CQC report explained · a nursing home
What the CQC found at Sherborne Court Neurological Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, June 2019
Rated Good overall; inspectors found kind, effective care, but safety records still needed improvement.
Inspectors visited without warning on 14 and 17 May 2019. They spoke with people, relatives, staff and visiting professionals. They reviewed care records, staff files, medicines records, accident reports, complaints and quality checks.
People and relatives were generally positive. Inspectors found caring staff, good specialist support, activities, community access and improvements to staffing and risk assessments. The home followed the Mental Capacity Act and supported people's choices, privacy and independence.
The overall rating was Good. Safe was rated Requires Improvement because some medicines records, emergency plans and other safety records were not complete or detailed enough. The home had improved since the previous inspection and was no longer in breach of regulations.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors saw warmth in conversations and found that privacy, dignity and equality were respected.
“People looked comfortable and at ease in their surroundings. Staff had clearly developed positive relationships with people.” from the report
Specialist support
The home had access to several specialist professionals who helped assess needs, support rehabilitation and work towards greater independence.
“There was an effective in-house team of specialist support, which ensured people's needs were fully assessed and supported to achieve goals and gain independence, where possible.” from the report
Choice and activities
People were supported to make everyday choices, take part in activities and go into the community. The home had an activities coordinator, a gym and a minibus.
“People were supported to undertake activities based on their interests. They were supported to go out into the community and had the use of a mini bus.” from the report
Improved management
The provider had acted on the previous inspection findings. Quality checks and action plans were being used to identify and address problems.
“At this inspection we found improvements had been made and the service was no longer in breach of regulations.” from the report
Medicines records
seriousAlthough medicines were generally managed safely, records for creams and ointments had gaps. Some handwritten medicine instructions were not countersigned, and allergy information needed more detail.
“This meant we could not be sure creams had always been applied as required.” from the report
Incomplete safety details
needs fixingSome emergency plans did not give enough information about people's individual support needs. Two further risk assessments were needed and were completed during the inspection.
“However, we found these would benefit from further details in relation to people's specific support needs.” from the report
Fluid records
needs fixingStaff recorded drinks, but individual fluid targets were not written down. There were also occasional gaps when people who relied on staff should have been offered drinks more often.
“However, individual targets were not identified, which meant it was unclear how much each person should ideally drink.” from the report
Care plan detail
needs fixingCare plans were reviewed and improved, but some did not contain enough personal detail. Some night-time notes were written early and did not always cover the whole night.
“The care plans would benefit from being more person centred in line with the detailed therapists plans in place.” from the report
- 01How are topical creams recorded now, and how do you check that every application is documented?
- 02What individual fluid targets are recorded for residents who need help to drink?
- 03How do emergency plans describe each resident's specific support needs?
- 04How are care plans made more person-centred and kept consistent with therapists' plans?
- 05What changes have been made since the May 2019 inspection, particularly in the Safe area?
This was an unannounced scheduled inspection covering all five CQC questions and the overall quality and safety of the home. This explanation was written from the published report of 11 June 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, June 2018
Rated Requires Improvement; inspectors found kind care, but identified serious gaps in safeguarding, staffing, records and management checks.
This was an unannounced inspection on 12, 13 and 19 February 2018. Inspectors spoke with people living at the home, relatives, staff and a visiting health professional. They looked at six care records, staffing, training, medicines, audits and the building.
The home was caring, clean and generally supported people with food, health needs, communication and activities. People said staff were kind, respected their dignity and involved them in decisions. Nutrition support had improved since the previous inspection.
However, the inspectors found that safeguarding concerns had not always been referred, some risks were not fully assessed, and nursing staff numbers had been reduced while people's needs were complex. Care records were sometimes incomplete or out of date, and quality checks had not found these problems.
The overall rating Requires Improvement means the home was not consistently safe, effective, responsive or well-led. Caring was rated Good. The report identified four breaches of regulations, and the provider was required to say what it would do to improve.
Kind and respectful staff
People and relatives described staff positively. Inspectors saw staff being patient, friendly and attentive to people's dignity and communication needs.
“We observed staff interactions with people and saw that staff were kind and caring in their approach.” from the report
Improved nutrition support
People had choices of meals and were supported to eat and drink in an unrushed way. Inspectors found improvement compared with the previous inspection.
“At this inspection we found that improvements had been made and people were happier with the support provided.” from the report
Activities and personal goals
The home provided activities through an activities coordinator, music therapist and therapy assistants. Inspectors saw examples of positive outcomes and support for independence.
“People were supported to follow their interests and take part in activities.” from the report
People involved in decisions
People and relatives were included in care reviews and service feedback. Staff used different ways to support communication and decision-making.
“People were encouraged to express their views regarding the service and were involved in decision-making about their care.” from the report
Safeguarding referrals
seriousA sequence of incidents raised possible safeguarding concerns but had not been referred to the local authority. Incident records were also incomplete.
“We found that systems in place did not effectively ensure that people were always safeguarded from potential abuse and harm.” from the report
Incomplete risk and care records
seriousSome significant risks were not fully assessed. Care information, including guidance about thickened drinks, was sometimes out of date or difficult to find.
“We also found that risks associated with this person's care had not been fully assessed and documented to help staff know how to mitigate any future risk.” from the report
Nursing staff levels
seriousDaytime nursing staff had been reduced from four to three during a trial period. Staff said this affected workloads and the time available for care plans and supervision.
“We found that nursing staff were not always deployed in a way to meet people's needs.” from the report
Care documentation
needs fixingOne newer person's care file had very little information, and there were gaps in records for care such as repositioning, hygiene and oral care.
“We found that one person had been living at Sherborne Court for around five weeks, but their care file contained minimal information.” from the report
Quality checks
needs fixingThe provider had introduced audits, but they were not yet working well enough to identify the concerns found by inspectors.
“Although these systems were in place, they had not been sufficiently effective because they had not identified issues found at this inspection” from the report
Some medicines records
minorMedicines were generally safe, but some instructions and records for creams and as-required medicines were incomplete. This could cause confusion about whether treatment was given as prescribed.
“However, we identified some minor shortfalls with aspects of medicines management.” from the report
- 01What changes have been made to ensure every safeguarding concern is referred and recorded correctly?
- 02How many nurses are now on duty during the day and night, particularly for people with complex clinical needs?
- 03How do you make sure new residents have complete care plans quickly, and that records are kept up to date?
- 04How are risks such as choking, thickened drinks and tracheostomy care assessed and communicated to agency staff?
- 05What evidence can you show that your audits now identify and correct problems before they affect people?
This was an unannounced inspection of all five key questions and the overall service; it was the first inspection since the home was re-registered with the new provider in October 2017. This explanation was written from the published report of 6 June 2018 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 Sherborne Court Neurological Centre
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Sherborne Court Neurological Centre →
- June 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Sherborne Court Neurological Centre →
- October 2017
Registered with the Care Quality Commission on 10 October 2017.
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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