CQC report explained · a nursing home
What the CQC found at Romford Nursing Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People's risks were assessed and monitored, medicines were generally managed safely, and infection control arrangements were satisfactory. Inspectors found one omitted signature on a medicine record and recommended clearer wording in some protocols.
- Effective?
- Good
- Staff had training, induction, supervision and appraisal. People were supported with food, drink and healthcare, although some healthcare plans were not always followed strictly.
- Caring?
- Good
- People and relatives described staff as caring. Inspectors observed respectful, patient interactions, including with people living with dementia, and found that privacy, dignity and independence were promoted.
- Responsive?
- Good
- Care plans reflected people's needs and preferences. The home responded appropriately to complaints, met communication needs and provided personalised activities, although one person's end of life wishes had not appeared to be recorded.
- Well-led?
- Good
- The home had a clear management structure and quality checks to identify and address shortfalls. People, relatives and staff had opportunities to give feedback, and inspectors found a positive culture.
What inspectors found, November 2021
Rated Good; inspectors found kind, personalised care and improvements since earlier inspections, with some medicines records and staffing concerns.
The unannounced inspection took place on 9 September 2021. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicine records, staff files and management records. They also checked infection prevention and control.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were treated with kindness and dignity, their care was personalised, and their health, food, drink and activities were generally well supported.
The home had improved from Requires Improvement at the previous comprehensive inspection. Staffing levels had improved and earlier breaches about safe care, staffing, nutrition and governance were no longer in place. Inspectors still recommended clearer wording in some medicine protocols and found a small number of recording shortfalls.
Caring staff
People and relatives gave positive feedback about staff. Inspectors saw staff supporting people patiently, respectfully and without rushing them.
“People were well treated and supported by staff.” from the report
Personalised care
Care plans recorded people's needs, preferences and communication requirements. Activities and support were adapted to individuals.
“People received personalised care.” from the report
Improved safety
Risk assessments, equipment checks and safeguarding systems were in place. The home was no longer in breach of the safe care regulation.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.” from the report
Learning and oversight
Incidents were reviewed and lessons were shared. Audits covered areas including medicines, care plans, weights and equipment.
“There were quality assurance systems to ensure effective monitoring of safety of people in the home.” from the report
Improved staffing support
Staffing levels had improved since the previous inspection, recruitment checks were robust, and staff received training and supervision.
“Staffing levels had improved since our last inspection and the provider was actively engaging in recruitment.” from the report
Medicine record gap
needs fixingOne medicine administration record had a missing signature. Audits were expected to identify this, and the provider said the medicine had been given.
“However, we noted one gap in someone's MAR chart, where a signature had been omitted.” from the report
Staffing views
needs fixingAlthough rotas showed the required staffing levels, people and relatives had mixed views about staffing levels and staff turnover. The provider was still recruiting.
“Similar to our last inspection in August 2020, people and relatives had mixed views on staffing levels and staff turnover.” from the report
Care records
needs fixingSome healthcare plans were not always followed strictly, although the provider showed that people had received adequate care. One person's end of life wishes also appeared not to have been recorded.
“We saw that some health care plans were not always being strictly followed.” from the report
- 01How do you make sure every medicine administration record is signed and checked?
- 02What changes have you made to ensure instructions for medicines given when needed are clear?
- 03How many care staff are normally on each unit, and how often do you use agency staff?
- 04How do you make sure staff follow each person's healthcare plan?
- 05How are each person's end of life wishes recorded and kept up to date?
This was a planned inspection covering all five key questions and infection prevention and control, following an earlier Requires Improvement rating and previous breaches. This explanation was written from the published report of 12 November 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.
What inspectors found, November 2020
Targeted inspection not rated; the home remained Requires Improvement, with breaches over staffing and nutrition and hydration.
This was a targeted inspection on 12 August 2020. Inspectors followed up concerns about staffing, people's safety, incidents, nutrition, activities and quality checks. They also checked infection prevention and control during the COVID-19 pandemic.
Inspectors found that staffing levels were sometimes below the home's own requirements. At times, there was no nurse rostered in one nursing unit, and two care staff were working on one unit. Inspectors found no evidence that anyone had been harmed, but said people were placed at risk.
The home had suitable recruitment checks, recorded incidents appropriately and had clean premises with PPE available. However, some staff did not wear PPE correctly, one person's drink was given before thickener was added, and people reported limited activities and mixed experiences of food and personalised care.
The inspection was not rated and did not change the previous ratings. The overall rating therefore remained Requires Improvement from the last comprehensive inspection, and the report identified continued breaches of staffing and nutrition and hydration regulations.
Safe recruitment
The home carried out checks on staff before they started work, including criminal record, identity and employment history checks.
“There were robust recruitment processes.” from the report
Learning from incidents
Incidents and accidents were recorded, followed up and used to update care plans and risk assessments.
“This showed people were kept as safe as possible, as the service learned lessons when things went wrong to minimise risk of re-occurrence.” from the report
Infection control
Inspectors found the home clean, with PPE available, and were assured about several infection prevention arrangements.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Personalised records
Care plans recorded people's likes, dislikes, life histories, health needs and risks. They were reviewed when people's needs changed.
“People's likes, dislikes and life histories were also recorded so staff had the opportunity to find out about people and their interests.” from the report
Staffing levels
seriousUnits were not always staffed to the home's own required level. Inspectors found occasions with no nurse rostered in one nursing unit and occasions with only two care staff on duty.
“We found no evidence that people had been harmed however, the provider had not deployed sufficient number of suitably qualified, competent, skilled and experienced staff.” from the report
Nutrition and choking risk
seriousA person who needed thickened drinks received the drink before the thickener was added. Inspectors said this could have allowed the person to drink an unsafe liquid and choke.
“This was not best practice as there was a risk this person could drink liquids without thickener and potentially choke.” from the report
Limited activities
needs fixingPeople said there was little to do, particularly at weekends. The activities coordinator had left and the home was seeking a replacement.
“It can be very boring here. Sundays and weekends are the worst. There is nothing to do.” from the report
Quality checks missed concerns
needs fixingThe home's audits and checks did not identify concerns that people and inspectors had about staffing and food.
“However, these quality assurance processes had not picked up people's concerns with staffing or food.” from the report
PPE use
needs fixingAlthough infection control arrangements were generally in place, inspectors saw some staff wearing masks incorrectly or not wearing gloves when providing food.
“However, we noted at times where staff wore masks incorrectly or were not wearing gloves when providing food.” from the report
- 01How many staff are planned for each unit on every shift, and how do you check this against residents' current needs?
- 02How do you ensure a nurse is available in each nursing unit when clinical support is needed?
- 03What checks now prevent a person from receiving a drink before the required thickener has been added?
- 04What regular activities are currently available, especially at weekends, following the departure of the wellbeing and activities coordinator?
- 05How are residents' concerns about food quality and choice recorded, acted on and checked for improvement?
This was a targeted inspection of specific concerns about staffing, safety, incidents, nutrition, activities, quality checks and infection control; it did not assess all parts of the five key questions, so the existing ratings carried over. This explanation was written from the published report of 21 November 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 Romford Nursing Care Centre
5 rated inspections over 6 years: the service has held its Good rating throughout.
- November 2021Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2020Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- September 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2016Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015
Report published without a new overall rating.
- October 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- May 2011
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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