CQC report explained · a residential care home
What the CQC found at Saltmarsh House Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from abuse and avoidable harm. Risks, medicines, staffing, recruitment and infection control were managed well overall, although visit arrangements needed clarification.
- Effective?
- Requires improvement
- This key question was not assessed during this focused inspection. Its previous rating was carried forward into the overall rating.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward into the overall rating.
- Responsive?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was carried forward into the overall rating.
- Well-led?
- Good
- Inspectors found effective monitoring of care, clear staff responsibilities and a positive, person-centred culture. Records had improved and the provider was working on further updates.
What inspectors found, January 2022
Rated Good; inspectors found safe, person-centred care and clear improvements since the previous inspection, with some uncertainty about visit arrangements.
This was an unannounced focused inspection on 7, 16 and 20 December 2021. One inspector spoke with three people living at the home, a relative, the provider and four staff. They also reviewed care, medicines, recruitment and management records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found that risks were assessed, medicines were managed safely, staffing was suitable and infection controls were mostly effective. They were only somewhat assured that visits were being facilitated in line with current guidance.
The previous rating was Requires Improvement, published in October 2019, when two regulations had been breached. Inspectors found enough improvement had been made and the home was no longer in breach. The other three areas were not assessed during this inspection, so their previous ratings were used in the overall rating.
Safe medicines
Staff were trained and checked as competent. Medicines records, storage and monitoring arrangements were found to be safe.
“People received their medicines safely from staff who were trained and whose competency was checked regularly.” from the report
Suitable staffing
Inspectors found enough staff with the right skills. People and relatives did not raise concerns about staffing levels or staff abilities.
“There were enough staff with the right mix of skills to support people safely.” from the report
Improved records and oversight
Care plans, medicines records and other records were up to date and clear. The provider's checks had identified and supported improvements.
“The provider's processes for monitoring the quality of care people received had been effective in identifying and driving improvements.” from the report
Personalised care
The small team knew people well and worked together to provide individual care. Staff gave examples of positive outcomes, including support with rehabilitation after hospital.
“The small, family-run ethos with low staff turnover had allowed staff to get to know people well, understand their needs and deliver individual care to meet their needs.” from the report
Visit arrangements
minorInspectors were only somewhat assured that visits were being facilitated in line with current guidance. They directed the provider to guidance about visit duration and nominated essential care givers.
“We were somewhat assured the provider was facilitating visits for people living in the home in accordance with the current guidance.” from the report
- 01How are visits arranged now, including visit duration and the role of nominated essential care givers?
- 02How do you check that medicines remain safely stored, administered and recorded?
- 03How are individual risks recorded and reviewed when a person's needs change?
- 04How do you use feedback from people and families to improve the service?
- 05Which ratings were carried forward from the previous inspection rather than checked during this visit?
This was an unannounced focused inspection of Safe and Well-led, including infection prevention and control; the other three key questions were not assessed and their previous ratings carried over. This explanation was written from the published report of 14 January 2022 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, October 2019
Saltmarsh House Residential Care Home was rated Requires Improvement; inspectors found kind, personalised care but unsafe medicines and weak record-keeping.
This was an unannounced inspection on 1 and 8 August 2019. Inspectors spoke with people, relatives, staff and visiting health professionals. They reviewed care plans, medicines records, staff files and management records.
The home was caring and responsive. Staff treated people with dignity, knew their preferences and supported activities, meals and healthcare. People and relatives generally said they felt safe and received kind care.
There were important safety and management problems. Medicines were not always stored, administered or recorded safely. Some risk plans were inaccurate, infection control measures were not always robust, and quality checks did not find or fix these issues.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive were rated Good. The previous overall rating was Good, published in February 2017.
Kind and respectful care
People were treated with dignity and compassion. Staff knew people's preferences and supported their independence.
“There was a relaxed and calm atmosphere and we observed staff interacted and engaged with people in a caring and respectful manner.” from the report
Personalised support
Care plans included people's likes, dislikes and communication needs. Staff supported people to make choices about meals and their care.
“People's preferences were regularly sought, and information was communicated through people's care plans.” from the report
Enough staff
Inspectors found enough staff to provide care without rushing. The home also had an established and long-standing staff team.
“There were enough staff deployed to provide safe care.” from the report
Activities and relationships
People could join activities, celebrations and community groups. Relatives and healthcare professionals described positive relationships with staff.
“People had the choice of engaging in planned activities at the home.” from the report
Medicines safety
seriousStaff did not always follow safe medicines procedures. This included controlled medicines, storage temperatures, medicine keys, patches and prescribed creams.
“People's medicines were not always managed safely, and staff did not always follow best practice guidance.” from the report
Inaccurate risk plans
seriousSome risk assessments did not accurately describe people's needs or the action staff should take. This included risks linked to skin damage, falls and diabetes.
“We found information around some people's level of risk and steps to be taken to mitigate the risk did not always reflect the care people required.” from the report
Weak quality checks
seriousThe home's audits did not identify or correct problems with medicines, care records, equipment and staff employment histories.
“The provider had some quality assurance processes in place to monitor and review the overall delivery of people's care and the service provided, however these were not always effective.” from the report
Infection control and maintenance
needs fixingSome fittings and equipment were not maintained well enough to prevent possible infection. The provider acted on the issues after inspectors raised them.
“Some fixtures and fittings in the home were not always appropriately maintained to prevent the possible risk of infection.” from the report
End of life wishes
needs fixingCare records did not always set out people's end of life wishes. The provider said staff knew people and their wishes.
“At the time of the inspection no one was receiving end of life care.” from the report
- 01How are medicines now checked, including controlled medicines, storage temperatures, medicine keys, patches and prescribed creams?
- 02How do you make sure each person's risk plan is accurate and gives staff clear instructions when their needs change?
- 03What changes have you made to your audits so they identify medicines, record-keeping, equipment and recruitment problems?
- 04How are people's end of life wishes discussed, recorded and kept up to date?
- 05What maintenance and infection control improvements were completed after the inspection?
This was an unannounced inspection covering all five CQC questions; the report compares all five ratings with the previous inspection. This explanation was written from the published report of 8 October 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 Saltmarsh House Residential Care Home
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- January 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Saltmarsh House Residential Care Home →
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Saltmarsh House Residential Care Home →
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 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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