CQC report explained · a residential care home
What the CQC found at Polonia Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks, medicines, staffing, recruitment, fire safety and infection control were well managed.
- Effective?
- Good
- Training and induction had improved, including use of the care certificate for new staff. People received support with food, healthcare, communication and their legal rights.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous rating was carried forward.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous rating was carried forward.
- Well-led?
- Good
- Quality checks, training records and provider involvement had improved. Inspectors found the management team created an open, positive and person-centred culture.
What inspectors found, May 2023
Polonia Residential Home is rated Good; inspectors found safe care, improved training and stronger oversight.
The inspection was unannounced and took place on 6 April 2023. One inspector visited with a Polish-speaking interpreter. Inspectors spoke with four people, the deputy manager and two care workers. They also reviewed care records, a staff file and management records.
The home was rated Good for Safe, Effective and Well-led. People told inspectors they felt safe. Risks, medicines, staffing, recruitment and infection control were well managed. Staff training had improved, including induction for new staff, and people were supported to make choices.
This was a focused inspection to check improvements after the previous Requires Improvement rating. The provider had addressed the earlier breach of Regulation 17, and the home was no longer in breach. Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward.
People felt safe
People told inspectors they felt safe. Staff understood how to recognise and report abuse, and risks were recorded with guidance for staff.
“People told us they felt safe at the service.” from the report
Safe medicines and infection control
Inspectors found no discrepancies in the medicine records they checked. The home was clean, regularly cleaned during the visit and free from odour.
“The home was clean and free from odour. We observed regular cleaning taking place throughout our inspection.” from the report
Improved staff training
The home introduced a training tracker and a new provider so new staff completed the care certificate during induction. Staff also had supervision and appraisal support.
“At this inspection a newly developed training tracker had been introduced, ensuring the management team were fully aware of individual staff skill and competencies” from the report
Stronger management oversight
Inspectors found that quality audits, health and safety checks and provider involvement had improved since the last inspection.
“Overall performance at the service had significantly improved.” from the report
Positive culture
People and staff spoke positively about the home. Inspectors saw a relaxed atmosphere and staff communicating with people in their preferred language.
“The management team and staff created an open and positive culture at the service which was person centred and achieved good outcomes for people.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you support my relative to register with a dentist if local practices are not taking new patients?
- 02How do you check that new staff complete the care certificate and receive the right refresher training?
- 03How do you keep track of any DoLS applications, renewals and conditions affecting my relative?
- 04What action has been taken following the new fire risk assessment, and how are fire safety checks kept up to date?
- 05How do you make sure care is provided in my relative's preferred language and reflects their personal preferences?
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 4 May 2023 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, August 2021
Rated Requires Improvement; inspectors found safe, caring support but continuing weaknesses in training, oversight and some safety systems.
This was an unannounced focused inspection on 7 July 2021. One inspector, with a Polish interpreter, spoke with people, relatives, staff and managers, and reviewed care, medicine, recruitment, training and quality records.
The home was rated Good for Safe. Staffing levels were suitable, recruitment checks had improved, medicines were managed safely and people said they felt safe. The home was clean and had measures to manage COVID-19, but its fire risk assessment was not completed by a suitably competent person and some infection control documents needed updating.
Effective and Well-led were both rated Requires Improvement. Inspectors found continuing weaknesses in tracking Deprivation of Liberty Safeguards, staff induction, dementia-friendly design, required notifications and provider oversight. The overall rating remained Requires Improvement, partly because ratings for areas not inspected were carried forward from the previous comprehensive inspection.
Safe staffing and recruitment
There were enough staff to meet people's needs, and recruitment checks had improved since the previous inspection.
“Staffing levels were appropriate to meet the needs of the people using the service.” from the report
Safe medicines
Inspectors found medicines were stored and given safely, with staff training, competency checks and regular audits.
“Systems were in place to ensure people received their medicines safely and as prescribed.” from the report
Personalised care records
Care plans covered important needs and risks. They were translated into people's preferred languages.
“Risk assessments and care plans were thorough and up to date and provided staff with enough detail to support people safely.” from the report
Kind and positive care
People appeared comfortable with staff and relatives were positive about the care. Staff spoke with people in their preferred language.
“The culture of the service was positive and inclusive.” from the report
Weak provider oversight
seriousThe provider's systems did not properly monitor and improve the service. Important areas, including DoLS, infection planning and the environment, had not been fully checked.
“This was a continued breach of regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
DoLS tracking
needs fixingThe manager was still not keeping adequate oversight of applications and authorisations. Inspectors were satisfied that people were not being unlawfully deprived of their liberty at the time.
“At this inspection we found the registered manager's oversight was still lacking.” from the report
Staff induction
needs fixingNew staff had an induction, but it did not include the Care Certificate or an equivalent. The provider said this would be introduced and inexperienced staff would be prioritised.
“However, the induction did not consider the care certificate.” from the report
Dementia-friendly environment
needs fixingNew flooring was an improvement, but communal areas were dark and dementia-friendly signs were only in English, although most people's first language was Polish.
“However, communal areas within the home décor was dark in presentation and dementia friendly signage within the home was only in English” from the report
Missed notifications and outdated policies
needs fixingSome notifications that should have been sent to CQC were outstanding. The infection control policy and business continuity plan had not fully considered the coronavirus pandemic.
“Statutory notifications required by law had not always been submitted to CQC when a DoLS notification had been granted.” from the report
- 01Has a new fire risk assessment been completed by a competent external assessor, and are fire drills now clearly recorded?
- 02How are you tracking DoLS applications, authorisations and expiry dates, and have all required notifications been sent to CQC?
- 03Do all new staff now complete the Care Certificate or an equivalent induction?
- 04What changes have been made to the communal areas and signage to make the home more dementia friendly and accessible to Polish-speaking residents?
- 05What provider-level audits are now being completed to check quality, safety, infection control and business continuity?
This was a focused inspection of Safe, Effective and Well-led only; the other key question ratings from the previous comprehensive inspection were carried forward. This explanation was written from the published report of 6 August 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 Polonia Residential Home
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017
Registered with the Care Quality Commission on 27 September 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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