CQC report explained · a residential care home
What the CQC found at Menwinnion Country House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and reviewed, staff knew how to support people safely, medicines were generally managed safely, and infection control arrangements were satisfactory. They recommended better recording of information about medicines given when needed.
- Effective?
- Good
- Staff had received relevant training and supervision. People were supported with consent, nutrition, hydration and healthcare, and the home worked with health professionals.
- Caring?
- Good
- No separate Caring rating was given in this report. Inspectors observed friendly interactions and reported that people were treated with respect and dignity.
- Responsive?
- Good
- Care plans had been reviewed and reflected people's preferences, needs and risks. People had access to activities, visitors were supported, complaints were recorded and investigated, and end-of-life wishes were documented.
- Well-led?
- Good
- The home had a registered manager, a clearer management structure and regular quality checks. Inspectors found a positive culture and evidence that the provider had acted on previous regulatory problems.
What inspectors found, December 2021
Rated Good; inspectors found kind, safe care and major improvement, but records for medicines given when needed were not always detailed.
Inspectors visited on 12, 16 and 17 November 2021. The first visit was announced, and the other two were unannounced. They spoke with people, staff, managers and a relative, observed care, and checked care, medicine, recruitment and management records.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Inspectors found that earlier problems with medicines, staff training, consent, care plans and management had been addressed.
People told inspectors staff were kind and respectful. Care plans were person-centred, people's health and nutrition needs were supported, and activities and end-of-life wishes were considered. Inspectors made one recommendation to improve information about medicines given when needed.
This was not a full review of every CQC area. The inspection focused on infection prevention and control under Safe. Ratings for the other inspected questions were carried forward from earlier comprehensive inspections.
Improved leadership
The provider had strengthened the management team and introduced systems to check quality and track improvements.
“This inspection assured us the provider had embedded the new practices into the day to day operation of the service.” from the report
Kind and respectful care
People told inspectors that staff were kind and compassionate. Inspectors also observed friendly and positive interactions.
“People told us staff were kind and compassionate to them. People were treated with respect and dignity.” from the report
Staff training and support
Staff received induction, regular training and supervision. Inspectors found that staff understood safeguarding, consent and how to support people whose behaviour might challenge.
“People were supported by staff who had appropriate skills and experience.” from the report
Activities and relationships
The home offered activities and supported people to maintain important relationships. Relatives were kept informed and visitors were welcomed under safe visiting procedures.
“The service had a range of activities taking place from music, art and involvement with local community organisations.” from the report
As-needed medicine records
needs fixingSome people were prescribed medicines to take when needed. Inspectors found that extra guidance was not always available to help staff make consistent decisions or record why the medicine was given.
“We recommend the service continues to improve their medicines processes to make sure that information around medicines, including when required medicines, is recorded in people's care plans.” from the report
Mobility equipment in lounge
minorInspectors found that a lounge area was sometimes cluttered with mobility equipment. The provider planned to change the use of the dining room to create more suitable space.
“The lounge area being changed was at times cluttered with mobility equipment.” from the report
- 01How do you record the reason and circumstances when a medicine is given only when needed?
- 02How do you check that staff have the guidance they need to make consistent decisions about these medicines?
- 03How are the improvements made since the previous Requires Improvement rating being monitored and maintained?
- 04What is the current management structure, including the registered manager, deputy manager and senior roles?
- 05How will the planned changes to the lounge and dining areas improve space for people using mobility equipment?
This was a planned focused inspection based on the previous rating, with infection prevention and control checked under Safe; the other ratings were carried forward from previous comprehensive inspections, and no separate Caring rating was given. This explanation was written from the published report of 11 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.
What inspectors found, May 2021
Menwinnion Country House was rated Requires Improvement, with unsafe medicines, gaps in staff training and inadequate leadership.
Inspectors carried out an unannounced focused inspection over two days. They looked at Safe, Effective and Well-led. They spoke with people, relatives, staff and managers, and checked care, medicine, training and management records.
The home was not always safe or effective. Staff lacked training and guidance about safeguarding, medicines and behaviour that could challenge others. Medicines were not always given as prescribed, and records and checks were not reliable.
People's rights were not always protected because mental capacity assessments were not specific to decisions or updated when needs changed. Staff training was also out of date, including training in first aid, infection control, moving and handling and fire safety.
Leadership was rated Inadequate. There had been several manager changes, and the provider had not acted on problems found at the previous inspection. The overall rating remained Requires Improvement. Some improvements had been made to recruitment checks, food and infection control.
Recruitment checks
The home had resolved the previous recruitment problem. Required checks were completed before new staff worked with vulnerable adults.
“All necessary checks including disclosure and barring service checks (DBS) had been completed before new staff were permitted to work with vulnerable adults.” from the report
Food and nutrition
People and relatives praised the food and range of choices. Staff understood individual nutritional needs and supported people at mealtimes.
“Kitchen staff had a good understanding of people's individual nutritional needs.” from the report
Staff availability
People and relatives said there were enough staff. Rotas showed planned staffing levels were usually achieved.
“These records showed planned staffing levels had been regularly been achieved.” from the report
Support with behaviour
seriousStaff did not have the training or guidance needed to support people whose behaviour could challenge others. Possible triggers were not included in care plans, increasing the risk of harm.
“Staff had not been provided with guidance on how to respond to or manage these behaviours.” from the report
Medicines
seriousPeople did not always receive medicines as prescribed. Medicine records, staff competency checks, audits and guidance for medicines given when needed were not reliable.
“People did not consistently receive their medicines as prescribes and Medicines Administration Records (MARs) were not always completed according to best practice.” from the report
Mental capacity and consent
seriousCapacity assessments were not specific to individual decisions and were not reviewed when people's needs changed. Records supporting restrictions on people's freedom were also missing in some cases.
“These capacity assessments were not decision specific and had not been updated or reviewed when people's needs changed.” from the report
Leadership and improvement
seriousFrequent manager changes affected the home's stability. Quality checks identified problems but the provider did not take effective action to resolve them.
“The provider had again failed to operate effective systems and make necessary improvements to ensure compliance with the regulations.” from the report
- 01What has changed to ensure every person receives medicines as prescribed, and how are medicine records and staff competency now checked?
- 02How are staff trained to support behaviour that could challenge others, and are possible triggers now recorded in care plans?
- 03How are mental capacity assessments made specific to each decision and reviewed when a person's needs change?
- 04Which staff training courses are now up to date, including first aid, safeguarding, infection control, moving and handling and fire safety?
- 05Who is currently responsible for leading the home, and how is the provider checking that the improvements required by the CQC are being completed?
This was a focused inspection of Safe, Effective and Well-led; the Caring and Responsive questions were not inspected, and ratings from the previous comprehensive inspection were carried forward for the overall rating. This explanation was written from the published report of 26 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.
Every inspection of Menwinnion Country House
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- December 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementResponsive: GoodWell-led: Requires improvement
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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10 live-in carers within about two hours of Cornwall
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 £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
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.