CQC report explained · a nursing home
What the CQC found at Moss Cottage Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and individual and environmental risks were assessed. Medicines were stored appropriately, although some medicine checks were not recorded on every occasion.
- Effective?
- Good
- People's needs were assessed and reviewed. Staff supported people's dietary needs, worked with healthcare professionals and received training and support.
- Caring?
- Good
- This key question was not looked at during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not looked at during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Good
- The registered manager used audits, investigated concerns and acted on feedback. Staff understood their roles and the home had a stable staff team.
What inspectors found, January 2022
Moss Cottage Nursing Home is rated Good; inspectors found important improvements, with minor gaps in medicine checks and activities.
This was an unannounced, focused inspection on 10 December 2021. Inspectors checked Safe, Effective and Well-led, including infection control. They spoke with six people, three relatives and eight staff, observed care, and reviewed care, medicine, recruitment and management records.
The home was rated Good overall and Good for Safe, Effective and Well-led. Inspectors found people felt safe, medicines were stored securely, infection control arrangements were suitable, staffing was generally enough, and care was planned around people's needs.
The home had improved since its previous rating of Requires Improvement, published in May 2020. The provider had previously breached Regulations 12 and 17, but inspectors found enough improvement and said the home was no longer in breach.
Some medicine checks were not always recorded. Some people wanted more activities, and parts of the building needed attention or updating. Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward.
Safer medicines
Medicines were stored securely and records gave staff detailed instructions for medicines that needed special support.
“Medicines were being stored appropriately. The clinic room was well organised and there were systems for regular checks to ensure people had the medicines they needed.” from the report
Infection control
The laundry was organised and inspectors were assured that the home was following current infection prevention measures, including the use of protective equipment and arrangements for visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Food and dietary support
People spoke positively about the food. Kitchen staff understood how to support people with modified diets and other specific dietary needs.
“People spoke very positively about the food and told us they had a good choice of what they would like to eat.” from the report
Staff support
Staff completed training and received support. Inspectors found systems for checking staff competence.
“Staff spoke positively about the training and support they received.” from the report
Improved management
The home had a stable staff team and management checks covered different aspects of care. Concerns were investigated and action was taken.
“The registered manager completed a variety of audits and checks which covered all aspects of care undertaken at the service.” from the report
Medicine records
needs fixingThere were occasions when medicine checks, including medicine counts, were not recorded. Inspectors raised this with the registered manager.
“There were some occasions where checks were not being recorded, such as counts of medicines, and this was fed back to the registered manager.” from the report
Limited activities
minorSome people said they wanted more activities and things to do in the home. This may be particularly relevant if someone spends a lot of time in their bedroom.
“Some people commented that they would like more activities and things to do in the home.” from the report
Areas needing updating
minorCommunal areas had recently been decorated, but some other parts of the home needed attention or updating. Refurbishment plans were in place.
“There were some areas of the service which required attention or updating, but refurbishment plans were in place.” from the report
- 01How are medicine counts and other medicine checks recorded now, and how do you make sure records are complete?
- 02What activities are currently available, particularly for people who spend time in their bedrooms?
- 03Which areas of the home still need updating, and what is the timetable for the refurbishment plans?
- 04What were the previous ratings for Caring and Responsive, and when will those areas next be reviewed?
- 05How are people's views and family feedback used to decide which improvements to make?
This was a focused inspection of Safe, Effective and Well-led, including infection control; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 5 January 2022 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 2020
Moss Cottage Nursing Home was rated Requires Improvement; inspectors found kind and responsive care, but concerns about medicines, records, infection control and management.
Inspectors visited on 3, 12 and 20 March 2020. They spoke with people, relatives and staff, observed care, checked the building and reviewed care, medicine, staffing and management records.
The home was not always safe or well managed. Medicines were not always stored securely, some records were inaccurate, infection control in the laundry was not always followed, and checks did not always lead to quick action. Inspectors also had concerns about staffing levels, care records, the environment and meal times.
People were generally treated with kindness and their needs were mostly met. The caring and responsive questions were rated Good. Safe, effective and well-led were rated Requires Improvement. The overall rating fell from Good at the previous inspection, published on 22 June 2019.
Kind staff
People and relatives generally described staff as kind and caring. Inspectors observed positive interactions during most of the inspection.
“We observed that when staff interacted with people they were kind and caring.” from the report
People's choices
Staff generally asked for consent and involved people in everyday decisions. Relatives were invited to care planning meetings.
“Staff encouraged people to make choices in their daily lives.” from the report
Healthcare support
People were referred to specialist services when needed, and staff worked with doctors and other healthcare professionals.
“People were referred to external services when additional needs were identified.” from the report
Activities and end of life care
An activity coordinator offered group and one-to-one activities. End of life plans and medicines were in place when needed.
“The activity co-ordinator told us they offered a range of group activities, such as pet therapy and intergenerational work with schools.” from the report
Medicine safety
seriousThickening powders were found in people's bedrooms, where they could be accessed. Medicine records included missing signatures and incorrect allergy information.
“We found three occasions where thickening powders were accessible to people in their bedrooms and posed a potential risk.” from the report
Infection control
seriousLaundry arrangements were disorganised and the process for handling soiled laundry was not always followed. This was a breach of the safe care and treatment regulation.
“A robust programme for good infection control was not being consistently followed in the laundry.” from the report
Records and oversight
seriousCare plans, handovers and other records did not always contain accurate, up-to-date information. Audits did not reliably identify problems or ensure they were fixed.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
Staffing and agency staff
needs fixingFeedback about staffing was mixed. Inspectors saw communal areas left unattended and recommended stronger checks on staffing levels and agency staff.
“We could not always be sure there were enough staff to meet people's needs.” from the report
Building and meal experience
needs fixingSome radiators, windows and hot water taps presented risks at the time of inspection. Communal areas and bedrooms needed redecoration, and meal times were not always sociable.
“Potential risks within the environment were not being fully assessed and quickly remedied.” from the report
- 01How are thickening powders and all other medicines now stored and checked?
- 02What changes have been made in the laundry to make sure soiled laundry is handled safely?
- 03How do you make sure care plans, dietary information and handover records are accurate and up to date?
- 04How have staffing levels and the use of agency staff changed since the inspection?
- 05What progress has been made with the window restrictors, radiator covers, hot water controls, redecoration and meal times?
This inspection looked at all five CQC questions and was prompted by concerns about swallowing difficulties, abuse and moving and handling; it did not examine the circumstances of a death because that was subject to a criminal investigation. This explanation was written from the published report of 1 May 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.
Every inspection of Moss Cottage Nursing Home
4 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2012
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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