CQC report explained · a residential care home
What the CQC found at Stonesby House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found unsafe or unsuitable equipment, poor cleanliness and maintenance problems. Staffing, recruitment checks, safeguarding arrangements and medicines were generally safe.
- Effective?
- Requires improvement
- The building was worn and needed renovation, and some care plans did not fully describe the care provided. People were supported with food, healthcare, training and legal decision-making.
- Caring?
- Good
- This question was not inspected during this focused inspection, so its previous rating was carried forward.
- Responsive?
- Good
- This question was not inspected during this focused inspection, so its previous rating was carried forward.
- Well-led?
- Requires improvement
- Quality checks and daily oversight had not identified important safety and environmental problems. There was no service improvement plan, although managers were open to feedback and acted promptly when inspectors raised concerns.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found kind care and safe medicines, but unsafe equipment, a tired environment and weak oversight.
This was an unannounced focused inspection over three visits in November 2023. Inspectors spoke with people, relatives and staff, and checked care records, medicines, recruitment files, training and management records. They inspected the environment on each visit.
People generally had enough staff, received their medicines safely and were supported by trained staff. Inspectors found kind and friendly relationships, suitable support with food and healthcare, and evidence that people's choices and legal rights were considered.
However, some equipment was unsafe or used for the wrong purpose. The home was not always clean or well maintained, and much of it was worn and needed renovation. Management checks had not found these problems, and there was no service improvement plan.
The overall rating changed from Good at the previous inspection in 2019 to Requires Improvement. This inspection only assessed Safe, Effective and Well-led. The Caring and Responsive ratings were not reassessed and were carried forward from the previous inspection.
Safe medicines
People received their prescribed medicines safely. Staff were trained and assessed as competent, and medicines records and storage supported safe practice.
“People received their prescribed medicines safely. People told us they felt well supported with their medicines.” from the report
Enough staff
Inspectors found enough staff on duty and safe recruitment checks were in place.
“People were supported by enough staff. One person told us, "We're in good hands, there are plenty of staff.” from the report
Kind atmosphere
People appeared comfortable with staff, and relatives described staff as friendly and welcoming. People and staff could raise concerns or make suggestions in meetings.
“The atmosphere in the service was relaxed and friendly. People seemed comfortable around staff and spoke fondly about them.” from the report
Food and healthcare support
People were supported to eat and drink enough, including people with specialist dietary needs. The home worked with health and social care professionals and supported people to attend appointments.
“People with specialist dietary requirements, and people who needed support with their meals, were supported in a dignified and caring way.” from the report
Prompt response to feedback
Managers acted straight away when inspectors raised concerns, including ordering a mattress, securing furniture and improving some cleaning and equipment problems.
“The deputy manager and provider were open to feedback during the inspection and took immediate action when concerns were raised.” from the report
Unsafe equipment
seriousOne person was given a crash mat instead of a mattress for sleeping. Furniture was not fixed in place and could have fallen and caused injury.
“One person was provided with a crash mat instead of a mattress for sleeping. This put the person at risk of injury and was not dignified.” from the report
Weak quality checks
seriousMonthly audits and daily oversight had not identified the unsafe sleeping arrangement or the environmental problems. There was no service improvement plan.
“Quality assurance systems were not always effective. For example, monthly audits had not identified the lack of cleanliness or environmental improvements required.” from the report
Incomplete care plan details
minorSome care plans did not contain full details of the care staff provided, although inspectors did not find concerns with the care being delivered.
“We identified some care plans that did not contain full details of the care provided by staff.” from the report
Missing financial authorisation
needs fixingOne person was being supported with their finances without the necessary authorisation in place. Managers completed an assessment promptly after inspectors raised this.
“We identified 1 person who was being supported with their finances, without the necessary authorisations in place.” from the report
- 01What work has been completed to remove mould, limescale and dirt, and how will you keep the home clean?
- 02Which equipment and furniture have been checked and secured since the inspection?
- 03What is the timetable for renovating the worn areas, and where is the service improvement plan?
- 04How do you now check that care plans fully describe the care each person receives?
- 05What action has been completed following the breach of Regulation 17, and how will you show that management checks are finding problems promptly?
This was an unannounced focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward from 2019. This explanation was written from the published report of 9 January 2024 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, July 2019
Rated Good; inspectors found safe, kind and personalised care, with a minor weakness in recording actions after incidents.
This was an unannounced inspection on 17 June 2019. One inspector met seven of the eight people living at the home, spoke with people, relatives and staff, and reviewed care plans, recruitment, training and quality records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practices, suitable training, good food and healthcare support, respectful relationships, personalised care and meaningful activities.
The home had improved its Well-led rating from Requires Improvement to Good since the previous inspection. Inspectors noted that the system for recording actions after accidents and incidents should be made more formal, and one new resident was temporarily without a wardrobe.
People felt safe
People told inspectors they felt safe. Staff understood safeguarding and how to respond to risks.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Personalised care
Care was based on people's preferences, needs and choices. People and their representatives were involved in care planning.
“People were at the centre of their care and support and involved in decisions about their care.” from the report
Kind relationships
Inspectors saw positive relationships between staff and people. Staff respected privacy, dignity and independence.
“We observed people and staff were comfortable in each other's company and had developed positive, trusting relationships.” from the report
Activities and community links
People were supported to enjoy activities, hobbies, outings and relationships. The home also had links with the local community.
“People were supported to maintain relationships and engage in meaningful activities, hobbies and interests.” from the report
Improved leadership
The Well-led rating improved from Requires Improvement to Good. Audits and feedback were used to support improvements.
“Quality audits were carried out on all aspects of the service and used to drive continuous improvement of the service.” from the report
Incident records could be clearer
needs fixingInspectors found that actions taken after accidents and incidents were not always recorded in a formal enough way. This could make it harder to identify patterns and show how repeat incidents were prevented.
“However, this system would benefit from being formalised to clearly record the actions taken to prevent repeat incidents.” from the report
Replacement wardrobe needed
minorA person who had just moved in did not have a wardrobe in their bedroom because the original was broken. Management said a replacement had been arranged.
“We noted they did not have a wardrobe in their bedroom.” from the report
- 01How do you now record actions taken after accidents and incidents, and how do you check that lessons have been learned?
- 02How are care plans reviewed when a person's physical or mental health changes?
- 03What activities and community outings would be available for my relative, based on their interests?
- 04How would you involve my relative and their representative in decisions about care?
- 05Will the bedroom, furniture and personal belongings be ready before my relative moves in?
This inspection looked at the premises and care provided and assessed all five CQC questions; the previous overall rating was Good, while Well-led had previously been Requires Improvement. This explanation was written from the published report of 19 July 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 Stonesby House
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
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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