CQC report explained · a nursing home
What the CQC found at Palm Court Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, appropriate risk management and safe medicines practice. Infection control arrangements were also found to be suitable.
- Effective?
- Good
- People had detailed care plans, appropriate support with food and drink, and access to healthcare. Staff had relevant training and consent was managed in line with legal requirements.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found clear leadership, supportive management and effective quality checks. The provider had made improvements to the building and used audits to identify further areas for improvement.
What inspectors found, July 2021
Rated Good; inspectors found safe, kind and well-managed care, with improvements since the previous inspection.
This was a focused follow-up inspection on 20 May 2021. Inspectors spoke with people, relatives and staff, and checked care records, medicines, recruitment files, training information and management records.
The home was rated Good overall. Safe, Effective and Well-led were all rated Good. Inspectors found enough staff, safe medicines practice, suitable risk assessments and detailed care plans. People were treated with dignity and respect, and staff were described as kind and committed.
The home had improved since the previous inspection, when it was rated Requires Improvement. Work had been completed on the premises and the home was no longer in breach of Regulation 15. Inspectors were still monitoring the recording of activities and people's engagement, and the quality of meals.
Kind and respectful staff
People, relatives and inspectors described staff as caring, kind and committed. Regular staff helped people build meaningful relationships.
“Palm Court had a person-centred culture which ensured that staff in all roles were motivated and offered care and support that was compassionate and kind.” from the report
Safe medicines
Medicines were stored, given and recorded safely. Staff had training and their competence was checked.
“People received their medicines as prescribed and the service had safe medicine storage systems in place.” from the report
Detailed care planning
People's needs and risks were assessed and care plans were changed when their needs changed. Staff could access important care information.
“All people had a very detailed computerised care plan.” from the report
Improvements to the building
The provider had carried out substantial work on the premises, including new flooring, furniture and laundry equipment. Inspectors found that the earlier premises concerns had been addressed.
“There was lots of evidence of investment to improve the environment.” from the report
Good leadership and teamwork
Staff said they felt supported, and inspectors found a clear leadership structure and quality assurance systems that were used to improve the service.
“There was a clear leadership structure which aided in the smooth running of the service, supported by the provider and management team.” from the report
Activities and daily records
needs fixingSome daily care records were brief and did not always show people's wellbeing and activities clearly. The home was working to improve activity recording and check how activity time was being used.
“The manager was reminding staff how to ensure that daily care records, which were sometimes brief, could be improved to cover wellbeing and activities.” from the report
Meal quality still being checked
minorThe home had changed its food provider, and some staff had concerns about food quality. The manager was auditing meals and checking what people liked.
“The manager was ensuring people liked the food as some staff were concerned about the quality.” from the report
Survey feedback not yet analysed
minorThe latest survey results had not yet been analysed, so it was not clear whether all comments had been acted on to improve the service.
“The results from the latest survey were currently needing to be analysed to ensure comments were acted on to drive improvement.” from the report
- 01What has changed in the recording and auditing of people's activities since the inspection?
- 02How do you make sure people receive enough meaningful engagement and leisure activities?
- 03What feedback have residents given about the current food provider, and what action have you taken about food quality?
- 04Have the latest survey results now been analysed, and what improvements followed from them?
- 05Which ratings for Caring and Responsive were carried forward from the previous comprehensive inspection?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 15 July 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.
What inspectors found, January 2020
Requires Improvement; inspectors found kind and safe care, but the environment, records and management systems needed improvement.
This was an unannounced inspection on 4 and 5 November 2019. Inspectors spoke with people, relatives, staff and professionals. They observed care and checked care plans, medicines, recruitment files, training and management records.
People were generally safe, treated kindly and supported in a personalised way. Medicines were managed safely. Health needs, food and drink, activities and complaints were usually handled well.
The inspectors found important problems with the building and some records. The third floor had a strong smell of urine, some flooring had not been replaced, alarm cords were not always reachable, and recruitment checks were not consistently recorded.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe, Caring and Responsive were rated Good. Effective and Well-led were rated Requires Improvement. The provider was asked for an action plan and will be monitored and re-inspected.
Kind and respectful staff
People and relatives described staff as kind, compassionate and respectful. Inspectors saw staff respond quickly and use gentle, caring communication.
“We observed staff interacted with people, responded quickly to requests for support and always spoke in kind, gentle tones.” from the report
Safe medicines practice
Medicines were ordered, stored, recorded and given safely. A community pharmacist also reviewed medicines records each month.
“People's medicines were ordered, stored, recorded and administered safely.” from the report
Good health support
People's health needs were identified and acted on quickly. Staff worked with GPs, dieticians, speech and language professionals and tissue viability nurses when needed.
“People had their health needs identified and responded to quickly.” from the report
Personalised support
People and relatives were involved in care planning, and staff supported individual choices about food, routines, activities and independence.
“People and relatives told us they felt people's views were considered and were able to remain in control of their care as long as they possibly could.” from the report
Poor building condition
seriousThe third floor had a strong smell of urine and some flooring had not been replaced despite the provider knowing about it. Some alarm cords could not be reached by a person who had fallen, and bathrooms were cluttered.
“The third floor of the building which was where people living with dementia resided had an all-pervading strong smell of urine.” from the report
Recruitment checks
needs fixingRecruitment records were inconsistent. Interviews were not recorded and some new staff had started before all checks were available.
“New staff had sometimes started working before all checks were available.” from the report
Incomplete care records
needs fixingWritten care plans did not always show the quality of care inspectors observed. Records also lacked some detail about nutrition monitoring, dental visits and people's end-of-life wishes.
“We identified that care plans were written with the person in mind; with their and key relative's involvement but sometimes the evidence in the care plans was not always as good as the care we observed and were told about.” from the report
Infection control records
needs fixingAfter a recent norovirus outbreak, the provider had not completed a root cause analysis. Some care plans did not clearly explain staff responsibilities for infection control, although evidence of improvements was later provided.
“The service had acted to keep people safe. We discussed the need (in line with guidance) to complete a root cause analysis of the recent outbreak to see if any learning could be gained.” from the report
- 01Has the third-floor flooring now been replaced, and how are you preventing or dealing with any continuing smell of urine?
- 02Are all alarm cords now long enough and positioned so that people who fall can reach them?
- 03What recruitment checks are completed before a new member of staff starts work, and how are these checks recorded?
- 04How do you now check that care records accurately reflect people's nutrition, oral care and end-of-life wishes?
- 05What learning was identified from the norovirus outbreak, and how is infection control being recorded in care plans?
This was an unannounced comprehensive inspection covering all five CQC questions, the premises and the care provided; the previous Good rating had been given in 2017. This explanation was written from the published report of 10 January 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.
Every inspection of Palm Court Nursing Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2020Requires improvementdown from GoodSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- May 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016
Registered with the Care Quality Commission on 14 April 2016.
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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Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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