CQC report explained · a residential care home
What the CQC found at Stonecross Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2023
Stonecross Care Centre is rated Requires Improvement; inspectors found ongoing safety and management failures, despite some improvements and caring interactions.
This was an unannounced focused inspection on 18 and 20 July 2023. Two inspectors reviewed information from the local authority, fire service and other professionals. They spoke with people, relatives, staff and health professionals, checked records and looked around the home.
Inspectors found ongoing problems with risk management, fire safety recommendations, environmental checks and staff recruitment. They also found that the provider did not have effective oversight or an active plan to put things right. Medicines were generally given as prescribed, but records for some creams needed improvement.
There were also positive findings. People and relatives said they felt safe and were happy with the care. Staff had safeguarding knowledge, infection control was appropriate and there were enough staff. The overall rating remains Requires Improvement, and the home has held this rating for the last two inspections.
People felt safe
People and relatives told inspectors that people felt safe at the home. Staff understood safeguarding procedures and knew how to report suspected abuse.
“People told us they felt safe living at the home.” from the report
Caring interactions
Inspectors saw positive interactions between staff and people. People and relatives said the care was person-centred and met people's needs.
“During the inspection visit, we saw positive and caring interactions between staff and people who lived at the home.” from the report
Infection control
Inspectors were assured that infection prevention measures were appropriate, including hygiene, protective equipment and managing possible outbreaks.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Enough staff
The staffing numbers observed during the inspection were considered sufficient.
“There were enough staff employed. Rotas and our observations at inspection supported this position.” from the report
Risks were not consistently managed
seriousRecords and oversight of weight, falls, accidents, incidents and food and fluid intake were not reliable. Fire safety recommendations had also not been acted on, and there was no active plan to resolve them.
“Some risks to people were not handled appropriately. For example, there was a lack of oversight of weight monitoring, accidents and incidents, falls risks and poor recording of people's food and fluid intake.” from the report
Recruitment checks were incomplete
seriousMost recruitment files did not show checks with previous health and social care employers or other important checks. Identity, right to work and criminal record checks had been completed.
“They were not properly assessing staff members' fitness to work with vulnerable people.” from the report
Weak provider oversight
seriousThe provider could not demonstrate effective quality monitoring and had no documented oversight available for inspectors. Some staff said they lacked confidence that concerns passed to the provider would be dealt with.
“This lack of oversight meant there was no active action plan to address failing and improve the service.” from the report
Cream records needed attention
minorPeople received their medicines as prescribed, but records for applying some essential creams were inconsistent with good practice.
“However, records around the application of essential creams were inconsistent with good practice.” from the report
- 01What has been done to complete the outstanding fire safety recommendations, and can we see the action plan?
- 02How are you now checking that all staff have suitable employment histories and the required recruitment checks?
- 03How are falls, accidents, weight changes and food and fluid intake being monitored and reviewed?
- 04How are provider directors checking the quality and safety of the home, and how are concerns raised by staff followed up?
- 05How are records for applying essential creams being checked for completeness?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 31 October 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, June 2022
Requires Improvement overall; inspectors found serious fire safety and management failures, although people received kind care and medicines were usually given as prescribed.
This was an unannounced focused inspection on 25 and 26 May 2022. Inspectors looked only at Safe and Well-led, after reviewing information about the home. They spoke with people, relatives, staff and healthcare professionals, checked records and looked around the building.
Inspectors found people were not always safe. Fire safety arrangements were substantially deficient, including an out-of-date fire risk assessment, blocked fire escapes, unreliable evacuation plans and insufficient staff training. People could also access harmful materials and, at times, the kitchen. Recruitment checks were incomplete in four of five files examined.
The home was rated Requires Improvement overall. Safe was rated Requires Improvement and Well-led was rated Inadequate. The other three areas were not inspected at this visit, so their previous ratings were used. The fire service took immediate enforcement action and most essential fire safety issues had been resolved before the report was published.
Kind, person-centred care
Inspectors saw positive interactions. People and relatives said they were happy with the care and that it was person-centred.
“During the inspection visit, we saw positive and caring interactions between staff and people who lived at the home.” from the report
Safeguarding
Staff understood how to recognise and report abuse. People and a healthcare professional said the home felt safe and there were no concerns about abuse or neglect.
“Staff told us they had received safeguarding training and were aware of the importance of reporting abuse.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including the use of protective equipment and safe visiting.
“We were assured the provider's infection prevention and control policy was up to date.” from the report
Healthcare support
Staff helped people access healthcare professionals and specialist support. External professionals were positive about the care and support provided.
“Staff supported people to have access to healthcare professionals and specialist support and the service worked well with external specialists.” from the report
Fire safety
seriousFire arrangements were not safe. The fire risk assessment was out of date, fire escapes were obstructed, some essential checks were missing, evacuation plans were unreliable and not enough staff had the required training.
“People were not safe in the event of a fire or a fire alarm sounding at the home.” from the report
Recruitment checks
seriousRequired checks with previous employers and other pre-employment checks were missing from four of the five recruitment files inspected. One disciplinary process also did not properly establish whether a staff member was suitable to work with vulnerable people.
“The provider had not always followed safe recruitment procedures.” from the report
Weak management oversight
seriousThere were no recorded provider-led audits, risks were not consistently acted on and records were incomplete or inaccurate. This meant the provider could not show that the home was being managed safely.
“Systems were either not in place, followed or robust enough to demonstrate the service was effectively managed.” from the report
Access to unsafe areas and materials
needs fixingPeople could access materials covered by hazardous-substance controls. The kitchen door was often left open and its closing mechanism was defective.
“People could access materials that were harmful to them and, on occasions, an empty kitchen.” from the report
Medicine record issue
needs fixingPeople usually received medicines as prescribed, but on one occasion staff did not do enough to correct errors by another agency, delaying a person's medicine.
“On one occasion, staff had not done enough to correct errors by other agencies that prevented a person receiving their medicine in a timely way.” from the report
- 01Have all the fire service's required improvements been completed, and can you show us the current fire risk assessment?
- 02Are every resident's personal emergency evacuation plans now accurate, current and available to staff and emergency services?
- 03Have all staff completed fire safety awareness and fire-fighting training, and how are new or temporary staff checked before working here?
- 04What provider-led audits are now in place to identify and act on safety, recruitment and record-keeping problems?
- 05Has the home resumed admissions, and if so, what evidence shows that the essential fire safety works and processes are complete?
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 30 June 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 Stonecross Care Centre
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- October 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Requires improvementSafe: Requires improvementWell-led: Inadequate
- March 2021Inspected but not ratedSafe: Inspected but not rated
- June 2019Goodstayed GoodSafe: GoodWell-led: Good
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2015
Registered with the Care Quality Commission on 17 August 2015.
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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