CQC report explained · a residential care home
What the CQC found at Palmarium
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found risks, consent, person-centred care and management were not consistently handled safely.
This was the first inspection since the home registered. It was unannounced and took place on 9, 14, 15 and 18 November 2022. Inspectors observed care, spoke with people, staff, relatives and health professionals, and checked care records, medicines, staffing and management systems.
All five areas were rated Requires Improvement: Safe, Effective, Caring, Responsive and Well-led. Inspectors found unclear risk plans, gaps in health monitoring, poor communication, incomplete care plans and a lack of evidence that restrictions had been agreed lawfully.
There were some positive findings. Staffing levels were enough during the inspection, recruitment checks had been completed, and medicines were managed safely. However, the provider had to produce an action plan, and CQC said it would monitor progress with the provider and local authority.
Enough staff observed
Inspectors saw enough staff to support people during the inspection. The provider was also working to build a more consistent core staff team.
“During our inspection we observed there were sufficient numbers of staff to support people.” from the report
Safe recruitment
The provider had completed recruitment checks before staff started work, including Disclosure and Barring Service checks.
“Staff had been recruited safely. Checks had been carried out prior to staff starting employment.” from the report
Medicines management
Medicines were recorded on medicines administration records. Staff had medicines training and their competence was checked.
“Staff received medicines training and had their competence levels checked.” from the report
Suitable accommodation
The home provided individual flats with their own bathrooms and kitchen areas. The building had also been adapted to meet people's needs.
“All the flats had their own bathrooms and kitchen areas.” from the report
Provider recognised problems
The provider accepted that the home was not operating to its usual standard and had started improvement work.
“We found the provider to be open and transparent about shortfalls seen.” from the report
Risk records and health checks
seriousRisk plans were unclear or incomplete. Records did not always show that staff acted when people had concerning temperatures, poor bowel monitoring or uncertain fluid intake.
“Failing to have clear, consistent and detailed risk management plans in place and failing to provide care and” from the report
Unlawful or unclear restrictions
seriousThe home had not recorded the required mental capacity and best-interest decisions for restrictions such as alarms, locked doors and moves between flats.
“People did not have MCA assessments or best interest decision making records in place for specific restrictive decisions made.” from the report
Safeguarding notifications
seriousSome safeguarding incidents had not been reported to CQC as required. Professionals also found it difficult to obtain information from the provider.
“Not all safeguarding incidents had been reported to CQC as required by law.” from the report
Limited activities and independence
needs fixingPeople were not consistently supported to stay active, develop skills or take part in activities that mattered to them. One engagement plan had not been completed.
“People were not involved in simple daily activities such as shopping, cleaning and laundry.” from the report
Poor leadership and communication
seriousThere was no registered manager in post, staff roles were unclear and communication changed frequently. Quality checks had not ensured that agreed actions were completed.
“Quality monitoring systems were not effective in assessing and monitoring the quality and safety of the service.” from the report
- 01What risk plans have been rewritten, and how are staff now told exactly what action to take when health records show a concern?
- 02Have mental capacity assessments and best-interest records now been completed for every restriction, including alarms, locked doors and moves between flats?
- 03How many permanent staff are now in the team, how much agency cover is still being used, and how are staff kept up to date?
- 04What activities and daily living tasks will each person now be supported to do, and how will progress be recorded?
- 05Who is currently leading the home, and what evidence can you show that the action plan and quality checks are being completed?
This was an unannounced first inspection covering all five CQC areas, with specific checks on infection prevention and control and risks linked to people's care and safeguarding. This explanation was written from the published report of 24 December 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.
Every inspection of Palmarium
Each visit the CQC has published, newest first, back to the day the home was registered.
- December 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2022
Registered with the Care Quality Commission on 11 July 2022.
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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