CQC report explained · a nursing home
What the CQC found at Scarlet House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe, medicines were given as prescribed, and infection control systems were in place. However, some risk assessments and management plans were not fully up to date.
- Effective?
- Good
- This question was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this visit. People consistently told inspectors that staff were kind and caring.
- Responsive?
- Good
- Staff understood people's support needs, communication needs were recorded, and activities and end of life support were available. This improved from Requires Improvement at the previous inspection.
- Well-led?
- Requires improvement
- A new management team and improvement plan were in place, with support from the provider. Inspectors said more time was needed to judge whether improvements to records and reviews of changing needs were effective and embedded.
What inspectors found, December 2021
Rated Good overall; inspectors found safe, kind care, but risk records and the home's leadership systems still needed improvement.
This was an unannounced focused inspection after concerns about people's safety. Inspectors visited on 27 and 28 October and 3 November 2021. They spoke with 16 people, nine relatives and 15 staff, and checked care, medicine and management records.
People were generally safe and received their medicines as prescribed. Staff were described as kind and caring. The home had infection control arrangements in place, and activities and end of life support were available.
Some risk assessments and care records were not always updated when people's needs changed. The new management team had started an improvement plan, but inspectors needed more time to see whether the changes were working and had become established.
The overall rating stayed Good. Safe and Responsive were rated Good, while Well-led fell from Good to Requires Improvement. The Responsive rating improved from Requires Improvement at the previous inspection.
Safe medicines
Electronic records, secure storage, audits and staff checks supported people to receive their medicines safely and as prescribed.
“The electronic records showed that people had received their medicines as prescribed.” from the report
Kind staff
People and relatives consistently described staff as kind, caring and supportive.
“People consistently told us that staff were kind and caring.” from the report
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infections, including COVID-19.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Improved responsiveness
Staff knew people's needs and preferences. The home offered group and individual activities and worked with health professionals when people's needs changed.
“At this inspection this key question has now improved to Good.” from the report
Risk records
seriousSome risk assessments and management plans were not updated as people's needs changed. This included risks linked to choking, eating, behaviour and mobility.
“These risk assessments had not always been updated when people's risks had changed.” from the report
Leadership still developing
needs fixingThe new management team had started improvement work, but inspectors could not yet judge whether it was effective or firmly established.
“Some time was needed to complete the planned actions before we could judge whether the provider's improvement plan had been effective” from the report
Daily care records
needs fixingThe home's own checks had found that daily notes did not always show the support people had received. A new recording system was being introduced.
“The provider had identified that people's daily care notes did not always reflect the support people had received” from the report
- 01How have you updated people's choking, eating, behaviour and mobility risk records since this inspection?
- 02What actions in the improvement plan have now been completed, and how do you check that they are working?
- 03How do daily care notes now show the support each person has received?
- 04How many staff vacancies remain, and how often are agency staff being used?
- 05What activities are available for my relative, and how are their personal interests used to plan them?
This was a focused inspection of Safe and Well-led, with Responsive also reviewed because it was previously Requires Improvement; Effective and Caring were not inspected and their previous ratings carried over. This explanation was written from the published report of 21 December 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, March 2019
Rated Good overall; inspectors found safe, kind care, but personalised care and records were not always consistent.
Inspectors visited the home without notice on 29 and 31 January 2019. They spoke with people, relatives, staff, nurses, managers and healthcare professionals. They also checked care records, complaints, accidents, staff records, medicines and quality checks.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable training, good food and kind care. People were supported to make choices, stay independent and access activities and healthcare.
Responsive care was rated Requires Improvement. Some people did not always receive care that reflected their personal wishes, especially people living with dementia. Care records were not always up to date. The home had improvement plans in place, and the overall rating improved from Requires Improvement at the previous inspection.
Safe staffing
Inspectors found enough staff to meet people's needs and noted that the home had reduced its use of agency staff. Recruitment checks were completed.
“There were enough staff deployed to ensure people's needs were met.” from the report
Kind and respectful care
People said staff were caring. Inspectors observed staff helping people feel comfortable, supporting their choices and protecting their privacy.
“People were treated with kindness and compassion by care and nursing staff.” from the report
Food and healthcare
Meals were varied and adapted to people's dietary and health needs. People had access to healthcare professionals and support with nutrition.
“People enjoyed a range of meals, which were nutritional and varied to meet their individual dietary and health needs” from the report
Activities and community links
People had a range of activities and events, with support where needed. The lifestyle team had links with local schools, play groups and other community organisations.
“People benefitted from a range of activities and events which were being tailored to their individual needs.” from the report
Improving leadership
The new management team was open about the home's weaknesses and had a detailed improvement plan. Provider representatives were giving extra support while the team became established.
“The provider had implemented a clear service improvement plan and was providing support to allow the manager to implement and sustain improvements.” from the report
Personalised care was inconsistent
needs fixingSome people did not always receive care in the way they wanted. This included missed small details and inconsistent support for some people living with dementia.
“People did not always receive fully person-centred care.” from the report
Care records were not always current
needs fixingSome records did not include the latest information about people's needs or healthcare appointments. This could mean staff missed important information about how to provide care.
“Staff had not always maintained a current record of people's needs, including the outcome of healthcare appointments, such as dentists.” from the report
Dementia support needed strengthening
needs fixingStaff did not always use a consistent, personalised approach when people living with dementia became anxious or distressed. The home was rolling out further dementia training.
“Staff members' approach to people living with dementia was not always personalised and had not always focused on reassuring them and promoting their independence and emotional wellbeing.” from the report
- 01How will you make sure my relative's care plan records their personal routines, interests, history and preferences?
- 02What dementia training have staff completed, and how do you check that they use a consistent approach when someone becomes anxious or distressed?
- 03How do you make sure care records are updated after healthcare appointments and that all staff can see the latest information?
- 04What progress has been made with the improvement plan for personalised care and the refurbishment of the dementia unit?
- 05How will you make sure staffing remains stable and that agency staff understand my relative's needs?
This was an unannounced planned inspection covering all five key questions and following up improvements required after the previous Requires Improvement rating in 2017. This explanation was written from the published report of 13 March 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 Scarlet House
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- December 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodup from Requires improvementSafe: GoodResponsive: Requires improvementWell-led: Good
- January 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Registered with the Care Quality Commission on 17 September 2014.
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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