CQC report explained · a nursing home
What the CQC found at New Victoria Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2024
Rated Requires Improvement; inspectors found kind care, but serious weaknesses in risk management, records, consent and management systems.
This was an unannounced inspection on 17 and 28 November 2023. Inspectors spoke with people, a visitor, a relative and staff. They observed care, checked medicines, reviewed care and recruitment records, and looked around the home.
The home was not always safe or well managed. Risk assessments, care plans and other records were incomplete or inaccurate. Medicines records were still not consistently complete, and recruitment checks had gaps. Inspectors also found problems with consent and covert medicines, including one case where a person had capacity but had been subject to restrictions.
People were treated with kindness and respect. They said they felt safe, and inspectors found enough staff during the visit. However, the home was rated Requires Improvement overall and in Safe, Effective, Responsive and Well-led. Caring was rated Good. The home has had this overall rating for three consecutive inspections.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff knew people's preferences and encouraged them to remain independent.
“People were treated with respect, compassion, and kindness, they were given emotional support when needed.” from the report
Enough staff during the visit
Inspectors saw staff respond to requests for help, and people said staff came quickly when they used their call buzzer.
“Staff were deployed effectively, during the inspection we observed staff responding to calls for assistance.” from the report
Activities and relationships
People were supported to maintain relationships and join in activities such as games, coffee trips and dominoes.
“There was an activities coordinator at the service and people told us they were supported to take part in activities.” from the report
Positive staff culture
Staff said they were happy in their roles and felt supported. People, relatives and staff were positive about the registered manager.
“There was a positive staff culture at the service and staff were happy in their roles.” from the report
Risk records were incomplete
seriousRisks to people's health, safety and wellbeing were not consistently assessed or managed. Incorrect emergency evacuation information was found in four records.
“People were at increased risk of harm as systems for monitoring and learning from accidents and incidents were not robust.” from the report
Medicines records still had gaps
seriousRecords did not always explain why medicines were not needed or give staff all the information required. This followed an earlier recommendation about medicines recording.
“At this inspection we found not enough improvement had been made.” from the report
Consent and restrictions
seriousThe home did not always follow the Mental Capacity Act. Covert medicines were started without the required decision, and the person involved had capacity and should not have been restricted.
“A person had been receiving covert medicines. The covert procedure had been implemented without a DoLS or best interests' decision prior to this being commenced.” from the report
Eating and drinking information
seriousRecords did not always show people's dietary needs or the correct consistency for drinks. This could have increased the risk of harm.
“We were not assured people received drinks prepared to the correct texture in line with professional guidelines.” from the report
Weak management checks
seriousAudits did not always identify or resolve the problems found by inspectors. Records were not reliably accurate, complete and up to date.
“The governance system was ineffective. Areas of concern on inspection had not been noted and fully addressed.” from the report
- 01What has been done to make sure every person's risk assessment and care plan is accurate, current and detailed enough for staff to follow?
- 02How are medicines records, including topical treatments and missed or refused medicines, now checked?
- 03How do you make sure capacity assessments, best-interests decisions and DoLS authorisations are completed before restrictions or covert medicines are used?
- 04What changes have been made to record the correct food and drink textures and each person's eating and drinking needs?
- 05What action plan followed the warning notices, and how will you show that improvements have been sustained?
This was an unannounced inspection covering all five key questions, the premises and the care provided; the detailed Responsive section says Good while the report's ratings table says Requires Improvement. This explanation was written from the published report of 29 February 2024 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
Rated Requires Improvement; inspectors found improvements in staffing, infection control and leadership, but medicines records and consistent practice still need attention.
This was an unannounced focused inspection on 30 June 2021. Inspectors spoke with people, a relative, staff and the registered manager. They checked the building, care records, medicines, staffing, recruitment, training and quality checks.
The home had enough staff to meet people's needs. People were supported with meals, healthcare, personal choices and activities. Inspectors were also assured about infection control, safeguarding and recruitment.
There were problems with medicines records, including missing signatures, handwritten entries that were not countersigned and unclear stock monitoring. Care plans and risk assessments were still being reviewed and updated.
The overall rating was Requires Improvement. Safe, effective and well-led were also rated Requires Improvement. The home was no longer in breach of regulations, but the CQC said it needed to show consistent good practice over time.
Staffing
Inspectors found enough staff to meet people's needs promptly. Recruitment checks were also in place.
“The registered manager deployed enough staffing levels to meet people's needs in a timely way.” from the report
Infection control
Inspectors were assured that the home used suitable measures to prevent and manage infections, including safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Choice and meals
People had choices about their daily lives and received meals that met their needs. Staff followed the relevant decision-making procedures.
“People signed care records to evidence their consent to care and treatment.” from the report
Improving leadership
The manager had introduced more regular audits, personalised care plans and a programme of improvement. Staff said they felt supported.
“The registered manager demonstrated they had taken sufficient action in the ongoing improvement of care and quality assurance records.” from the report
Activities
The home had employed an activities coordinator, and inspectors heard that activities had increased and improved.
“One area of improvement involved employing a specific activities coordinator to increase people's stimulation and wellbeing.” from the report
Medicines records
needs fixingSome medicines records were incomplete. Missing signatures, unchecked handwritten entries and unclear stock monitoring could make it harder to confirm that medicines had been managed correctly.
“Staff did not always follow safe recordkeeping associated with medicines management.” from the report
Care plan reviews
needs fixingCare plans and risk assessments were still being reviewed and updated. Inspectors planned to check this at the next comprehensive inspection.
“The registered manager was in the process of reviewing and updating all care plans and risk assessments, which we will check at our next comprehensive inspection.” from the report
Consistency over time
needs fixingThe CQC did not raise a current breach, but it said the home needed to demonstrate consistent good practice before its ratings could improve.
“However, we rated the key areas as requires improvement because the management team and staff need to demonstrate consistent good practice over time.” from the report
- 01How are medicines records now checked for missing signatures, countersigned handwritten entries and stock control?
- 02Have all care plans and risk assessments been reviewed and updated, and how are changes shared with staff?
- 03What evidence can you show that safe, effective and well-led practice has stayed consistent since the inspection?
- 04What activities are now available, and how are they matched to each person's interests and needs?
- 05What progress has been made on the provider's action plan and when is the next CQC review expected?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and previous ratings for those areas were carried forward. This explanation was written from the published report of 20 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 Victoria Nursing Home
6 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- February 2024Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- November 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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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32 live-in carers within about an hour of Blackpool
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 £1,250 a week. 31 can care for a couple. 12 years' experience on average.
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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.