CQC report explained · a nursing home
What the CQC found at Scotia Heights
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, and staff had guidance about risks. Medicine errors had reduced after new checks and processes were introduced, although inspectors found some poor PPE practice.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Management and quality checks had improved since the previous inspection. The provider had action plans, contingency plans and systems to identify and address problems.
What inspectors found, January 2022
Scotia Heights was rated Good; inspectors found safe care and improved leadership, but staffing consistency and PPE practice needed attention.
This was an unannounced, focused inspection on 3 November 2021. Inspectors looked only at Safe and Well-led because concerns had been raised about medicine errors and staffing. They spoke with four people, 17 staff and relatives, and checked care, medicine, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff on the inspection day, safer medicine systems, appropriate recruitment checks and safeguarding arrangements. They also found that care plans and risk assessments were regularly reviewed.
The inspection found some problems with infection control practice. Some staff wore unsuitable jewellery, were not bare below the elbows or used PPE incorrectly. Managers acted after the inspection. The Well-led rating improved from Requires Improvement to Good, while the overall Good rating stayed the same.
Risk management
Care plans and risk assessments covered areas such as mobility, pressure care and anxiety. Staff had clear instructions to support people safely.
“Risks to people's safety and wellbeing had been identified and assessed and plans were in place to minimise these risks.” from the report
Improved leadership
The home had improved its oversight since the previous inspection. Action plans showed what needed to improve, who was responsible and when actions should be completed.
“Improvements in the use of the provider's quality assurance systems meant they were effectively identifying issues within the service.” from the report
Kind and personal care
Inspectors saw positive interactions and found staff knew the people they supported. Relatives also praised the staff.
“Staff were knowledgeable about the people they supported and demonstrated they took a person-centred approach to providing care.” from the report
PPE and infection control
needs fixingNot all staff followed the expected infection control practice. Inspectors saw inappropriate jewellery, staff who were not bare below the elbows and four care staff using PPE incorrectly in the smoking area.
“Not all staff followed good infection control practice (IPC) because they wore inappropriate jewellery and were not bare below the elbows.” from the report
Reliance on agency staff
needs fixingAgency staff were being used to maintain safe staffing. Staff said this was tiring because of a lack of consistency, and some relatives and staff said it had reduced social activities for some people.
“Staff told us working alongside agency staff was tiring because of a lack of consistency.” from the report
Management turnover
minorThe home had had four registered managers in three years. Staff said the recent management changes had contributed to stress, although they found the current manager supportive.
“This is the fourth registered manager in three years.” from the report
- 01How many permanent staff are now working at the home, and how much agency cover is still being used?
- 02What checks are now in place to make sure all staff follow the correct PPE and infection control rules?
- 03How are medicine counts, spot checks and refresher training being maintained to prevent medicine errors returning?
- 04Has the unit that was kept closed because of staffing pressures reopened, and if so, how is it staffed?
- 05What is being done to restore social activities for people affected by the use of agency staff?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from previous comprehensive inspections. This explanation was written from the published report of 11 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, December 2020
Rated Good overall, with safe care improved but well-led rated Requires Improvement because staff training evidence was incomplete.
This was an unannounced focused inspection on 22 and 23 October 2020. Inspectors checked whether the home had acted on problems found earlier, mainly around safety, staffing and management. They spoke with five people and 18 staff, and reviewed care, medicines, recruitment, training and management records.
The home was rated Good for Safe. Inspectors found improvements in welfare checks, medicines, staffing and infection control. People told inspectors they felt safe, and the home had improved how it learned from incidents.
Well-led remained Requires Improvement. New staff had been recruited, but records did not show that all required training and induction competency checks had been completed. The overall rating rose from Requires Improvement to Good, but this was a focused inspection and some other ratings were carried forward from the previous comprehensive inspection.
Improved safety checks
People who could not use their call bells had regular 15-minute welfare checks. This reduced the risk of them being left without help.
“At this inspection we found 15-minute checks were in place for everyone who was unable to use their call bell.” from the report
Safer medicines support
Inspectors found that people were receiving the right level of support with their medicines. Audits and investigations were used when errors happened.
“At this inspection we found people were now receiving the appropriate level of support.” from the report
Infection control
Inspectors were assured that the home was following Covid-19 guidance, including safe use of protective equipment, testing and outbreak arrangements.
“We were assured that the provider was using PPE effectively and safely.” from the report
Positive culture
Inspectors found a positive atmosphere. People said they were listened to and could contribute to developing the home.
“The culture of the service presented as positive and people told us they were listened to and able to contribute to the development of the service.” from the report
Training records incomplete
needs fixingSome staff, particularly new starters, had not completed required training. Inspectors could not find documented evidence of the competency checks expected during induction.
“Also, we struggled to find any documented evidence of the competency assessments staff are required to complete as part of their induction programme.” from the report
Physical intervention training
needs fixingNot all staff had training for physical intervention, and trained staff could be spread across different units. Inspectors said this could affect the response to an unexpected incident if people with unpredictable behaviour were admitted.
“However, we would recommend more staff training is needed should the service again accept people who exhibit unpredictable behaviour and may require an unplanned physical hold to protect them and others.” from the report
- 01Have all staff now completed the required training, especially new starters?
- 02Where are induction competency assessments recorded, and can you show how each staff member has been checked as competent?
- 03How do you make sure each unit has staff with the right skills to meet residents' complex needs?
- 04How do you ensure that moving staff between units does not affect continuity of care?
- 05What was the previous rating for Effective, Caring and Responsive, and when were those areas last fully inspected?
This was a focused inspection of Safe and Well-led, including Covid-19 infection control; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 15 December 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 Scotia Heights
8 rated inspections over 6 years: the service has held its Good rating throughout.
- January 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- September 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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