CQC report explained · a residential care home
What the CQC found at Natalie House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about most infection prevention arrangements, including visitors, admissions, protective equipment, testing, cleaning and outbreak management. They were only somewhat assured that the infection control policy was up to date because staff had not been risk assessed for COVID-19 and their individual needs.
- Effective?
- Good
- This area was not assessed in this targeted inspection.
- Caring?
- Good
- This area was not assessed in this targeted inspection.
- Responsive?
- Good
- This area was not assessed in this targeted inspection.
- Well-led?
- Requires improvement
- This area was not assessed in this targeted inspection.
What inspectors found, April 2021
Inspected but not rated; inspectors found strong infection-control arrangements, but staff COVID-19 risk assessments were not in place.
This was an announced, targeted inspection on 16 March 2021. It focused on infection prevention and control during the COVID-19 pandemic.
Inspectors were assured that the home managed visitors, social distancing, admissions, protective equipment, testing, cleaning and possible outbreaks. People had care plans covering their COVID-19 needs.
The home had not risk assessed staff to consider COVID-19 and their individual needs. Inspectors signposted the provider to resources to improve this.
The service was inspected but not rated. This was not a full inspection of all five areas of care.
Visitor arrangements
A visiting policy was in place so people could see loved ones in line with the COVID-19 guidance at the time. Families had been told how the process worked.
“A visiting policy was in place to facilitate people seeing loved ones in line with new Government guidance.” from the report
Protective equipment
Staff were using protective equipment in line with guidance and had received training in how to use it during the pandemic.
“Staff were wearing Personal Protective Equipment (PPE) in line with Government guidance.” from the report
Enhanced cleaning
Cleaning arrangements included extra attention to frequently touched areas and sanitising the home every two hours.
“Cleaning schedules were enhanced to include high touch areas and two hourly sanitisation of the home.” from the report
COVID-19 care planning
Care plans considered people's individual COVID-19 needs. Where people could not make relevant decisions, plans involved loved ones and professionals.
“Where people lacked capacity, plans were made in people's best interests and involved the person, their loved ones and relevant professionals.” from the report
Staff risk assessments
needs fixingStaff had not been individually risk assessed for COVID-19 and their own needs. Inspectors signposted the provider to resources to develop this approach.
“However, staff were not risk assessed to consider COVID-19 and their individual needs.” from the report
- 01Have all staff now had individual COVID-19 risk assessments?
- 02What changes have been made to the infection prevention and control policy since this inspection?
- 03How are visitors currently supported to see people living in the home?
- 04How often are high-touch areas cleaned and sanitised now?
- 05How does the home support testing for residents and staff?
This was a targeted inspection of infection prevention and control during the COVID-19 pandemic; the service was inspected but not rated and the other care areas were not assessed. This explanation was written from the published report of 22 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, February 2020
Natalie House is rated Good overall; inspectors found safe, kind and responsive care, but leadership and monitoring still required improvement.
This was a planned follow-up inspection on 20 December 2019. One inspector spoke with a person using the home, staff, the manager, relatives and health and social care professionals. They also checked care, medicine, recruitment and management records.
The home was rated Good for being safe, effective, caring and responsive. People appeared comfortable and staff knew them well. Inspectors found safe medicines support, suitable staffing, kind care, access to health professionals, personalised plans and opportunities for activities and independence.
Well-led was rated Requires Improvement. Some key worker reviews were missing or not completed regularly. The provider had made only two checks during 2019, and some risk and behaviour support records needed more detail. The overall rating improved from Requires Improvement at the previous inspection in 2018.
People were safe
Staff understood how to protect people and manage risks. Inspectors found enough suitably recruited staff on duty and medicines were managed safely.
“People were safe living at the home. Staff knew how to protect people from harm and reduce the risk of accidents and incidents.” from the report
Kind and respectful staff
Staff knew people's preferences and supported them with patience, dignity and respect. Relatives and professionals also gave positive feedback.
“Our own observations showed staff treating people with patience and respect.” from the report
Personalised support
Care plans described people's likes, dislikes and preferences. People were encouraged to make choices, develop skills and take part in activities.
“The care plans gave a clear picture of the person as an individual.” from the report
Accessible information
Care plans used symbols and large print. The home also displayed pictures, signs and easy-read information.
“The care plans were written in an easy read format using symbols and large print text which was easier for people to access and understand.” from the report
Inconsistent key worker reviews
needs fixingMonthly key worker reviews were not completed consistently. The provider's audits had not identified this problem.
“two people had one review for 2019. Another person had completed two reviews and one person 10.” from the report
Limited provider checks
needs fixingThe provider's oversight was less regular than in previous years. Only two checks of the home were recorded during 2019.
“The provider completed their own audits of the home, however, records we looked at showed the provider had made just two checks during 2019.” from the report
Some risk records were missing
needs fixingOne person's file did not include risk assessments for hoist use and catheter care. Staff knew how to provide the support, and the manager said the care plan would be updated.
“We saw on one person's file there was no risk assessment for the use of a hoist and catheter care.” from the report
Training records were not up to date
minorStaff said training had been completed, but the provider's records had not been updated and inspectors could not check all training.
“We could not check all staff training was up to date because records were not easily available for us to review” from the report
- 01How often are key worker reviews now completed for each person, and who checks that none are missed?
- 02How regularly does the provider audit the home, care plans and risk records?
- 03Have the missing hoist and catheter risk assessments been added to the relevant care plan?
- 04How are staff training records kept up to date and made available for checking?
- 05What clearer instructions are now in place for supporting the person when they become distressed?
This was a planned inspection covering all five CQC questions, following the previous Requires Improvement rating; the inspection included one person's experience, two care records, medicine records, two staff files and feedback from relatives and professionals. This explanation was written from the published report of 6 February 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 Natalie House
6 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- February 2020Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2017Requires improvementstayed Requires improvementWell-led: Requires improvement
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
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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