CQC report explained · a nursing home
What the CQC found at Sutton Grange
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2019
Rated Good; inspectors found kind, effective care, but staffing levels needed closer review.
This was an unannounced, planned inspection on 19 November 2019. Inspectors spoke with people living in the home, visitors and staff. They observed care and checked care files, medicines records, staff files, training records, rotas and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People generally felt safe and spoke positively about the care, staff kindness, activities, food and management.
There were some areas to watch. Feedback about staffing levels was mixed, and inspectors found some shifts where staffing needed review. Staff knowledge about mental capacity rules was limited, and records did not always show that people had been involved in reviewing their care plans.
The previous overall rating was Requires Improvement, published in December 2018. All five areas rated Requires Improvement or Good at that time had improved or remained Good. Conditions previously placed on the home's registration had been lifted.
Kind and respectful care
People and relatives were positive about the care. Inspectors observed staff treating people with kindness, dignity and respect and asking for consent before providing care.
“We observed staff delivering care with kindness, respecting their individual needs.” from the report
Improved medicines safety
Medicines were stored and administered safely, with training and competency checks for staff. The previous medicines breach had been resolved by this inspection.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.” from the report
Good staff training
The home provided induction, supervision and training across a wide range of subjects. Inspectors found the training records showed full completion across the areas provided.
“The training matrix confirmed the service had achieved 100% of staff training across all areas of the training provided.” from the report
Activities and relationships
People had access to activities inside the home and in the community. Visitors were welcomed, and inspectors saw activities taking place during the inspection.
“A range of activities were provided to people and we saw some of these taking place during the inspection.” from the report
Positive management
The home had audits, staff meetings and systems for learning from incidents and complaints. Feedback about the management and changes made was positive.
“The registered manager had developed a positive, inclusive culture which supported good outcomes for people.” from the report
Staffing levels
needs fixingFeedback about staffing was mixed. Inspectors found some shifts where staffing levels needed review, particularly in a unit supporting people with higher needs.
“We noted some shifts where staffing levels would need to be reviewed to ensure there was enough staff in place to ensure people's needs could be met.” from the report
Limited capacity guidance knowledge
needs fixingStaff had received training about mental capacity and liberty safeguards, but their knowledge of who to contact about capacity concerns was limited.
“However the staff knowledge was limited about who to refer to if they had concerns about a person's capacity” from the report
Care plan involvement
minorCare records contained good information, but it was not always recorded that people had been involved in reviewing their plans or understood and agreed to them.
“It was not consistently recorded that people had been involved in the reviews, or understood and agreed to their care plan.” from the report
Medicines guidance
minorThe medicines systems were considered safe, but the policy needed more detail and some as-required medicines guidance needed to be more personal to the individual.
“Whilst most of these contained good information some records would benefit from more person- centred guidance.” from the report
- 01How do you check that there are enough staff on each unit when sickness or other absences occur?
- 02What changes followed the urgent review of staffing numbers and staff deployment?
- 03How do you check that staff understand who to contact when they have concerns about a person's mental capacity?
- 04How will you make sure residents and families are involved in, and agree to, care plan reviews?
- 05How have you updated medicines policies and as-required medicines guidance to reflect each person's needs?
This was an unannounced inspection of the care home, covering all five CQC questions, the premises and the care provided. This explanation was written from the published report of 31 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.
What inspectors found, December 2018
Rated Requires Improvement; inspectors found major improvements since special measures, but medicines were still not always managed safely.
Inspectors visited the home without warning on 31 October 2018. They spoke with people living there, relatives, staff and visiting professionals. They also checked care records, medicines, staff files, training, rotas and management records.
The home had improved significantly since its previous inspection, when it was rated Inadequate overall and placed in special measures. Inspectors found improvements in staffing, training, care planning, safeguarding, activities, food, complaints and management.
There was still a breach of Regulation 12 because one person missed medicines for two days. The home was rated Good for caring, but Requires Improvement for safe, effective, responsive and well-led. It was no longer in special measures, but inspectors said improvements needed to become consistent and lasting.
Kind and respectful care
People and relatives were very positive about the care. Inspectors saw staff speaking kindly and protecting people's privacy and dignity.
“It was clear people's privacy, dignity and human rights were respected, this was confirmed by people and relatives we spoke with.” from the report
Detailed care planning
Care records gave staff clear information about people's individual needs, risks, preferences and communication.
“All of the care files we looked were comprehensive, detailed, person centred, well organised and provided very good information about how to meet people's needs.” from the report
Activities
The home offered a broad programme of activities, including outings, entertainment, exercise, crafts and baking. Records showed people took part.
“A comprehensive programme of activities was provided to people who used the service.” from the report
Improved staffing and training
Inspectors found improved staffing levels, safer recruitment and relevant staff training. People and staff described staffing as better than before.
“During this inspection we found improvements had been made and the home was meeting the requirements of the regulation.” from the report
Positive management changes
People, relatives and staff were very positive about the registered manager and the changes since the previous inspection.
“Significant improvements had been noted since our last inspection.” from the report
Medicines were still not fully safe
seriousOne person's medicines were not given as directed for two days because of a communication problem and a decision not to use handwritten medicines records. The report recorded an ongoing breach of Regulation 12.
“There was a continued breach of Regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014 because systems in place were not robust and a person missed medicines as a result.” from the report
Improvements needed to last
needs fixingInspectors found progress across the home, but said it was not yet consistent or proven to be sustainable.
“Whilst improvements were noted the home needed to embed these improvements and demonstrate their sustainability.” from the report
Meal support was uneven
minorFood choices and special diets were available, but one unit was less organised when supporting people during meals.
“However, we noted one unit was less organised in their approach to supporting people with their meals.” from the report
Some records and policies needed attention
needs fixingThe medicines policy was overdue for review. Inspectors also found a gap in records showing that monitoring had been completed after one incident.
“However, the local medicine policy was overdue for review and the existing policy did not reflect these processes.” from the report
- 01What changes have been made to prevent medicines being missed or given incorrectly?
- 02How are medicines records checked each day, and what happens when a record has a gap?
- 03How do you make sure improvements found after the previous inspection have been maintained?
- 04How do you monitor staffing levels against each person's needs, including at busy times and during meals?
- 05What is the current position of the Banks View unit and any conditions on the home's registration?
This was an unannounced inspection of all five key questions, covering the accommodation, care and management of the home; 26 people lived there and Banks View was closed. This explanation was written from the published report of 12 December 2018 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Sutton Grange
4 rated inspections over 3 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- September 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Registered with the Care Quality Commission on 20 August 2014.
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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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.