CQC report explained · a residential care home
What the CQC found at Selborne Mews
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2022
Rated Requires Improvement; the home had improved since its previous Inadequate rating, but governance remained in breach and some safety work was unfinished.
Inspectors visited unannounced on 11 and 12 January 2022. They spoke with people, relatives and staff, observed care, and checked care records, recruitment files, medicines records and quality checks.
The home had improved from Inadequate to Requires Improvement. Risks were better assessed, medicines were available when needed, staffing was enough on the inspection days, and staff showed kindness and understood people's needs.
There were still important gaps. Fire safety work, repairs, cleaning and infection control needed further attention. Checks on medicines and the wider quality of the home did not always identify problems.
This was a focused inspection of Safe and Well-led only. The other three question ratings were carried forward from the previous comprehensive inspection. The home was no longer in special measures, but Regulation 17 on good governance was still breached.
Better risk management
Care plans and risk assessments had improved, and staff understood how to support people safely. Environmental hazards identified at the previous inspection had also been removed.
“Risks to people were identified with assessments and care plans in place to inform staff on how to support people to stay safe.” from the report
Enough staff on the day
Inspectors found staff available to meet people's needs. Recruitment checks were in place, although the home had vacancies and relied on agency staff.
“Staff were available to respond to people's needs and staff told us there was enough staff on shift to provide safe care.” from the report
Kind interactions
Inspectors saw staff listening to people and speaking about them in a caring way. Staff showed a good understanding of people's needs.
“We saw staff and the interim manager took time to listen to people.” from the report
Improvements to people's living spaces
Some people had moved to quieter, more suitable flats. The home was also introducing technology to help some people's communication.
“Some people had been supported to move to a different flat and this had been significant for some people.” from the report
Governance remained in breach
seriousThe provider's systems did not consistently identify or act on problems. The breach of Regulation 17 was repeated from the previous inspection.
“Systems in place to monitor and improve the quality of the service were not always effective.” from the report
Outstanding fire safety work
seriousSome fire doors needed replacement or repair, some door guards did not work, an escape route needed review and some staff needed fire extinguisher training.
“The fire risk assessment identified some areas that required attention including replacement of fire doors, some door guards were not operational, a fire escape route via a store area required review and key staff needed fire extinguisher training.” from the report
Medicines recording errors
needs fixingInspectors found two medicines documentation errors within ten days for the same person. The interim manager changed the checks during the inspection.
“We saw that two errors in ten days had been made for the same person and checks on documentation had failed to identify this.” from the report
Infection and building work still unfinished
needs fixingA high temperature was not escalated promptly, and further cleaning and repairs were needed. The provider said building works would be completed by the end of February 2022.
“One person's temperature was high however staff had not escalate the concern or taken steps to carry out a COVID-19 test.” from the report
- 01Have all the fire door repairs, door guard repairs and fire extinguisher training identified in the report now been completed?
- 02What checks are now in place to prevent medicines recording errors, and can you show us recent audit results?
- 03How are high temperatures and possible COVID-19 symptoms escalated and tested promptly?
- 04Has the broken bed base, the strong bathroom odours, the stained carpet and the other environmental work been fixed?
- 05Has the new manager started, and who is currently responsible for quality and safety while the management arrangements settle?
This was an unannounced focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings carried forward. This explanation was written from the published report of 24 February 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, November 2021
Rated Inadequate and placed in special measures; inspectors found people at risk from weak safety and management systems.
This was an unannounced focused inspection on 6 May 2021. Two inspectors and an assistant inspector spoke with staff and people living at the home, observed care, and checked care, staff and management records.
The home was not safe. Risks were not always identified or dealt with promptly. Inspectors found unsafe surroundings, poor cleanliness, weak infection control, and care plans that were not always followed. They also found that some incidents were not reported to CQC on time.
There were some positive findings. People received their medicines when needed. Staff understood safeguarding and said they felt supported by the management team. However, inspectors found that people were not always treated with dignity, privacy or effective communication.
The overall rating was Inadequate. Safe and well-led were rated Inadequate, while caring was Requires Improvement. Effective and responsive were not inspected, so their previous ratings were used. The home was placed in special measures because significant improvement was needed.
Safeguarding awareness
Staff understood how to recognise and report abuse. The manager took action when an allegation of verbal abuse was raised.
“Staff told us they had received safeguarding training and confirmed their understanding of protecting people from poor care or harm.” from the report
Medicines arrangements
People whose medicines were checked had arrangements for safe storage. Staff competency checks for medicine practice were repeated every six months.
“Staff competency for safe medicine practice were in place and repeated every six months.” from the report
Positive relationships
Inspectors saw some warm and enjoyable interactions between people and staff. Staff were able to describe people’s needs.
“In another person's flat we saw positive interaction between the person and the staff supporting them.” from the report
People were exposed to avoidable risks
seriousImportant risks were not always acted on. Examples included unsecured toiletries, a damaged chair, an unsafe heater, missed checks and a lighter being held despite a known fire risk.
“Risk's to people's health and welfare were not mitigated.” from the report
Poor cleanliness and infection control
seriousSome flats were heavily dirty, stained and difficult to clean. Inspectors were not assured that PPE and current COVID-19 guidance were being used properly.
“The lack of cleanliness in people's flats placed them at increased risk of cross infection.” from the report
Weak management oversight
seriousThe home’s checks did not identify problems with risks, weights, cleaning or infection control. This was a repeated breach of the governance regulation.
“Systems to monitor the quality and safety of the service were ineffective and placed people at the risk of harm.” from the report
Privacy and communication
needs fixingSome staff entered flats without knocking or announcing themselves. One person with limited verbal communication did not have an effective communication system in place.
“Some staff when entering people's flats did not knock their flat door or announce their arrival.” from the report
Late reporting to CQC
seriousThe provider did not report legally notifiable incidents to CQC promptly. This meant CQC could not seek timely reassurance about people’s safety.
“CQC had not been informed in a timely way about legally notifiable incident.” from the report
- 01What has been done to make sure risks such as unsafe items, damaged furniture, heaters and smoking materials are dealt with immediately?
- 02How are you checking that cleaning schedules, PPE risk assessments and current infection control guidance are being followed?
- 03How do you now monitor care records, safety checks, weights and incidents, and who reviews these findings?
- 04What has changed to make sure legally notifiable incidents are reported to CQC on time?
- 05What communication system is now in place for people who have limited verbal communication?
This was a focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their previous ratings were carried over. This explanation was written from the published report of 11 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.
Every inspection of Selborne Mews
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- November 2021InadequateSafe: InadequateWell-led: Inadequate
- August 2021Inspected but not ratedSafe: Inspected but not rated
- March 2021Inspected but not ratedSafe: Inspected but not rated
- January 2020Requires improvementdown from GoodSafe: Requires improvementCaring: GoodWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- March 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 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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