CQC report explained · a residential care home
What the CQC found at Nynehead Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and staff responded promptly when help was requested. Medicines, risks, recruitment, infection control and accidents were managed through systems inspectors found effective.
- Effective?
- Good
- People's needs were assessed and care plans gave staff clear instructions. Staff had relevant training, people received support with food and healthcare, and mental capacity decisions were recorded.
- Caring?
- Good
- People described staff as kind, attentive and respectful. Staff promoted privacy, dignity, independence and involvement in decisions about care.
- Responsive?
- Good
- Care plans were described as comprehensive and individual. People could follow their own routines, choose activities and receive support with communication, relationships and end-of-life care.
- Well-led?
- Good
- Management and quality checks had improved since the previous inspection. The home used audits, feedback and observations to make changes, and staff said they felt supported.
What inspectors found, March 2020
Nynehead Court is rated Good; inspectors found safe, kind and personalised care, with improvements since the previous Requires Improvement rating.
This was a planned inspection based on the previous rating, but the visit was unannounced. One inspector visited on 12 and 13 March 2020. They spoke with people, visitors, staff and visiting professionals, observed care, and checked care, medicine, recruitment and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, suitable risk assessments, kind staff, personalised care plans and a range of activities. People were supported to make choices and stay involved in their community.
The previous inspection was rated Requires Improvement, with breaches of two regulations. The provider had introduced electronic care plans, stronger quality checks and a quality manager. Inspectors found the earlier breaches had been addressed and the home was no longer in breach of regulations.
Safe medicines
Staff received specific training and records showed whether medicines had been given or refused. A pharmacist's audit found no major shortfalls.
“People received their medicines safely from staff who had received specific training to carry out the task.” from the report
Kind relationships
People had trusting relationships with a stable staff team. Inspectors saw staff treating people with kindness, respect and attention.
“People had built trusting relationships with a stable and caring staff team.” from the report
Personalised care
The new electronic care planning system gave staff detailed information about each person's needs, preferences and choices.
“Care plans we saw were comprehensive and unique to each individual.” from the report
Activities and community links
People could take part in group and one-to-one activities, follow hobbies and attend events in the wider community.
“People continued to be active members of the community.” from the report
Improved oversight
New quality checks and a quality manager helped identify improvements in areas such as medication storage and food choices.
“These systems led to improvements to the service people received.” from the report
Food was not always consistent
minorPeople were generally happy with the food, but one person said its quality varied. Ask how the home responds when meals do not meet expectations.
“Sometimes the food is superb but other times not so.” from the report
- 01How will you make sure medicines prescribed for very specific times are given without being missed?
- 02How will you keep my relative's electronic care plan up to date as their needs or preferences change?
- 03How will you support my relative to follow their own routine and choose activities that interest them?
- 04How do you check that meals remain varied and suitable if someone is unhappy with the food?
- 05How was the change to the new manager managed, and who is currently responsible for day-to-day care quality?
This was an unannounced planned inspection of the care home and personal care provided in the extra-care houses; CQC did not inspect the premises used as extra-care housing. This explanation was written from the published report of 25 March 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, June 2019
Rated Requires Improvement; inspectors found kind care and enough staff, but ongoing concerns about medicines, risk records, care plans and management checks.
This was an unannounced inspection on 31 October 2018. Two inspectors and an expert by experience spoke with people, visitors, staff and visiting professionals. They observed care and meals, and checked care plans, medicines, staff files, meeting records and quality checks.
The home was rated Good for Effective and Caring. People were treated kindly and respectfully. Staff knew people well, had training and support, and inspectors found enough staff. People had access to healthcare, food and drink, activities and local community links.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Inspectors found that some medicines instructions and risk assessments were incomplete. Care plans did not always give staff enough personalised guidance. Management checks did not identify all these problems.
The home had improved in some areas since the December 2017 inspection, including medicines management and staff understanding of the Mental Capacity Act. However, two regulations remained breached. The CQC imposed conditions on the provider's registration.
Kind and respectful staff
People and relatives spoke highly of staff. Inspectors saw warm, respectful interactions and found that staff understood people's preferences and supported their dignity.
“People and their relatives spoke highly of the staff supporting them.” from the report
Staffing and training
There were enough staff to meet people's needs. Staff received induction, ongoing training and support to carry out their roles.
“There were enough staff on duty to meet people's needs.” from the report
Activities and community links
People could choose from many activities, outings and services. The home also had strong links with local groups and events.
“There was a wide range of activities on offer and these were provided seven days a week.” from the report
Access to healthcare
People were supported to see relevant health professionals, and staff shared useful information when asking for reviews.
“Records showed people were reviewed by the GP, district nurses and physiotherapists.” from the report
Medicines and risk management
seriousSome as-required medicine instructions were not personalised, and reasons for giving extra medicines were not always recorded. Risk assessments and guidance were missing in some areas, including pressure areas, choking and thickener use.
“Some aspects of people's medicines management needed to be improved.” from the report
Incomplete care plans
seriousSome care plans did not explain how staff should support people's communication, personal care choices or anxiety. This could lead to inconsistent care, especially for new or unfamiliar staff.
“People's care plans were not consistently person centred and detailed.” from the report
Mental Capacity Act records
needs fixingSome capacity assessments and best-interest decisions did not clearly record how decisions had been reached or whether less restrictive options had been considered. The home was asked to revisit the relevant guidance.
“We recommend that the service revisits guidance relating to the Mental Capacity Act 2005 in relation to recording how they support people to make decisions.” from the report
Management checks
seriousAudits identified some shortfalls but missed problems found by inspectors in care plans, risks and medicines. The new quality assurance system was not yet fully effective.
“The governance systems to monitor and improve the quality and safety of the service people received were not fully effective.” from the report
- 01What changes have been made to medicines protocols, especially for as-required medicines, pain relief and thickener?
- 02How do you now make sure every person's risks have a current assessment and clear instructions for staff?
- 03Can you show how care plans have been updated to describe each person's communication needs, preferences and responses to anxiety?
- 04What evidence is available that the conditions placed on the provider's registration have been met?
- 05How do your current audits identify problems in medicines, risk assessments and care plans before they affect people?
This was an unannounced comprehensive inspection covering all five CQC questions; it also looked at personal care for people in extra care housing, but not the premises used for that housing. This explanation was written from the published report of 5 June 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 Nynehead Court
4 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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76 live-in carers within about two hours of Somerset
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Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
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