked in the week after the inspection, according to the provider, and CQC said it would monitor the service and carry out another comprehensive inspection within 12 months.
Kind and respectful care
People spoke positively about staff, and inspectors saw support that respected privacy and dignity.
“People were treated with kindness and were positive about the staff's caring attitude.” from the report
Personalised support
Care plans recorded people's preferences and needs. People were involved in decisions and supported to keep as much control and independence as possible.
“People were supported to make choices and have as much control and independence as possible, including in developing care plans.” from the report
Staffing and medicines
There were enough staff, call bells were answered promptly, and medicines records were complete. Staff followed safe practice when giving medicines.
“Medicines administration records had been fully completed.” from the report
Health and nutrition support
Staff understood people's medical conditions, supported people with meals and drinks, and worked with health professionals when needed.
“People had access to drinks throughout the day and staff supported people to drink where needed.” from the report
Gas safety check was overdue
seriousThe annual gas safety check due in May 2018 had not been completed. This meant the home had operated for nine months without confirmation that its gas appliances were safe.
“This meant the home had been operating for nine months without assurance that the gas appliances were safe and did not pose a risk to people using the building.” from the report
Quality checks were not reliable
seriousManagement systems did not identify the missing gas certificate. Regular management meetings had stopped, and negative survey comments about dignity, communication and responses to requests were not formally investigated.
“The provider's quality assurance systems were not effective.” from the report
- 01Can you show us the current gas safety certificate and explain how future checks will be tracked?
- 02How often are quality assurance meetings now held, and what records show that they lead to improvements?
- 03How are complaints, surveys and negative comments now investigated and followed up?
- 04What changes have you made since the previous Good rating and the Requires Improvement inspection?
- 05How will you check that people's dignity, communication needs and requests for support are being met consistently?
This was an unannounced planned inspection that looked at the premises and care provided across all five CQC questions. This explanation was written from the published report of 8 March 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 Maristow Nursing Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 17 June 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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