CQC report explained · a nursing home
What the CQC found at Puddingstone Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe, and inspectors found risks had been assessed and managed. They found enough staff, safe medicines arrangements and suitable infection control.
- Effective?
- Good
- This question was not inspected during this visit. Its rating was carried forward from the previous inspection when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this visit. Its rating was carried forward from the previous inspection when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this visit. Its rating was carried forward from the previous inspection when calculating the overall rating.
- Well-led?
- Good
- Managers had oversight of the home and systems were in place to monitor quality and safety. Inspectors found that some records were not updated or completed consistently.
What inspectors found, November 2022
Rated Good; inspectors found safe care and good leadership, but some care records were not updated promptly.
This was an unannounced inspection on 28 September 2022. Inspectors spoke with 18 people, two relatives and 10 staff. They reviewed care, risk and medicine records, staff recruitment files and management records.
The home was rated Good for Safe and Well-led. People said they felt safe. Inspectors found suitable risk plans, enough staff, safe medicines management, suitable infection control and systems for learning from incidents. Managers were visible and quality checks were being carried out.
The inspection followed notification of an incident involving a death. The report says it did not examine the circumstances because of a criminal investigation. It did examine falls risks and found that action taken by the home had reduced the risk. The overall Good rating also used ratings from the previous inspection for areas not inspected this time.
Falls risk was addressed
The inspection was prompted by concerns about falls risk. Inspectors found that the home had taken effective action to reduce this risk.
“We found no evidence during this inspection that people were at risk of harm from this concern.” from the report
Safe staffing arrangements
Inspectors found enough staff to meet people's needs safely. Recruitment checks were completed before staff started work.
“People were supported by enough staff on each unit to ensure their needs were safely met.” from the report
Safe medicines systems
Medicines were stored, administered and checked safely. Staff supporting people with medicines had training and competency checks.
“Regular medicines checks were carried out to ensure people were receiving their medicines as prescribed by healthcare professionals.” from the report
Visible management
Managers were present in the home and people said they checked on residents and staff. The home used meetings, surveys and other feedback to make improvements.
“Managers were visible in the home and people told us they came around daily to greet them and ask about their welfare.” from the report
Care records were not always up to date
needs fixingSome records were not reviewed within the required timescales. Oral risk assessments, mattress checks and repositioning instructions were not consistently recorded.
“some records were not always reviewed promptly or within the time scales specified.” from the report
Staffing could sometimes feel stretched
minorOne person said staff were sometimes thin on the ground. Staff also said agency workers had recently been needed, although inspectors judged arrangements adequate at the time.
“Sometimes they're a bit thin on the ground and they need a few more but most of the time it's alright.” from the report
Recent management changes affected staff
minorA management restructure had caused some problems, and some issues remained unresolved. Head office staff were providing extra support and staff said the culture was improving.
“At the time of this inspection, there were still some unresolved issues.” from the report
- 01What has been done since the inspection to keep oral risk assessments and repositioning instructions up to date?
- 02How are airflow mattress checks recorded now, and who checks that the records are complete?
- 03What are the usual staffing levels on each unit, and how often are agency staff used?
- 04What unresolved issues remained after the management restructure, and what action has been taken?
- 05Which ratings for Effective, Caring and Responsive were carried forward from the previous inspection?
This was an unannounced focused inspection of Safe and Well-led, including falls risks; ratings for the other key questions were carried forward from the previous inspection. This explanation was written from the published report of 11 November 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, March 2021
Puddingstone Grange was inspected but not rated; inspectors were assured that infection prevention and control arrangements were safe.
The inspection was unannounced and took place on 4 March 2021. It was a targeted inspection focused on infection prevention and control during the coronavirus pandemic.
Inspectors found that visitors were screened, visits were managed safely and suitable protective equipment was available. New residents needed a negative COVID-19 test and were isolated for 14 days with regular checks.
The home was clean and had cleaning schedules, infection control policies and audits. The service was inspected but not rated, so this report does not give an overall quality rating.
Managed visits
Visits were booked and visitors were screened for respiratory infections. Staff supported visitors to use protective equipment and follow distancing rules.
“All visits were booked in advance and visitors were screened for any acute respiratory infections which included a temperature check and a COVID-19 test.” from the report
Safe admissions
New residents needed a negative COVID-19 test before moving in and were isolated for the first 14 days, with regular monitoring.
“New admissions needed a negative COVID-19 test result before they moved in.” from the report
Protective equipment
Staff had access to protective equipment, received infection control training and used the equipment appropriately.
“Staff wore PPE appropriately and, where preferred, people were supported to wear face masks.” from the report
Clean environment
Inspectors found the home clean and without unpleasant smells. A cleaning schedule was in place.
“The home appeared clean and free from odour.” from the report
Inspectors raised no specific concerns in this report.
- 01How have your visiting arrangements changed since the March 2021 inspection?
- 02What COVID-19 or other infection testing is currently offered to residents, staff and visitors?
- 03How are new residents assessed and supported during their first days in the home?
- 04How do you check that staff are using protective equipment correctly?
- 05How often are visiting areas and other shared areas cleaned, and how is this recorded?
This was an unannounced targeted inspection of infection prevention and control only, so the service was inspected but not rated and the other care questions were not assessed. This explanation was written from the published report of 19 March 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 Puddingstone Grange
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- November 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Inspected but not ratedSafe: Inspected but not rated
- January 2020Goodstayed GoodSafe: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Registered with the Care Quality Commission on 26 November 2013.
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 Greenwich
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 £1,250 a week. 87 can care for a couple. 11 years' experience on average.
“She cared for my mum with Alzheimer's with endless patience and kindness, always arriving with a smile and a positive attitude”
“Usha rapidly became 'one of the family' and is sorely missed.”
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.