CQC report explained · a nursing home
What the CQC found at Symonds House - Care Home with Nursing Physical Disabilities
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, risks were assessed, medicines were managed safely and the home was clean. The service was struggling to recruit and retain permanent staff, and some identity checks in recruitment records had not been signed and dated.
- Effective?
- Good
- People's physical, mental and social needs were assessed, and staff received training and supervision. People enjoyed the food and had access to healthcare services.
- Caring?
- Good
- Staff treated people with respect and dignity and knew their individual needs. People were involved in care decisions as far as possible, although some had lost valued relationships when permanent staff left.
- Responsive?
- Good
- Care was personalised and activities reflected people's interests and choices. End-of-life plans covered practical and clinical issues but did not fully cover emotional needs or comfort.
- Well-led?
- Good
- The management team prioritised people's needs, used audits and improvement plans, and encouraged feedback from people, relatives and professionals. Inspectors found an open and transparent culture.
What inspectors found, February 2020
Symonds House was rated Good overall; inspectors found safe, kind and personalised care, with some concerns about agency staffing and end-of-life plans.
This was an unannounced inspection on 17 February 2020. One inspector spoke with people, staff and a visiting health professional, observed care, and checked care, medicine, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe, received the care they needed, and were treated with dignity and respect.
Inspectors found personalised care, safe medicine systems, suitable staff training, good access to healthcare and activities that reflected people's interests. The home was clean, and relatives and professionals could give feedback.
There were some areas to improve. The home was finding it difficult to recruit and retain permanent staff, and end-of-life care plans did not fully explain how to meet people's emotional needs or keep them comfortable.
Safe medicines
Medicine records showed people received their medicines as prescribed. Staff competence was checked, medicines were stored correctly and regular audits were carried out.
“Medicine administration records (MAR) indicated people had received their medicines as prescribed.” from the report
Personalised care
Care plans described people's individual needs, preferences and communication methods. Staff used this information to provide consistent support.
“The information within the care plans supported staff to deliver consistent care and support in the way that people wanted and needed.” from the report
Respect and dignity
Staff supported people's choices and protected privacy and confidentiality. Inspectors saw staff knock and wait before entering bedrooms.
“Staff were proactive in protecting people's privacy and promoting their dignity.” from the report
Meaningful activities
People were supported to take part in activities, outings and celebrations based on their interests and wishes.
“People received care and support that was flexible and responsive to their individual needs.” from the report
Open management
The management team used audits, feedback and improvement plans to monitor the service. Staff and professionals said support was available when needed.
“The management and staff were open and transparent throughout the inspection process.” from the report
Reliance on agency staff
needs fixingThe home was struggling to recruit and retain permanent staff. People and staff said agency workers were skilled but that frequent changes made it harder to build strong relationships and affected morale.
“However, the service was struggling to recruit and retain permanent staff.” from the report
End-of-life care plans
needs fixingPlans mainly covered practical and clinical matters. They did not give staff enough guidance about people's emotional needs or how to keep them comfortable at the end of life.
“The care plans failed to inform staff about how to meet people's emotional needs and how to keep each person as comfortable as possible at this time.” from the report
Recruitment records
minorMost pre-employment checks were completed, but copies of identity documents had not been signed and dated to show that original documents had been checked.
“However, copies of identity documents had not been signed and dated to confirm that the original documents had been seen and when.” from the report
- 01How many permanent staff are currently employed, and how often are agency staff used?
- 02What has been done to reduce the effect of agency staff changes on people's relationships and morale?
- 03Have end-of-life care plans been updated to include each person's emotional needs and comfort?
- 04How are staff checked and assessed as competent to give medicines safely?
- 05How can people and relatives give feedback about care, staffing and any complaints?
This was an unannounced planned inspection covering all five CQC questions, and all five ratings remained Good from the previous inspection. This explanation was written from the published report of 29 February 2020 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 2017
Symonds House was rated Good; inspectors found safe, kind and personalised care, with effective leadership and no reported breaches.
This was an unannounced inspection on 12 July 2017. One inspector and a registered nurse visited. They spoke with people living in the home, a relative, staff and managers. They reviewed care records, staff files and management records, and observed care.
The home provided nursing care for 20 adults with physical disabilities. At the time, 19 people lived there. Inspectors found good ratings in all five areas: safe, effective, caring, responsive and well-led.
People said they felt safe and had enough staff to support them. Inspectors found personalised care, suitable support with medicines, food and communication, kind staff, meaningful activities and systems for listening to complaints and improving the service.
The home had also been rated Good at the previous inspection. This inspection found that it remained Good.
Risk management
The home had individual risk assessments and clear guidance about moving and handling. Inspectors found that staff understood how to keep people safe.
“Records demonstrated that risks to people were identified and comprehensive control measures were put in place to reduce these risks.” from the report
Kind and respectful care
People described staff as caring. Inspectors saw staff supporting people thoughtfully and respecting their dignity and choices.
“We observed staff interacting with people in a thoughtful and considerate way.” from the report
Personalised activities
The home supported people to follow their interests, maintain relationships and take part in activities both inside and outside the home.
“People were supported to engage in meaningful activities, during our visit we observed the theatre show that had been arranged.” from the report
Open management
People and staff were encouraged to give their views. The manager used audits and an improvement plan to address issues.
“The registered manager promoted a positive, transparent and inclusive culture.” from the report
Inspectors raised no specific concerns in this report.
- 01How are my relative's individual moving and handling needs assessed and updated?
- 02How are medicines, including medicines given when needed, checked and recorded?
- 03What communication aids are available if my relative cannot communicate verbally?
- 04Which activities, outings and community visits are currently available, and how are they matched to each person's interests?
- 05Has the planned fitted kitchen in the activities area been installed, and how is the space being used?
This was an unannounced inspection covering all five questions and the overall rating; the report says the previous rating was also Good. This explanation was written from the published report of 11 August 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 Symonds House - Care Home with Nursing Physical Disabilities
3 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Symonds House - Care Home with Nursing Physical Disabilities →
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Symonds House - Care Home with Nursing Physical Disabilities →
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 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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