CQC report explained · a residential care home
What the CQC found at St Marguerite
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe medicine systems, suitable risk assessments, enough staff, safe recruitment, infection control and safeguarding arrangements.
- Effective?
- Good
- This question was not assessed during this inspection.
- Caring?
- Good
- This question was not assessed during this inspection.
- Responsive?
- Good
- This question was not assessed during this inspection.
- Well-led?
- Good
- Inspectors found clear leadership, quality checks, good communication and a positive culture. The previous Regulation 17 governance breach had been addressed.
What inspectors found, October 2022
St Marguerite is rated Good; inspectors found safe care and improved management, with only minor points to keep under review.
The unannounced inspection took place on 25 August 2022. One inspector spoke with people, relatives, staff and visiting health professionals. They observed care, checked medicines and reviewed care, recruitment, safety and management records.
The home was rated Good for Safe and Well-led. People said they felt safe and well cared for. Inspectors found enough staff, safe medicine systems, suitable risk assessments, good infection control and appropriate safeguarding arrangements.
The home had improved since the previous inspection, which was rated Requires Improvement in 2019. The provider was no longer in breach of Regulation 17, and practice around as-required medicines had improved.
This inspection only assessed Safe and Well-led. The report does not give new ratings for Effective, Caring or Responsive.
People felt safe
People and relatives told inspectors they felt safe and well cared for. Staff understood how to respond to safeguarding concerns.
“People told us they felt safe and well cared for.” from the report
Medicines were managed safely
Medicines were given by trained staff at the correct times and doses. Records for as-required medicines had improved since the previous inspection.
“At this inspection we found practice had improved and records supported the safe and consistent administration of PRN medicines.” from the report
Enough staff
People, relatives and staff said staffing levels were suitable. Inspectors observed staff responding to people in a polite and timely way.
“There are enough staff, you ask for help and they come” from the report
Positive leadership
The home had a stable management structure, regular quality checks and a team culture in which staff felt supported and valued.
“There was a stable management structure and staff felt well supported and valued.” from the report
Good partnership working
Staff worked with health professionals and responded to people's health needs. Visiting professionals described communication and handovers positively.
“They provide thorough handovers when asked and are always responsive, polite and helpful when discussing the residents.” from the report
Employment history records
minorThe provider said the application form would be reviewed so that a full employment history was recorded when a CV was not available.
“The provider confirmed the application form was to be reviewed to ensure full employment history was documented when a CV was not available.” from the report
Residents' meetings
minorResidents' meetings were taking place, but the manager said they should be held more regularly and that notes should be shared with everyone.
“The registered manager confirmed these were to be held more regularly with shared notes for everyone to read.” from the report
- 01How are you checking that the improvements to medicines records have continued since the inspection?
- 02How do you make sure every new staff member has a complete employment history recorded?
- 03How regularly are residents' meetings now held, and how are the notes shared with residents and families?
- 04How do you monitor staffing levels when people's needs change or staff are absent?
- 05What are the current ratings or most recent inspection findings for Effective, Caring and Responsive?
This was an unannounced inspection focused on Safe and Well-led, including infection prevention and control; the other three key questions were not assessed. This explanation was written from the published report of 6 October 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, October 2019
St Marguerite was rated Requires Improvement; inspectors found kind, responsive care but important safety records and management checks were not reliable.
This was an unannounced comprehensive inspection on 27 and 28 August 2019. One inspector spoke with people, a relative, staff and visiting professionals. They also checked care plans, daily records, medicines records, staff files and the home's quality checks.
People generally felt safe and said staff were kind, respectful and available. Staff knew people well, supported choices, helped with food and healthcare, and provided activities. The ratings for Effective, Caring and Responsive were Good.
There were important problems with medicines records, daily care records and follow-up of known risks. A window restrictor had not been fitted even though an audit had identified the risk. The registered manager's safeguarding knowledge was not up to date. Safe and Well-led were rated Requires Improvement, and the overall rating fell from Good at the previous inspection.
Kind and respectful care
Staff knew people well and supported them in a calm, compassionate way. People were offered choices and were not rushed.
“Staff provided care in a kind and compassionate manner.” from the report
Personalised support
Care plans included people's backgrounds, interests, likes, dislikes and preferences. Staff understood how people communicated, including through non-verbal signs.
“Care plans were person centred and included information on people's background, hobbies, interests, likes and dislikes and preferences on how they wished to receive their care and support.” from the report
Activities and relationships
People could choose from activities and were supported to keep in touch with relatives. Staff encouraged participation without pressuring people.
“Activities included a choir, flower arranging, dominoes, knitting and cards club, musical afternoon, weekly piano, music and exercise.” from the report
Food and healthcare support
People were offered meal choices and regular drinks. The home worked with healthcare professionals and made referrals when needed.
“People were supported to eat and drink well.” from the report
Clean environment
Inspectors found infection control measures, protective equipment and handwashing facilities. Visiting professionals said the home and people's rooms looked clean and well presented.
“Cleanliness of the home was well managed and visiting professionals told us the home always looked clean and people's rooms were well presented.” from the report
PRN medicines records
seriousWhen medicines were given as needed, staff did not consistently record the reason or time. The report gave an example where medicine was recorded on the medicines chart for eight days but explained in daily records on only one day.
“Medicines documentation was not consistent in relation to PRN medicines.” from the report
Window safety risk
seriousA first-floor communal hallway window could be opened without a restrictor, giving access to a flat roof. An earlier health and safety audit had identified the problem, but it had not been resolved during the inspection.
“This gave access to a flat roof. A recent health and safety audit completed on 2 August 2019 by a professional consultant had also highlighted this as a risk.” from the report
Incomplete care records
needs fixingDaily records were not consistently completed with relevant information about people's care, health and support. The home relied too much on verbal handovers.
“People's daily records were not completed by all care staff.” from the report
Weak management checks
seriousInternal audits had not identified the medicines and window problems, and actions from external audits had not been dealt with promptly. This led to a breach of the governance regulation.
“The provider had not ensured good governance had been maintained to ensure systems were assessed monitored and used to improve the quality and safety of the services provided.” from the report
- 01Have you fitted the window restrictor, and how do you now check that this safety risk remains controlled?
- 02How are PRN medicines recorded now, including the time given and the reason for giving them?
- 03Who checks daily care records, and how do you make sure important information is recorded rather than passed on only verbally?
- 04What up-to-date safeguarding training and local safeguarding procedures does the registered manager now have?
- 05What actions from the inspection action plan have been completed, and how are these checked by the provider?
This was an unannounced comprehensive inspection covering all five CQC questions, including the premises, care, records, medicines, staff and quality systems. This explanation was written from the published report of 12 October 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 St Marguerite
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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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