CQC report explained · a nursing home
What the CQC found at Picktree Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were assessed and reviewed, safeguarding systems had improved, and inspectors found enough staff. Some medicines were briefly stored outside national guidance, but this was corrected immediately.
- Effective?
- Good
- People had access to healthcare, food and drink suited to their needs, and staff had appropriate training. Mental capacity work had improved, although records did not always fully show relatives' involvement or legal authority.
- Caring?
- Good
- People and relatives described staff as kind, respectful and supportive. Inspectors observed warm interactions and found that privacy, dignity, independence and involvement in decisions were promoted.
- Responsive?
- Good
- Care was personalised and people were supported with activities, family contact, complaints and end-of-life planning. Some care plans had less person-centred detail than others and were being reviewed.
- Well-led?
- Good
- The home had an approachable management team, quality checks and action plans for improvement. Significant incidents were being reported to CQC and lessons were shared with staff.
What inspectors found, November 2022
Rated Good; inspectors found safe, kind and personalised care, with a few records and medicine-storage issues corrected or being improved.
Inspectors visited unannounced on four dates in September and October 2022. They spoke with people, relatives, staff and a healthcare professional. They observed care and checked care, medicine, staff and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found improvements in risk management, safeguarding, medicines, nutrition, activities, complaints and end-of-life planning.
There were some minor shortfalls. A few medicines were not stored in line with national guidance, although this was corrected straight away. Records did not always fully show relatives' involvement or legal authority in decisions, and some care plans needed more person-centred detail.
The previous inspection rated the home Requires Improvement and found breaches of regulation. At this inspection, inspectors found enough improvement and said the home was no longer in breach.
Improved safety
Risks were assessed and reviewed as people's needs changed. The home had improved its response to falls, fire safety and safeguarding concerns.
“Risks to people had been assessed, and safety was monitored and well managed within the service.” from the report
Kind and respectful staff
People and relatives said staff were caring and respectful. Inspectors also saw staff respond warmly and reassure someone who was distressed.
“People and their relatives told us staff were very caring and treated people with respect.” from the report
Personal involvement
People and relatives were involved in care planning and daily choices. Staff supported privacy, dignity, independence and contact with loved ones.
“People were supported to be involved in decisions regarding their care and choosing how their daily support was given.” from the report
Open management
The management team was described as approachable and open to suggestions. Feedback was gathered from people, relatives, staff and visiting professionals.
“People, staff and relatives described the registered manager as approachable and open to suggestions for improvements.” from the report
Medicine storage
minorSome medicines were not stored in line with national guidance. Nurses and the registered manager corrected the issues immediately when inspectors raised them.
“We found some medicines that were not stored in-line with national guidance.” from the report
Family decision records
needs fixingRelatives were involved in decisions, but records did not always show their involvement or legal authority. The home was updating these records.
“Relatives confirmed they were involved in care decisions, but their involvement or legal authority to act was not always recorded.” from the report
Care plan detail
minorSome care plans did not contain as much person-centred detail as others. The registered manager said all plans were being reviewed.
“Some plans had less person-centred detail than others.” from the report
Dementia-friendly signs
minorSome signs helped people living with dementia find their bedrooms, but more decoration was planned to improve the environment.
“Some signage was available for those people living with dementia who needed assistance to locate their bedrooms.” from the report
- 01How do you now check that all medicines are stored in line with national guidance?
- 02How do your records show relatives' involvement and any legal authority to make decisions?
- 03What changes have been made to make every care plan fully person-centred?
- 04What further signs or decoration have been added to help people living with dementia find their way around?
- 05How are the improvements identified through your quality checks followed up?
This was an unannounced follow-up inspection after a previous Requires Improvement rating; inspectors assessed all five key questions and found Good ratings in each. This explanation was written from the published report of 11 November 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, June 2021
Picktree Court Care Home was rated Requires Improvement; inspectors found caring staff but serious safety, safeguarding and management weaknesses.
Inspectors inspected the home over several visits between 21 October and 11 December 2020. They reviewed care, medicines and other records, spoke with relatives and staff, and checked infection control. The inspection was prompted by concerns about falls and an incident involving a death, but it did not examine the circumstances of that death because of a criminal investigation.
The home was not always safe. Inspectors found weaknesses in falls management, fire evacuation arrangements, medicines records, PPE use and the reporting of unexplained injuries. Weighing had stopped during the pandemic, so some weight loss was not identified quickly, and fluid records did not reliably show whether people were drinking enough.
Staff were kind and respectful, and some relatives valued the care and video calls. However, activities, complaints handling and end of life arrangements needed improvement. The culture was not always open, and the provider missed opportunities to learn from concerns and incidents.
The overall rating changed from Outstanding at the previous inspection, published in March 2018, to Requires Improvement. The five question ratings were Safe Requires Improvement, Effective Requires Improvement, Caring Good, Responsive Requires Improvement and Well-led Requires Improvement.
Kind and respectful care
Inspectors found that staff treated people with kindness and empathy. Relatives also described staff as respectful and supportive.
“Staff treated people with kindness and empathy. Relatives felt staff treated people with respect.” from the report
Safe oral medicines
Inspectors found that staff administered oral medicines safely, although records and protocols for some other medicines needed improvement.
“Staff administered oral medicines in a safe manner.” from the report
Clean environment
The home had cleaning schedules and was described as clean, tidy and well presented. Other infection control arrangements, including testing and cleanliness, were followed.
“The home was clean, tidy and well-presented.” from the report
Personal care planning
Care plans contained information about people's needs, preferences and communication requirements. Staff supported people to make choices and maintain independence.
“Care plans provided staff with information about people's preferences and their individual needs.” from the report
Support for some family contact
Staff spent considerable time helping people make video calls. Relatives said this gave them reassurance during visiting restrictions.
“The introduction of regular Zoom calls has enabled some degree of contact which has eased the separation forced upon everyone by COVID-19.” from the report
Falls and safety risks
seriousFalls were not analysed in enough detail, and other safety arrangements, including fire evacuation and medicines protocols, were not reliable. This created an increased risk that people could be harmed.
“Care and support was not always delivered in a safe manner, and action to mitigate risks had not always been taken.” from the report
Unexplained injuries
seriousUnexplained bruising and other injuries were not always referred to the local safeguarding team or CQC. This was a breach of safeguarding requirements.
“Some unexplained injuries were not reported to the local authority safeguarding team or CQC.” from the report
Weight and fluid monitoring
seriousPeople were not weighed during the pandemic, and fluid charts did not show clear targets or reliable totals. Inspectors said some weight loss was not addressed promptly.
“Consequently, some weight loss was not addressed in a timely manner.” from the report
PPE and social distancing
needs fixingInspectors were not assured that staff always used full PPE correctly or kept socially distant when entering the home. The provider was signposted to infection control resources.
“Photographs shared with us during the pandemic showed staff were not always wearing full PPE when in close proximity with people.” from the report
Activities and isolation
needs fixingActivities were limited during the pandemic, and some people had no activities recorded for a month. Relatives were worried that isolation was affecting people's emotional wellbeing.
“Activities seem to have mostly stopped.” from the report
Open management and complaints
needs fixingInspectors found that some complaints were handled inappropriately and that the provider did not always learn from concerns. Information sent to relatives was not always consistent with what inspectors found.
“The culture of the service was not always open and transparent.” from the report
- 01What changes have been made to analyse falls, including the times when falls happen, and how are those changes checked?
- 02How are unexplained bruises or injuries now reported to the local safeguarding team and CQC?
- 03How often are residents weighed, and how are weight loss and fluid intake monitored and acted on?
- 04What has changed about fire evacuation training, equipment, PPE checks and social distancing for staff?
- 05How are activities, complaints and end of life visiting arrangements now planned around each person's needs?
The inspection looked at all five CQC questions and included infection control, falls risks and records, but it did not examine the circumstances of the death that prompted part of the inspection because of a criminal investigation. This explanation was written from the published report of 5 June 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 Picktree Court Care Home
4 rated inspections over 7 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2021Requires improvementdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018Outstandingup from GoodSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 5 May 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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Most charge £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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