CQC report explained · a nursing home
What the CQC found at Rushden Park
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Most risks had been identified and medicines, infection control and incident reporting had improved. However, unsafe furniture placement was seen and risks linked to manual and electric wheelchairs had not yet been assessed.
- Effective?
- Good
- Staff had relevant training and people were supported with eating, drinking, healthcare and decisions about their care. Improvements included better catheter and PEG care and monitoring of DoLS applications.
- Caring?
- Good
- People said staff were kind and caring, and inspectors saw privacy and dignity being respected. However, some staff did not always speak to people while providing support, and some relatives had not been involved in care planning.
- Responsive?
- Requires improvement
- Care plans better reflected people's histories, likes and dislikes, and social isolation had reduced. Communication needs were not always recorded or supported, and the new personalised care review system still needed to become established.
- Well-led?
- Requires improvement
- The home had introduced more audits, meetings and feedback systems, but these did not yet reliably identify and fix risks or poor records. The provider remained in breach of Regulation 17 because governance and leadership were not consistent enough.
What inspectors found, September 2023
Rushden Park was rated Requires Improvement; care was kind and more consistent, but safety checks, communication records and management oversight still needed work.
This was an unannounced follow-up inspection on 26 and 27 July 2023. Inspectors spoke with 11 people, 7 relatives and 14 staff. They reviewed care plans, medicines records, daily records, staff files and management information.
The home had improved since its previous Inadequate rating. Staffing had increased, medicines were generally managed safely, staff had more training, and people were treated with kindness and dignity. Inspectors also saw more social activity and found that complaints were being recorded and followed up.
Important problems remained. Furniture had been placed unsafely on crash mats, wheelchair risks had not been assessed, and communication needs were not always recorded. Management checks did not reliably find risks or poor records, so the home remained in breach of Regulation 17 on good governance.
The overall rating and the Safe, Responsive and Well-led ratings were Requires Improvement. Effective and Caring were rated Good. The home had been in Special Measures since April 2023, but it left Special Measures because it was no longer rated Inadequate.
More staff and fewer incidents
The provider had recruited more staff, and records showed fewer accidents and incidents than at the previous inspection. People and staff said there was more time for support and conversation.
“Accident and incident records showed there had been a reduction of incidents such as injuries and falls since the last inspection.” from the report
Kind and dignified care
People described staff as kind and caring. Inspectors saw staff respecting privacy and dignity during personal care.
“People we spoke with told us that staff were kind and caring.” from the report
Better support with health and nutrition
People at risk of poor nutrition or dehydration were monitored and encouraged to eat and drink. Staff also worked with healthcare professionals when needed.
“People at risk of malnutrition and dehydration were monitored and encouraged to eat and drink.” from the report
More social contact
People spent more time in communal areas and accessed the community. Activities, social events and trips had been arranged.
“Improvements had been made to ensure people did not suffer from social isolation.” from the report
Unsafe furniture placement
seriousInspectors saw chairs and tables placed on crash mats beside two people's beds. The furniture was unstable and could have caused harm.
“This meant the furniture was unstable and placed people at potential risk of harm.” from the report
Wheelchair risks not assessed
seriousRisks linked to manual and electric wheelchairs had not been assessed at the time of inspection. The provider said this would be done afterwards.
“Risks to people using manual and electric wheelchairs had not been assessed to ensure any potential risks to people were mitigated.” from the report
Weak management checks
seriousDaily checks did not always find environmental risks or poor records. This led to a continued breach of the good governance regulation.
“The provider's oversight systems and processes required further improvements, and consistent leadership to effectively assess, monitor and improve the quality and safety of the services provided.” from the report
Communication needs not recorded
needs fixingCare plans did not always explain how people with communication difficulties should be supported. Inspectors were not assured that suitable professional advice or communication tools had always been obtained.
“People's communication needs were not always recorded in their care plans to ensure staff had the information available to communicate with people in a way they understood.” from the report
Limited involvement in care planning
needs fixingSome relatives said they had not seen care plans or attended care plan reviews. This was passed to the management team to address.
“People we spoke with could not recall seeing or being involved with the planning of their care and feedback received from people's relatives confirmed this.” from the report
- 01What has been done to assess and manage risks for people using manual or electric wheelchairs?
- 02How do you now check that furniture, crash mats and other equipment are safe?
- 03How will my relative's communication needs be recorded, including any pictures, symbols, technology or professional advice they need?
- 04How will relatives be involved in care planning and regular care plan reviews?
- 05How are you checking that staff understand important training, including recognising when someone with diabetes may be unwell?
This was an unannounced follow-up inspection that assessed all five key questions and also checked infection prevention and control; the previous ratings had been Inadequate or Requires Improvement and all were reassessed. 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, April 2023
Rated Inadequate and placed in special measures; inspectors found serious risks, poor staffing and weak management oversight.
The inspection took place without notice on 7, 9 and 14 February 2023. Inspectors spoke with people, relatives and staff, and checked care plans, medicines records, daily records, policies and management records.
The home was rated Inadequate overall. Safe, Effective, Responsive and Well-led were rated Inadequate. Caring was rated Requires Improvement. Inspectors found people were at risk from poor catheter care, pressure care, constipation management, feeding records, medicines, staffing and environmental hazards.
There were also concerns about consent, staff training, dignity, activities, personalised care, complaints and how the home was managed. The home was clean, infection control arrangements were satisfactory, and staff worked with health professionals. The provider started an action plan during and after the inspection, but inspectors said improvements needed to continue and become part of everyday practice.
Infection control
Inspectors were assured that the home had arrangements to reduce infection risks, including safe use of protective equipment and outbreak management.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Health partnerships
Staff worked with GPs, dieticians, diabetic nurses and other professionals to support people's health.
“Staff worked in partnership with health and social care professionals to maintain people's health.” from the report
Privacy
Inspectors saw staff taking some practical steps to protect privacy during personal care and when entering bedrooms.
“Staff ensured people's privacy and dignity during personal care by ensuring bedroom doors were shut and curtains were closed.” from the report
Action started
The provider accepted the failings and began an action plan, including increasing staffing and arranging extra training.
“During and following the inspection, the provider implemented an action plan to address the shortfalls identified during the inspection” from the report
Risks were not managed
seriousInspectors found serious gaps in care for catheters, pressure damage, constipation, diabetes, nutrition and hydration. One person's catheter was not draining and another person's mattress was set incorrectly for their weight.
“The provider had failed to assess, monitor and mitigate risks to people's health and safety.” from the report
Safeguarding concerns
seriousSome incidents were not reported to the local safeguarding authority. The home could not show that all concerns raised by staff or relatives had been properly recorded and investigated.
“Safeguarding systems and processes did not always protect people.” from the report
Not enough staff
seriousPeople who needed one-to-one supervision did not always receive it, and inspectors linked staffing shortages to falls, missed support, delayed meals and unmet personal care needs.
“People were not always supported by enough staff to meet their needs.” from the report
Consent and restrictions
seriousMental capacity assessments and best-interest decisions were not always completed. The home could not evidence the legal authority for two people who were under constant supervision.
“The provider had failed to ensure they acted in accordance with the Mental Capacity Act 2005.” from the report
Limited personalised care
needs fixingCare records did not always contain people's preferences and life history. Most people spent much of their time alone, and some could not take part in activities or go into the community.
“People were not supported to take part in activities they enjoyed doing.” from the report
Weak complaints and oversight
seriousSome complaints had not received a response. Audits failed to identify important problems, and incidents were not regularly reviewed to prevent them happening again.
“Systems and processes were ineffective in assessing, monitoring and improving the quality and safety of people's care.” from the report
- 01What evidence can you show that staffing levels now meet people's assessed needs, including one-to-one supervision?
- 02How are catheter care, pressure damage, constipation, diabetes, nutrition and hydration risks now checked and recorded?
- 03How do you make sure safeguarding concerns and complaints are recorded, investigated and answered promptly?
- 04What has changed to ensure mental capacity assessments, best-interest decisions and Deprivation of Liberty Safeguards are up to date?
- 05How are people's personal interests, activities, community access and end-of-life wishes now recorded and supported?
This was an unannounced inspection prompted by concerns about risk, staffing and management oversight; it did not examine the circumstances of the incident involving a person's death, and infection prevention and control was also checked. This explanation was written from the published report of 7 April 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 Rushden Park
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2023InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- January 2022Inspected but not ratedSafe: Inspected but not rated
- April 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2020Inspected but not ratedSafe: Inspected but not rated
- January 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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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