CQC report explained · a nursing home
What the CQC found at Swallowfield Garden Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found robust risk assessments, safe recruitment, safe medicines management and suitable infection control, although some safety records were not accurate or timely.
- Effective?
- Good
- This question was not assessed during this inspection.
- Caring?
- Good
- This question was not assessed during this inspection.
- Responsive?
- Good
- This question was not assessed during this inspection.
- Well-led?
- Good
- Managers had clear responsibilities, used audits to monitor quality and listened to people, relatives and staff. The rating improved from Requires Improvement at the previous inspection.
What inspectors found, November 2022
Rated Good overall; inspectors found people were safe and the home was better led, but some safety records were not accurate or completed promptly.
This was an unannounced inspection on 25 and 26 October 2022. Inspectors spoke with people living there, relatives, managers and staff. They reviewed care records, audits and other documents.
The home was rated Good for Safe and Well-led. Inspectors found that risks, medicines, staffing, safeguarding, infection control and accidents were generally managed safely. They found no evidence that people were harmed by the concern about nutrition and hydration examined during this inspection.
Some staff did not record support activities accurately or promptly. The inspectors recommended that the home review current record-keeping guidance and improve its practice. The previous overall rating was Good, and the home had improved its leadership rating from Requires Improvement to Good.
Risk management
People had individual risk assessments and emergency plans. Staff understood and followed the risk management plans.
“The registered manager identified, assessed and recorded people's risks. Staff understood and followed risk management plans.” from the report
Safe staffing and medicines
Inspectors found enough suitably trained staff and safe systems for giving medicines, including medicines given covertly where needed.
“The provider ensured there were enough staff, with the right training and skills, to meet people's needs.” from the report
Improved leadership
The home had clearer accountability, regular audits and staff who understood their roles. This addressed the previous recommendation about risk and policy systems.
“At this inspection we found improvements had been made and in line with our previous recommendations.” from the report
People's involvement
People and relatives were invited to give feedback and take part in decisions about menus, bedrooms and activities.
“People and relatives told us they were regularly invited to take part in surveys and questionnaires about the service.” from the report
Incomplete safety records
needs fixingStaff did not always record support activities accurately or promptly. Inspectors found no impact of harm, but recommended that the home improve its record-keeping practice.
“Staff did not always accurately record support activities carried out to ensure people's safety and health needs were met” from the report
- 01What exact changes have been made to improve records of support activities and safety checks?
- 02How do managers check that staff complete these records accurately and promptly?
- 03What audits are currently used to identify missing or inaccurate records?
- 04What is the current position of the CQC investigation into the incident mentioned in the report?
This was a focused inspection of Safe and Well-led; the report does not give current ratings for Effective, Caring or Responsive. This explanation was written from the published report of 17 November 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.
What inspectors found, August 2021
Rated Good overall; inspectors found safe, kind and personalised care, but leadership and quality checks required improvement.
This was the first inspection since the home registered. Inspectors visited on 10, 15, 16 and 21 June 2021. They spoke with people living there, relatives and staff, and checked care, medicine, recruitment and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found that people were protected from abuse, received suitable care and medicines, and were treated with dignity. Staff supported people's choices, independence, communication needs and activities.
The home was rated Requires Improvement for Well-led. Some risks had not been fully assessed, some policies needed stronger review, and the audits had not found these issues. The home completed some risk assessments and updated policies during or after the inspection.
Safe staffing and medicines
Inspectors found enough staff, safe recruitment processes and appropriate medicines management. Infection prevention measures were also in place and followed.
“Staffing levels were adequate and recruitment processes were safe.” from the report
Kind, respectful care
People were supported with dignity, privacy, equality and independence. Relatives were involved in care planning where possible.
“Staff supported people to be as independent as possible and respected their privacy and dignity.” from the report
Personalised support and activities
Care plans reflected people's needs, histories, likes and dislikes. The activities co-ordinator arranged activities, and people were supported to maintain relationships and interests.
“Care plans were regularly reviewed, was person centred and detailed the persons history, likes and dislikes.” from the report
Learning from incidents
The home recorded incidents, shared information with staff and used lessons learned to reduce the chance of problems happening again.
“Accidents and incidents were being recorded and information was shared with staff.” from the report
Risk and policy checks
needs fixingSome risks needed further assessment and some policies needed reviewing. The home's audits had not identified these issues, so its quality checks were not fully effective.
“The audits in place did not identify the issues mentioned above.” from the report
Environmental adaptations
minorFurther changes were needed to make doors, toilet seats and disability aids easier for people living with dementia to recognise.
“Work was needed to make peoples doors, toilet seats and disability aids more easily recognisable.” from the report
Dental access
minorPeople were not registered with a dentist. The home said the pandemic had made this difficult, although emergency dental support was used when needed.
“However, when a person needed dental support, the service accessed an emergency dentist.” from the report
End of life discussions
needs fixingSome older people had been asked about their end of life wishes, but this had not been discussed with everyone.
“Some older people were asked about their end of life wishes and where agreed, an end of life care plan was in place, however, this was not discussed with everyone.” from the report
- 01What risk assessments were completed after the inspection, and how are you checking that they stay up to date?
- 02What changes have been made to doors, toilet seats and disability aids to help people living with dementia recognise them?
- 03Is the home now registered with a dentist, and how are routine dental needs being managed?
- 04How are you making sure every person can discuss and record their end of life wishes?
- 05How often are staff supervisions now taking place, and how do your audits check that policies are being followed?
This was the first inspection of the newly registered home and covered all five key questions, including infection prevention and control measures. This explanation was written from the published report of 5 August 2021 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 Swallowfield Garden Care Home
2 rated inspections over a year: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Swallowfield Garden Care Home →
- August 2021GoodSafe: GoodWell-led: Requires improvement
Read what inspectors found at Swallowfield Garden Care Home →
- March 2020
Registered with the Care Quality Commission on 31 March 2020.
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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At least 100 live-in carers within about an hour of Bolton
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. 92 can care for a couple. 10 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.