CQC report explained · a nursing home
What the CQC found at Stable Steps Care 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, August 2023
Rated Requires Improvement; inspectors found risks from staffing, recruitment, care planning and oversight, with all five areas needing improvement.
The inspection was unannounced and took place over two visits on 8 and 19 June 2023. Inspectors spoke with people, relatives and staff. They observed care, checked medicines and the building, and reviewed care records, staff files and management records.
The home had improved its medicines systems, environmental checks and safeguarding arrangements. However, inspectors found that staffing was not always sufficient, recruitment checks were incomplete and care records were often inaccurate or lacking detail. People were not always given person-centred care, enough support with personal care, food, drink or activities, or clear communication.
The overall rating remained Requires Improvement, as did Safe, Effective, Caring, Responsive and Well-led. The home had been rated Requires Improvement at the previous inspection in August 2022. It was no longer in breach of Regulation 12, but remained in breach of other regulations and received a warning notice about person-centred care.
Medicines management
The home had improved its systems for ordering, storing and administering medicines. Staff had medicines training and competency checks, and records showed people generally received medicines as prescribed.
“Processes were in place for the timely ordering and supply of medicines.” from the report
Safety checks
Environmental and equipment checks were being completed. The home had introduced systems to oversee maintenance and safety.
“Checks and maintenance of the environment and equipment were completed to manage safety.” from the report
Safeguarding arrangements
The home had safeguarding policies and processes, and staff had completed safeguarding adults training.
“The service had suitable processes and policies in place to safeguard people.” from the report
Responding to feedback
The management team acted on concerns raised during the inspection and made some immediate changes.
“The management team were responsive to feedback throughout the inspection and took steps to address any concerns.” from the report
Staffing levels and deployment
seriousInspectors observed people left without enough staff support, including in communal areas. People and families reported delays with call bells and said staff were often too busy.
“Staff were not sufficient and suitably deployed to ensure people received timely, appropriate, and safe person centred care.” from the report
Recruitment checks
seriousRecruitment files repeatedly lacked important information, including references, interview notes, employment history and, where needed, right-to-work documents.
“Robust recruitment processes were either not being followed or not being suitably recorded to ensure staff were safely and appropriately recruited.” from the report
Person-centred care
seriousCare records did not consistently describe people's preferences or needs. Inspectors found care was often organised around tasks and people did not always receive the planned support.
“People were not receiving care that was consistently person-centred and met their needs and preferences.” from the report
Personal care and dignity
needs fixingSome people were not consistently receiving personal care. Records did not show that refusals of care were always followed up or escalated.
“Some people were not clean and care records did not evidence that people were consistently having personal care.” from the report
- 01How many staff are on each unit during busy periods, and how do you respond when people are waiting for the call bell?
- 02What recruitment checks have been completed for all current staff, including references, employment gaps and right-to-work documents?
- 03How are care plans being corrected and checked so they accurately reflect each person's needs, preferences, diet and pressure-relief arrangements?
- 04How do you monitor personal care, food and drink, weekly weights and support for people who refuse care?
- 05What action has been taken in response to the warning notice, and what evidence can you show that person-centred care has improved?
This was an unannounced follow-up inspection over two visits that looked at all five key questions and infection prevention and control; it followed concerns found at the previous inspection. This explanation was written from the published report of 19 August 2023 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, August 2022
Stable Steps Care Centre was rated Requires Improvement; inspectors found kind care but important safety, staffing, care planning and management weaknesses.
This was the first inspection since the home was registered. Inspectors visited on three days, including an unannounced first day. They spoke with people, relatives, staff and health professionals, observed care, and checked care, medicines, recruitment and management records.
The home had caring staff and people generally felt respected and safe. Activities were available, health professionals were involved, medicines were stored properly, and managers acted quickly when inspectors raised concerns.
However, risks were not always identified or managed. Examples included unsecured furniture, incomplete risk assessments, medicines given in modified or hidden forms without all the required records, busy staffing periods and weak recruitment evidence.
Care plans were not consistently detailed or personal. People were not always supported to make choices, eat and drink well, or receive care in the way they preferred. The overall rating and four of the five question ratings were Requires Improvement. Caring was rated Good.
Kind and respectful interactions
People generally felt well cared for. Inspectors saw positive interactions, and staff usually respected privacy and dignity.
“We observed positive interaction between staff and people.” from the report
Training and staff support
Staff spoke positively about their induction, training and support. Further training was arranged in oral care and end of life care.
“Staff spoke positively about the induction, training and support they received in their roles.” from the report
Working with health professionals
The home worked with doctors, district nurses and specialist services. Health professionals gave generally positive feedback about people's progress and support.
“Staff worked closely with other health care professionals such as doctors, district nurses and specialist services, including mental health services, to meet people's needs.” from the report
Activities and relationships
People spoke positively about activities, and the home supported visits from family and began developing community links.
“People spoke positively about the activities. One person said, "I enjoy the quizzes the best. The entertainment lady is good.” from the report
Managers responded to feedback
The management team accepted concerns raised during the inspection and took immediate action on several issues.
“The registered manager and management team were responsive to feedback and keen to drive improvement.” from the report
Risks were not always controlled
seriousInspectors found overly hot water, unsecured furniture and incomplete risk assessments, including for bed rails. These issues were addressed during the inspection, but the checking systems were not reliable enough.
“Systems had not been established to assess, monitor and mitigate risks to the health, safety and welfare of people using the service.” from the report
Medicines records were incomplete
seriousPeople receiving crushed or covert medicines did not always have the required assessments and care plans. Inspectors could not be certain that these medicines were being given safely.
“We could not be certain that these medicines were being safely administered.” from the report
Staffing and recruitment
seriousStaff were not always suitably deployed, and call bells were not consistently answered. Recruitment records did not always show that the home's required checks and interview process had been completed.
“Staff were not always visible or suitably deployed across the home to meet the needs of people.” from the report
Mealtimes and drinks
needs fixingSome people did not have drinks within reach or readily available. Mealtimes could be noisy and busy, and people were not always supported to eat safely or with dignity.
“People did not always readily have access to drinks, and meal times could be busy and noisy experiences which did not always encourage people to have a good diet.” from the report
Care plans were not personal enough
seriousCare plans did not always explain people's preferences, needs or how they wanted to be supported. Daily records also lacked detail or were not completed promptly.
“People were not receiving care that was consistently person centred and met their needs and preferences.” from the report
Management checks were weak
seriousThe home's quality systems did not reliably identify problems, make sure lessons were learned, or ensure the provider's policies were followed.
“Systems were not robust and effective to assess, monitor and mitigate for people using the service.” from the report
- 01What has changed to make sure risks such as unsecured furniture, hot water and bed rail entrapment are found and dealt with quickly?
- 02How are crushed or covert medicines now assessed, recorded and checked with prescribers and pharmacists?
- 03How do you make sure there are enough staff in busy periods and that call bells are answered promptly?
- 04How are care plans being updated to record each person's preferences, choices, risks and communication needs?
- 05What evidence can you show that mealtimes, drinks and activities for people cared for in bed have improved?
This was the first comprehensive inspection of the newly registered home and covered all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 5 August 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 Stable Steps Care Centre
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- August 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2022Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2021
Registered with the Care Quality Commission on 15 March 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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Most charge £980 to £1,260 a week. 88 can care for a couple. 10 years' experience on average.
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“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
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