CQC report explained · a nursing home
What the CQC found at Neville Williams House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. There were enough staff, recruitment checks had been completed, risks were recorded and medicines were managed safely.
- Effective?
- Good
- Staff had the skills and training needed and worked with health professionals. People were supported with eating, drinking, healthcare and choices about their daily lives.
- Caring?
- Good
- People and relatives spoke very positively about staff. Inspectors saw kind interactions, respect for privacy and dignity, and support for people's independence.
- Responsive?
- Good
- The home provided activities based on people's interests and recorded their care preferences. Inspectors found good support for relationships, communication, complaints and end of life care.
- Well-led?
- Good
- The management team had good oversight and used audits and action plans to improve the home. This rating improved from Requires Improvement at the previous inspection.
What inspectors found, September 2019
Rated Good; inspectors found kind, person-centred care, safe medicines and strong activities, with well-led care improved since the previous inspection.
This was an unannounced inspection on 10 July 2019. Inspectors spoke with people living in the home, relatives, staff and visiting professionals. They also observed care and checked care records, medicine records, staff recruitment files and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicine systems, suitable care plans and good links with health professionals.
People were treated with kindness and respect. They had choices about their care, food and activities. The home offered a wide range of activities and places to use, including a farm, shop, pub and outdoor tea room. The Well-led rating improved from Requires Improvement at the previous inspection to Good.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs promptly. Medicines were given as prescribed and errors were dealt with quickly.
“There were enough staff available to people and people felt staff knew them well.” from the report
Personalised care
Care plans recorded people's preferences and support needs. Staff involved people in decisions and supported independence.
“People's care plans contained information about their preferences and the support needed to maintain their individuality and independence.” from the report
Activities and social life
The home offered varied activities and encouraged contact with relatives and the local community. Inspectors saw activities helping people become more involved.
“People's lives had been improved because of the diverse range of activities.” from the report
End of life support
People's wishes were recorded and staff had received end of life training. Relatives and professionals praised the support provided.
“Peoples end of life wishes and preferences were recorded in their care plans” from the report
Improved leadership
Management systems gave the team oversight of care, risks and quality. Inspectors rated well-led Good, an improvement from the previous inspection.
“At this inspection this key question has now improved to good.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you adapt care and activities to my relative's specific likes, dislikes and communication needs?
- 02How do you make sure staffing levels remain enough when people's needs change or staff are absent?
- 03How are relatives involved in reviewing care plans and making best interest decisions?
- 04How would you support my relative's eating, drinking and any specialist diet recommended by health professionals?
- 05How would you record and follow my relative's end of life wishes, including any religious or cultural needs?
This was an unannounced inspection covering all five CQC questions; the overall rating remained Good and the Well-led rating improved from Requires Improvement at the previous inspection. This explanation was written from the published report of 3 September 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, October 2016
Rated Good overall; inspectors found safe, kind and responsive care, but well-led was Requires Improvement because checks were not always effective.
The inspection took place on 9 and 10 August 2016. The first day was unannounced and the second was announced. Inspectors spoke with people living at the home, relatives, staff and a health professional. They also observed care and checked care, medicine, staff and management records.
The home was rated Good for safe, effective, caring and responsive care. People generally felt safe and well cared for. Inspectors found suitable staffing, staff training, support with medicines, good food choices, access to health professionals, personalised care and a range of activities.
The home was rated Requires Improvement for being well-led. Managers had introduced better checks, but these did not always find gaps in care reviews, food and fluid records, medicine records or complaints records. Inspectors also found that a required notification about significant skin damage had not been sent at the time.
People felt safe
People and relatives generally said they felt safe. Staff knew how to report safeguarding concerns and inspectors found risk assessments and emergency procedures in place.
“People felt safe living at Neville Williams House.” from the report
Kind and respectful care
Inspectors found improvements in staff attitudes since the previous inspection. Staff were described as kind and compassionate, and people were supported with privacy, dignity and personal choices.
“People felt they were treated well by staff and their privacy was respected.” from the report
Good food and health support
People enjoyed the food and had choices. Meals were adapted for dietary needs, and staff supported people to eat and drink when needed and to access healthcare professionals.
“Everyone we spoke with was complimentary about the quality of the food.” from the report
Activities and personalised support
People were supported to join group and individual activities. Inspectors saw improvements in activities for people with complex needs and advanced dementia.
“People were supported and encouraged to participate in a range of group or individual activities that they enjoyed.” from the report
Management checks missed gaps
needs fixingQuality checks were in place but did not consistently identify missing care plan reviews, food and fluid records, medicine records and skin monitoring records. This was the main reason for the Requires Improvement rating for well-led.
“The audits were not always effective at identifying gaps in some monthly reviews and monitoring charts.” from the report
Medicine records and checks
needs fixingInspectors found recording errors on two people's medicine sheets and a medicine stock balance that did not match the records. One as-needed pain relief protocol was also missing during the inspection, although it was added afterwards.
“Audits had not identified recording errors on two peoples' medication sheets.” from the report
Complaints were not recorded
needs fixingSome concerns had been discussed and resolved, but they were not recorded as complaints. Inspectors said recording all dissatisfaction would help identify repeated problems.
“However, the complaints that had been discussed with us had not been recorded as complaints.” from the report
Important notification was late
needs fixingA required notification about significant skin damage had not been sent to the CQC at the time. The notification was sent after the inspection.
“Although we had received some notifications in a timely way, we had not received this notification.” from the report
Dignity was not always maintained
needs fixingInspectors saw two separate occasions involving different staff where people's dignity was not maintained. Managers discussed this with staff and said it would be followed up through observations and supervision.
“We saw on two separate instances involving different staff that peoples' dignity was not always maintained.” from the report
- 01How do you now make sure care plan reviews and food and fluid monitoring records are completed every month?
- 02How are medicine records and stock balances checked when the care manager is away?
- 03How do you record and review all complaints, concerns and informal grumbles?
- 04What checks are now used to make sure staff consistently maintain people's dignity?
- 05How do you make sure significant incidents, such as serious skin damage, are notified to the CQC on time?
This was a planned inspection of the overall service and all five CQC questions; it found improvements since the previous inspection but retained a Requires Improvement rating for well-led. This explanation was written from the published report of 8 October 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 Neville Williams House
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 15 March 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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