CQC report explained · a nursing home
What the CQC found at Stratton House Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Are people protected from harm? Staffing, medicines, infection control, safeguarding.
- Effective?
- Requires improvement
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Requires improvement
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Requires improvement
- Provider oversight and management audits had improved, but not all planned audits were completed and further work was needed. The full Well-led question was not assessed, so its previous Requires Improvement rating was not changed.
What inspectors found, October 2023
Stratton House Nursing Home: targeted follow-up found significant improvements, but the service remained Requires Improvement and further work was needed.
This was an unannounced, targeted inspection by two inspectors on 21 and 22 September 2023. They checked whether the home had met a warning notice about its systems for managing and checking the service.
Inspectors reviewed seven people's care records, food and fluid records, wound and skin care records, accident and safeguarding records, audits and the home's improvement plan. They found better recording and oversight of risks, including eating and drinking, repositioning, choking, accidents and safeguarding.
Some work was still incomplete. Wound care planning was not fully clear, not all planned audits had been completed, and some records and responsibilities needed stronger management oversight. This inspection was not a full reassessment, so the overall rating stayed Requires Improvement.
Better monitoring of food and drink
Fluid records included people's target intake and were completed and discussed daily. Staff had information about specialist diets and thickened fluids.
“Food and fluid charts had been completed in full and fluid records were reviewed and discussed at handover daily.” from the report
Repositioning records improved
People at risk of skin breakdown had care plans with guidance about equipment and how often they should be repositioned. Records showed this guidance was followed.
“Position change charts showed people had their positions changed in line with care plan guidance.” from the report
Improved risk oversight
The home had introduced daily meetings and checks covering accidents, safeguarding, wounds, fluid intake and repositioning. Choking risk assessments and professional guidance were available.
“Staff attended a daily meeting and were updated on areas such as accidents, incidents, safeguarding, wound care and people's current risks.” from the report
Incomplete wound care planning
needs fixingOne person had two wounds but a care plan covered only one. Inspectors also found conflicting information about how the other wound should be managed.
“However, 1 person had 2 wounds but there was only a wound plan for 1 area.” from the report
Audits were not all completed
needs fixingThe home had improved its audits, but some planned monthly checks were missed. The provider had not identified this, including a lack of wound audits.
“However, an overview indicated that not all audits the service had outlined to undertake were completed each month.” from the report
Management checks were not consistent
needs fixingAccident and incident records had not been reviewed by a manager in August and September because of management absence. The provider said this would be addressed.
“Accident and incident records were reviewed by a manager. This had not occurred in August and September due to management absence.” from the report
Confidentiality issue with wound photographs
minorWound photographs were being shared using personal mobile telephone and email details. Inspectors told the provider this did not follow confidentiality policies.
“However, we highlighted to the provider where confidentiality policies were not being followed as personal mobile telephone and email addresses were being used to communicate this information.” from the report
- 01What has been done to make sure every wound has a clear and up-to-date care plan?
- 02Are all planned monthly audits now being completed, including wound audits?
- 03Who is responsible for reviewing accident and incident records when the registered manager is absent?
- 04How are wound photographs now shared securely and in line with confidentiality policies?
- 05What actions remain outstanding from the Regulation 17 warning notice, and when will they be completed?
This was a targeted inspection of the warning notice linked to Regulation 17 and did not assess the whole Well-led question or change the previous ratings. This explanation was written from the published report of 17 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 2023
Stratton House Nursing Home is rated Requires Improvement; inspectors found kind care and safer staffing, but repeated problems with risk records and provider oversight.
This was an unannounced follow-up inspection on 18 and 21 April 2023. Inspectors spoke with people, relatives, staff and health professionals. They observed care and checked care plans, medicine records, staff recruitment files and management records.
The home had improved its staffing, training, recruitment, cleanliness, environment and communication. People and relatives generally described staff as kind, responsive and approachable. Medicines and infection control were managed safely.
However, records about skin wounds, repositioning, fluid intake and catheter care were not always complete or clear. Care plans were still not consistently personal or detailed. Some safeguarding records and mental capacity decisions were also not fully completed.
The overall rating remains Requires Improvement. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. The report says the home has been rated Requires Improvement or Inadequate at the last four consecutive inspections.
More stable staffing
The home had a consistent staff team with little use of agency staff. Inspectors said this meant staff knew people better.
“Changes in the staff team had meant a stable, structured, consistent staff team were now in place.” from the report
Medicines managed safely
Medicines were stored, administered and audited safely. Staff who gave medicines had training and competency checks.
“Medicines were stored, managed and administered safely.” from the report
Clean environment
The home was clean and tidy, and infection prevention measures were in place. Inspectors said the home was no longer in breach for infection control risks.
“At this inspection improvements had been made and the provider was no longer in breach of Regulation 12 in relation to infection control risks.” from the report
Improved staff support
Staff received induction, ongoing training and regular supervision. Staff told inspectors that supervision was supportive.
“Improvements had been made to ensure staff were fully supported through appropriate induction, ongoing training and regular supervision.” from the report
Incomplete risk records
seriousRecords did not always show that people’s risks were being managed correctly. This included wounds, repositioning, fluid intake, malnutrition and catheter care.
“Not enough improvement had been made at this inspection and the provider was still in breach of Regulation 12.” from the report
Weak provider oversight
seriousThe provider had not reliably checked whether earlier problems had been fixed. Some shortfalls were identified by the local authority rather than by the provider.
“There was no provider oversight of the service.” from the report
Care plans not consistently personal
needs fixingSome care plans lacked enough detail about people’s preferences and how staff should provide personal care. Work to improve the plans had not been completed.
“This meant the quality of care plans varied.” from the report
Mental capacity records
needs fixingBest-interest decisions did not always explain how decisions were reached or whether less restrictive options had been considered. Some relatives signed consent forms without clear legal authority.
“However, when best interest decisions were made, the documentation in place lacked information to show how decisions were reached.” from the report
Safeguarding records
seriousTwo incidents involving unexplained bruising were recorded internally, but the process had not been completed to decide whether further reporting was needed. The manager completed this after the inspection.
“However, the process had not been fully completed to consider if this required further reporting in line with safeguarding procedures.” from the report
- 01What has been done since the inspection to make sure wound photographs, measurements and repositioning records are complete and accurate?
- 02How are fluid records now checked, and what happens if someone is not drinking enough?
- 03Have all care plans been rewritten with clear, personal guidance about people’s preferences and how staff should provide care?
- 04How are mental capacity and best-interest decisions now recorded, including consideration of less restrictive options and who has legal authority to give consent?
- 05What changes have been made after the warning notice to improve provider oversight and identify problems before they affect people?
This was an unannounced follow-up inspection covering Safe, Effective, Responsive and Well-led findings, including infection control; no Caring rating is given in the report. This explanation was written from the published report of 14 June 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.
Every inspection of Stratton House Nursing Home
6 rated inspections over 9 years: the service has held its Requires improvement rating throughout.
- October 2023Inspected but not ratedcurrent ratingWell-led: Inspected but not rated
- June 2023Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2022Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- October 2021Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- July 2021Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- September 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 10 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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