CQC report explained · a residential care home
What the CQC found at Proctor Residential Care Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by safeguarding training, risk assessments, premises checks, suitable staffing and safe medicines arrangements. Infection control had improved, but inspectors found two soiled mattresses with split waterproof coverings and asked for mattress checks to be added to audits.
- Effective?
- Good
- Care needs were assessed and reviewed. Staff had a training programme, worked with health and social care professionals, supported people's nutrition and followed the principles of the Mental Capacity Act.
- Caring?
- Good
- Staff knew people well and treated them respectfully. People were encouraged to make choices and express their views, although support with personal hygiene and changing clothes was not always successful.
- Responsive?
- Good
- Care plans were detailed, person centred and updated when people's needs changed. The home checked people's satisfaction and kept a record of complaints.
- Well-led?
- Good
- The home had introduced regular quality and safety audits, and staff said they were well supported. One infection control audit had not identified the mattress concerns, and inspectors were not given evidence of the registered manager's more recent training.
What inspectors found, March 2018
Proctor Residential Care Home Limited was rated Good; inspectors found safe, respectful and personalised care, with some mattress and management checks needing attention.
This was an announced inspection on 19 and 25 January 2018. One inspector spoke with four people, two staff members and two health or social care professionals. The inspector also checked care files, staff records, medicines, policies, audits and the building.
The home supported up to five people with enduring mental health conditions. Inspectors found that people were safe, staff knew them well, and care plans were detailed and regularly reviewed. Medicines, staffing, risk management and links with health services were judged to be effective.
The home had improved since December 2016. Earlier concerns about infection control and checking service quality had been addressed, and the overall rating improved from Requires Improvement to Good. Inspectors still asked for better mattress checks and noted some other smaller shortfalls.
Improved infection control
The home had acted on the previous inspection's infection control concerns. Bathroom, shower room and utility room improvements had been completed, and cleaning practices had improved.
“The measures in place to prevent the spread of any infection had improved so that people were protected from the risks of cross infection.” from the report
Good risk management
The home had individual risk assessments and plans for risks linked to people's health, behaviour, smoking and community activities. Staff also reviewed accidents and incidents for lessons.
“Risk assessments were completed for each person and ensured where risks were identified there were plans in place to reduce or eliminate the risk.” from the report
Personalised care planning
Inspectors found that care plans covered daily life, health needs and lifestyle choices. They were based on staff's long-term knowledge of each person and were reviewed regularly.
“The plans were person centred and were evidently based on a long term knowledge of the person.” from the report
Safe medicines support
Staff were trained to administer medicines and their competence was checked. Weekly stock checks were also carried out.
“The processes in place for ordering, receiving, storing and disposing of medicines were safe.” from the report
Damaged mattresses
needs fixingInspectors found two soiled mattresses with split waterproof coverings. One was replaced during the inspection, but the second still needed replacing, and mattress checks were missing from the infection control audit.
“We saw that two people's mattresses on their beds were soiled and the outer waterproof coverings were split.” from the report
Personal hygiene was not always maintained
minorStaff encouraged people to maintain personal hygiene and change clothes, but this was not always achieved.
“People were prompted and encouraged to maintain good personal hygiene, and to change their clothing regularly, although at times this was not achieved.” from the report
Some staff did not know all safeguarding reporting routes
needs fixingTwo staff members did not know they could report concerns directly to the police or the CQC. Managers were available at the time of the inspection.
“The two staff members were unaware they could report directly to the Police or the Care Quality Commission however the registered manager lived on site and one of the managers were always available.” from the report
Management training evidence
minorInspectors were not given details of the registered manager's more recent training, so they could not confirm that the manager was up to date with legal changes and current best practice.
“The registered manager did not provide us with any other details regarding more recent training they had received in order to satisfy us that the registered manager was up to date with legislation changes and effective best practice.” from the report
- 01Has the second mattress been replaced, and how are all mattresses now checked and recorded?
- 02How do staff make sure people receive the personal hygiene and clothing support they need?
- 03What training have all staff completed on reporting safeguarding concerns directly to the police or CQC?
- 04What recent training has the registered manager completed on legislation and current best practice?
- 05How are accidents, incidents, complaints and audit findings used to make further improvements?
This was an announced inspection of all five key questions, covering the overall quality and safety of the home and checking progress since the December 2016 inspection. This explanation was written from the published report of 8 March 2018 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 2017
Rated Requires Improvement; inspectors found kind, personalised care but unsafe environmental conditions and weak quality checks.
Inspectors visited on 10 December 2016. The announced inspection covered the overall service. They spoke with one resident, two staff members and the deputy manager, and reviewed three care records and records about medicines, complaints, training and quality checks.
The home was rated Good for Effective, Caring and Responsive. People had personalised care plans, staff understood their needs, healthcare support was arranged and people were encouraged to be independent.
Safe and Well-led were rated Requires Improvement. Bathrooms and other areas needed repair and cleaning, infection control checks were missing, and health and safety audits had not identified the problems. There were also some medicines recording errors.
The report found one breach of legal requirements. The provider was required to send the CQC an action plan explaining what it would do, and the CQC said it would check that the action was taken.
Personalised support
Care plans described people's preferences, relationships, interests and support needs. Staff followed guidance about behaviour and communication.
“Care records were personalised and described how people preferred to be supported.” from the report
Kind and respectful staff
Inspectors found enabling relationships and said staff respected privacy. Staff supported people to make choices and become more independent.
“People were supported by a small experienced staff team.” from the report
Support for independence
People could access the community and were encouraged to manage more of their own personal care and appointments.
“Action plans to enhance people's independence were promoted by the service and staff members.” from the report
Health and training
Staff received relevant training and supervision. People had access to GPs, social workers, mental health teams and community psychiatric nurses.
“People's healthcare needs were met and the service had obtained support and guidance where required.” from the report
Unsafe and unclean areas
seriousBathrooms had problems including exposed brickwork and wires, mould, missing soap and hand-drying facilities, and a lack of hot water in one basin. Other areas and the garden also needed maintenance and clearing.
“People were not supported in a safe and clean environment.” from the report
Poor infection control checks
seriousThere were no infection control audits, and existing health and safety audits did not identify the problems found during the inspection.
“The provider did not have effective auditing systems in place to assess the quality and safety of the service.” from the report
Medicines recording errors
needs fixingInspectors found one discrepancy in a stock balance and several inaccuracies in medicine records. The report said medicines were otherwise managed appropriately.
“There were two inaccuracies regarding an omission of not accounting for weekend medicines being taken out of the service and one mistake of not correctly totalling the amount remaining.” from the report
- 01What repairs have been completed in the bathrooms, smoking area and garden since the inspection?
- 02How do you now check for mould, missing soap, hand-drying facilities and other infection control risks?
- 03What new quality and safety audits are in place, and how are problems followed up?
- 04How are medicine stock balances and weekend medicines checked to prevent recording errors?
- 05What action was included in the report sent to the CQC, and has the CQC checked that it was completed?
This was an announced inspection of the overall service, covering all five key questions and reviewing three people's care records. This explanation was written from the published report of 13 January 2017 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 Proctor Residential Care Home Limited
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- March 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Proctor Residential Care Home Limited →
- January 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Proctor Residential Care Home Limited →
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 January 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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