CQC report explained · a residential care home
What the CQC found at Nelson Street
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe and trusted staff. Risks were assessed, staffing levels were sufficient and medicines were adequately managed, although 'as required' medicines instructions were not always clear until corrected during the inspection.
- Effective?
- Good
- People had personalised care plans, staff received relevant training and people had access to healthcare. The building and garden needed some repairs and redecoration, with improvements reported after the inspection.
- Caring?
- Good
- Staff were seen treating people respectfully and people said they liked and trusted staff. People were given choices, privacy and support to develop independence.
- Responsive?
- Good
- Care plans reflected people's preferences and changing needs. People were supported with communication, family relationships, activities, community access and complaints.
- Well-led?
- Requires improvement
- The home had an open culture and management was viewed positively, but governance was not always reliable. Confidential records were accessed using a personal computer and environmental checks did not identify all repair and decoration needs.
What inspectors found, June 2020
Rated Good overall; inspectors found safe, kind care, but leadership and records needed improvement.
This was an unannounced inspection on 2 March 2020. Inspectors spoke with one person and one staff member, observed the home, reviewed two people's care records and medicines records, and checked recruitment and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. People were described as safe, treated with respect and involved in their care. Staff supported people with medicines, health appointments, meals, activities and independence.
Well-led was rated Requires Improvement. The provider was moving from paper records to an electronic system, but one new staff member used a personal computer to access confidential records. Environmental checks also failed to identify some repair and decoration problems. Some of these issues were fixed after, or during, the inspection.
People felt safe
A person told inspectors they felt safe and trusted the staff. Staff also knew what to do if they suspected abuse.
“It's very good, no complaints. It definitely feels safe.” from the report
Enough staff
Inspectors found staffing levels matched people's needs. Recruitment checks were completed before staff worked unsupervised.
“There were enough staff to meet people's needs.” from the report
Kind and respectful care
Staff built respectful relationships, offered choices and respected privacy. People were encouraged to do tasks for themselves.
“Staff developed caring and respectful relationships with people using the service.” from the report
Personalised support
Care plans included people's preferences, life histories and changing needs. People could contribute to their care planning.
“The care plans were personalised with information about their preferences.” from the report
Support with health and activities
People were supported to attend healthcare appointments, maintain relationships and take part in activities such as volunteering and leisure opportunities.
“Staff reminded people of their appointments and accompanied people to regular clinics.” from the report
Confidential records
needs fixingDuring the move to electronic records, a new staff member used a personal computer to access confidential care records. The provider supplied the correct equipment after the inspection.
“A new member of staff did not have access to the provider's computer and were using a password-protected personal computer to access care records” from the report
Building repairs and decoration
minorThe garden, fixtures and fittings, walls and plaster needed attention. The provider said repairs were scheduled and that affected walls had been repainted after the inspection.
“The provider's environmental checks were not robust enough to highlight those areas of the service that were in need of redecoration” from the report
As-required medicines instructions
minorInstructions did not always explain clearly why 'as required' medicines should be given. The registered manager corrected the forms during the inspection.
“Protocols for staff to follow about when to give people medicines on an 'as required' basis where not always clear” from the report
- 01What equipment and safeguards are now in place so every staff member can access confidential care records securely?
- 02What repairs and redecoration have been completed since the inspection, and what work is still planned?
- 03How do you now record why and when 'as required' medicines should be given?
- 04How will you check that care records stay up to date during the move to the electronic system?
- 05What actions are being taken to improve the Well-led rating from Requires Improvement?
This was an unannounced planned inspection covering all five CQC questions, with detailed checks of care, medicines, staffing, the environment and management systems. This explanation was written from the published report of 16 June 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.
What inspectors found, September 2017
Rated Good; inspectors found safe, caring and personalised support, and confirmed that earlier medicines-record issues had been fixed.
Inspectors visited the home on 10 August 2017. The visit was announced 24 hours in advance. They spoke with one person and three staff members, and checked care plans, risk assessments, medicines records, staff records, meetings and audits.
The home supported up to three adults with mental health needs. One person was living there during the inspection. Inspectors found that people were protected from harm, medicines were managed safely, staffing met people's needs and staff recruitment checks were robust.
Care was described as kind, respectful and focused on independence. Care plans were personal and regularly reviewed. Staff supported people to use health services and worked with other professionals.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. At the previous inspection in November 2015, a recommendation had been made about medicines. Inspectors found that this had been addressed.
Medicines now managed safely
The previous recommendation about medicines was addressed. Records, daily medicine counts and monthly audits were in place.
“At this inspection we found action had been taken to address these issues and medicines were now being managed safely.” from the report
Personalised risk support
Risk assessments described people's individual risks and the steps staff should take to reduce them. They were reviewed every three months.
“These identified the risks people faced and included information about how to mitigate and reduce the risks.” from the report
Caring and respectful staff
Inspectors found that staff had positive relationships with people and respected their privacy, dignity and independence.
“Staff demonstrated a caring and supportive approach towards people who used the service.” from the report
Support with healthcare
The home supported people to see healthcare professionals, including mental health practitioners, and worked with other professionals involved in their care.
“People's health care needs were documented in their care plans and the service supported people to access healthcare professionals as needed.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you check and record my relative's medicines, including when they go out on social leave?
- 02How would you support my relative's particular mental health needs and personal goals?
- 03How often would my relative's care plan and risk assessments be reviewed, and how would they be involved?
- 04How would you work with my relative's GP, care coordinator, social worker and other healthcare professionals?
- 05How can my relative give feedback or make a complaint, and how are residents' views acted on?
This was an announced inspection of the overall service, including all five key questions; inspectors spoke with one person and reviewed one care plan and related records. This explanation was written from the published report of 19 September 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 Nelson Street
3 rated inspections over 4 years: the service has held its Good rating throughout.
- June 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 31 December 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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At least 100 live-in carers within about an hour of Newham
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.
Most charge £980 to £1,190 a week. 78 can care for a couple. 11 years' experience on average.
“She is a safe pair of hands and her years of experience certainly shine through.”
“Sidonia is a first class live-in carer whose dedication and thoughtfulness made her stay a happy experience.”
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.