CQC report explained · a nursing home
What the CQC found at Tadworth Grove Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2022
Tadworth Grove Care Home was rated Good overall, but inspectors found staffing concerns and that management systems still needed improvement.
This was an unannounced follow-up inspection on 15 June 2022. Inspectors spoke with people, relatives and staff. They reviewed care plans, medicines records, staff files, complaints, training and the home's checks on quality and safety.
The home was rated Good for safe, effective, caring and responsive care. People generally felt safe and said staff were kind, respectful and supportive. Medicines, food, healthcare support and activities were found to be good.
Well-led was rated Requires Improvement. The home had made changes since the previous inspection, including improving activities, mealtime arrangements and record keeping. Inspectors said some improvements were still new and needed to become routine.
The overall rating improved from Requires Improvement to Good. The home was no longer in breach of regulations, but inspectors recommended using a recognised tool to assess staffing levels.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff knew people well and supported their independence.
“We observed a lot of kind and supportive care throughout the day and people were confident to ask for staff support.” from the report
Improved activities
The range of activities had increased since the previous inspection. People were more positive about what was available and staff also spent time with people in their rooms.
“The social aspect of the service had improved since our last inspection when we found there were few activities for people.” from the report
Medicines and clinical support
Medicines records showed no gaps, and people were supported to see healthcare professionals when needed.
“Each person had a medicine administration record (MAR) in which their prescription details were recorded and staff signed to say medicines had been given.” from the report
Food and drinks
People had meal choices, alternative food when needed, and regular drinks and snacks. Dietary needs were recognised.
“People were provided with sufficient food and drink to maintain a good level of wellbeing.” from the report
Open management
People, relatives and staff said managers were approachable and listened to feedback. Meetings and surveys gave people opportunities to raise suggestions.
“Residents and relatives meetings took place where all aspects of the service were discussed and people could express their views and specific suggestions were considered.” from the report
Staffing levels
needs fixingFeedback about staffing was mixed. Some people said call bells were answered quickly, while others and some staff said they sometimes had to wait. Inspectors recommended a recognised tool to assess staffing levels.
“Good and bad. You have to wait for staff sometimes” from the report
Records and new systems
needs fixingSome records were scantily completed, and the new electronic care planning system was still being introduced. Inspectors said improvements needed to become part of everyday practice.
“We found some minor issues, such as the feedback about staffing levels, the wish for people to have some more outside activities and some scantily completed records.” from the report
More outside activities
minorPeople were positive about activities but some wanted more activities outside the home and more trips.
“People did tell us they would like more outside activities and trips and this was one thing they missed.” from the report
- 01How many care staff and nurses are normally on each shift, and how do you decide whether that is enough for residents' needs?
- 02How quickly are call bells answered now, and what happens if staff have to turn a bell off before returning?
- 03Has the electronic care planning system now been fully introduced, and how do you check that daily records are complete?
- 04What outside activities and trips are currently available to residents?
- 05How are residents and relatives involved in reviewing care plans and raising concerns?
This was an unannounced follow-up inspection of the whole service, including infection prevention and control, after the previous inspection found areas requiring improvement. This explanation was written from the published report of 8 July 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, October 2021
Tadworth Grove Care Home is rated Requires Improvement; inspectors found kind interactions and safe medicines systems, but staffing, activities and quality checks were not reliable.
This was an unannounced focused inspection on 22 July 2021. Inspectors spoke with people, relatives, staff and a healthcare professional. They reviewed care records, medicines records, staff files and management records.
The home was not always able to provide enough staff to support people in their rooms promptly, including at mealtimes. People in their rooms did not always receive meaningful activities, and some care plan preferences were not followed. Quality checks had not found several of these problems.
The home was rated Requires Improvement overall, and for Safe, Responsive and Well-led. Effective and Caring were not assessed at this inspection, so their previous ratings were carried forward.
Safeguarding
Staff understood how to recognise and report possible abuse. People told inspectors they felt safe.
“Staff were confident in their knowledge of safeguarding and the process for reporting any concerns they had.” from the report
Medicines systems
Inspectors found safe systems for ordering, storing, giving and disposing of medicines. The records checked were up to date and accurate, apart from one late medicine recording.
“Medicines were managed safely, were administered by qualified nursing staff and reviewed regularly by the GP.” from the report
Positive interactions
Inspectors saw many positive interactions between staff and people. Relatives also spoke positively about the care and support.
“We observed many positive interactions between staff and service users throughout the inspection day.” from the report
Accessible communication
Communication needs were recorded and the home provided information in different formats, including large print and Braille books.
“People were supported to order books in Braille from the Royal National Institute for the Blind.” from the report
Staffing delays
seriousThere were not always enough staff to support people in their rooms promptly. Inspectors saw that some people waited a long time for help with lunch.
“We found there were not always sufficient staff to meet the needs of people.” from the report
Limited meaningful activities
seriousPeople cared for in their rooms were at risk of social isolation. Activity records often showed sleeping, staying in bed or no activity rather than meaningful engagement.
“People were not always supported to participate in activities which were meaningful to them.” from the report
Care preferences not always followed
needs fixingAlthough care plans were regularly reviewed, staff did not always follow the routines and support needs recorded in them. Inspectors could not account for one person's hearing aids during the visit.
“Although care plans were person centred, up to date and regularly reviewed, people's daily routines and specific care and support needs were not always followed.” from the report
Weak quality checks
seriousThe home's audits did not identify staffing, activity and record-keeping problems found by inspectors. This was also a problem at the previous inspection.
“Although there were management systems in place, we found that quality audits were not always effective in identifying concerns and areas for improvement found at this inspection.” from the report
Late medicine recording
needs fixingOne person's time-critical medicine was given 25 minutes late, and the delay was not accurately recorded on the medicines record.
“There was one occasion when we observed a person was given their time critical medicines 25 minutes later than prescribed” from the report
- 01How many staff will be available at lunchtime and on the upper floors, and how will you prevent delays for people cared for in their rooms?
- 02What one-to-one activities are available for people who stay in their rooms, and how do you record whether each person finds them meaningful?
- 03How do you check that staff follow each person's care plan, including daily routines and equipment such as hearing aids?
- 04What has changed since the previous inspection to make the quality audits identify staffing, activities and record-keeping problems?
- 05How will you make sure time-critical medicines are given on time and any delay is accurately recorded?
This was a focused inspection of Safe, Responsive and Well-led only; the ratings for Effective and Caring were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 5 October 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 Tadworth Grove Care Home
7 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- July 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2021Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2016InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- August 2015Inspected but not ratedSafe: Requires improvementCaring: Requires improvement
- February 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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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