CQC report explained · a residential care home
What the CQC found at Pranam Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Pranam Care Centre was rated Requires Improvement; inspectors found unsafe moving support, disrespectful interactions and weak oversight, although personalised care and activities were good.
This was an unannounced, focused inspection on 22 and 24 November 2022. Inspectors spoke with 10 people, a relative and a healthcare professional. They observed care, checked records, medicines and part of the building, and spoke with staff.
The home had improved its care planning and medicines systems. People said their needs were met and they could make choices. However, staff sometimes supported people to walk in an unsafe way. Some interactions were not respectful, including during meals. Infection control problems were found on the first day and were addressed by the second visit.
The overall rating remained Requires Improvement. Safe and well-led remained Requires Improvement. Caring fell from Good to Requires Improvement, while Responsive improved from Requires Improvement to Good. The home remained in breach of three regulations and received a warning notice requiring improvements by 31 January 2023.
Personalised care
Care plans recorded people's choices and needs clearly. Inspectors found that staff followed them and people's needs were being met.
“The provider had created personalised care plans with people. These were clear, detailed and included evidence the person had made choices and been consulted about their care.” from the report
Medicines
People received their medicines as prescribed, including controlled drugs. Staff were trained, medicines were stored safely and records were appropriate.
“People received their medicines as prescribed, including controlled drugs.” from the report
Activities and relationships
People could join varied social and leisure activities and were supported to stay in touch with family and friends.
“People were supported to take part in a range of planned leisure and social activities.” from the report
Communication and culture
Information was available in different languages, and staff supported people's communication, cultural and religious needs.
“The staff spoke a range of languages and were able to communicate with most people in their first language.” from the report
Unsafe moving support
seriousStaff sometimes held people's wrists and pulled them forward while walking. Inspectors said this increased the risk of falls.
“The staff regularly supported people by holding their wrists and walking in front of the person pulling at them to walk along.” from the report
Dignity and respect
seriousSome staff did not respect people's wishes or comfort. Inspectors saw poor communication and unsuitable support during meals.
“People were not always treated respectfully or well.” from the report
Infection control
needs fixingSome toilets lacked soap or suitable bins, and some hand sanitisers were empty on the first day. These problems were addressed by the second visit, but some staff also wore face masks incorrectly.
“On the first day of the inspection, we found some toilets did not have soap or waste bins for sanitary products and the hand sanitisers in some areas of the building were empty.” from the report
- 01How do you now make sure staff support each person to walk safely, and how are staff competencies checked?
- 02What changes have you made to ensure staff respect people's choices, comfort and dignity during meals?
- 03What evidence can you show that the warning notice requirements were completed by 31 January 2023?
- 04How do your quality checks now identify unsafe moving support and poor staff interactions?
- 05How are you monitoring falls and deciding when someone needs extra individual support?
This was a focused inspection of Safe, Caring, Responsive and Well-led; Effective was not inspected, and the report says ratings for questions not inspected were carried over from the last inspection. This explanation was written from the published report of 5 January 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
Pranam Care Centre was rated Requires Improvement; inspectors found kind and mostly safe care, but care planning and quality checks were not reliable enough.
This was an unannounced focused inspection on 15 July 2021. Inspectors spoke with nine people and nine staff, and reviewed care records, medicine records, recruitment files and management records. They looked mainly at Safe, Responsive and Well-led, including nutrition and infection control.
People received their medicines as prescribed, staff followed infection control procedures, and recruitment and safeguarding processes were in place. However, some medicine guidance was not detailed enough, and some risks did not have clear instructions for staff. The provider updated some risk assessments after the inspection.
People's care plans did not always reflect their current needs. Activities did not meet everyone's needs, and some people said there was not much to do. The provider's quality checks had not identified or fixed these problems.
The overall rating remained Requires Improvement. Safe, Responsive and Well-led were rated Requires Improvement. Effective was inspected but not rated, and its previous Good rating was carried forward for the overall assessment. The report says the provider breached Regulations 9 and 17.
Infection control
Inspectors were assured that the home had measures covering visitors, protective equipment, testing, cleaning, isolation and visits during the pandemic.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Safeguarding
Staff understood how to report concerns, and the home had processes for investigating safeguarding issues and contacting relevant agencies.
“The provider had a clear process in place for the reporting and investigation of safeguarding concerns.” from the report
Recruitment
The recruitment records checked by inspectors included employment histories, references and criminal record checks.
“We saw each staff member's records included a full employment history, two references and a criminal record check which followed the provider's process.” from the report
Handling complaints
Complaints were recorded, investigated and answered within the home's stated timescales. The report says responses were open and included action to prevent similar problems.
“We looked at the records of complaints and found that where there had been complaints, these were appropriately recorded, investigated and responded to within the stated timescales.” from the report
Communication and culture
Staff spoke many of the languages used by people living in the home, and care plans recorded communication needs. People said staff were respectful and managers were approachable.
“Staff at the home spoke over 15 languages between them.” from the report
Care plans were not always current
seriousSome care plans contained conflicting or outdated information about people's support needs. This could leave staff without the right guidance.
“People's care needs were not always met in a person centred way and their care plans did not always reflect their individual needs.” from the report
Quality checks missed problems
seriousThe provider's audits had not identified or resolved gaps in care plans, risk assessments, medicines guidance and meal choices. This was a continued breach of good governance.
“The provider's quality assurance systems were not effective enough to enable to them to appropriately monitor, assess and improve the quality and safety of the service.” from the report
Activities and time outdoors
needs fixingActivities did not meet the needs of everyone, including younger adults with mental health needs or dementia. Several people said there was little to do and wanted more walks.
“There is not much to do and you do not know what to do with yourself.” from the report
Risk planning
seriousSome people who went into the community did not have risk plans explaining how staff should support them safely. The provider created or updated plans after the inspection.
“We saw two people went into the community to go shopping on their own, but risk management plans had not been developed to identify any possible risks.” from the report
Medicine instructions
needs fixingSome instructions for medicines given only when needed did not explain clearly when to give them or which dose to use. Inspectors made a recommendation for improvement.
“In a few cases these were not detailed enough to indicate when the medicines should be given and where a variable dose was prescribed” from the report
Meal choices
needs fixingPeople received enough food and drink, but inspectors found mixed evidence about whether people were offered choices. The way meals were served did not always reflect personal preferences.
“There was mixed feedback from people and staff about whether people were offered choices about their meals.” from the report
- 01What changes have been made to ensure every person's care plan reflects their current needs and is checked regularly?
- 02How are risk plans now prepared for people who go into the community independently or with staff?
- 03What detailed guidance is now available for medicines prescribed to be given only when needed?
- 04What activities and community outings are now available for younger adults and people with mental health needs or dementia?
- 05How do managers check that people are offered genuine choices about meals and that audits lead to lasting improvements?
This was a focused inspection of Safe, Responsive and Well-led, with a specific review of nutrition; Effective was inspected but not rated, and previous ratings for Effective and Caring were used in calculating the overall rating. This explanation was written from the published report of 18 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 Pranam Care Centre
11 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- August 2021Requires improvementSafe: Requires improvementEffective: Inspected but not ratedResponsive: Requires improvementWell-led: Requires improvement
- November 2020Inspected but not ratedSafe: Inspected but not rated
- February 2020Requires improvementup from InadequateSafe: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- January 2017Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2015
Registered with the Care Quality Commission on 12 June 2015.
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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