CQC report explained · a residential care home
What the CQC found at Newgrange Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, and staff knew how to identify and report abuse. Inspectors noted that some risk assessments needed more detail, and one medicine had been recorded as given when it had not been.
- Effective?
- Good
- People's care and support achieved good outcomes. Staff assessed people's needs, supported eating and drinking, received training, and involved health professionals when needed.
- Caring?
- Good
- This area was not covered by this focused inspection, so no rating was given in this report.
- Responsive?
- Good
- This area was not covered by this focused inspection, so no rating was given in this report.
- Well-led?
- Good
- Inspectors found committed management, regular monitoring and an open approach to concerns. However, some recording discrepancies and gaps in risk assessment detail still needed attention.
What inspectors found, March 2022
Newgrange Residential Home was rated Good; inspectors found safe, effective and well-led care, with some records and medicine checks needing improvement.
This was an unannounced focused inspection. Inspectors visited on 8 February 2022, with inspection activity continuing until 16 February 2022. They spoke with people, relatives, staff, managers and health professionals, and checked care records, training, medicines, incidents and quality checks.
The home was rated Good overall. Safe, Effective and Well-led were also rated Good. Inspectors found that people were protected from abuse, staff were safely recruited, medicines were generally managed safely, and staff had suitable training and support.
The inspection found some weaknesses. A medicine had been recorded as given when it had not been given, and this was not found by the home's weekly audit. Some risk assessments and care records did not fully reflect people's current needs. The home had improved since its previous Requires Improvement rating.
Safeguarding
Staff understood how to recognise and report possible abuse. People and relatives said they felt safe and well cared for.
“People were safe and protected from avoidable harm because staff knew how to identify and report any concerns relating to the risk of abuse.” from the report
Training and support
Staff said they felt supported and had training relevant to their roles. New staff were expected to complete the Care Certificate where needed.
“Staff felt supported by managers and the team around them. They felt the training was good and provided them with the knowledge required to understand their role.” from the report
Food and health support
Staff monitored people's weight and fluid intake when needed and involved health professionals. Action was taken where people were at risk of malnutrition or dehydration.
“Actions were taken in providing fortified meals and encouraging a good intake.” from the report
Open management
Relatives said management was approachable and responded to concerns. The provider used monitoring and regular meetings to review the quality of care.
“The provider's quality assurance was robust and transparent. A range of monitoring was undertaken continuously on a rolling basis.” from the report
Risk assessments were not always current
needs fixingSome care plans and risk assessments did not accurately reflect people's changing needs. One person at increased risk of pressure ulcers was still assessed as being at low risk.
“Some care plans and risk assessments needed further development to ensure they accurately reflected people's current needs.” from the report
Medicine check missed an error
seriousA medicine was recorded as given when it had not been given. The error was not identified during the home's weekly management audit.
“We noted a medicine had been signed as being administered but had not been given to the person.” from the report
Some medicine guidance needed more detail
needs fixingInstructions for medicines given only when needed did not explain clearly enough why they should be given or what symptoms to look for when a person could not communicate this verbally.
“However, these protocols needed further development to include the reasons for giving the 'when required' medicine and the symptoms to look for in people who could not express this verbally.” from the report
Some people questioned staffing levels
minorTwo people said staff seemed very busy and that more staff were needed, although they also said call bells were answered promptly. Staff and the provider gave a more positive view of staffing.
“People told us they thought staff were very busy and there was a need for more staff.” from the report
- 01What changes have you made to prevent medicines being recorded as given when they have not been given?
- 02How do you now check that medicine audits identify errors promptly?
- 03How often are risk assessments updated when a person's mobility or health changes?
- 04What precise instructions do staff follow if someone is at risk of choking or cannot explain their symptoms?
- 05How do you make sure there are enough staff at busy times and when staff are absent?
This was a focused inspection of Safe, Effective and Well-led, so the other key questions were not inspected and no rating was given for them in this report. This explanation was written from the published report of 2 March 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, October 2019
Rated Requires Improvement; inspectors found kind, responsive care but weaknesses in safety, training, consent and management.
This was an unannounced comprehensive inspection on 26 June and 5 July 2019. Inspectors spoke with people, relatives, staff and visiting professionals. They reviewed care records, incident records, training information, audits and safeguarding records.
The home was rated Good for Caring and Responsive. People described staff as kind and respectful. They said care matched their preferences, activities were available and they could raise concerns. Food, staffing levels, cleanliness and access to healthcare were also viewed positively.
The overall rating fell from Good to Requires Improvement. Inspectors found that some injuries and a person leaving the home had not been reported properly. Training, consent arrangements, care records and quality checks were not consistently effective. The home was asked to improve and its findings were referred to the local authority.
Kind and respectful care
People described staff as kind, gentle and respectful. Inspectors observed staff being attentive and reassuring.
“Interactions observed between staff and people were positive. We saw staff being attentive and reassuring to people.” from the report
Enough staff
Inspectors saw enough staff on both inspection days. Staff were not rushed and recruitment checks were in place.
“There were enough staff on duty on both days of the inspection. The home was calm, staff were seen to be able to spend time with people and were not rushed.” from the report
Activities and social contact
The home offered a range of activities and adapted them when activity staff were away. People were seen smiling and joining in.
“On the day of the inspection, activity staff were on leave. Staff had rallied round to put on activities for the residents.” from the report
Access to healthcare
People had regular contact with healthcare professionals, including visiting specialists and GP clinics.
“People had regular access to health and social care professionals.” from the report
Care records were incomplete
needs fixingRecords did not consistently describe people's preferences, changing needs or the care provided. Important information was sometimes entered in the wrong part of the electronic system.
“People's care records were not comprehensive and did not describe specifically how to provide care to people.” from the report
Consent processes were not consistent
seriousThe legal principles for consent and best-interest decisions were not always followed. Bedrail use initially lacked the required supporting assessments and decisions, although this was updated during the inspection.
“However, we found the principals of the MCA 2005 were not consistently met.” from the report
Training did not cover all needs
needs fixingSome staff had not received enough training about how health conditions such as Parkinson's disease affected daily life, mobility and behaviour.
“However, staff had not always received training to understand how some health condition like Parkinson impacted on people's daily living, mobility, behaviour and other areas.” from the report
Environment was not dementia-friendly
needs fixingAlthough the building had been refurbished and was well maintained, inspectors found limited visual guidance for people with dementia. There were also no risk assessments about the possible risks of free access to the stairs.
“The environment was newly decorated to a high standard; however, this did not meet the recommended best practice guidelines issued by SCIE and NICE for a supportive environment for people living with Dementia.” from the report
Audits did not find problems
needs fixingManagement checks did not identify several weaknesses in consent, medicines records, care records and staff training before the inspection. An action plan was developed after inspectors raised these issues.
“However, we identified further areas where these audit tools had not been effective in addressing areas for improvement.” from the report
- 01How do you now make sure every unexplained injury, incident or person leaving the home is recorded, reported and reviewed?
- 02How will you make sure my relative's care plan records their likes, dislikes, preferences and changing needs accurately?
- 03What training have staff completed about dementia, Parkinson's disease, pressure care, nutrition and other conditions affecting residents here?
- 04How are consent, best-interest decisions and bedrail use assessed and recorded for each person?
- 05What changes have you made to the environment and risk assessments for people living with dementia, particularly around the stairs?
This was an unannounced comprehensive inspection of the care home, covering all five CQC questions and both the premises and the care provided. This explanation was written from the published report of 5 October 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.
Every inspection of Newgrange Residential Home
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- March 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementstayed Requires improvementWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- February 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 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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