CQC report explained · a residential care home
What the CQC found at Regency Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2023
Regency Care Home is rated inadequate and remains in special measures; inspectors found improvements but one repositioning plan was not always followed.
This was an unannounced targeted inspection on 19 July 2023. Two inspectors checked whether the home had acted on earlier warning notices about safe care, staffing and governance. They reviewed care plans, records, medicines, training and audits, and spoke with people, a relative and staff.
Inspectors found improvements in medicines management, care records, infection control, staff training and management oversight. They said people generally received their medicines as prescribed and risks were mostly managed in line with care plans.
There were still some shortfalls. One person's repositioning guidance was not always followed. Cleaning products were also briefly kept in an unlocked kitchenette cupboard, although they were removed and stored securely during the inspection.
The overall rating remains inadequate and the home remains in special measures. This was a targeted inspection, so the ratings were not reassessed and the inspectors did not examine the whole of each key question.
Medicines
Medicines were stored correctly, records were accurate and people received medicines as prescribed.
“People received their medicines as prescribed as improvements were seen in the ordering and supply of medicines.” from the report
Cleanliness
Inspectors saw improvements in cleaning and infection control. Bedrooms, bathrooms and shared areas appeared clean.
“Bathrooms', communal areas and people's bedrooms appeared clean.” from the report
Staff training
Training, supervision and competency checks had improved, helping staff carry out their roles safely.
“People were supported by staff who were trained to carry out their roles.” from the report
Management oversight
Audits and systems for reviewing accidents, incidents and risks had improved. The home was better at identifying actions needed.
“Audits identified risk and the actions needed to address the risk.” from the report
Repositioning plan not always followed
needs fixingOne person's repositioning guidance was not consistently followed. The person's pressure sore was healing, but staff were reminded to follow the plan.
“We identified that for one person their repositioning guidance was not consistently followed.” from the report
Cleaning products briefly left unsecured
needs fixingTwo spray bottles were found in a kitchenette cupboard. They were removed during the inspection and the home said they would be stored securely afterwards.
“One kitchenette cupboard had 2 spray bottles of cleaning substances in.” from the report
No registered manager
minorThere was no registered manager in post at the time of the inspection. An interim manager was in place and had received positive feedback.
“At the time of our inspection there was no registered manager in post.” from the report
- 01How do you check that each person's repositioning plan is followed every time?
- 02How are cleaning products stored when staff are using them in communal areas?
- 03What is the current plan for appointing and registering a permanent manager?
- 04Which staff still need refresher training, and how do you check their competence before they provide care?
- 05What improvements have been made since this inspection and what evidence can you show the family?
This was a targeted inspection of specific concerns under Safe, Effective and Well-led; the whole key questions were not assessed, and Caring and Responsive were not covered. This explanation was written from the published report of 7 September 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, May 2023
Queensferry Court Care Home was rated Inadequate and placed in special measures after inspectors found serious safety, training, nutrition and management problems.
This was an unannounced focused inspection on 21 March 2023. Inspectors, a pharmacist inspector and a specialist nurse advisor spoke with people, relatives and staff, observed communal areas, and checked care, food and fluid, medicine and management records.
The home was rated Inadequate for Safe, Effective and Well-led. Inspectors found unsafe medicines management, gaps in pressure care and risk records, poor cleaning and environmental risks. People were also at risk of dehydration and malnutrition, and some staff had not received the training needed for their roles.
The home had enough staff and followed safe recruitment checks. Inspectors also saw kind and respectful interactions, and found that people's diets and preferences were catered for. However, the overall rating fell from Good at the previous inspection to Inadequate because the problems were widespread and significant.
Enough staff
Inspectors found enough staff on duty, with communal areas supervised and people's requests answered quickly. People and relatives also said staffing had improved.
“There were enough staff employed to support people.” from the report
Safe recruitment
The provider completed pre-employment checks before staff worked with people.
“The provider followed safe recruitment practices. Pre-employment checks had been made before staff worked with people.” from the report
Kind interactions
Inspectors saw respectful relationships between staff and people. Some people and relatives spoke warmly about individual care staff.
“We observed kind, respectful interactions and genuine relationships between staff and people.” from the report
Choice and best interests
People were supported to make choices where possible. Staff understood the Mental Capacity Act principles, and applications for safeguards had been made where needed.
“People were supported to have maximum choice and control of their lives” from the report
Food preferences
The cook had information about people's dietary, cultural and health needs. People said they enjoyed the food and mealtimes were relaxed.
“People's diets and preferences were catered for.” from the report
Unsafe medicines
seriousSome people did not receive medicines as prescribed. Inspectors found missing medicines, an out-of-date pain relief medicine, problems with patches and concerns about covert medicines and storage temperatures.
“Medicines were not managed safely, and people did not always receive their medicines as prescribed.” from the report
Pressure care and other risks
seriousRisk information was incomplete or inconsistent. Records showed gaps of up to 24 hours in repositioning for one person who had skin concerns and discomfort.
“Healthcare professionals had advised 1 person required hourly re-positioning to support with pressure relief.” from the report
Food and fluids
seriousFood and fluid records were missing or incomplete for people at risk. Some records showed very low fluid intake, and drinks were not always provided promptly.
“People were at risk of malnutrition and dehydration.” from the report
Staff training
seriousNot all staff had completed mandatory training, including manual handling and fire safety. Staff also lacked knowledge about dehydration and did not receive regular supervision or competency checks.
“Staff were not always appropriately trained to carry out their roles.” from the report
Poor cleanliness and environment
needs fixingSome areas, furniture and equipment were visibly dirty. Carpets were damaged and unclean, and unsafe items were accessible in communal kitchenettes.
“The home was not cleaned to a high standard.” from the report
Weak management oversight
seriousAudits did not accurately show the risks inspectors found. Incidents were not reviewed quickly or fully, and staff did not always understand their responsibilities.
“The providers systems to monitor risk within the service were not effective.” from the report
- 01What changes have been made to ensure medicines are ordered, stored, checked and given as prescribed?
- 02How do you now record and check repositioning, pressure care, falls risks and other health risks?
- 03How do you monitor people's food and fluid intake, and what happens when someone is not drinking enough?
- 04Which mandatory training and competency checks have all staff now completed?
- 05Who is currently managing the home, and how are audits and incidents checked to make sure problems are acted on quickly?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward when calculating the overall rating. This explanation was written from the published report of 18 May 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 Regency Care Home
5 rated inspections over 8 years: the service has slipped, from Good to Inadequate.
- September 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- May 2023InadequateSafe: InadequateEffective: InadequateCaring: GoodResponsive: GoodWell-led: Inadequate
- February 2022Inspected but not ratedSafe: Inspected but not rated
- April 2021GoodSafe: Requires improvementEffective: GoodWell-led: Good
- February 2021Inspected but not ratedSafe: Inspected but not rated
- October 2020Inspected but not ratedSafe: Inspected but not rated
- July 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2020
Registered with the Care Quality Commission on 13 January 2020.
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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