CQC report explained · a nursing home
What the CQC found at Poldhu
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines were generally given safely, but records for some prescribed creams and guidance for some as-required medicines were not always complete.
- Effective?
- Good
- People's health, nutrition and hydration needs were supported, and staff worked with health professionals. Inspectors found gaps in some repositioning, skin condition and other care records.
- Caring?
- Good
- This question was not inspected during this focused visit. The report says the rating from the previous comprehensive inspection was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report says the rating from the previous comprehensive inspection was used in calculating the overall rating.
- Well-led?
- Good
- New management and stronger monitoring were beginning to improve the service. However, the home did not have a registered manager at the time and some care plans were overdue for review.
What inspectors found, December 2021
Rated Good; inspectors found safe, effective care, but records, staffing and leadership had recently been unsettled.
This was an unannounced focused inspection on 23 November 2021. Inspectors looked at Safe, Effective and Well-led because of concerns about staffing and stable management. They spoke with people, relatives and staff, and reviewed care, medicine, recruitment, training and management records.
The home was rated Good for Safe, Effective and Well-led. People were protected from abuse, risks were assessed, medicines were generally given safely, and infection control arrangements were suitable. People and relatives said staff were caring, the home was clean, and people's health and food needs were supported.
Inspectors found some gaps in records, including medicine cream records, repositioning and skin checks. There had also been a few shifts below planned staffing levels, supervision had not always happened as planned, and the home did not have a registered manager at the time. The provider had started taking action, including appointing a new manager and clinical lead and improving monitoring.
Safeguarding
The home had safeguarding systems and trained staff who knew how to recognise and report possible abuse.
“People were protected from potential abuse and avoidable harm by staff who had received safeguarding training and knew about the different types of abuse.” from the report
Infection control
Inspectors found suitable arrangements for preventing and managing infection, including updated procedures and suitable visiting arrangements.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Food and choice
People said they enjoyed the food and had choices. People could also choose how they spent their time, including staying in their rooms.
“Yes, the food is fine. We can choose what we want and there is plenty of it.” from the report
Medicine records
needs fixingRecords did not always show whether prescribed creams and lotions had been applied as directed. Inspectors recommended improving medicine administration records.
“It was not possible to tell from records if people were having creams applied as prescribed.” from the report
Care records
needs fixingSome repositioning and skin condition checks were missing from records. Inspectors recommended improving the recording of care and support.
“At this inspection we continued to identify some gaps in specific records such as re-positioning and skin condition checks.” from the report
Staffing pressures
needs fixingThere had been a couple of shifts below planned staffing levels because short-notice sickness could not be covered. Staff also described recent shortages and pandemic pressures.
“Although, there had been a couple of shifts when staffing levels had dropped below planned levels, due to short notice sickness absences, which could not be covered by other staff or agency.” from the report
Leadership changes
needs fixingThe home had experienced a period without a registered manager and inconsistent leadership. A new manager and clinical lead had only recently started when inspectors visited.
“The service has experienced a period of time without a registered manager.” from the report
- 01Are staffing levels now consistently at the planned level, and how are short-notice absences covered?
- 02Has the new manager completed registration with the CQC, and how have the new manager and clinical lead changed the service?
- 03How do you now check that prescribed creams and lotions are recorded each time they are applied?
- 04How are repositioning and skin condition checks recorded and audited?
- 05Have all staff now received the supervision and competency checks that were being introduced?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 7 December 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.
What inspectors found, January 2019
Rated Good; inspectors found kind, personalised care and improvements since earlier concerns, although night nurse vacancies remained.
This was an unannounced inspection on 18 December 2018. Inspectors reviewed care plans, medicines records, staff files, training records and other documents. They spoke with people, relatives, healthcare professionals, the manager and staff, and observed care.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were treated with kindness, their care plans reflected their needs, medicines were managed safely and staff were well supported.
The home had previously been rated Requires Improvement and had breached regulations about consent, safe care and treatment, and good governance. After focused inspections found those breaches had been met, this inspection found that improvements had been sustained enough for the overall rating to become Good.
Improved call bell response
Earlier inspections found that people sometimes waited too long for help. At this inspection, audits and observations showed that responses had improved.
“Audits of call bell response times showed call bells were usually answered quickly.” from the report
Personalised care
Care plans reflected people's current needs, preferences and communication requirements. Staff also monitored people more closely when there was a risk of their health worsening.
“Care plans were up to date and reflected people's current needs.” from the report
Staff support and training
Staff received induction, training, supervision, appraisal and opportunities to raise concerns or suggestions.
“Staff were well supported by a system of induction, training, supervisions, appraisals and staff meetings.” from the report
Night nurse vacancies
needs fixingThe report said there would be two night nurse vacancies when a new senior nurse started. Bank and agency staff were being used to cover gaps.
“This would leave two vacancies for night nurses.” from the report
Audits still being developed
minorThe home carried out regular checks, but its wider organisational audits were not yet fully embedded.
“Organisational audits were being developed but were not yet fully embedded.” from the report
Call bell technology not yet in place
minorThe home was planning new technology to help staff identify calls that had been ringing for longer. This suggests the service was still strengthening its response monitoring.
“The provider was planning on introducing technology to allow staff to identify when individual call bells had been ringing for a period of time” from the report
- 01How are the two night nurse vacancies now covered, and has the nursing team changed since the inspection?
- 02What are the current call bell response times, and how are long waits followed up?
- 03Has the planned call bell technology been introduced?
- 04How are the organisational audits being completed now that they were not yet fully embedded?
- 05How are relatives involved in care plan reviews and discussions about concerns?
This was an unannounced inspection of the whole care home, including the premises and care provided, and it assessed all five CQC questions. This explanation was written from the published report of 4 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.
Every inspection of Poldhu
9 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- August 2018Requires improvementstayed Requires improvementSafe: GoodWell-led: Requires improvement
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Goodstayed GoodSafe: Requires improvement
- April 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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