CQC report explained · a nursing home
What the CQC found at Prestwood Coach House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received medicines safely, risks were assessed and staff knew how to reduce avoidable harm. Inspectors also found enough staff and effective infection prevention measures.
- Effective?
- Good
- People's needs and choices were assessed, staff were trained and healthcare referrals were made when needed. People were supported with eating, drinking and decisions about their care.
- Caring?
- Good
- People described staff as kind, compassionate and respectful. Inspectors saw people involved in decisions and supported to maintain their privacy and independence.
- Responsive?
- Good
- This key question was not inspected during this focused visit, so this report does not provide a new Responsive rating or detailed findings for it.
- Well-led?
- Good
- The provider had improved its quality monitoring systems and involved people and relatives in discussions about care and the refurbishment. The registered manager was in post and staff said they felt supported.
What inspectors found, October 2022
Rated Good; inspectors found safe, effective and kind care, with improvements since the previous inspection.
This was an unannounced focused inspection on 4 October 2022. One inspector and one Expert by Experience spoke with 12 people, three relatives and seven staff. They also reviewed care plans, medicines records, quality checks and recruitment records.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found enough staff, safe medicines support, suitable risk assessments and good infection control. Staff were trained and knew people's needs. People described staff as kind, respectful and responsive.
The previous rating was Requires Improvement, published in July 2020, when there were breaches of regulations. The provider made improvements and was no longer in breach at this inspection. The home was also undergoing extensive refurbishment, which inspectors said was being managed safely.
Safe medicines support
Staff were trained and assessed as competent. Inspectors found that medicines were given as prescribed, including time-sensitive medicines.
“People received their medicines as prescribed and when directed.” from the report
Enough staff
Inspectors found enough staff to support people in a timely way. Recruitment checks were also in place.
“People were supported by enough staff who were available to assist them in a timely way.” from the report
Kind and respectful care
People had positive relationships with staff. They were involved in everyday choices and were supported with dignity, privacy and independence.
“People told us they were treated with care by a kind, engaging and compassionate staff team.” from the report
Improved management checks
The provider had strengthened checks on care plans, medicines and the physical environment. People and relatives were asked for their views.
“The provider had made improvements to their quality monitoring systems and now had effective systems in place.” from the report
Refurbishment was still under way
minorBuilding work and changes to bedrooms and communal areas were taking place during the inspection. Inspectors found it was being managed safely, but families may want to understand how the work affects daily routines and access.
“The location was undergoing an extensive refurbishment programme at the time of the inspection.” from the report
- 01What refurbishment work is still outstanding, and how will it affect my relative's room, routines and access to communal areas?
- 02How do you check that staffing levels remain sufficient at busy times and overnight?
- 03How are medicines errors recorded, investigated and followed up with retraining if needed?
- 04How will you involve my relative and our family in care planning and regular reviews?
- 05What was the previous Requires Improvement action plan, and how do you check that the improvements are maintained?
This was a focused inspection of Safe, Effective, Caring and Well-led; any key questions not inspected used ratings from the previous inspection to calculate the overall rating. This explanation was written from the published report of 26 October 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, July 2020
Rated Requires Improvement; inspectors found risks with medicines, staffing and management oversight, although activities and complaints handling were good.
This was an unannounced inspection on 27 November 2019. Inspectors spoke with people, relatives, staff and healthcare professionals. They observed care and checked care records, medicine records, training information and management records.
The home was not always safe or effective. People sometimes waited for care and medicines. Medicines were not always given on time, stored safely or disposed of when expired. Care plans and daily notes did not always give a clear or accurate record of people's needs.
The home was rated Good for being Responsive. People had choices, personalised care plans, activities and support to keep relationships. However, Safe, Effective, Caring and Well-led were all rated Requires Improvement.
The home had breaches of regulations about safe care and treatment, staffing and good governance. The provider was asked for an action plan, and CQC said it would monitor progress and return for another inspection.
Activities and community links
People spoke positively about the range of activities, including trips, exercise and gardening. The home also supported people to contribute to their local community.
“People gave consistently positive feedback about the variety of activities.” from the report
Choice and personalised care
People were involved in care decisions and their preferences were recorded. Requests such as support from female staff were acted on.
“People had personalised care plans which explored their preferences and life histories.” from the report
Safeguarding
People felt safe and staff understood how to recognise and report abuse. Safeguarding concerns had been referred and investigated.
“Staff received training in safeguarding and understood the different types of abuse and how to report them.” from the report
Complaints and feedback
People and relatives knew how to raise concerns. The home responded to complaints according to its policy and used feedback to make some changes.
“The provider had a complaints policy in place and we saw complaints had been responded to in line with this.” from the report
Medicines were not consistently safe
seriousSome people did not receive medicines on time, including prescribed night medicines. Medicines were also left unsecured in a bedroom and expired medicines remained in the fridge.
“People did not consistently receive their medicines in a timely way.” from the report
Staffing delays
seriousPeople sometimes waited for personal care and medicines. Staff did not always have time to spend with people outside direct care tasks.
“There were not sufficient and effectively deployed staff to meet people's needs in a timely way.” from the report
Care records were not reliable
needs fixingCare plans were not always clear, up to date or consistent. Daily notes did not always show that planned care had been provided.
“People's care files did not consistently contain clear guidance to enable to staff to meet their needs.” from the report
Management checks missed problems
seriousQuality checks did not identify several concerns before the inspection, and some improvements from earlier inspections had not been sustained.
“Systems were not in place to effectively monitor and assess the quality of the service, to drive and sustain improvements and to ensure compliance with the regulations.” from the report
Care could feel rushed
needs fixingSome people were left waiting or alone, and one person waited over an hour for medicines and missed a morning activity. This affected dignity and wellbeing.
“The registered manager had not ensured the deployment of staff supported people to receive care in a flexible way that did not rush them.” from the report
- 01What changes have you made to ensure medicines are given on time, recorded with start and finish times, stored securely and removed when expired?
- 02How do you check that there are enough staff for personal care, medicines and meaningful time with residents?
- 03How are care plans and daily notes now checked to make sure they are accurate and show that planned care was provided?
- 04What action plan did you send to CQC, and what evidence can you show that the changes have lasted?
- 05How are healthcare professionals' instructions recorded and checked to make sure staff follow them?
This was an unannounced inspection covering all five key questions; the previous overall rating was Requires Improvement, with some individual ratings changing since earlier inspections. This explanation was written from the published report of 30 July 2020 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 Prestwood Coach House
6 rated inspections over 7 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- December 2018Requires improvementup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 1 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Staffordshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,230 a week. 85 can care for a couple. 10 years' experience on average.
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.