CQC report explained · a nursing home
What the CQC found at Pytchley Court Nursing Home
Rated Outstanding: inspectors found the home performing exceptionally well.
What inspectors found, October 2020
Rated Requires Improvement; inspectors found concerns about infection control, staffing levels, care records and management oversight.
This was an unannounced focused inspection on 1 September 2020. Inspectors looked only at Safe and Well-led, after concerns about staff training, record keeping and clinical oversight. They reviewed records, medicines, recruitment files and management information, and spoke with staff, one person and relatives.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found that infection control procedures were not always followed, some risk plans were not consistently followed, and not all staff or relatives felt there were enough staff. Care records were incomplete and checks by managers had not always found problems.
There were also positive findings. Medicines were generally managed safely, staff knew people well, recruitment checks were completed, and relatives spoken with were positive about the care. The home remained Requires Improvement, the same as at the previous inspection in April 2019.
The inspection found a breach of Regulation 17 about good governance. CQC asked for an action plan and said it would continue to monitor the home and return under its reinspection programme.
Medicines
Medicines were generally managed safely, with administration records usually signed correctly. Staff responsible for medicines had received training.
“Medicine administration record's (MAR) were signed accurately to indicate medicine had been administered to people as prescribed.” from the report
Staff knew people
Inspectors saw staff supporting people who knew their needs and communicated effectively with them.
“We saw people being supported by staff who knew them well and communicated effectively with them.” from the report
Positive relatives' views
The relatives spoken with gave positive feedback about the care and support provided.
“Relatives we spoke to were all positive about the care and support given by staff.” from the report
Recruitment checks
The home completed DBS checks and obtained references from previous employers, helping check that staff were suitable for care work.
“Records confirmed that Disclosure and Barring Service (DBS) checks were completed and references obtained from previous employers.” from the report
Infection control
seriousPPE was not always disposed of correctly. Cleaning schedules did not show whether high-touch areas were cleaned regularly.
“PPE was not always disposed of appropriately.” from the report
Incomplete care records
seriousRecords did not consistently show that planned care had happened. Examples included gaps in repositioning records and missing fortified milkshakes.
“Records of care were not always documented or kept up to date.” from the report
Management oversight
seriousAudits and checks did not reliably identify problems, and some actions were not recorded. This led to a breach of Regulation 17.
“The provider failed to have systems and processes in place to assess, monitor and improve the quality and safety of care and to maintain accurate and complete records.” from the report
Staffing levels
needs fixingSome staff and relatives did not feel there were enough staff. Inspectors said people may not always have received the support they needed, although they found no evidence of harm.
“This meant people may not always have received support as needed, however we found no harm to people.” from the report
Risk plans not always followed
seriousStaff did not consistently record or follow some risk management instructions, including repositioning and monitoring constipation.
“However, staff had not consistently followed these strategies.” from the report
- 01What changes have you made to PPE disposal, isolation signage and cleaning of high-touch areas since the inspection?
- 02How do you now check that repositioning, bowel monitoring, food and drink support and other planned care are recorded every day?
- 03How many staff are on each shift now, and how do you decide whether staffing is enough for people's individual mobility and eating needs?
- 04What action did you take in response to the Regulation 17 breach, and what evidence can you show that the changes are working?
- 05How are medicine records now checked, including the reasons for giving medicines prescribed as required?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from previous comprehensive inspections. This explanation was written from the published report of 2 October 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.
What inspectors found, April 2019
Rated Requires Improvement; inspectors found kind and responsive care, but safety records and management systems still needed strengthening.
This was an unannounced inspection on 18 March 2019. Inspectors spoke with people living at the home, relatives, staff and a visiting GP. They observed care and checked care records, medicines records, staff files, rotas, complaints, incidents and audits.
The home had made significant improvements since the previous inspection. Staff identified changes in people's health and sought medical help promptly. People were treated with kindness, involved in their care and supported with food, activities, health appointments and end of life wishes.
Some important systems were not yet reliable. Records about behaviours, care plans and some medicines were incomplete. The home also needed to prove that its new safety and management systems would continue to work with a full service and new management.
The overall rating was Requires Improvement. Effective, caring and responsive were rated Good. Safe and well-led were rated Requires Improvement. The home had been in special measures after the previous inspection but was taken out of special measures after this inspection.
Prompt medical help
Staff had been trained to recognise when people's health deteriorated. Inspectors found that medical help was sought in good time.
“Audits showed staff acted promptly and sought medical assistance in a timely way.” from the report
Kind and respectful care
People had positive relationships with staff. Staff protected people's dignity, involved them in decisions and spent time offering companionship.
“People had developed positive relationships with staff. Staff had a good understanding of people's needs and preferences.” from the report
Enough staff
Inspectors found enough staff were deployed to meet people's needs. Agency staff were used, with regular agency workers used where possible for continuity.
“There were enough staff deployed to meet people's needs.” from the report
Personalised support
People and relatives were involved in care planning. Plans included people's histories, preferences and important relationships.
“People and where appropriate, their relatives had been involved in updating and creating care plans that were person-centred.” from the report
Incomplete behaviour records
needs fixingStaff did not consistently record what happened, what triggered behaviours or what action was taken. This could delay accurate assessment and treatment.
“However, staff did not reliably record every occurrence, what triggered the behaviours, or what actions they took and the outcome.” from the report
Care plans not always current
needs fixingSome care plans did not reflect people's current needs, including the equipment needed for safe movement.
“Staff had not ensured all care plans had been updated to reflect people's current needs.” from the report
Medicines recording
needs fixingThe home needed to improve records showing where and when creams should be applied and to check medicine stock levels more accurately.
“Further improvements were required to record where and when to apply creams and check the accuracy of stock levels.” from the report
Management systems still developing
needs fixingThe home had no registered manager, and inspectors had not yet seen whether the new systems would remain effective with a full service and new management.
“Systems needed to be embedded into practice; such as assessing and monitoring people's health, clinical oversight, risk assessment reviews and staff supervision and mentoring.” from the report
- 01How do you now make sure every occurrence of behaviour, its trigger, the response and the outcome are recorded?
- 02How often are care plans reviewed, and how do you check they reflect people's current equipment and needs?
- 03How are cream application records and medicine stock levels checked now?
- 04Who is currently responsible for the home while there is no registered manager?
- 05What evidence shows that the new health, risk assessment and supervision systems are working consistently?
This was a planned inspection covering all five key questions; it followed a focused inspection of Safe and well-led in September 2018, when the home was rated Inadequate and placed in special measures. This explanation was written from the published report of 27 April 2019 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 Pytchley Court Nursing Home
8 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- October 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- January 2019Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 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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At least 100 live-in carers within about an hour of West Northamptonshire
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 £1,280 a week. 87 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
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.