CQC report explained · a nursing home
What the CQC found at Paternoster House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found enough staff on shift and were assured about infection prevention and control, including PPE, testing, cleaning and infection-outbreak arrangements.
- Effective?
- Good
- This area was not rated in this targeted inspection.
- Caring?
- Good
- This area was not rated in this targeted inspection.
- Responsive?
- Good
- This area was not rated in this targeted inspection.
- Well-led?
- Requires improvement
- This area was not rated in this targeted inspection.
What inspectors found, February 2022
Inspected but not rated; inspectors found good infection-control arrangements, but visiting guidance had not been followed until after the inspection.
This was an unannounced, targeted inspection on 21 January 2022. Inspectors looked at infection prevention and control, visiting arrangements, and whether COVID-19 staffing pressures affected care.
Inspectors found enough staff on shift to meet people's needs. They found suitable supplies and use of protective equipment, staff infection-control training, increased cleaning, and arrangements for testing, shielding and social distancing.
The home had not followed current government visiting guidance since 14 December 2021. It used individual risk assessments for extra visits and said it had not refused specific requests. After the inspection, the provider told inspectors it was following the guidance.
The service was inspected but not rated. This means the report does not give an overall quality rating or a full rating for the five areas of care.
Enough staff
Inspectors observed enough staff on shift to safely meet people's needs, despite reported COVID-19-related staffing pressures.
“We observed there were enough staff on shift to safely meet people's needs.” from the report
Infection-control supplies
The home had enough protective equipment, staff had infection-control training, and protective equipment was used appropriately.
“There were sufficient stocks of personal protective equipment (PPE) which staff used appropriately.” from the report
Cleaning and visiting arrangements
Cleaning of frequently touched surfaces had increased. The home also created safe visiting spaces and arranged regular contact with families and friends.
“Cleaning schedules were increased to ensure high touch surfaces such as door handles and light switches were cleaned regularly.” from the report
Visiting guidance
needs fixingThe home had not followed current government visiting guidance since 14 December 2021. It used individual risk assessments and said it had not refused specific requests, then told inspectors it was following the guidance after the inspection.
“Whilst the provider had not followed current Government guidance for visiting since 14 December 2021, Paternoster House had accommodated any additional requests for visiting by using individual risk assessments.” from the report
- 01What visiting arrangements are in place now, and how do you make sure they follow current government guidance?
- 02How do you manage staffing pressures caused by COVID-19 or other absence?
- 03How often are high-touch surfaces such as door handles and light switches cleaned?
- 04How do you check that staff and visiting professionals meet the COVID-19 vaccination requirements or have an exemption?
- 05Can you show us the home's latest full inspection ratings for areas that this targeted report did not cover?
This was an unannounced targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated. This explanation was written from the published report of 16 February 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.
What inspectors found, September 2021
Rated Requires Improvement; inspectors found kind care and enough staff, but safety checks, infection control and management oversight were not reliable.
This was an unannounced focused inspection on 29 and 30 June 2021. Inspectors looked only at Safe and Well-led after concerns about management, accidents, incidents and infection control. They spoke with people, relatives and staff, observed care and checked care, medicine, recruitment and management records.
The home had enough staff, safe recruitment, medicines records that were completed correctly and care plans with risk assessments. People and relatives said they felt safe and found staff kind and caring. However, some building repairs were needed, some staff did not use protective equipment correctly, and some incidents that should have been treated as safeguarding concerns had not been identified.
The home had recently appointed a new manager who was beginning to make improvements. However, the inspection found that quality checks had not identified important problems. The home breached Regulation 12, Safe care and treatment, and Regulation 17, Good governance. The overall rating fell from Good to Requires Improvement.
Kind and attentive staff
People and relatives spoke positively about staff. Inspectors observed staff responding to people's needs and helping with meals.
“Staff were attentive to people's needs.” from the report
Enough staff
Inspectors found there were enough staff on duty to meet people's needs.
“There were enough staff on duty to meet the needs of people.” from the report
Medicines managed safely
Medicine records were completed correctly, storage temperatures were checked and controlled medicines tallied. Staff also had medicine training and competency checks.
“We found MAR charts completed correctly.” from the report
New manager making changes
The new manager had introduced daily handovers and meetings to discuss people's needs and actions. Staff said they felt listened to and were positive about the changes.
“Staff told us they felt the service went through a period of poor management but now feel listened to by the new manager and the standards were improving.” from the report
Infection control and repairs
seriousSome staff wore masks incorrectly or did not always use hand sanitiser between people. Missing bathroom tiles and other environmental problems made effective cleaning more difficult.
“Not all staff were using PPE effectively and safely.” from the report
Risks and safeguarding not always identified
seriousSome accidents and incidents that should have been reported as safeguarding concerns were missed. Inspectors also found a bed and mattress that created a possible injury risk, although this was corrected during the inspection.
“Some incidents and accidents that should have been raised as safeguarding concerns had not been identified.” from the report
Weak quality checks
seriousThe home's monitoring systems had not picked up problems with the building, infection control or equipment. This meant leaders did not have reliable oversight of safety.
“The overall systems for quality assurance were not robust at all levels.” from the report
Limited activities
minorInspectors saw some activities, but these were limited. The manager planned to recruit another activities staff member.
“Although we saw some people engaged in activities, these were limited” from the report
- 01Which repairs and refurbishment identified in the report have now been completed, including the missing tiles, damaged walls and bedroom furniture?
- 02How do you check that all staff use PPE and hand sanitiser correctly every time?
- 03How are accidents and incidents now reviewed so that possible safeguarding concerns are identified and reported?
- 04What quality checks are now in place to make sure environmental and infection control problems are found promptly?
- 05What activities are available now, and has another activities staff member been recruited?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 2 September 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.
Every inspection of Paternoster House
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- February 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- September 2021Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Goodstayed GoodSafe: GoodWell-led: Good
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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