CQC report explained · a nursing home
What the CQC found at St Cyril's Neurological Care and Rehabilitation Service
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2022
Requires Improvement; inspectors found kind care and rehabilitation support, but safety checks, medicines and management oversight were not reliable enough.
This was an unannounced inspection over 25 and 27 October 2022. Inspectors spoke with two people using the service, seven relatives and staff. They reviewed five care plans, medicine records, recruitment files, training records and management records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found pressure area care was not always delivered as planned, some medicine checks were incomplete, fire evacuation arrangements needed attention and quality checks had missed important problems.
There were also positive findings. Staff were kind and respectful, there were enough safely recruited staff, and people received individual rehabilitation from a multi-disciplinary team. The provider took some immediate action and was required to send CQC an improvement plan.
Kind and respectful staff
Staff treated people with kindness, respect and dignity. Relatives said staff were caring and some knew their loved ones well.
“Staff treated people with kindness and treated them with respect and dignity.” from the report
Individual rehabilitation
People were supported by different health professionals to take part in rehabilitation suited to their needs.
“People were supported by a multi-disciplinary team to engage in a rehabilitation programme that was individual to them.” from the report
Staffing and training
Inspectors found enough safely recruited staff. Staff had training and were assessed as competent to use moving and handling equipment.
“There were enough safely recruited staff to meet the needs of the people supported.” from the report
Infection control
Inspectors were assured that infection prevention arrangements, including PPE, visiting and outbreak planning, were in place.
“We were assured that the provider was using PPE effectively and safely.” from the report
Pressure area care
seriousCare plans were not always followed and staff were not always clear about repositioning and skin checks. One person at very high risk did not have an associated care plan.
“Risks to people were not always effectively managed.” from the report
Medicine records and protocols
seriousThirteen as-required medicines were given without clear protocols. Eye drops had no opening dates, and duplicate medicine records increased the risk of an overdose.
“We found 13 PRN medicines being administered without a clear protocol in place.” from the report
Fire evacuation
seriousNo full evacuation drills had taken place recently. Inspectors also found concerns about lighting and padlocked gates on an exit route, although the provider addressed these immediately.
“No full evacuation fire drills had taken place recently at the service.” from the report
Weak management checks
seriousAudits and quality checks had not found several safety and record-keeping problems. Care plans were not always updated promptly when people's needs changed.
“Audits and quality assurance checks had not identified the issues found during the inspection.” from the report
Unsafe storage
needs fixingThe sluice door was found unlocked twice, and cleaning products were left in communal areas. The provider removed the products after inspectors raised the issue.
“On two occasions we found the sluice door unlocked.” from the report
- 01What changes have you made to pressure area checks, repositioning and care plans since the inspection?
- 02How do you now make sure every as-required medicine has a clear protocol and that medicine records cannot be duplicated?
- 03When was the last full fire evacuation drill, and have all exit lighting and gates been checked?
- 04How do your current audits identify missed care, unsafe storage and changes in people's needs?
- 05What progress has been made against the action plan requested by CQC?
This was a focused inspection of Safe and Well-led; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 9 December 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, July 2021
Rated Good; inspectors found safe, kind and well-organised care, with a new system for recording end-of-life wishes still being developed.
Inspectors made an unannounced, comprehensive visit on 29 June 2021. They reviewed five people's care records, recruitment and training records, safety checks, meeting minutes and audits. They also spoke with people, relatives, staff, managers and health and social care professionals.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people's risks were assessed, medicines were managed safely, staff were trained and there were enough staff to meet people's needs.
People received personalised rehabilitation and therapy support. Inspectors found kind and respectful care, good communication, suitable food and drink support, and effective work with healthcare professionals. A new system for recording end-of-life wishes was being developed.
This was the first rated comprehensive inspection under the new provider. The previous provider had been rated Requires Improvement, with breaches relating to risk assessment and governance. Inspectors found enough improvement had been made and there were no longer breaches.
Safe staffing
Inspectors found enough staff to meet people's individual needs. Relatives also reported continuity of staff and sufficient staffing.
“Sufficient staff were available to meet people's individual needs.” from the report
Kind care
People appeared comfortable with staff, and relatives described the care as caring, patient and hardworking.
“People were treated with care, patience and kindness by the staff team.” from the report
Personalised rehabilitation
Care and support were centred on people's rehabilitation needs, choices and preferences. Plans were reviewed and updated when needs changed.
“People's care and support was centred around their rehabilitation needs, choices and preferences.” from the report
Strong oversight
The home used regular audits and reviewed incidents to identify trends and reduce future risks. Staff had opportunities to raise concerns and suggest changes.
“Systems to assess, monitor and improve the service were effective and had identified areas for development and improvement.” from the report
End-of-life records
minorAt the inspection, a new system for recording people's end-of-life wishes was still being developed. Ask what has since been put in place and how your relative's wishes will be recorded.
“A new system was being developed for the recording of people's end of life wishes.” from the report
- 01How will you assess whether the rehabilitation and therapy programme matches my relative's neurological needs and goals?
- 02How are end-of-life wishes recorded now, and how will you involve my relative and our family in reviewing them?
- 03How do you maintain continuity of staff for each person, and how do you decide staffing levels from individual needs?
- 04How will you support my relative's communication needs, including any alternative formats or extra time needed?
- 05How are relatives informed about safeguarding concerns, incidents or changes in their relative's care?
This was an unannounced comprehensive inspection covering all five key questions, including infection prevention and control; it was the first rated inspection under the new provider. This explanation was written from the published report of 29 July 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 St Cyril's Neurological Care and Rehabilitation Service
2 rated inspections over a year: the service has slipped, from Good to Requires improvement.
- December 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at St Cyril's Neurological Care and Rehabilitation Service →
- July 2021GoodSafe: GoodWell-led: Good
Read what inspectors found at St Cyril's Neurological Care and Rehabilitation Service →
- August 2020Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- January 2020
Registered with the Care Quality Commission on 16 January 2020.
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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84 live-in carers within about an hour of Cheshire West and Chester
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. 76 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.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
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.