CQC report explained · a residential care home
What the CQC found at Messenger 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
- People felt safe and there were enough staff. However, care plans and risk assessments did not always contain enough detail, some staff did not know enough about health risks, and some Covid-19 procedures did not follow current guidance.
- Effective?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This question was not assessed during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- The home had monitoring systems, but they did not always identify problems with care records, risk assessments and infection control. This led to a breach of Regulation 17 on good governance.
What inspectors found, April 2021
Rated Requires Improvement; people felt safe and well supported, but care records and quality checks were not reliable enough.
This was a focused inspection on 18 February 2021. One inspector spoke with the three people living in the home, staff and a relative. They reviewed care records, medicines records, staff files and management records.
The inspectors found that people generally had positive experiences. They felt safe, medicines were given as needed, staffing levels were enough, and recruitment checks had improved. People had good relationships with staff and felt able to raise concerns.
There were important weaknesses. Care plans and risk assessments did not always give staff enough detail about health conditions and risks. Infection control arrangements did not fully follow Covid-19 guidance at the time, although action was taken after the inspection.
The overall rating remained Requires Improvement. Safe and Well-led were both rated Requires Improvement. The home had received the same overall rating at the previous inspection, and this was the second consecutive inspection with that rating.
People felt safe
People said they felt safe and knew they could raise concerns with staff or the manager.
“People we spoke with told us they felt safe and would report any concerns they had to staff.” from the report
Enough staff
Inspectors saw enough staff on duty, and people said there were plenty of staff to help them.
“The staff are all brilliant, I like them all and there are plenty of staff to help me.” from the report
Medicines practice improved
The earlier medicines administration problem had been addressed. Staff had competency checks and records showed medicines were given regularly.
“Administration of medication records indicated people received their medicines regularly.” from the report
Safer recruitment
Recruitment checks had improved since the previous inspection, including references and DBS checks.
“Staff had been recruited safely. All pre-employment checks had been carried out including reference checks from previous employers and Disclosure and Barring Service (DBS) checks.” from the report
Good relationships
People had developed positive relationships with staff and said staff understood how to support them.
“People had developed good relationships with the staff who supported them.” from the report
Care records lacked detail
needs fixingCare plans and risk assessments did not always explain people's needs and health risks clearly enough for staff. This included diabetes, epilepsy and choking risks.
“Care plans and risk assessments did not always contain enough detail to inform staff about people's needs.” from the report
Covid-19 procedures
needs fixingSome infection control arrangements did not follow the guidance in force at the time. This included the use of a cloth mask and staff testing arrangements, although the manager took action afterwards.
“Use of cloth masks is not recommended by Public Health England.” from the report
Weak quality checks
seriousThe home's audits and monitoring had not reliably identified the problems found by inspectors. This was a breach of Regulation 17.
“Systems were either not in place or not robust enough to demonstrate the provider had maintained effective management oversight of the quality and safety of the service.” from the report
One medicines protocol needed detail
minorOne protocol for medicine given when needed was not detailed enough. The manager corrected this after the inspection.
“One protocol needed review and further detail, this was rectified by the registered manager following our inspection.” from the report
- 01How have you rewritten care plans and risk assessments so staff have enough detail about diabetes, epilepsy and choking risks?
- 02What checks now make sure staff understand the signs and actions linked to each person's health conditions?
- 03What changes have you made to your quality audits since the Regulation 17 breach?
- 04How do you now check that infection control and staff testing follow current guidance?
- 05What progress has been made since the action plan requested by CQC?
This was a focused inspection of Safe and Well-led, including infection control; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 9 April 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, December 2019
Rated Requires Improvement; inspectors found kind, person-centred care, but recruitment, medicines checks and oversight needed strengthening.
This was the home’s first inspection since it registered. It was a planned, unannounced visit on 13 November 2019. One inspector spoke with people and staff, observed care and checked care, medicine, recruitment and management records.
People told inspectors they felt safe and were treated with kindness and respect. Staff supported people to make choices, stay involved in their care, join activities and use local services. The ratings for Effective, Caring and Responsive were Good.
The home was not always safe or well-led. Recruitment checks did not fully show that staff were suitable, and one medicine stock count was wrong. The systems used to check quality had not found these problems. The overall rating was Requires Improvement.
Kind and respectful care
Inspectors saw positive interactions. People said staff listened to them and treated them with dignity.
“People were treated with kindness and compassion by the staff.” from the report
Choice and independence
People were involved in everyday decisions, care planning, food choices and activities. Staff encouraged people to do things for themselves.
“People were supported and encouraged to be independent.” from the report
Personalised care plans
Care plans included people’s likes, dislikes, life histories, beliefs and preferred ways of being supported.
“People's care plans contained detailed information about how they liked to be supported.” from the report
Community involvement
People were supported to follow their interests, keep in touch with family where appropriate and take part in community life.
“People were encouraged and supported to be part of their local community where they wanted to.” from the report
Recruitment checks
seriousSome staff had DBS checks from previous employers without an assessed risk, and gaps in employment history had not been explored before staff started work.
“Recruitment processes were not always effective in ensuring staff were suitable for the roles prior to commencing their employment.” from the report
Medicine records and administration
seriousThe stock of one medicine did not match the records. On one occasion, a staff member gave medicines after they had been dispensed by a manager who had left the home.
“We found one example where the stock of tablets did not balance with what should have been left.” from the report
Weak quality checks
needs fixingThe home had monitoring systems, but they had not found the recruitment and medicine problems identified during the inspection.
“These had not always been effective at identifying where improvements were needed as identified during our inspection.” from the report
Access to records
minorWhen the manager was away, staff could not access records kept in locked cabinets. The manager said this would be addressed.
“However, when the registered manager was off site, staff were not able to access locked cabinets.” from the report
- 01Have all staff now received new DBS checks, and have any risks from previous checks been assessed?
- 02Have all gaps in staff employment histories been explained and recorded?
- 03How do you now check medicine stocks and investigate any mismatch with the records?
- 04What safeguards are in place to prevent medicines being given by staff who are not authorised or fully trained?
- 05Have people and families now been asked for formal feedback about the care and support?
This was the first inspection of the newly registered home and covered all five CQC questions, with Safe and Well-led rated Requires Improvement and the other three areas rated Good. This explanation was written from the published report of 21 December 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 Messenger House
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- April 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2019Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2018
Registered with the Care Quality Commission on 23 November 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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