CQC report explained · a nursing home
What the CQC found at The Cottage Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received their medicines as prescribed, risks were assessed and managed, and inspectors found enough safely recruited staff. Safe care improved from Requires Improvement at the previous inspection.
- Effective?
- Good
- Staff had training and support, people's dietary and health needs were met, and people were helped to make decisions and give consent.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors found that people were treated with dignity, privacy and respect and were involved in decisions about their care.
- Responsive?
- Good
- Care plans reflected people's needs and preferences, although protected characteristics were not always formally recorded. People had access to activities, social events, religious support and personalised end-of-life care.
- Well-led?
- Requires improvement
- The home's leadership and quality checks were not always consistent or strong enough. Medicines audits missed recording and stock-checking problems, and care-record checks were not formally recorded or comprehensive.
What inspectors found, January 2020
Rated Good overall, but inspectors found weaknesses in medicines and care-record checks and rated the home Requires Improvement for being well-led.
This was an unannounced planned inspection on 10 December 2019. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care records, medicines records, staff files and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, safe recruitment, kind support, personalised care, activities and suitable help with meals, health needs and end-of-life care.
The well-led rating fell from Good to Requires Improvement. Audits did not always identify problems with medicines records, and checks of care plans were not formally recorded or comprehensive enough. The home remained Good overall, but the provider was told to improve its audit and governance systems.
Staffing and recruitment
The home had enough staff, and recruitment checks had improved. People said staff responded quickly and knew them well.
“The provider had made improvements and followed robust procedures to ensure staff were suitable to work with people.” from the report
Kind and respectful care
Inspectors found a warm atmosphere. Staff knew people well, respected their privacy and supported their independence.
“Staff were kind and caring, treated people with respect and promoted their privacy and dignity at all times.” from the report
Personalised support
Care plans reflected people's preferences and staff adapted support to individual needs. People were involved in decisions about their daily lives.
“People received personalised care from staff that knew them well.” from the report
Activities and relationships
People could take part in activities, outings, hobbies and religious worship. Families were involved and people were supported to maintain relationships.
“People and relatives were able to join in social events and were supported to follow their hobbies and interests.” from the report
Learning from incidents
The home reviewed incidents and made changes after things went wrong, including after a medicines error.
“We saw that thorough reviews were carried out when incidents occurred, and staff reflected on their practice and discussed how improvements could be made to minimise the risk of reoccurrence.” from the report
Medicines audits
seriousPeople received their medicines, but checks were not strong enough to identify stock discrepancies and incomplete records. Staff could not always reconcile medicines with administration records.
“The lack of an audit trail meant that any errors could not easily be traced.” from the report
Medicines recording
seriousStaff did not always record why medicines were given. Some entries for medicines supplied outside the usual cycle were not countersigned.
“Staff did not consistently record why the person had been administered the medicine.” from the report
- 01How are medicines stocks now checked and reconciled with medicine administration records?
- 02How do you make sure staff record why each medicine was given and countersign medicines added outside the regular cycle?
- 03How are care-plan audits recorded, and how do you check that all areas of people's care are covered?
- 04How do you record and act on people's protected characteristics and relationship needs?
- 05What changes have been made since the inspection to strengthen quality and governance checks?
This was an unannounced planned inspection covering all five key questions, with the home and the care provided both examined. This explanation was written from the published report of 8 January 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, June 2017
The Cottage Nursing Home was rated Good overall; inspectors found kind, effective care but safety systems needed improvement.
This was an unannounced inspection on 3 May 2017. Inspectors spoke with people living at the home, relatives, staff and the manager. They observed care and checked care records, medicines records, staff files, complaints and quality checks.
People generally felt safe and said there were enough staff. Medicines were given as prescribed, risks were managed and staff understood how to report abuse. However, two staff files did not contain references from previous employers, and one file did not show how the person had been checked as suitable to work there.
Inspectors found good care in the other areas. Staff were kind, respected choices and dignity, supported independence, provided activities and helped people access healthcare. The home was also judged to be well led, with checks that identified some improvements.
The overall rating improved from Requires Improvement at the previous inspection in October 2015 to Good. Safe was still rated Requires Improvement, while Effective, Caring, Responsive and Well-led were rated Good.
Kind and respectful care
People and relatives described staff as kind. Inspectors saw staff listen to people, offer choices and support them with dignity.
“People and their relatives told us staff were kind and caring.” from the report
Consent and legal rights
Staff sought consent before care and medicines. The manager used the Mental Capacity Act principles and had applied for the required safeguards where people's liberty might be restricted.
“We saw where people lacked capacity to make decisions for themselves the registered manager had sought the opinion of others involved in their care” from the report
Individual support and activities
Staff knew people's routines and interests. People were supported with hobbies, outings and meaningful activities.
“People were supported to follow their hobbies and interests and had meaningful activities to spend their time.” from the report
Positive leadership and improvement checks
Staff said they felt supported and could raise concerns. The manager used questionnaires and audits, and took action when checks identified problems.
“The provider operated a quality assurance system which identified areas where improvements needed to be made.” from the report
Incomplete recruitment checks
seriousTwo staff files did not show references from previous employers. In one file there was no interview record or work history, and the manager could not explain how suitability had been checked.
“However, in two people's files we saw references had not been sought from their previous employers.” from the report
Getting staff attention
needs fixingOne person could not attract staff when they needed personal support because the staff member was out of sight. No suitable system was in place at the time.
“there wasn't. Staff told us they would look at systems they could introduce which meant people could attract a member of staff if required.” from the report
Medicines left unsecured
needs fixingSome prescribed creams were left on a trolley during the inspection. The manager said they would be locked away after the inspection.
“We saw some people's prescribed creams were left out on a trolley throughout our inspection” from the report
Privacy and dignity not always consistent
needs fixingOn two occasions, staff did not protect one person's privacy or dignity while giving medicine. The manager intervened and a screen was used afterwards.
“People's privacy and dignity was respected by staff although this was not always consistent.” from the report
- 01Have all staff files now been audited, and do they contain references, interview notes and work histories?
- 02What checks are completed before a new member of staff starts working with residents?
- 03How are prescribed creams and other medicines kept secure at all times?
- 04How can residents attract staff quickly when they need personal support, including when staff are out of sight?
- 05How do you ensure privacy and dignity are protected when medicines are given outside a resident's bedroom?
This unannounced inspection covered all five key questions and provided ratings for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 23 June 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 The Cottage Nursing Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Walsall
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 £950 to £1,200 a week. 85 can care for a couple. 9 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
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.