CQC report explained · a nursing home
What the CQC found at New Meppershall Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2022
Rated Good overall, but inspectors found the home still needed to improve its management, audits and communication.
This was an unannounced comprehensive inspection on 21 and 28 April 2022. Inspectors spoke with people living in the home, relatives and staff. They also reviewed care records, medicine records, staff files and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found people were safe, supported by enough staff, treated kindly and helped to make choices. Care was personalised, although some support plans needed more detail.
The home was rated Requires Improvement for Well-led. There had been major improvements since the previous inspection, and the provider was no longer in breach of regulations. However, some medicine audits did not identify errors, some improvement actions lacked clear deadlines, and communication with relatives was still mixed.
Kind and respectful staff
People and relatives were positive about the staff's kindness, compassion and respect. Staff knew people as individuals and supported their dignity and independence.
“People were positive about the kind and caring nature of staff.” from the report
People felt safe
Risks were assessed and managed, including risks linked to falls and pressure area care. People generally received timely support and did not wait long for call bells.
“People felt safe living at the service and staff were knowledgeable about how to safeguard people from abuse.” from the report
Good support with health and nutrition
People were supported with their dietary needs and preferences and could access health professionals when needed. Staff recorded and followed advice from health professionals.
“People were supported to eat and drink in line with their dietary needs and preferences.” from the report
Activities and relationships
The home provided activities such as gardening, cooking, games and pet therapy. Staff also supported people to stay in contact with friends and family.
“There is always something going on if you want to do it.” from the report
Improved culture
Inspectors found a significant improvement in the home's culture since the previous inspection. Staff morale was good and staff felt supported by the registered manager.
“There had been a significant improvement in the culture of the service following our previous inspection.” from the report
Medicine checks
needs fixingInspectors found errors in medicine stock records. The provider acted immediately and strengthened the audits, but this remains an area to check closely.
“We found some errors relating to the amount of medicines that should have been in stock.” from the report
Management audits
needs fixingSome audits did not identify medicine issues, and some improvement actions did not say clearly what would be done or when it would be completed.
“Other audits identified actions to take where improvements needed to be made but were not specific as to what actions should be taken and when they would be achieved by.” from the report
Communication with relatives
needs fixingSome relatives found it difficult to contact the management team and had not been involved in discussions about care or support plans. Feedback was mixed, so families should ask how communication works in practice.
“Some relatives also told us they had not been involved in discussions regarding their family members support or support plans.” from the report
Personalised care plans
minorSome support plans did not give enough detail about people's specific preferences. The registered manager agreed that improvements were needed.
“People's support plans contained details of how they like to be supported, however some of these could have been more detailed around people's specific preferences.” from the report
- 01How do you now check medicine stocks and identify any missed or incorrect doses?
- 02What specific actions are being taken to make support plans more personalised, and when will this work be completed?
- 03Who should relatives contact about care concerns, and how quickly should they expect a reply?
- 04How will you involve relatives in discussions and reviews of their family member's support plan?
- 05How do your audits record who will complete improvement actions and the deadline for each action?
This became a comprehensive inspection covering Safe, Effective, Caring, Responsive and Well-led after inspectors initially examined concerns about pressure area care and falls. This explanation was written from the published report of 26 May 2022 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, August 2021
New Meppershall Care Home was rated Requires Improvement because inspectors found risks in care, medicines, staff training and management systems.
This was an unannounced focused inspection on 17 June and 12 July 2021. Inspectors looked only at Safe and Well-led after concerns about risk management, nutrition, hydration, pressure care and responses to deteriorating health.
The home was not always safe. Care risks were not fully assessed, guidance for staff was limited, medicines records were sometimes inaccurate, and staff had not received some training or competency checks. Inspectors also found that care plans did not always reflect people's needs.
The home was not always well-led. Quality checks had not found the problems, and communication with people and relatives was sometimes unclear. There were positive findings too, including caring staff, safe recruitment, suitable staffing levels on the inspection day and prompt action on some issues.
The overall rating remained Requires Improvement. The CQC found two legal breaches and asked for an action plan. It said it would work with the provider and local authority to monitor progress and inspect again.
Caring interactions
People said staff were caring and spoke to them in a personalised and dignified way.
“Staff spoke with people in a personalised and dignified manner.” from the report
Safe recruitment
The home completed the required employment checks and followed its recruitment policy.
“Staff were recruited safely; the required employment checks were completed, and ongoing recruitment reviews took place in line with the provider's policy.” from the report
Day-to-day support
People said staff responded to their everyday requests, including mobility support.
“People appeared comfortable in their surroundings and care staff were responsive to their day to day requests.” from the report
Partnership with health professionals
Health professionals said referrals were appropriate and staff responded to advice.
“Healthcare professionals told us that the referrals they received from New Meppershall Care Home were appropriate and the staff were responsive to advice given.” from the report
Prompt action during inspection
The provider acted immediately on some infection control issues and began reviews after inspectors identified care and risk concerns.
“The provider took immediate action to rectify these findings at the time of our inspection.” from the report
Incomplete risk assessments
seriousSome risks, including diabetes, dehydration and choking risks, were not fully assessed or supported by clear guidance for staff. Inspectors said this increased the risk of harm.
“Risks associated with care and support for people had not always been fully assessed. There was limited guidance in place for staff to follow which placed people at increased risk of harm.” from the report
Medicines records and practice
seriousMedication administration records were not always accurate. Inspectors also found limited guidance for some medicines and concerns about how prescribed products were used.
“Medication administration records (MAR) were not always accurate and this had not been identified by staff.” from the report
Training and competency
seriousStaff had not received training in diabetes and end of life care. Competency checks after training were not consistently completed.
“Staff had not received training in diabetes care, or end of life care, and staff competency was not being effectively monitored” from the report
Care planning and involvement
needs fixingCare plans were not always personalised, and people and relatives were not always involved in planning their care or discussing future wishes.
“People, and their relatives were not always involved in the care planning process.” from the report
Communication
needs fixingRelatives were not always clear about visiting arrangements or who to contact about concerns and support needs. Some relatives also found telephone communication difficult.
“People and their relatives were not always confident regarding who they should speak to if they had concerns.” from the report
Weak quality checks
seriousThe home's audits and governance systems had not found the problems identified by inspectors or driven enough improvement.
“There were quality assurance and governance systems in place, but they had not identified our findings, nor did they always drive continuous improvement.” from the report
- 01What has changed in the way you assess and record risks for diabetes, dehydration, choking and deteriorating health?
- 02How do you check that medicines are prescribed, recorded and given correctly, including insulin and as-required medicines?
- 03What diabetes and end of life care training have staff completed, and how are their practical competencies checked?
- 04How will my relative and I be involved in creating and reviewing the care plan, including future and end of life wishes?
- 05Who should relatives contact about concerns, visiting arrangements and changes in care, and how quickly will they receive a response?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from earlier comprehensive inspections. This explanation was written from the published report of 17 August 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.
Every inspection of New Meppershall Care Home
5 rated inspections over 6 years: the service has held its Good rating throughout.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- September 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2014
Registered with the Care Quality Commission on 24 November 2014.
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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