CQC report explained · a nursing home
What the CQC found at Steeton Court Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments, medicines systems, safeguarding arrangements and staffing had improved and were found to be safe. Infection control measures for COVID-19 were also in place.
- Effective?
- Good
- Staff had appropriate training and support. People’s nutrition, healthcare needs, capacity and consent were assessed and reviewed.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Care plans reflected people’s choices and supported independence.
- Responsive?
- Good
- Care was personalised and complaints were managed effectively. Staff supported people to stay in contact with relatives during the pandemic.
- Well-led?
- Good
- New management and auditing systems had improved oversight of safety and quality. Relatives and staff reported substantial improvements.
What inspectors found, November 2020
Rated Good; the home improved from Inadequate and left Special Measures, with safe and caring support found across all five areas.
This was a follow-up inspection after serious problems were found in December 2019. Inspectors visited on 24 and 25 September 2020, spoke with relatives and staff, and checked care records, medicines, recruitment files and quality checks.
Inspectors found improvements in risk management, medicines, staffing, training, nutrition, care planning, complaints and management oversight. They also found infection control arrangements for COVID-19 were effective.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home was no longer in breach of regulations and was no longer in Special Measures.
Safer care systems
Risk assessments were detailed and kept up to date. Inspectors found that people received their medicines as prescribed.
“Care plans included up to date and comprehensive individual risk assessments which gave staff the information they needed to maintain people's safety.” from the report
Kind and respectful care
Staff supported people with dignity and encouraged them to make choices and go at their own pace.
“People were treated respectfully. One staff member said, "We are guests in their home. This is their home.” from the report
Strong improvement in leadership
The new management approach included regular audits, staff involvement and action plans based on feedback.
“They have since registered with CQC and established robust systems for auditing safety and quality within the service to continue to drive improvement.” from the report
Care plan agreement records
needs fixingAlthough people were involved in developing their care plans, the records did not always show their agreement or how they had been involved. The manager identified this for further work.
“People had not signed their agreement to their care plans, or, where the person was unable to sign, record had not been made of how the person had been involved.” from the report
- 01How do you now record that each person has agreed to their care plan or has been involved in it?
- 02How are medicines checked and audited, particularly for people who need regular or specialist medicines?
- 03How do you decide whether staffing levels are enough for people’s current needs?
- 04How do you keep relatives informed about infection risks, testing and visiting arrangements?
- 05What quality checks are carried out now, and how do you act when they identify a problem?
This was a follow-up inspection after the previous Inadequate rating, with infection prevention and control also checked; the report gives ratings for all five key questions. This explanation was written from the published report of 11 November 2020 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, December 2019
Rated Inadequate and placed in special measures; inspectors found people at risk from poor medicines management, staffing, care planning and oversight.
Inspectors visited unannounced on 10 and 22 October 2019. They spoke with people living in the home, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
They found serious safety concerns. Medicines records were inaccurate, risks were not always managed, some safeguarding concerns had not been reported, and there were not always enough suitably skilled staff. The fire risk assessment was out of date and important safety checks had not been completed.
Care was not consistently suited to people's needs. People's hydration was not always monitored properly, healthcare advice was not always followed, care plans lacked detail, and some complaints were not dealt with. Inspectors also saw examples where dignity and personal presentation were not protected.
The overall rating fell from Good at the previous inspection to Inadequate. Safe, Effective, Responsive and Well-led were Inadequate. Caring was Requires Improvement. The home was placed in special measures, with CQC and the local authority monitoring its progress.
Clean environment
The home was clean and free from unpleasant smells. People and relatives also described regular cleaning.
“The home was clean and odour free.” from the report
Meals and choice
People generally spoke positively about the food, its quality and the choices available. The chef knew people's preferences and sought feedback.
“The food is excellent, good quality, service and variety.” from the report
Access to healthcare
People said they could see a GP when needed and that staff arranged visits from other healthcare professionals.
“The GP comes in once a week and when requested.” from the report
Kindness from some staff
Some people said staff were kind and caring, including the night staff.
“Yes, they are kind” from the report
Medicines and safety checks
seriousMedicines records were poorly completed and stock did not always match the records. Important safety checks, including fire safety and equipment checks, had not been completed.
“Medicines were not managed safely, and we could not be assured people received medicines safely in line with good practice.” from the report
Staffing and recruitment
seriousThere were not always enough suitably qualified staff, and the home relied heavily on agency workers. Recruitment files did not show that all required checks had been completed.
“There were not always enough suitably qualified, competent, skilled and experienced staff on duty to keep people safe.” from the report
Food and fluids
seriousPeople were at significant risk of dehydration because fluid monitoring was ineffective. Some people did not receive snacks needed for a liquidised diet.
“People were at significant risk of dehydration.” from the report
Care planning
needs fixingCare plans did not contain enough detail about people's needs, preferences or end of life wishes. People and relatives were rarely shown to have been involved in planning care.
“Care plans did not give staff enough detail to provide person centred care.” from the report
Dignity and respect
needs fixingInspectors saw people left wearing clothing protectors and found that personal presentation and responses to anxiety were not always handled appropriately.
“People were not always treated with dignity and respect.” from the report
Weak oversight
seriousThe provider's audits and monitoring systems had not identified the problems. There was no evidence that earlier external recommendations had been acted on.
“There was no evidence to show any learning from accidents, incidents or complaints.” from the report
- 01What has been changed to make medicines records accurate, and how are medicine stocks now checked?
- 02How many permanent and agency staff are currently on each shift, and how do you ensure there are enough suitably trained staff?
- 03How are people's fluid targets recorded and monitored, and what happens when someone is not drinking enough?
- 04How have care plans been rewritten with people and relatives, including end of life wishes and cultural or spiritual needs?
- 05What quality checks are now in place for accidents, complaints, safeguarding concerns and care tasks?
This was an unannounced inspection covering all five CQC questions, using observations, discussions with people, relatives and staff, and checks of care, medicines, recruitment and management records. This explanation was written from the published report of 6 December 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 Steeton Court Nursing Home
5 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- November 2020Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Goodup from Requires improvementResponsive: Good
- July 2015Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 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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