CQC report explained · a nursing home
What the CQC found at Perry Locks Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found risk assessments, emergency arrangements, safe recruitment and trained staff giving medicines, although some people and staff said staffing could sometimes feel stretched.
- Effective?
- Good
- Staff had training, supervision and knowledge of people's needs. People received suitable food, healthcare and support with consent and best-interest decisions.
- Caring?
- Good
- Staff treated people kindly and respectfully. Inspectors saw staff supporting privacy, dignity, independence, choice and people's cultural and spiritual needs.
- Responsive?
- Good
- Care plans were personalised and included people's preferences, routines, interests and relationships. Activities and complaints processes were available, but people in their rooms did not always receive one-to-one activities.
- Well-led?
- Requires improvement
- Management was approachable and people and staff felt listened to. However, checks did not always identify incomplete or inaccurate records, delays to repairs, or potential environmental hazards.
What inspectors found, January 2019
Rated Good overall, but inspectors found the home was not consistently well-led and records and repairs needed improvement.
Inspectors visited on 04 and 05 December 2018. The first visit was unannounced and the return visit was announced. They spoke with people living in the home, relatives and staff, observed care, and checked care, medicine, recruitment, training and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found people were protected from abuse, supported by trained staff, treated kindly and helped with their individual needs. People had access to food, activities, healthcare and support for their cultural, religious and end of life wishes.
The well-led rating was Requires Improvement. Some care plans and medicine records were not kept fully up to date. Inspectors also found delays in repairing damaged fire doors and potential hazards from hot pipes. The overall rating improved from Requires Improvement in every area at the previous inspection in May 2017 to Good overall.
Kind and respectful care
Inspectors saw staff building warm relationships with people and offering calm reassurance. People were supported with dignity and privacy.
“On all the units, we saw staff were kind and compassionate and had clearly formed strong relationships with people and knew them well.” from the report
Personalised support
Care plans included people's likes, dislikes, preferences, social history and family relationships. Staff knew what mattered to the people they supported.
“The care plans we looked at were very person centred, they contained information about people's likes, dislikes, preferences, social history and family relationships.” from the report
Staff skills and healthcare
Staff received training and supervision, and inspectors saw them using their skills safely. People were supported to access doctors and other healthcare professionals.
“People were supported by staff that had the skills and knowledge to deliver effective care and support.” from the report
Choice and inclusion
People could choose where to spend their time and were supported with hobbies, faith and cultural needs. A multi-faith prayer room was available.
“People were given choices and were asked whether they had any special dietary requirements in association with their spiritual, religious or cultural beliefs” from the report
Care and medicine records
needs fixingSome records did not accurately show changes in people's care. Inspectors found gaps in topical cream records and errors about covert medicines, which could make it harder for staff to give the right support.
“There were several errors noted on two people's medicine charts, for example both were receiving their medicine covertly but only one was noted in the medicine administration sheet and the second was not.” from the report
Delayed repairs and hazards
seriousTwo damaged fire doors had not been repaired or replaced promptly. Hot pipes in toilets were not covered and had temperatures that could burn skin.
“In Calthorpe we saw a number of hot pipes in toilets were not covered with temperature readings of 47 degrees, with the potential to cause burning to skin if a person had contact with the pipes.” from the report
Mixed views about staffing
needs fixingSome people and staff said there were not always enough staff or that waits could be frustrating. Inspectors generally saw people attended to promptly, but this is worth checking for the particular unit your relative may use.
“Not enough staff. When I want to go to the toilet, I have to go in the pad. The first time I did it I was upset, but used to it now.” from the report
Limited accessible information
minorInspectors did not see much accessible information on the units, including pictorial menus, easy-read complaints information or easy-read activity plans.
“We did not see on the units much in the way of accessible information for people, there were no pictorial menus, easy read complaints procedures on display and easy read activity plans.” from the report
One-to-one activities
minorThere were group activities and trips, but people staying in their rooms said staff did not always spend time with them. Inspectors saw little one-to-one activity in people's rooms.
“People we spoke with told us this did not always happen and our observations across the four units saw little one to one activities in people's rooms.” from the report
- 01Have the two damaged fire doors now been replaced, and how do you check that repairs are completed promptly?
- 02Have the hot pipes in the toilets been covered, and what checks are now in place to prevent burns?
- 03How do you check that medicine administration records, covert medicines and topical cream applications are recorded accurately?
- 04How do you make sure care plans are updated after visits from doctors, nurses or other professionals?
- 05How do you ensure enough staff are available on each unit to answer call bells and help people with toileting promptly?
This was an overall inspection of the home, covering all five key questions and including observations, discussions and checks of care, medicine, recruitment, training and management records. This explanation was written from the published report of 12 January 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, July 2017
Requires Improvement; inspectors found kind care and improved staffing, but safety records, training and care planning were not consistently reliable.
This was an unannounced inspection over the evening of 10 May 2017 and the full day of 11 May 2017. Inspectors spoke with people living there, relatives and staff. They observed care, reviewed 16 care records, checked medicine records for 23 people, and examined training, recruitment and quality checks.
There had been improvements since earlier inspections. Staffing had increased and medicines were usually given as prescribed. People generally said staff were kind, respectful and helpful. Food was well received, and people had access to health professionals and activities.
However, inspectors found important gaps. Risk assessments and care plans were sometimes out of date or contradictory. Medicine records and guidance for some medicines were not always complete. Some staff training was overdue, and people were not always involved in care planning. The systems used to check quality had not found all these problems.
All five areas were rated Requires Improvement. This means the home was not consistently meeting the standard expected, although inspectors did not find evidence that people were unsafe overall and noted that improvements were being made.
Kind and respectful staff
Inspectors saw staff speaking to people with kindness and compassion. People's privacy, dignity and personal preferences were generally respected.
“We saw staff interacting with people with kindness and compassion.” from the report
Food and choice
People spoke positively about the food and had choices about what, where and how they ate. Staff supported people kindly with meals.
“We observed a meal time on each of the four units and consistently found that meal times were a pleasant and social experience for people” from the report
Health support
People had access to GPs and other health and social care professionals. Records showed referrals and follow-up when people needed specialist support.
“People had access to GP's and other health and social care professionals.” from the report
Activities and relationships
People were supported to take part in activities they found meaningful and to maintain contact with family and friends.
“People were actively encouraged and supported to engage in activities that were meaningful to them” from the report
Incomplete risk information
seriousSome risk assessments and care plans were not updated when people's needs changed. Conflicting information could lead to staff providing the wrong support, particularly when staff were unfamiliar with a person.
“People were not always protected from risks associated with their care needs because risk assessments and management plans were not always sufficiently detailed or updated.” from the report
Medicine records and guidance
seriousInspectors could not always confirm that liquid medicines had been given correctly. Guidance for covert and as-needed medicines was sometimes missing or not understood by staff.
“However discrepancies found between the liquid medicines and the administration records meant that we were unable to tell whether these particular medicines had been administered correctly.” from the report
Night-time delays
needs fixingShort staffing on some units meant people waited for help, including help to go to bed. A further improvement was needed to keep care consistent across the home.
“People did not always get their needs met in a timely manner.” from the report
Overdue training
needs fixingSome staff had missed required training updates. Staff also reported that some face-to-face training had been replaced by online learning and tests.
“Records we looked at showed that some staff had missed the target dates for some of their learning and development needs.” from the report
Care planning involvement
needs fixingPeople and relatives were not always involved in planning and reviewing care. Records did not consistently show who had agreed changes or when updates had been made.
“People and/or their relatives did not always feel involved in the planning and review of their care.” from the report
- 01How do you now make sure risk assessments and care plans match people's current mobility, dementia and behavioural support needs?
- 02What checks are made on liquid, covert and as-needed medicines, and how are staff shown the correct instructions?
- 03How do you cover staff sickness and night-time shortages without moving staff between units in a way that affects people's care?
- 04Which staff training was overdue at the inspection, and has all required training now been completed?
- 05How are residents and relatives invited to take part in care reviews, and how can they see what was agreed?
This was an unannounced comprehensive inspection covering all five questions, including an evening visit to examine night-time care and a full-day visit to complete the inspection. This explanation was written from the published report of 6 July 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Perry Locks Care Home
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- January 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2017
Registered with the Care Quality Commission on 31 January 2017.
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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