CQC report explained · a residential care home
What the CQC found at Stafford Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2022
Stafford Hall was rated Requires Improvement; inspectors found staffing and management problems, although medicines, risk checks and some activities had improved.
This was an unannounced focused inspection. Inspectors visited on 10 October and 7 November 2022. They looked only at Safe and Well-led because they were checking earlier concerns and a previous warning notice.
There were not always enough staff to meet people's needs. This affected mealtimes, activities and the amount of personal attention people received. The home had also not made sure staff were replaced when they were away for training.
Some improvements were found. Risk assessments were clearer, medicines were managed safely, and systems for infection control and safeguarding were in place. Mealtime support and activities improved during the second visit, but staffing and management systems were still not strong enough.
The overall rating remained Requires Improvement, as did Safe and Well-led. The other three key question ratings were not inspected during this visit and previous ratings were used.
Risk management
Risk assessments had become more detailed and up to date. They included risks such as choking and falls, and explained how to reduce them.
“Risk assessments had been reviewed and we saw they were more robust containing relevant and up to date details about people's risks and how to mitigate them.” from the report
Some activities improved
The second visit found people taking part in activities after lunch. Staff encouraged people to join in and made games available.
“We saw some people were engaged in meaningful activities after lunch. A table with a host of games was made accessible and people were encouraged to participate.” from the report
Mealtime support improved
During the second visit, staff were allocated to the lounge or dining room at lunchtime. Inspectors saw people being supported to eat.
“We saw that this was put into action during lunchtime and that people were supported to eat their meal.” from the report
Not enough care staff
seriousStaffing shortages continued, including when staff were attending training. Inspectors saw people without help at lunchtime, and some people did not try to eat.
“There was not enough staff to meet the needs of people using the service.” from the report
Weak management oversight
seriousThe provider's systems did not make sure staffing levels and staff deployment were effective. This remained a breach of the good governance regulation.
“The providers systems for the overview and management of staffing was still not effective.” from the report
Limited activities and personal attention
needs fixingPeople did not always receive activities or enough individual time with staff. Inspectors saw many people sitting with little to do.
“The provider did not promote a person-centred culture which was empowering or respectful.” from the report
Infection control details
minorSome staff did not always wear masks as required. Dirty toilet brushes were also found, although these were removed before the inspection ended.
“Some staff, however, were not always wearing their masks as required when around the service.” from the report
- 01How many care staff are normally on duty in the afternoon and evening, and what happens if someone is absent or attending training?
- 02How will you make sure people receive help with eating and drinking at every meal?
- 03How often are activities provided, and who covers them when the wellbeing worker is unavailable?
- 04What action has been taken to address the breaches of Regulation 18 on staffing and Regulation 17 on good governance?
- 05How do you check that staffing levels reflect people's changing needs, the layout of the home and their social needs?
This was a focused inspection of Safe and Well-led only; the other key question ratings carried over from previous comprehensive inspections. This explanation was written from the published report of 7 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, August 2021
Rated Requires Improvement; inspectors found unsafe risk management, staff shortages and weak oversight, although medicines and infection controls were satisfactory.
This was an unannounced inspection after concerns about safeguarding and risks to people. Two inspectors spoke with people, relatives and staff, observed care, and checked care records, medicines records, staff files and management records.
The home was not always safe. Risk assessments were inconsistent, guidance for staff was missing in some care plans, a stair gate was left open, and staffing levels were sometimes below the planned number. Safeguarding referrals had also not always reached the local authority for investigation.
The home was rated Requires Improvement overall, with Safe and Well-led also rated Requires Improvement. The other three areas were not inspected at this visit, so their previous ratings were used. The previous overall rating was Good.
Medicines
Inspectors found that medicines were stored, ordered, given, monitored and disposed of safely. Records checked were in good order.
“People were supported to take their medicines safely.” from the report
Infection control
Inspectors were assured about infection prevention, including PPE, testing, hygiene, social distancing and visiting arrangements.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Recruitment checks
The staff files checked showed that references and disclosure and barring service checks had been completed.
“We reviewed staff files and saw safe recruitment practices were in place, including checking references and obtaining disclosure and barring service checks.” from the report
Staff attitude
Although people and relatives raised concerns about staff shortages, they spoke positively about the staff team.
“However, people and relatives were complimentary of the staff team.” from the report
Health partnerships
The home worked with district nurses and GPs to review people's health needs when required.
“The service had worked in partnership with other health professionals such as district nurses and GPs to have people's health needs reviewed when required.” from the report
Risk assessments
seriousRisk assessments did not always agree with each other or give staff clear instructions. A stair gate was left open after a previous fall on the stairs.
“Risks were not always assessed and monitored safely.” from the report
Staff shortages
seriousStaffing was below the calculated level on some afternoons and nights. This caused pressure for staff and delays for at least one person needing help to get to bed.
“The service had on numerous occasions not been able to maintain the correct level of staff on each shift.” from the report
Safeguarding referrals
seriousSome safeguarding referrals were sent to an inactive email address, so the local authority had not received or investigated them.
“This placed people at risk, if no external investigations were being completed to ensure people's well-being and safety.” from the report
Weak oversight
needs fixingAudits and incident reviews did not always identify the causes of falls, ongoing weight loss or other risks, and did not set out effective actions.
“The provider's systems for monitoring the safety and quality of the service were not effective.” from the report
Care plan guidance
needs fixingSome support plans did not consistently explain the help people needed or how staff should respond to particular behaviours and risks.
“Support plans needed to be consistent in identifying the support people needed and give clear guidance to staff on how best to support people.” from the report
- 01What staffing levels are now in place on afternoons, nights and weekends, and what is the contingency plan when staff are absent?
- 02How do you make sure risk assessments and care plans agree and give staff clear instructions?
- 03How are safeguarding referrals sent, tracked and checked to make sure the local authority has received and investigated them?
- 04What action has been taken following the warning notice about safe care and treatment?
- 05How are falls, weight loss and other incidents now reviewed, and how do you check that the agreed actions have worked?
This was an unannounced focused inspection of Safe and Well-led, prompted by safeguarding and risk concerns; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 20 August 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 Stafford Hall
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- December 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2020Goodstayed GoodSafe: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- March 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2014Inspected but not rated
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 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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