CQC report explained · a nursing home
What the CQC found at Stretton 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
- Medicine records and checks were not always complete. Some windows lacked restrictors and some wardrobes were not secured, although immediate action was taken during the inspection.
- Effective?
- Good
- People's needs were assessed, staff training had improved, and people were supported with nutrition, hydration, healthcare and activities.
- Caring?
- Good
- People were treated with kindness, privacy and dignity. They and their relatives were involved in care decisions wherever possible.
- Responsive?
- Good
- Care plans reflected people's current needs and preferences. People were supported to communicate, maintain relationships, make complaints and take part in activities.
- Well-led?
- Requires improvement
- Leadership and oversight had improved, but audits did not yet reliably identify medicine and environmental risks. The home did not have a registered manager in post at the inspection.
What inspectors found, June 2023
Rated Requires Improvement; inspectors found kind, person-centred care, but medicines, risks and oversight still needed improvement.
This was an unannounced follow-up inspection on 10 May 2023. Inspectors spoke with people, relatives and staff. They reviewed care records, medicine records, accidents, audits, recruitment checks and how care matched people's records.
The home was rated Good for Effective, Caring and Responsive. People were treated with kindness and dignity, had personalised care plans, received support with food and healthcare, and were offered activities and family contact.
Safe and Well-led were rated Requires Improvement. Medicine administration times and checks on medicine patches were not always recorded. Some environmental risks had not been identified. The new auditing systems were still being developed.
The home was no longer in breach of Regulations 12 and 17, which had applied at the previous inspection. However, the overall rating remained Requires Improvement because inspectors found limited assurance about safety and inconsistent management oversight.
Kind and respectful care
People were treated well and their privacy, dignity and independence were respected. Relatives were also involved in care planning.
“People were treated well and respected by the staff.” from the report
Personalised care
Care plans covered people's health, independence, goals, skills and abilities. The new electronic system helped staff access and update them.
“The plans were comprehensive, covering all aspects of people's lives such as health, independence, goals, skills and abilities, and guided staff on how best to support people.” from the report
Improved staffing and training
Inspectors found enough staff to meet people's individual needs. Training and induction had improved since the previous inspection.
“This inspection found there were sufficient staff on duty to meet people's individual needs.” from the report
Activities and relationships
People were supported to keep in touch with families and enjoy activities suited to their interests, including group and one-to-one activities.
“Activities co-ordinators knew people's interests and encouraged and arranged both group and 1 to 1 activities that were of interest to people.” from the report
Medicine records
needs fixingTimes for some time-sensitive medicines were not always recorded. Checks that skin patches remained in place were also not recorded, although the report found no evidence that medicines had not been given as prescribed.
“Administration times of 'time sensitive' medicines were not always recorded.” from the report
Environmental risks
seriousSome windows did not have restrictors to reduce the risk of falls, and some wardrobes were not secured. The manager took action during the inspection.
“We found some windows did not have window restrictors in place to prevent falls from height and some wardrobes were not secured to the wall.” from the report
Management oversight
needs fixingThe new audits did not yet reliably identify medicine and environmental risks. The systems for overseeing the service were still being developed.
“These audits required further development to be effective and provide sufficient oversight of medicines and environmental risks.” from the report
- 01How are exact administration times for time-sensitive medicines now recorded and checked?
- 02How are checks on people's skin patches recorded, and who reviews those records?
- 03Have all windows been fitted with restrictors, and have all wardrobes and other furniture been checked for safety?
- 04Who is currently responsible for the home while the manager's registration application is being considered?
- 05How often are the new audits reviewed, and how will you show that they identify and fix medicine and environmental risks?
This was an unannounced follow-up inspection covering all five key questions and infection prevention and control, following the previous inspection's concerns. This explanation was written from the published report of 8 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.
What inspectors found, December 2019
Rated Requires Improvement; inspectors found risks to safety, staffing and care records, with well-led rated Inadequate.
Inspectors visited without notice on 10, 11 and 14 October 2019. They spoke with people, relatives and staff, observed care, and checked care records, medicines records and management records.
They found people were at risk because risk assessments and safety measures were missing or not followed. Medicines records were incomplete. There were not always enough staff at busy times, and some people received personal care earlier or later than they wanted.
People and relatives described staff as kind and caring. People enjoyed the food, could access healthcare and had activities. However, privacy was not always protected, some end of life records needed more information, and care plans were being updated.
The overall rating was Requires Improvement. Safe, Effective, Caring and Responsive were all Requires Improvement. Well-led was Inadequate. The home remained in breach of Regulations 12 and 17, and the provider had not made or sustained enough improvement since the previous inspection.
Kind staff
People and relatives said staff were kind, patient and knew people well. Inspectors also saw examples of sensitive and considerate care.
“People and their relatives said they were supported by kind and caring staff.” from the report
Food and drinks
People were offered choices, snacks and drinks. They said they enjoyed the food and could ask for something different.
“People were offered drinks and snacks through the day and enjoyed their meal time experience.” from the report
Healthcare access
People could access healthcare when needed, and appropriate referrals were made for their health needs.
“People could access healthcare services when they needed.” from the report
Activities
People had access to group and one-to-one activities, including crafts, hand massages and reminiscing.
“We saw examples of group activities arranged that people told us they enjoyed.” from the report
Risk of harm
seriousRisk assessments and agreed security measures were not always in place. One person left the building during the inspection and was at risk of potential harm.
“On the second day of the inspection one person left the building and was at risk of potential harm.” from the report
Medicines records
seriousMedicines were not always recorded or monitored properly. This included missing photographs and records showing whether topical medicines had been applied.
“Medicine records were not maintained to ensure people had their medicines as prescribed.” from the report
Staffing pressures
needs fixingThere were not always enough staff at busy times. Some people received personal care very early or in the afternoon rather than at their preferred time.
“There was not always sufficient staff on duty to meet people's needs in a timely way.” from the report
Privacy
needs fixingStaff did not always knock before entering bedrooms or use signs when personal care was taking place. This meant people's dignity was not consistently protected.
“People did not consistently have their dignity respected.” from the report
Weak oversight
seriousThe provider's quality checks repeatedly failed to identify or fix problems with care plans, clinical checks, records and staffing. This was a continuing breach over three inspections.
“This was the third inspection in three years where there was a continuous breach in this regulation.” from the report
- 01What has been done to prevent people leaving the building without staff knowing, and how are these measures checked?
- 02How are medicines, including topical medicines, now recorded and monitored?
- 03What staffing levels are now in place in the mornings, and can people receive personal care at their preferred times?
- 04How are care plans, catheter care, diabetes care and seizure information checked for accuracy?
- 05What action has been taken in response to the Regulation 12 warning notice and the Regulation 17 requirement notice?
This was an unannounced planned inspection based on the previous rating and covered all five CQC questions, including the care provided and the home itself. This explanation was written from the published report of 19 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 Stretton Nursing Home
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2018Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- February 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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