CQC report explained · a nursing home
What the CQC found at Mulberry Court Care 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 2019
Rated Good overall, with Outstanding responsiveness; inspectors found safe, kind care and some safety issues were fixed during the visit.
This was an unannounced inspection on 17 January 2019. Inspectors spoke with people living in the home, relatives, staff and visiting professionals. They reviewed care records, medicine records, staff files and the home’s policies.
The home was rated Good overall. Safe, Effective, Caring and Well-led were all rated Good. Responsive was rated Outstanding. Inspectors found enough staff, safe medicine systems, caring relationships and detailed care plans.
The home had improved since the previous inspection, when it was rated Requires Improvement. Inspectors praised the very personalised activities and community links. They also found some environmental and infection-control issues during the visit, which the provider acted on straight away.
Personal wishes
The home helped people achieve important personal ambitions through its Hopes and Dreams programme. Examples included going on patrol with local police and spending time with the fire service.
“People received care that was exceptionally personalised and responsive to their needs.” from the report
Activities and community
People had many meaningful activities, community links and opportunities to work or swim. Children and pupils visited, and people were supported to take part outside the home.
“People had access to a wide range of meaningful and interesting activities throughout their day.” from the report
Kind and respectful care
Inspectors saw friendly relationships and staff who knew people’s personalities, preferences and support needs. People were treated with dignity and involved in decisions.
“During our visit, we observed a warm, pleasant, family orientated and relaxed atmosphere.” from the report
Improved outcomes
Inspectors found examples of people’s health and quality of life improving, including fewer hospital admissions, weight gain and greater involvement in social activities.
“As a result, the persons condition improved meaning they required only a single hospital admission in six months, they put on weight and were able to socialise and join in activities with fellow residents.” from the report
Open leadership
The management team had clear monitoring systems and encouraged staff to report incidents and learn from them. People, relatives and professionals were able to give feedback.
“The service had an open and transparent culture.” from the report
Environmental safety checks
needs fixingRoutine checks had not identified the need for window-limiters on high-opening first-floor windows. Some exposed water pipes were also very hot and could have caused harm, although the provider acted during and immediately after the inspection.
“We noted that maintenance checks had not identified the need for window limiters on high opening first floor windows and that some exposed water pipes were very hot to the touch and could cause risk of harm.” from the report
Infection control
needs fixingInspectors initially found some practices that did not follow infection-control best practice. The provider took action during and immediately after the inspection, and inspectors said people were then protected from the risk and spread of infection.
“During our initial tour of the service we identified some issues where infection control best practice was not followed.” from the report
- 01What checks are now in place to make sure high-opening windows have suitable limiters?
- 02How do you check that exposed hot water pipes remain safe?
- 03What infection-control changes were made after the issues found during this inspection?
- 04How will you continue the Hopes and Dreams programme and the range of community activities?
- 05What improvements have been made since the January 2019 inspection?
This was an unannounced comprehensive inspection covering all five CQC questions and both the care provided and the care home premises. This explanation was written from the published report of 6 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.
What inspectors found, May 2017
Rated Requires Improvement; inspectors found kind, safer care, but records, staff training and quality checks still needed work.
Inspectors visited the home without warning on 31 January and 1 February 2017. They spoke with people, relatives, staff and health professionals. They observed care and checked care records, medicine records, training records and quality checks.
The home had improved since the previous inspection. Medicines were generally managed safely, staffing levels were enough, the home was cleaner, and people's rights under the Mental Capacity Act were better protected. Staff were kind, and people had personalised activities and support.
The overall rating was Requires Improvement. Safe, caring and responsive care were rated Good. Effective and well-led were rated Requires Improvement because some risk and care records were incomplete, not all staff had finished core training, and the new quality checks needed to continue for longer to show they worked.
Improved medicine safety
Medicine administration and storage were checked and were generally safe. Staff had training and their competence was assessed.
“Recent medicine audits completed by Boots Pharmacy and the local Clinical Commissioning Group showed the service managed medicines safely and had scored well” from the report
Enough staff
Inspectors found sufficient staff to meet people's needs. Staff responded quickly when people needed help.
“We checked the rotas and there were sufficient staff available to meet the needs of the service.” from the report
Kind and respectful care
People were relaxed with staff and were treated with dignity. Staff supported people's independence and respected their choices.
“We observed many interactions between staff and people that were positive and supportive.” from the report
Activities and choice
People could take part in daily group activities, hobbies and community trips. Staff encouraged people to remain independent.
“There was evidence of wide range of activities taking place in the home, people leaving the home to go to pubs, cafes and shopping.” from the report
Incomplete risk guidance
seriousSome risk assessments did not give staff enough information. One person at risk of choking had no guidance on how to manage that risk.
“one person's file stated a person was at risk of choking but no guidance was in place to advise staff how to effectively manage this.” from the report
Missing medicine protocols
needs fixingSome medicines prescribed for use when needed did not have protocols explaining when they should be given.
“However protocols were not always in place for medicines which had been prescribed to be given 'as required'.” from the report
Incomplete care records
needs fixingSome records did not match people's current needs or show that planned support had happened. Examples included diabetes guidance, night-time repositioning and continence support.
“This showed us that records had not always been updated to reflect people's needs.” from the report
Training still being completed
needs fixingNot all staff had completed core training at the inspection. The manager said this would be completed by mid-February 2017.
“However not all staff had completed the core training.” from the report
Quality checks not yet proven
needs fixingNew quality audits had been introduced, but the home needed to use them for longer and show that they consistently found and fixed problems.
“The provider needed to sustain and evidence the quality audit processes for a longer period of time to confirm this was effective.” from the report
- 01Have all 'as required' medicines now got clear protocols explaining when staff should give them?
- 02Have the missing risk instructions, including the choking guidance, been completed and checked?
- 03Have all staff completed the core training and had their competence assessed?
- 04How are care plans and repositioning records now checked to make sure they are current and accurate?
- 05What evidence can you show that the quality audits have continued and are finding and fixing problems?
This was an unannounced follow-up inspection to check action taken after the April 2016 inspection and confirm whether legal requirements were now met. This explanation was written from the published report of 23 May 2017 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 Mulberry Court Care Home
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- May 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2015
Registered with the Care Quality Commission on 27 November 2015.
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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