CQC report explained · a nursing home
What the CQC found at Selly Park
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2019
Selly Park rated Requires Improvement overall; inspectors found caring and responsive support, but risk records, staff training and quality checks still needed improvement.
Inspectors visited on 29 and 30 October 2019. They spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records. The first visit was unannounced and the second was announced.
The home had improved since its previous inspection. Inspectors found enough staff during their visits, medicines were handled safely, and people were generally protected from abuse and avoidable harm. However, some seizure plans, fluid records, incident follow-up and medicines protocols were not consistently detailed.
People were treated with kindness and respect, and care was generally personalised and responsive. The home was rated Requires Improvement for Safe, Effective and Well-led, and Good for Caring and Responsive. It had previously been rated Inadequate and placed in Special Measures, but it was no longer in Special Measures after this inspection.
Improved staffing
Inspectors found enough suitably recruited staff on duty during the visits to meet people's needs and keep them safe. Staffing levels had improved since the previous inspection.
“At the time of our site visit, we found there were enough suitably recruited staff on duty to meet people's needs and to keep people safe.” from the report
Kind and respectful care
People and relatives gave positive feedback about staff. Inspectors observed patient, respectful interactions and found that people were supported with dignity and independence.
“Our own observations showed staff treating people with patience, humour and respect.” from the report
Personalised support
Care plans were person-centred, and staff knew people's preferences and communication methods. Staff adapted support for people who communicated without speech.
“Staff provided responsive care to people in line with their preferences and choices.” from the report
Safe medicines practice
Medicines were stored and disposed of safely, and records showed no areas of concern when staff supported people with their medicines.
“Medicines were safely stored and disposed of in accordance with best practice.” from the report
Improvement since the last inspection
The home improved from an overall Inadequate rating and left Special Measures. Previous breaches relating to staffing, safe care, dignity and governance were no longer in place at this inspection.
“Therefore, this service is no longer in Special Measures.” from the report
Incomplete seizure plans
seriousThree people's seizure risk assessments were inconsistent. One person did not have a clear recovery plan or instructions explaining when staff should contact emergency services.
“For one person, there was no recovery plan or clear protocol in place to instruct staff how to support the person safely in the event of a seizure.” from the report
Quality checks did not find all problems
needs fixingThe provider's checks had not consistently identified gaps in employment records, medical protocols, risk assessments and incident follow-up. Inspectors said stronger systems were needed to sustain improvements.
“Although there had been improvement since the last inspection, the provider must ensure they sustained the improvement with robust quality assurance systems in place to prompt action to be taken.” from the report
Training gaps
needs fixingNo staff had completed oral healthcare training, and no falls training had been completed. Two new nurses were still waiting to complete safe medicines administration training.
“We saw oral healthcare training had not been completed by any staff members.” from the report
Drinks not always within reach
minorTwo people did not always have drinks within easy reach. The manager said staff were reminded to check this and would continue monitoring it.
“We saw on occasion these were not always within easy reach for two people.” from the report
- 01What specific changes have been made to seizure care plans, including when staff should call emergency services?
- 02Have all staff now completed oral healthcare, falls and safe medicines administration training?
- 03How do you check that people at risk of dehydration are regularly encouraged to drink and that this support is recorded?
- 04How do you prevent delays with morning personal care when staff are absent or taking breaks?
- 05What checks now confirm that care protocols, risk assessments, employment records and incident actions are complete and up to date?
This was a planned inspection covering all five key questions, including the care and the premises; the previous overall rating was Inadequate and the inspection checked whether improvements had been made. This explanation was written from the published report of 29 November 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.
What inspectors found, May 2019
Rated Inadequate and placed in special measures; inspectors found serious safety, staffing and leadership failures.
Inspectors visited on 30 and 31 January 2019. The first day was unannounced. They reviewed eight care records and other documents, spoke with people, relatives, staff and a health professional, and observed care.
They found that people were at risk because moving and handling was not always safe, some medicines were not given or recorded correctly, and there were not always enough staff. Some people waited too long for care or help with meals. Staff training and care records were also inconsistent.
The home was rated Inadequate overall. Safe and well-led were Inadequate. Effective, caring and responsive were Requires Improvement. The home was placed in special measures, meaning CQC said it would be monitored and inspected again within six months unless immediate enforcement action was taken.
Safe recruitment
Inspectors found that staff recruitment checks were carried out to help ensure staff were safe to work with vulnerable people.
“Staff had been recruited safely to ensure they were safe to work with vulnerable people.” from the report
Some safe medicines practice
Part of the medicines round was observed to be calm and careful. Medicines were checked, explained to people and cleared away after use.
“When satisfied that the medicines had been taken all items used to support the administration was cleared away.” from the report
Healthcare referrals
A healthcare professional said referrals were timely and appropriate, and advice was followed.
“Referrals are made in a timely manner. The referrals are appropriate and advice is always followed” from the report
Family involvement
Care records showed relatives were involved in discussions about care, and families were told about changes in people's health.
“There was evidence of families being informed of changes in people's health” from the report
Risk of injury
seriousStaff did not always follow safe moving and handling procedures. Inspectors saw wheelchair brakes left unapplied during two transfers.
“We saw two incidents where the brakes on wheelchairs were not applied during a moving and handling transfer.” from the report
Medicines records
seriousRecords did not show reliably whether some prescribed barrier creams had been applied. Some arrangements for covert and as-needed medicines also lacked important detail.
“We were not able to determine if people had received the creams and staff had failed to sign or if people had not received their creams as prescribed.” from the report
Staffing levels
seriousThere were shifts with only four or five care staff. People were left without timely support, including help with personal care and meals.
“Despite these measures we found that there were not sufficient numbers of staff to meet the needs of people and keep them safe.” from the report
Dignity and personal care
seriousSome staff did not respond promptly or explain what they were doing. Inspectors also found poor monitoring of oral care and personal care needs that were not always met.
“The evidence above supports the failure to ensure that service users are treated with dignity and respect.” from the report
Weak oversight
needs fixingAudits and checks did not lead to timely action. Accidents and incidents had not been analysed since November 2018, so the provider could not show that lessons were being learned.
“No analysis of accidents and incidents had taken place since November 2018” from the report
Limited activities
minorPeople had access to some activities, but inspectors saw times when there were few things for people to do. The provider said it hoped to improve this.
“We observed at times that there were a lack of things for people to do.” from the report
- 01What staffing levels are now in place on every shift, and how do you cover sickness, annual leave and agency staffing?
- 02How do you check that medicines, barrier creams and as-needed medicines are given as prescribed and recorded correctly?
- 03What training and competency checks do staff now complete for moving and handling, safeguarding, fire safety and the Mental Capacity Act?
- 04How are accidents, incidents, care-plan changes and complaints reviewed so that lessons lead to lasting improvements?
- 05How do you make sure each person's personal care, oral care, mealtime support and activities match their current needs and preferences?
This was a planned inspection of the care home, covering the premises and care provided and all five key questions. This explanation was written from the published report of 29 May 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 Selly Park
5 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- November 2019Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Registered with the Care Quality Commission on 14 August 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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