CQC report explained · a nursing home
What the CQC found at Swinton Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were kept safe and risks were assessed and reviewed. Staff recruitment checks were appropriate, although inspectors found minor medicine-record issues and concerns about staff deployment at busy times.
- Effective?
- Good
- People's needs, choices and cultural requirements were recorded, and staff had the skills and training to support them. Inspectors found the lunchtime experience was not good enough and recommended that new arrangements be embedded.
- Caring?
- Good
- Staff were generally kind, patient and respectful. People were involved in decisions and encouraged to remain as independent as possible, although staff became task focused during lunchtime.
- Responsive?
- Good
- Care was mostly personalised and records reflected people's preferences. Activities were limited on the inspection day, so the provider was recommended to deploy staff so people could take part in meaningful activities.
- Well-led?
- Good
- The home had an open culture and regular quality checks. Some issues had not been found through audits, but the registered manager acted on them immediately.
What inspectors found, September 2019
Swinton Grange is rated Good; inspectors found safe, kind care, but saw problems with mealtimes, staff deployment and activities.
The inspection was unannounced and took place on 8 August 2019. Inspectors spoke with people living in the home, relatives, staff and a visiting health professional. They also reviewed care, medicine, staff and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were generally safe, treated kindly, supported by trained staff and involved in decisions about their care.
There were some shortcomings. Staff deployment was not always effective, especially at lunchtime. Some medicine records needed improvement. The lunchtime experience was poor on the inspection day, and no meaningful activities were seen. The home acted on some of these issues during or after the inspection.
People were kept safe
Risks were assessed and updated, including detailed guidance for people who needed a hoist. Staff understood how to recognise and report abuse.
“Risks to people were assessed and updated regularly.” from the report
Kind and respectful staff
Inspectors saw staff supporting people with kindness and patience. Staff knew people well and respected their privacy, choices and independence.
“We observed people being treated with respect and kindness throughout our inspection.” from the report
Personalised care
Care records included people's preferences, communication needs and choices. Staff generally supported people as individuals.
“Care records detailed how people preferred to spend their day and when they liked to perform their daily living activities.” from the report
Open management
The management team encouraged people, relatives and staff to give feedback. Complaints were recorded, investigated and used to improve the service.
“The culture in the home was friendly and open.” from the report
Staff deployment at mealtimes
needs fixingThere were enough staff on duty overall, but staff were not always organised in the right places. This affected the support people received with meals.
“during lunch staff were disorganised and this meant people did not receive appropriate support with the meals.” from the report
Medicine records
minorSome 'as required' medicine instructions did not give staff enough detail. Medicine storage temperatures were not always recorded, although the registered manager addressed these issues immediately.
“the protocols for medicines to be given as and when required lacked some detail” from the report
Lunchtime experience
needs fixingSome people were not taken to dining tables, were not offered a choice, were left with food in front of them or were not offered enough support. The home made significant changes after the inspection.
“We saw people were not taken to dining tables, not offered a choice, left with food in front of them and not always offered support.” from the report
Limited activities
needs fixingNo activities were provided on the inspection day because the activity coordinator was working in the kitchen. Staff said care staff did not have time to organise activities.
“There were no activities provided on the day of our visit.” from the report
Formal staff supervision
minorStaff said they felt supported, but formal supervision had not always taken place. The manager said this was behind because of a staffing change and would be addressed.
“However, staff had not always received a formal supervision.” from the report
- 01How do you make sure staff are deployed effectively at mealtimes, especially when someone is unexpectedly absent?
- 02What changes have you made to the lunchtime arrangements, and how do you check that they are now working well?
- 03How will you provide meaningful activities when the activity coordinator is covering kitchen or other duties?
- 04How do you check 'as required' medicine instructions and medicine storage temperatures?
- 05How are formal staff supervisions now being brought up to date?
This was an unannounced planned inspection that assessed all five key questions; all five ratings remained Good from the previous inspection. This explanation was written from the published report of 10 September 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, February 2017
Rated Good; inspectors found safe, kind and personalised care, with one medicines issue resolved immediately.
The inspection was unannounced and took place on 12 January 2017. Inspectors observed care, spoke with relatives and staff, and checked care records, medicines, recruitment files, training and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, regular training, suitable food and access to health professionals.
Staff were described as kind and respectful. Care plans were detailed and activities were provided seven days a week. Inspectors found one problem with medicines being prepared before people were ready to take them, but this was resolved straight away and refresher training was arranged.
Enough staff
Inspectors found sufficient staff throughout the visit. Staffing levels were based on people's assessed needs.
“We found there were sufficient numbers of staff available throughout the inspection.” from the report
Kind, respectful care
Staff supported people at their own pace and maintained their dignity. They knew people's likes, dislikes and care needs.
“We observed staff interacting with people who used the service and found that they were kind and caring in nature.” from the report
Personalised support
Care plans described how each person should be supported. Staff used information about people's preferences and life stories.
“We looked at records belonging to people and found they were detailed and explained how people needed supporting.” from the report
Good management checks
The home carried out regular audits covering care, medicines, staffing and safety. Actions were followed up.
“We saw that audits had been completed to ensure the service was providing appropriate care and support.” from the report
Medicines prepared too early
needs fixingInspectors saw that medicines were sometimes put into medicine pots when the person was not available to take them. The issue was dealt with immediately and refresher training was arranged.
“However, we saw that medicines were sometimes 'potted up,' into medicine pots if the person was not available to take their medicines.” from the report
- 01What changes were made after inspectors found that medicines were sometimes prepared before people were ready to take them?
- 02How is the home now checking that medicines are given and recorded safely?
- 03How are staffing levels adjusted when people's needs change?
- 04How will my relative's likes, dislikes and life story be recorded and used in their care plan?
- 05What activities would be suitable for my relative, and how would their preferences be taken into account?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home; the previous inspection in August 2015 had identified two unmet legal requirements. This explanation was written from the published report of 18 February 2017 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 Swinton Grange
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 8 November 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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