CQC report explained · a nursing home
What the CQC found at Queens Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with safe medicines systems, risk assessments, suitable staffing and infection control measures. Inspectors recommended reviewing instructions for medicines given when needed, and noted that some fluid charts were incomplete.
- Effective?
- Good
- This area was not assessed during this focused inspection.
- Caring?
- Good
- This area was not assessed during this focused inspection.
- Responsive?
- Good
- This area was not assessed during this focused inspection.
- Well-led?
- Good
- A registered manager was in place, supported by a deputy manager. Audits and other checks were being used, and inspectors found the management responsive to concerns.
What inspectors found, October 2020
Rated Good; inspectors found safe care and improved management, but some medicines guidance and records needed attention.
This was an unannounced, focused inspection prompted by wider concerns about medicines and nursing care. Inspectors reviewed only Safe and Well-led. They spoke with people, relatives and staff, observed care, and checked care, medicines, training and management records.
The home was rated Good for Safe and Well-led. Inspectors found trained staff administered medicines safely, enough staff were on duty, recruitment checks were completed, and infection control arrangements were suitable. Risks were assessed and the earlier problem with bed rail documentation had been addressed.
There were still some weaknesses. Instructions for medicines given when needed did not always give staff enough detail. Some fluid charts had not been totalled. The overall rating improved from Requires Improvement to Good, based on this inspection.
Safe medicines administration
Medicines were administered by trained staff, with checks that staff remained competent. Audits had identified areas for improvement and actions had been taken.
“Only staff who were fully trained administered medicines and checks were in place to ensure staff remained competent in this task.” from the report
Enough staff
Inspectors observed enough staff on duty to keep people safe and meet their needs. Recruitment checks were also completed.
“We made observations that there were enough staff on duty to keep people safe and meet their needs.” from the report
Risks were better documented
The earlier problem with bed rail consent and safety records had been addressed. Care plans included assessments for falls, moving and repositioning, bed rails and malnutrition.
“At this inspection this had been addressed.” from the report
Improved management
A registered manager was now in place, supported by a deputy manager. Inspectors found quality checks were in use and that the manager acted quickly on minor concerns.
“A registered manager was now in place and was supported by a deputy manager.” from the report
Fluid records
needs fixingSome fluid charts had not been totalled. This meant it was uncertain whether concerns would be identified quickly enough for action.
“Some fluid charts had not been totalled so it was uncertain if any concerns would be identified quickly to enable appropriate action to be taken.” from the report
Previous changes in managers
minorSome relatives described a long period of changing managers and mixed views about communication. They also said things had improved during the year before the inspection.
“They have had a long string of managers. I don't know who it is, but in the last year there has been an improvement.” from the report
- 01How have you changed the protocols for medicines given when needed, especially for people who cannot clearly describe pain?
- 02How do you now check that fluid charts are totalled and that concerns are acted on quickly?
- 03Who is currently responsible for managing the home, and how long have they been in post?
- 04What checks are used to make sure staff remain competent to administer medicines?
- 05What improvements have been made to nursing care since the concerns that led to this focused inspection?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not assessed in this report. This explanation was written from the published report of 24 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, February 2020
Queens Court Nursing Home rated Requires Improvement; inspectors found kind, personalised care but safety records and leadership needed improvement.
This was an unannounced planned inspection on 11 December 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed care and activities, and checked care records, medicines, staff files and management records.
The overall rating was Requires Improvement. Safe and well-led were rated Requires Improvement. Effective, caring and responsive were rated Good. The home had improved staffing, medicines management, cleanliness, activities and care planning, but some bedrail information was unclear.
Inspectors also found the home had not had a registered manager since November 2018, despite this being a condition of its registration. The new manager was not yet registered. The home was asked to review several areas, including bedrail processes, dementia meal choices and staff knowledge of the Mental Capacity Act.
The previous overall rating was Good at the inspection on 24 April 2017. CQC said it would continue to monitor the home and inspect again through its re-inspection programme.
Kind and respectful care
Inspectors saw staff spending time with people and supporting them gently. People and relatives said staff were kind, friendly and respectful.
“People were treated individually and respectfully, and their privacy and dignity protected.” from the report
Personalised support
Care plans recorded people's routines, interests and preferences. Staff knew people's backgrounds and what mattered to them.
“Care plans contained personalised and detailed information about the way people liked to be supported and what was important to them.” from the report
Bedrail information
seriousThree people had bedrails in place even though their care plans said they did not need them. The plans were updated during and after the inspection, but the home needed stronger monitoring and clearer information for all staff.
“This meant there was a risk staff could put these rails up if clear information was not provided in the care plan.” from the report
No registered manager
needs fixingThe home had not had a registered manager for over a year, despite a registration condition requiring one. The new manager was not yet registered when inspectors visited.
“Satisfactory steps have not been taken to recruit and retain a suitable registered manager within a reasonable timescale.” from the report
Meal choices for people with dementia
needs fixingPeople chose meals the day before, but inspectors said this might not work well for people living with dementia who may not remember their choice.
“However, for people living with dementia, these timescales could prove difficult as they may not remember making this choice.” from the report
Mental Capacity Act records
needs fixingStaff understood the Mental Capacity Act in general, but knowledge and records about bedrails and falls sensor mats were not always up to date.
“However, staff knowledge and the recording of people's need for bed rails and falls sensor mats was not always up to date.” from the report
- 01Is there now a registered manager, and how long have they been in post?
- 02How do you check that bedrails are only used when needed and that care plans are kept up to date?
- 03How are permanent and agency staff told about changes to bedrail and falls sensor mat instructions?
- 04How do people living with dementia choose their meals at the time they are served?
- 05What training have staff received on the Mental Capacity Act since this inspection?
This was an unannounced planned inspection covering all five CQC questions, the premises and the care provided. This explanation was written from the published report of 6 February 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 Queens Court Care Home
6 rated inspections over 5 years: the service has improved, from Inadequate to Good.
- October 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016Inadequatestayed InadequateSafe: InadequateEffective: InadequateWell-led: Inadequate
- December 2015InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 31 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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