CQC report explained · a nursing home
What the CQC found at St Catherines Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2022
Overall rated Requires Improvement, with Well-led rated Inadequate; inspectors found serious failures in leadership, risk management, training, recruitment and infection control.
This was the home's first inspection since it registered. It was an unannounced, planned inspection on 12, 17 and 22 August 2022. One inspector spoke with people, relatives and staff, and looked at care records, medicines, staffing, training, infection control and how the home was managed.
Inspectors found that risks were not always assessed or monitored properly. Care records were incomplete or out of date. Recruitment checks were not well organised, staff training was seriously incomplete, and staffing levels received mixed feedback. The kitchen was unclean and infection control systems were not reliable.
There were also positive findings. People received their medicines as prescribed, staff were seen treating people with kindness and respect, and people could access healthcare support. However, the provider's systems did not identify or correct problems, so all five key questions were rated Requires Improvement and Well-led was rated Inadequate.
Kind interactions
People and relatives described staff as kind and respectful. Inspectors also saw staff treating people with care.
“We observed heartfelt and caring interactions between people living in the home and the care staff.” from the report
Healthcare support
People were supported to use healthcare services, and staff worked with outside professionals to support medical needs.
“The new management team had established supportive relationships with other agencies and professionals to ensure people received advice and support with their medical needs.” from the report
Privacy and independence
Staff knocked before entering rooms and supported people to do parts of their care themselves when appropriate.
“People were supported to promote their independence.” from the report
Leadership and oversight
seriousThe provider's quality systems did not identify or deal with widespread problems. Inspectors found that people were left at risk of harm.
“The provider failed to assess, monitor and improve the quality and safety of the service.” from the report
Risk records
seriousRisk assessments and care plans were not always reviewed or detailed enough to guide staff. Daily care notes and monitoring records had gaps.
“Risks had not been sufficiently assessed or mitigated and care plans were not always in place to guide safe practice.” from the report
Staff training
seriousTraining completion was low, including training on safeguarding, fire safety, moving and handling, and mental capacity. Staff also did not have regular supervision or appraisals.
“At the time of the inspection the training matrix illustrated clear gaps in training with an overall compliance of 33%.” from the report
Recruitment checks
seriousSome staff started without meeting the registered manager, and staff files and DBS records were difficult to locate. This meant the provider could not always show that recruitment was safe.
“Staff were not always recruited safely. We found that recruitment processes were not robust.” from the report
Infection control
seriousThe kitchen was unclean, and cleaning records and schedules were not readily available. Inspectors said this placed people at risk of harm, although the provider said immediate cleaning work was carried out.
“We found substandard kitchen hygiene standards.” from the report
Involvement and contact
needs fixingPeople and relatives were not always involved in care decisions or kept updated. Some people were not supported consistently to keep in touch with relatives and friends.
“People and those important to them had not been involved in their care.” from the report
- 01What has been done to make sure every person's risks and care records are current and complete?
- 02What percentage of staff have now completed safeguarding, fire safety, moving and handling, infection control and mental capacity training?
- 03How are recruitment checks, including DBS records and interviews, now stored and checked before staff start work?
- 04What changes have been made to kitchen cleaning, infection control records and cleaning schedules?
- 05How will relatives be kept informed, involved in care decisions and supported to maintain contact with people living in the home?
This was the home's first inspection and covered all five key questions, including infection prevention and control; the report says the provider was newly registered and had not previously been inspected. This explanation was written from the published report of 23 September 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, March 2022
Inspected but not rated; Safe and Well-led were Requires Improvement, with risks in care, recruitment, infection control and oversight.
Inspectors visited the home on 11, 26 and 27 January 2022. They spoke with people, a relative, staff and another professional. They also reviewed care, medicine, recruitment and management records.
The home was not given an overall rating. Safe and Well-led were both rated Requires Improvement. Inspectors found risks were not always properly assessed or managed, recruitment checks were incomplete, and infection control systems were not reliable enough.
There were some positive findings. People said they felt safe, medicines were managed safely, and staff were seen responding to people's needs. Managers took prompt action during the inspection and created an improvement plan, but CQC said further improvements were needed and would be monitored.
Medicines
Inspectors found that people received their medicines safely and as prescribed. Medicines were ordered, given and audited through established systems.
“People received their medicines safely and as prescribed.” from the report
Staff response
Inspectors observed enough staff to meet people's needs at the time of the visit. People also said staff responded to them.
“During the inspection, we observed there were enough staff to meet people's needs.” from the report
Prompt action
The manager and provider acted during the inspection to reduce some risks. They also produced a detailed improvement plan.
“The nominated individual and manager were very responsive and took some immediate actions during the inspection.” from the report
People involved in care
People were involved in care plan reviews and said care was provided in a way that suited their needs.
“People were involved in these reviews and told us care was provided in a way that suited their individual needs.” from the report
Risk management
seriousSome risk assessments were missing or had not been followed. This included risks linked to modified diets, personal belongings, safety checks and pressure-relieving mattresses.
“Risk assessments were either not in place or had not been followed to effectively manage risk. This placed people at risk of harm.” from the report
Recruitment checks
seriousThe home could not show that all staff had been recruited safely. Records had gaps in DBS checks, references and employment history, including for agency staff.
“The provider was unable to demonstrate safer recruitment procedures had been followed.” from the report
Infection control
seriousThe home could not reliably show that staff and visiting professionals had the required vaccination or COVID-19 checks. PPE use and cleaning also needed improvement.
“There was failure to ensure appropriate infection control measures in response to the COVID-19 pandemic.” from the report
Management oversight
seriousAudits, records and monitoring systems did not reliably identify risks or show that care was being delivered as planned. The manager had also not notified CQC about three safeguarding enquiries until after the inspection.
“Systems and records were not always robust enough to demonstrate risks to people's health and safety were effectively monitored.” from the report
- 01What checks have now been completed for all permanent and agency staff, including DBS checks, references and full employment histories?
- 02How do you assess and monitor choking risks for people who need modified diets, especially people living with dementia?
- 03How do you make sure safety checks and risk management plans are carried out and recorded every time?
- 04How do you now check the COVID-19 vaccination and testing status of agency staff and visiting professionals?
- 05What progress has been made against the improvement plan, and how are audits now checking that care records and risk management are accurate?
This was a focused inspection of Safe and Well-led, prompted by concerns about risk, staffing and infection control; Effective, Caring and Responsive were not inspected and were not rated. This explanation was written from the published report of 9 March 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.
Every inspection of St Catherines Care Home
8 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2022Inspected but not ratedSafe: Requires improvementWell-led: Requires improvement
- October 2020Requires improvementstayed Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- September 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2018Inadequatedown from Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2015Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2021
Registered with the Care Quality Commission on 12 October 2021.
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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At least 100 live-in carers within about an hour of Cheshire East
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 88 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.