CQC report explained · a nursing home
What the CQC found at Miramar Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were assessed and reviewed, medicines were audited and staff knew how to report suspected abuse. Inspectors identified chipped paint, torn flooring and toilet handwashing arrangements that made infection control harder.
- Effective?
- Good
- People were supported with nutrition, hydration and healthcare, and staff received induction, training and supervision. The training matrix was not up to date, and some oral health information needed more detail.
- Caring?
- Good
- Staff showed kindness and warmth, respected people's privacy and dignity, and involved people in decisions. People could express their views and receive advocacy support where needed.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People had choices about routines and staff gender for personal care, but some people said there were not enough activities.
- Well-led?
- Good
- The home had a registered manager, regular audits and systems for gathering feedback and improving care. Staff said the team worked well together, and this rating improved from Requires Improvement at the previous inspection.
What inspectors found, August 2019
Miramar Nursing Home was rated Good; inspectors found kind, safe care, but some building, infection control and activity issues.
This was an unannounced inspection on 18 and 19 June 2019. One inspector spoke with 10 people and eight staff, and reviewed care records, medicines, recruitment, training, staffing and quality checks.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staff were trained and people received personalised care.
People were treated with kindness and respect. They were involved in decisions, could access health professionals and received support with food, drink, faith, independence and end of life care.
Inspectors noted dated décor, chipped paint and torn flooring that made cleaning harder. Some people also wanted more activities. The provider agreed to improve infection control practice, staff training records, oral health information and activities.
Kind and respectful staff
Inspectors saw staff reassuring people, explaining things and respecting their dignity, choices and preferences.
“Staff showed kindness and warmth towards people. This included reassuring people when they were anxious and taking time to explain things.” from the report
Personalised care
Care plans gave staff guidance about people's individual needs and preferences, and were updated when needs changed.
“Care and support was tailored to people's individual needs.” from the report
Safe medicines and risk management
The home assessed risks, checked staff competence with medicines and reviewed medicines practice through audits.
“The provider had a safe system to manage medicines.” from the report
Good leadership
Inspectors found regular quality checks, positive staff teamwork and a manager who responded openly to feedback.
“There was a quality assurance system and regular audits were conducted to check on the quality and safety of the service.” from the report
Building and infection control
needs fixingSome chipped paint and torn flooring meant surfaces were harder to keep clean. The layout of some ground-floor toilet sinks did not support good hand hygiene, and inspectors made a recommendation.
“Chipped paintwork in some areas of the home and small tears in flooring meant that surfaces were not impervious to bacteria and harder to keep clean.” from the report
Limited activities
minorInspectors saw limited activities at the home, and some people wanted more group activities. The manager said they would work with people to provide more options.
“There's not a lot of group activities. There used to be a craft group but that stopped.” from the report
Training records
needs fixingStaff received training and supervision, but the training matrix was out of date, making it difficult to track refresher training.
“The provider's training matrix was not up to date, making it difficult for the registered manager to easily track when staff were due for their refresher training.” from the report
- 01What improvements have been made to the chipped paint, torn flooring and ground-floor toilet handwashing arrangements?
- 02How do you now check that infection prevention and control practice follows best practice?
- 03What activities are currently available, and how are residents' hobbies and interests used to plan them?
- 04How do you track staff refresher training now that the training matrix was out of date?
- 05How is each person's oral health care recorded and reviewed?
This was an unannounced scheduled inspection covering all five key questions, with the previous overall rating of Good and the previous Well-led rating of Requires Improvement considered. This explanation was written from the published report of 1 August 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.
What inspectors found, November 2016
Miramar Nursing Home was rated Good overall, but inspectors found weaknesses in management and quality monitoring.
Inspectors visited the home without notice on 25 August 2016. They spoke with people living there, staff and professionals, observed care, and checked care plans, staff records, medicines records and quality checks.
People were generally safe and received kind, respectful care. Inspectors found enough staff, suitable training, clear care planning, safe medicines systems and quick responses to call bells. People were supported with food, healthcare, activities and making choices.
The home was rated Good for Safe, Effective, Caring and Responsive. Well-led was rated Requires Improvement because there was no registered manager in post and the provider had not sent required information to CQC. Parts of the building also looked worn, and meetings and surveys for people's views were not regular.
Enough staff
Inspectors found staffing was sufficient for people's needs. Contingency arrangements were in place for short-term absences.
“We found that there were sufficient staff to meet the needs of people using the service.” from the report
Kind and respectful care
Staff knew people well and respected their wishes, privacy, dignity and independence.
“People were treated with kindness and respect.” from the report
Safe medicines
Medicines were locked away, stock was controlled and administration records were accurately completed. Staff explained medicines and stayed with people while they took them.
“Medicines were kept in a locked area. There was good stock control. Records about people's medicines were accurately completed.” from the report
Care planning
People's health needs and risks were assessed. Care plans gave staff clear guidance and were reviewed with people and, where needed, relatives or advocates.
“People's health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan.” from the report
No registered manager
seriousThere had been no registered manager since September 2015. A manager was applying to CQC, but having a registered manager was a condition of the provider's registration.
“There had not been a registered manager in post since September 2015.” from the report
Incomplete quality information
needs fixingThe provider had not returned its provider information return to CQC. This limited the information available about how the service monitored its quality.
“However, the provider had failed to return their provider information return to us prior to the inspection which would show us how they were monitoring the quality of the services being provided.” from the report
People's views not gathered regularly
needs fixingNo surveys had been sent since the previous inspection, and community meetings were infrequent. This meant opportunities to gather people's views were not consistent.
“No surveys had been sent to people since our last inspection, to test whether people's needs were being met and the quality of the services provided were acceptable to people.” from the report
Some activities were limited
minorThere were activities and trips, but some people sometimes had little to do. Extra staff were needed for some outings, which could reduce how spontaneous activities were.
“However, this sometimes hindered the spontaneity of people's wishes being fulfilled.” from the report
Worn areas of the home
minorSome communal areas and furniture looked tired or worn. Refurbishment work was included on the maintenance programme.
“Parts of the home were looking tired in the décor and there were items of furniture which were showing signs of long term wear and tear.” from the report
- 01Is there now a registered manager in post, and has the registration application been completed?
- 02How do you now gather residents' views, including through surveys and regular community meetings?
- 03Has the provider information return been submitted to CQC, and what quality improvements did it identify?
- 04Which communal areas and furniture have been refurbished since this inspection?
- 05How do you make sure people can take part in activities or outings when they want to, including at short notice?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 30 November 2016 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 Miramar Nursing Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
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.