CQC report explained · a residential care home
What the CQC found at Nelson's Croft
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments, safeguarding procedures, recruitment checks and medicine training were in place. Inspectors noted that it was not clear whether all recommendations from a 2017 fire risk assessment had been completed.
- Effective?
- Good
- Staff had suitable induction and ongoing training. People received support with food, healthcare, communication, consent and independence.
- Caring?
- Good
- Inspectors observed warm relationships between staff and people. People were involved in decisions, treated with dignity and encouraged to be independent.
- Responsive?
- Good
- Care plans recorded people's needs, routines, preferences and communication methods. Complaints procedures were available in different formats and complaints were investigated.
- Well-led?
- Good
- Managers used audits, meetings and feedback to review the service and make improvements. Staff said managers were supportive and they could raise concerns.
What inspectors found, July 2019
Nelson's Croft was rated Good; inspectors found safe, kind and personalised care, with some building checks and repairs needing attention.
This was a planned inspection on 12 June 2019. One inspector spoke with relatives, staff and people living in the home, and reviewed care, medicine, recruitment, training and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were supported to make choices, build independence and receive care suited to their communication and personal needs.
The home was clean, but one shower room needed repair and decoration. Inspectors also found that it was not clear whether some recommendations from a fire risk assessment had been completed. The overall Good rating was unchanged from the previous inspection, published in October 2018.
Choice and independence
People were supported to make choices and develop everyday skills. Staff used individual support plans and understood how to help people become more independent.
“People were supported to have maximum choice and control of their lives” from the report
Kind relationships
Inspectors saw warm relationships between staff and people. Relatives gave positive feedback about how people were treated.
“During the inspection we observed warm and comfortable relationships between staff and people living in the home.” from the report
Personalised communication
The home recorded how each person communicated, including signs, body language and other non-verbal methods. Information and complaints procedures were available in different formats.
“Staff were able to explain how different people made use of facial expressions, body language and behaviour as alternative forms of communication.” from the report
Good management checks
Managers used audits, meetings and feedback to identify and address improvements. Staff said they received regular support and training.
“The registered manager and provider completed regular safety and quality audits to measure performance and generate improvements.” from the report
Shower room needed work
needs fixingOne shower room needed repair and decoration. The manager gave inspectors an expected date for the work after the inspection.
“The home was clean, however we identified that a shower room was in need of refurbishment.” from the report
Fire assessment follow-up unclear
needs fixingThe required actions from the fire risk assessment had been completed, but the report did not make clear whether all recommendations had also been completed or still needed action.
“it was not clear recommendations were completed or still to be carried out.” from the report
Larger than current guidance
minorThe home was registered for up to eight people and was larger than current best practice guidance for this type of setting. Inspectors said the design and location reduced the impact on people.
“This is larger than current best practice guidance.” from the report
- 01Has the shower room repair and refurbishment been completed, and if not, when will it be finished?
- 02Have all recommendations from the 2017 fire risk assessment now been completed and recorded?
- 03How does the home make sure its larger size does not affect people's privacy, independence or community life?
- 04How will staff support my relative's particular communication methods and personal routines?
- 05How will my relative be involved in decisions about their care and activities?
This was a planned inspection covering all five CQC questions, and all five ratings remained Good from the previous inspection. This explanation was written from the published report of 19 July 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, December 2016
Rated Good; inspectors found caring, person-centred support, with some safeguarding and medicines records needing improvement.
Inspectors visited on 16 and 19 August 2016. The visit was announced 24 hours beforehand. They spoke with people living at the home, the manager and staff. They observed care, checked three care files, staff training and recruitment records, and looked at how the home was run.
The home supported seven people, although it was registered for up to eight. Inspectors found enough staff, safe recruitment, suitable training and good care planning. People appeared comfortable with staff. Food and drink choices were available, medicines were generally administered safely, and people's families were involved in care reviews.
There were some shortfalls. Several minor incidents had not been identified as possible safeguarding concerns. Some medicines records were harder to audit, and a controlled medicine was recorded in the wrong type of book. The manager agreed to put these matters right.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This means the inspection found the service met the required standard overall, but it does not mean that every part of the service was without problems.
Kind relationships
Staff were patient, respectful and friendly. Inspectors saw good relationships between people and staff.
“We saw that staff interacted and supported people with care and patience.” from the report
Personalised care
Care plans described people's needs, interests and preferences. People and their families were involved in creating and reviewing them.
“The care files that we saw were easily readable, understandable and person centred.” from the report
Good communication support
The home used easy-read information and a picture exchange communication system. Staff were trained to use this to support communication and independence.
“Many of the documents in the care plans and the posters on the notice boards were in 'easy read' format.” from the report
Staffing and training
Inspectors found enough staff on duty and safe recruitment checks. Staff received induction, specialist training and regular updates.
“The training records we reviewed showed that the staff were regularly updated with safeguarding training and able to tell us about abuse and how to report it.” from the report
Family involvement
Relatives were involved in care planning and reviews. The home supported people to keep in touch with family and friends.
“We saw that the relationships which people had with friends and family were well maintained.” from the report
Safeguarding identification
needs fixingSeveral minor incidents had not been recognised as safeguarding issues. The manager said all incidents would be reported in future, but the report does not confirm that this had been checked later.
“However, we noted that several instances had not been identified as a safeguarding issue and we discussed this with the registered manager.” from the report
Medicines records
needs fixingThe medicines generally tallied with the records, but missing carried-forward figures made the records harder to follow and audit.
“The carried forward figure did not appear on the MAR sheets and this made it difficult to follow and accurately audit.” from the report
Controlled medicine register
needs fixingA controlled medicine had been recorded in a loose-leaf file instead of the required bound register. The manager ordered the correct book during the inspection.
“The controlled drugs had been recorded in a loose leaf file, but had not been recorded in such a book.” from the report
Medicine storage temperature checks
minorThe medicine room temperature was checked in the morning and evening rather than at the hottest part of the day. The manager agreed to change this.
“We discussed with the registered manager taking the recordings at the hottest part of the day and they agreed to implement this.” from the report
Fridge temperature
minorA fridge was slightly outside the safe temperature limit during the inspection. It was adjusted while inspectors were there.
“All were within safe limits, apart from a slight issue with a fridge which was adjusted to achieve the correct temperature, whilst we were there.” from the report
- 01How do you now decide whether an incident should be referred to the local safeguarding authority or the CQC?
- 02Have all medicines records been changed so carried-forward figures can be followed and audited?
- 03Are controlled medicines now recorded in a bound, numbered register?
- 04How often is the medicine storage temperature checked, and is it checked at the hottest part of the day?
- 05How will you support my relative's preferred communication method, activities and contact with family?
This was an announced inspection of the overall quality of the home, covering all five CQC questions and including observations, discussions and checks of selected records. This explanation was written from the published report of 14 December 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 Nelson's Croft
2 rated inspections over 3 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- January 2013
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 24 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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