CQC report explained · a nursing home
What the CQC found at Padgate House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staffing and recruitment were safe, risks were assessed, and medicines were generally managed appropriately, although some topical creams were not locked away during the inspection.
- Effective?
- Good
- People received timely care from nursing, therapy and social care staff. Their nutrition, hydration, healthcare and rehabilitation needs were supported, although not all required staff training had been completed.
- Caring?
- Good
- People and relatives described staff as kind, respectful and attentive. Staff knew people well and supported their dignity, choices, confidence and independence.
- Responsive?
- Good
- Care was personalised and based on people's needs, preferences and goals. Therapeutic activities supported rehabilitation, but some feedback suggested that more stimulating activities were needed at weekends.
- Well-led?
- Requires improvement
- The home had a positive culture and worked well with other professionals. However, audits and checks did not always identify or address issues with staff training, medicine storage, the décor and weekend activities.
What inspectors found, March 2020
Rated Good overall, but inspectors found that management and quality checks required improvement.
This was an unannounced planned inspection on 17 and 18 February 2020. Inspectors spoke with people using the home, relatives and staff. They also checked care records, medicines, recruitment files and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found suitable staffing, safe recruitment, kind and personalised care, good support from therapy staff, and care plans that reflected people's needs and goals.
The well-led rating fell from Good to Requires Improvement. Some staff had not completed required refresher training. Some medicines were not stored safely, although this was put right during the inspection. Quality checks did not always identify issues such as dated décor and limited weekend activities.
Thorough induction
Staff received a thorough induction and were familiar with people's support needs.
“All staff were supported with a thorough induction and people told us they received effective care and support by staff who were familiar with their support needs.” from the report
Safe staffing
Inspectors found enough staff to provide timely care, with recruitment checks in place.
“Staffing levels were routinely monitored; people received a safe level of care from sufficient numbers of staff who were responsive to their needs.” from the report
Kind and personalised care
People received care shaped around their individual needs, wishes and preferences. Staff supported dignity and independence.
“People received person-centred care; the care and support they received was tailored around individual needs, wishes and preferences.” from the report
Rehabilitation support
Therapy staff helped people build confidence, independence and everyday living skills.
“Dedicated physiotherapists and occupational therapists provided therapeutic support to people living at Padgate House.” from the report
Good partnership working
The home worked with its in-house therapy teams and external healthcare professionals to monitor and improve people's health and wellbeing.
“Effective partnership working meant that people's overall health and well-being was monitored, reviewed and improved upon in the time they spent at Padgate House.” from the report
Some medicines were not stored safely
seriousTopical creams were not always locked away in people's bedrooms. The registered manager addressed this during the inspection.
“For instance, topical creams were not always locked away in people's bedrooms.” from the report
Refresher training was incomplete
needs fixingNot all staff had completed training courses required by the organisation. Inspectors recommended that training compliance should be strengthened.
“Although we identified that not all Bridgewater NHS Foundation Trust staff had completed training courses that had been identified by the organisation.” from the report
Quality checks missed some issues
needs fixingAudits did not always identify problems with training, medicine storage, the décor and activities. Inspectors said these checks needed to be reviewed and strengthened.
“Quality assurance systems did not identify some of the areas of improvement that were required in relation to the décor.” from the report
Limited weekend activities
minorSome feedback suggested that people would benefit from more stimulating activities at weekends. The home did not have a dedicated activities co-ordinator.
“We received some feedback to suggest that more stimulating activities could take place over the weekend.” from the report
Dated décor
minorSome parts of the home looked tired and needed attention. The quality checks had not picked this up.
“For instance, the décor was dated and appeared tired in some parts of the home.” from the report
- 01What action has been taken to ensure all staff complete their required refresher training?
- 02How are medicines, including topical creams in bedrooms, now being stored and checked?
- 03What changes have been made to the quality assurance audits since the inspection?
- 04What weekend activities are now available for people who want more stimulation?
- 05Has the dated décor identified by inspectors been improved?
This was an unannounced planned inspection that considered all five CQC questions and included the premises, care records, medicines, staffing and management systems. This explanation was written from the published report of 17 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, August 2017
Padgate House was rated Good; inspectors found safe, kind care, although activities were briefly limited.
This was an unannounced inspection on 10 and 11 July 2017. The inspectors spoke with 18 people, visitors, staff and healthcare professionals. They reviewed five care plans, medicine records, risk assessments and staff recruitment checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were protected from abuse, supported by enough staff and given medicines safely. Staff had the training and skills needed to support people.
People were treated with kindness and respect. Care plans reflected people's needs and goals, and were updated when needs changed. The report noted that activities were limited for a couple of days, and some people wanted more stimulation.
The overall rating remained Good, as it had been at the previous inspection. The report also says improvements had been made in bringing together staff employed by the two organisations involved in running the home.
People were kept safe
Staff knew how to recognise and report abuse. Risks linked to falls, eating and drinking, skin care, the environment and equipment were identified and managed.
“People continued to remain safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns.” from the report
Skilled support
Staff received an introduction, training and support. Inspectors found that information was shared between staff and healthcare professionals to provide coordinated care.
“We saw staff members sharing information appropriately between themselves and other healthcare professionals responsible for supporting people.” from the report
Kind and respectful care
People were encouraged to reach their goals and were supported when anxious or nervous. Staff respected privacy, dignity and personal choices.
“People told us that they continued to be supported by a caring and compassionate staff team.” from the report
Individual care planning
Care plans reflected people's needs and hopes. Staff reviewed them with people and sought extra healthcare support when needed.
“The care and support plans we saw were individualised to the person they related to and included information that reflected their needs and aspirations.” from the report
Improved teamwork
The report says the home had improved how staff employed by the two organisations worked together. Staff felt valued and their ideas led to changes such as daily information-sharing meetings.
“At this inspection we found that improvements had been made.” from the report
Activities were briefly limited
minorThe usual activities coordinator was unavailable during the inspection. Some people said they wanted more stimulation, although inspectors saw people socialising and using puzzles, games and reading materials.
“However, some people told us they felt more could be done to stimulate them further.” from the report
- 01How do you keep activities and stimulation going when the usual activities coordinator is unavailable?
- 02How will you agree and review my relative's goals during a stay of up to six weeks?
- 03How are care plans updated if my relative's needs change during their stay?
- 04How do staff from the two organisations work together now, and who should the family contact with concerns?
- 05How do you make sure medicines remain safe and are given by staff who are trained and assessed as competent?
This was an unannounced inspection covering all five questions; the report says the home remained Good after the previous inspection in May 2015. This explanation was written from the published report of 22 August 2017 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 Padgate House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- 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 26 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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