CQC report explained · a nursing home
What the CQC found at Patcham Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2019
Rated Requires Improvement; inspectors found kind, personalised care, but staffing, cleanliness and staff supervision needed improvement.
This was an unannounced inspection on 03 October 2019. Inspectors spoke with people, relatives, staff and a visiting healthcare professional. They reviewed care plans, medicines records, staff files and management records.
The home was rated Good for caring, responsive care and leadership. People were treated kindly, involved in decisions and supported to keep their independence. Care was personalised, activities and complaints were managed, and the new management team had improved teamwork and morale.
The home was rated Requires Improvement for safe and effective care. Inspectors found concerns about staffing at busy times, cleanliness in some areas, and how often staff received supervision and feedback. This overall rating means some aspects of care were not consistently good and there was limited assurance about safety.
Kind and respectful care
People were treated kindly and staff understood the importance of dignity, privacy and independence.
“People were treated with dignity and staff ensured people's privacy during care.” from the report
Personalised support
Care plans included people's medical needs, histories, likes and dislikes. Staff used this information to support people's choices.
“People had personalised care with their choices met by staff.” from the report
Improved leadership
The new management team had improved teamwork, morale and the way people and relatives were involved in changes.
“At this inspection we found this had improved.” from the report
Safe medicines and risk management
Nurses administered and recorded medicines safely. Staff also assessed risks such as falls, poor hydration, infections and pressure ulcers.
“We saw nursing staff administering and recording the administration of medicines safely.” from the report
Busy mornings
needs fixingPeople and staff said mornings could be too busy, especially when people needed help with personal care. Inspectors did not see evidence that anyone had been harmed, but staffing remained an area for improvement.
“We did not see any evidence that people came to harm, but staffing levels continue to be an area that needs improvement.” from the report
Cleaning and smells
minorSome areas did not smell clean and fresh. The manager was working on this, including replacing some carpets and planning regular deep cleaning.
“Some areas of the home did not smell clean and fresh.” from the report
Staff supervision
needs fixingSome staff said they had received very little supervision or appraisal. The manager was introducing staff development plans, but competency checks and feedback still needed improvement.
“Staff competency checks via supervision, and chances to receive feedback were areas that needed improvement” from the report
- 01How many staff are scheduled during the morning personal care period, and how do you check this is enough for residents' needs?
- 02What action has been taken about areas that did not smell clean and fresh, and has the planned regular deep clean started?
- 03How often does each staff member receive supervision and an appraisal?
- 04Which subjects are taught face to face rather than online, and how are new staff checked as competent?
- 05What changes have been made since the inspection to improve the areas rated Requires Improvement?
This was an unannounced inspection covering all five CQC questions, including the care provided and the home's premises; the previous overall rating was also reviewed. This explanation was written from the published report of 18 December 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.
What inspectors found, October 2018
Patcham Nursing Home was rated Requires Improvement; inspectors found kind, responsive care, but staffing and workplace culture needed improvement.
Inspectors visited the home without warning on 31 July 2018. They spoke with people, relatives and staff, observed care and checked care records, staff files, training records and management audits.
The home was rated Good for Effective, Caring and Responsive. People were supported by trained staff, treated with kindness and dignity, and offered choices, activities and care that reflected their preferences. Medicines, infection control and risk management had improved.
The home was rated Requires Improvement for Safe and Well-led. Staffing levels were below the assessed need on seven occasions in the previous two weeks. Staff feedback also showed low morale, concerns about discrimination and a negative workplace culture.
The overall rating was Requires Improvement. The provider breached Regulation 17 on good governance because it had not acted on staff feedback and had not ensured that the home's culture was open, inclusive and empowering.
Medicines management
Inspectors found that medicines were stored, administered, audited and reviewed appropriately. Records were accurate and nurses gave medicines sensitively.
“Medicines were managed safely and in accordance with current regulations and guidance.” from the report
Kind and respectful care
People said they were well cared for. Inspectors saw friendly, respectful interactions and support for people's privacy, dignity, choices and independence.
“People were supported by kind and caring staff.” from the report
Personalised care
Care plans included people's likes, dislikes, routines, communication needs and support preferences. Staff knew people well and used this information in care.
“Care plans accurately recorded people's likes, dislikes and preferences.” from the report
Activities and relationships
People could take part in activities including reminiscence sessions, manicures, one-to-one time and outings. Staff also supported people to stay in touch with family and friends.
“We saw a varied range of activities on offer, which included, manicures and themed events, such as reminiscence sessions and visits from external entertainers.” from the report
Clean environment
The home and its equipment were clean and well maintained. Inspectors found robust infection control arrangements and appropriate use of protective equipment.
“The service was clean and procedures in relation to infection control were robust.” from the report
Staffing levels
seriousThe home did not always have the assessed number of care staff on shift. People and staff said this could make care rushed and affect staff wellbeing.
“On seven occasions the service did not have the assessed number of care staff working on shift.” from the report
Workplace culture
seriousStaff feedback was mixed, with reports of low morale, poor support, bullying and problems between staff and management. Inspectors found that the provider's values were not consistently reflected in daily care.
“The day to day culture in the service, including the attitudes, values and behaviour of staff did not promote a positive ethos that was open, inclusive and empowering.” from the report
Equality and human rights knowledge
needs fixingSome staff did not show a good understanding of equality, diversity and human rights. The inspectors recommended training from a reputable source.
“Some staff did not have a good understanding of equality, diversity and human rights.” from the report
- 01How do you now make sure every shift has the assessed number of care staff, including at night and during busy meal times?
- 02What action have you taken about the staff reports of low morale, bullying, discrimination and concerns not being acted on?
- 03What equality, diversity and human rights training have staff completed since this inspection?
- 04How do you check that staff feedback is acted on and that the workplace culture is open and inclusive?
- 05What changes were made after the provider's action plan for the Regulation 17 breach?
This was an unannounced inspection of the whole service, covering all five key questions, and it also checked progress since the previous inspection on 27 June 2017. This explanation was written from the published report of 4 October 2018 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 Patcham Nursing Home
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- December 2019Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 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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