CQC report explained · a residential care home
What the CQC found at Providence Court
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, July 2023
Rated Good overall, but Safe Requires Improvement; inspectors found major progress after earlier safety failures, with some medicines checks still needing work.
This was an unannounced follow-up inspection. Inspectors visited on 23 May 2023, spoke with people, relatives, staff and professionals, and reviewed care records and other documents. The inspection activity continued until 13 June 2023.
The home had improved significantly since its previous inadequate rating. People told inspectors they felt safe and well supported. Staffing had increased, risks were better managed, safeguarding systems were in place, and care plans were more complete.
Safety was still not fully reliable. Inspectors found out-of-date eyedrops, gaps in staff knowledge about blood-thinning medicines and some missed handwashing. One person was not initially positioned fully upright for eating. These issues led to a Requires Improvement rating for Safe.
The other four areas were rated Good: Effective, Caring, Responsive and Well-led. The home was no longer in breach of regulations and was taken out of special measures. A Good rating means inspectors found the service was consistently managed and that people's outcomes and care were generally good.
Significant improvement
The home had improved from its previous inadequate rating. Inspectors found the provider was no longer breaching regulations.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff asking permission, protecting privacy and responding with compassion.
“All observations found staff to be attentive and caring about the people they supported.” from the report
Better staffing
Staffing levels had increased since the previous inspection, and inspectors found people's needs were met in a timely way.
“At this inspection we found staffing had been increased and people's needs were met.” from the report
Stronger management oversight
The management team used audits, checks and an improvement plan to identify problems and track action.
“The management team had worked on an improvement action plan to give an overview of performance and any areas that needed addressing.” from the report
Medicines practice
needs fixingInspectors found out-of-date eyedrops, a staff member who did not know the risks of blood-thinning medicines, and handwashing that was not always carried out. The manager acted on the eyedrops issue, but said medicines checks needed to be more robust.
“We found eyedrops for 1 person that were out of date.” from the report
Meaningful activities
minorInspectors saw limited meaningful engagement outside care tasks on one unit. Work was still under way to involve care staff more in activities.
“Sometimes there was a lack of meaningful engagement observed outside of care tasks.” from the report
Communication support
needs fixingFor one person whose first language was not English, staff could not find or use the communication booklet. The manager said this would be put in place.
“For the other person, while staff thought there was a booklet, they did not use it and could not locate it.” from the report
- 01What action have you taken since the inspection to make sure eyedrops and other medicines are always in date?
- 02How do you check that staff understand the risks of blood-thinning medicines and always wash their hands when giving medicines?
- 03How do you make sure people are positioned safely when eating and drinking?
- 04What has changed to provide meaningful activities and regular engagement for people who prefer to stay in their rooms?
- 05How do you now support the person whose first language is not English, and where is their communication booklet kept?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also reviewed under Safe; it followed an earlier comprehensive inspection that rated the home inadequate and placed it in special measures. This explanation was written from the published report of 1 July 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, February 2023
Rated Inadequate and placed in special measures; inspectors found serious safety, staffing, dignity and leadership problems.
This was an unannounced inspection. It started as a targeted inspection because of concerns about standards of care, changes in people's health, management and staffing. Inspectors widened it to a comprehensive inspection covering all five key questions.
Inspectors found that people's safety was not consistently protected. Problems included poor infection control during a COVID-19 outbreak, delays in care, unsafe medicines practices, missed changes in health, and staff not always having quick access to people's care information. There were also concerns about staffing levels and staff training.
People were not always treated with dignity. Inspectors saw a person using the toilet in view of a communal area and heard staff discussing personal care loudly. Activities and interaction were limited for some people, and complaints were not always answered.
The overall rating fell from Good at the previous inspection, published in June 2018, to Inadequate. Safe and well-led were rated Inadequate. Effective, caring and responsive were rated Requires Improvement.
Choice and legal safeguards
Inspectors found that the home supported people to make choices where possible and used best-interest decisions and legal authorisations appropriately.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Food and nutrition plans
People had documented dietary needs, weight monitoring and plans to support those at risk of losing weight.
“People's dietary needs and preferences were documented in their care plans.” from the report
Family contact
People were supported to keep in touch with relatives and friends, and visitors could visit freely with controls such as mask wearing.
“People were supported to maintain contact with family and friends.” from the report
Access to help
People had call bells or sensor mats available, although inspectors found that calls sometimes rang for too long.
“People had access to their call bells or sensor mats were in place to help alert staff to their need for assistance.” from the report
Safety and infection control
seriousInfection control was not reliable during a COVID-19 outbreak. Inspectors found poor handwashing, incorrectly worn masks, empty hand-gel dispensers and unclear information about which units were affected.
“We were not assured that the provider was using PPE effectively and safely.” from the report
Delayed and unsafe care
seriousPeople sometimes waited for continence care, repositioning, call-bell responses and pain relief. Staff did not always recognise changes in health or use pressure equipment correctly.
“People's needs were not always met in a timely way by staff to reduce risks.” from the report
Safeguarding
seriousInstructions from the local safeguarding team after a serious allegation had not been put into action. A medicines error had also not been reported appropriately.
“We found that instructions given by the safeguarding team had not been actioned.” from the report
Dignity and privacy
seriousInspectors saw a person using the toilet in full view of a communal area. Staff also spoke loudly about people's personal care needs.
“The person was in full view of people sitting in the communal area.” from the report
Staffing and training
seriousPeople, relatives, staff and health professionals raised concerns about staffing levels. Some training updates were overdue, and important subjects such as diabetes had not been covered for all relevant staff.
“Due to people needing to wait for support and staff skills and knowledge not being consistently updated or in place to ensure people's safety, this was a breach of regulation 18” from the report
Weak management oversight
seriousManagement audits had identified some problems but had not fixed them. The home had no registered manager in post, had experienced four managers in a year, and staff reported low morale and limited support.
“The issues found within the homes governance monitoring systems had an impact on people's safety and standard of care received.” from the report
- 01What has been done to make sure staff can access each person's current risks, needs and care instructions at all times?
- 02How are staffing levels now matched to people's needs, and how are delays to call bells, continence care and repositioning being monitored?
- 03What changes have been made to infection control, including handwashing, mask use, cleaning and managing outbreaks between units?
- 04How are medicines, pain relief and safeguarding incidents now checked, recorded and reported?
- 05Who is managing the home now, and how are relatives told about progress against the CQC action plan?
This began as a targeted inspection of specific concerns and was widened to a comprehensive inspection covering Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 10 February 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.
Every inspection of Providence Court
6 rated inspections over 8 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2023Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 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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