CQC report explained · a residential care home
What the CQC found at The Court
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2023
The Court was rated Inadequate and placed in special measures; inspectors found serious risks to safety, nutrition, medicines and management.
Inspectors made an unannounced visit on 14 June 2023. They spoke with staff, one person living in the home and relatives. They also checked care records, medicines, staff recruitment files and management audits.
They found serious problems with risk assessments, fire safety, the environment, medicines and infection control. Records did not always show that people received the care they needed. Nutritional and hydration support was not always properly assessed or recorded.
The home was rated Inadequate overall. Safe, effective and well-led were rated Inadequate. Caring and responsive were rated Requires Improvement. The rating fell from Requires Improvement at the previous inspection, published in September 2020.
Positive feedback about staff
People and relatives described staff as kind, caring and respectful. Staff said they felt supported and could raise concerns.
“Staff felt well supported in their roles and able to raise any issues they may have.” from the report
Access to health professionals
People were supported to contact health and social care professionals when needed. Relatives said they were kept informed about changes in health and wellbeing.
“People received support to access a range of other health and social care professionals when required.” from the report
Family visits
Relatives said they could visit freely and stay as long as they wanted.
“Relatives told us they could visit the home at any time and stay as long as they wanted.” from the report
Food and drinks available
Although inspectors found serious weaknesses in nutritional assessments and monitoring, people said there was enough food and drink available.
“People told us there was enough food and drinks available.” from the report
Fire and environmental safety
seriousFire doors were wedged open, the fire risk assessment was inadequate and the external fire escape was not well maintained. Broken radiator covers, garden items and other environmental problems also created risks.
“People were at unnecessary risk of harm in relation to fire safety as fire doors were wedged open, some did not close fully, the fire risk assessment was not adequate, there was a lack of fire exit signage and not all people had emergency evacuation plans in place.” from the report
Medicines
seriousMedicines were not always stored securely or at the correct temperature. Records and guidance were not always sufficient to show that people received medicines safely and as prescribed.
“Information to support staff to safely administer 'when required' (PRN) medicines was not always available, including guidance when there was an option to give a variable dose.” from the report
Nutrition and hydration
seriousSome people did not have nutritional risk assessments, and professional advice was not always added to care plans or followed. Fluid monitoring records were incomplete and showed that insufficient fluids had sometimes been offered.
“Failure to ensure people's nutritional and hydration needs were assessed and met is a breach of Regulation 14 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Weak management checks
seriousAudits failed to identify important problems with the environment, fire safety, medicines, care planning and risk management. Previously identified fire safety concerns had not been addressed.
“Failure to ensure effective systems were in place to monitor the quality and safety of the service is a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Infection control
seriousSome areas needed more cleaning and there was no evidence of what cleaning had been completed each day. Some infection control practices were not followed and not all staff had completed the relevant training.
“Failure to adhere to infection prevention and control guidance is a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Personalised care records
needs fixingCare plans did not always reflect current needs, choices or preferences. One person had no detailed care plans, and another person's preference for female staff could not regularly be met.
“People's care was not always planned in a person-centred way.” from the report
- 01What has been done to make sure fire doors, the fire risk assessment, fire exit signs and the external fire escape are now safe?
- 02How are medicines now stored, temperature-checked and recorded, including 'when required' medicines and thickening agents?
- 03How do you assess and monitor people's food and fluid needs, and how do you show that advice from dietitians and other professionals is followed?
- 04What checks now make sure care plans and daily records accurately reflect each person's current needs, risks and preferences?
- 05What changes have been made to staff training, cleaning checks and management audits since the warning notices?
This was an unannounced inspection that assessed all five key questions and included infection prevention and control checks, care and medicines records, staff files and management systems. This explanation was written from the published report of 22 August 2023 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, September 2020
Rated Requires Improvement; inspectors found important improvements, but the home must show that safe, effective and well-led care is sustained.
This was a focused inspection on 18 August 2020. Two inspectors reviewed information, care and medication records, staff recruitment and training records, management checks and infection control arrangements. They could not speak directly with people living at the home, but spoke with relatives, staff and the manager.
Inspectors found that risks, care plans and medicines were being managed safely. Staff recruitment, training, supervision, safeguarding procedures and infection control had improved. The home was clean and well maintained, and management checks had become more effective.
The overall rating improved from Inadequate to Requires Improvement. The home was no longer in Special Measures. However, inspectors said they needed more assurance that the improvements would continue over time. Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward.
Clear risk information
Care plans and risk assessments were described as detailed, consistent and up to date. Staff had the information needed to provide consistent care.
“Risk assessments and care plans contained detailed, consistent and up to date information for staff to familiarise themselves with people's needs.” from the report
Medicines managed safely
Medicines were stored, given and disposed of safely. Records for creams and medicines given when needed were regularly reviewed.
“Medication management procedures were safely followed. Medicines were safely stored, administered and disposed of in accordance with medication policies and procedures.” from the report
Improved staff support
Staff received regular supervision and had completed the required training. Relatives felt staff had the skills needed to provide care.
“Staff received regular supervision and told us they received support on a day to day basis from the management team.” from the report
Strong infection control
The home was visibly clean. Inspectors found suitable COVID-19 procedures, enough protective equipment and extra cleaning checks.
“The environment was visibly clean, and robust infection prevention control procedures (IPC) including those relating to COVID-19 were in place.” from the report
Improved management checks
Care plans and risk assessments had been reviewed. Audits and action plans were being used to monitor care and learn from incidents.
“Audits and actions plans were completed, lessons were learnt, and measures were in place to continuously review, assess and monitor the quality and safety of care being provided.” from the report
Safety needs to be sustained
needs fixingAlthough safety arrangements had improved, inspectors had not yet seen enough evidence over a longer period to be fully assured.
“Although we received assurances that people were safe and protected from harm, we need assurances that safe care is being delivered over a longer period of time.” from the report
Care outcomes need monitoring
needs fixingThe home had improved how it assessed and delivered care, but inspectors wanted evidence that these improvements were producing good outcomes consistently.
“This meant the effectiveness of people's care, treatment and support had improved but we need assurances that good outcomes are achieved over a longer period of time.” from the report
Leadership needs continued oversight
needs fixingManagement and governance had improved, but inspectors had not yet seen enough evidence that the changes would remain effective.
“This meant the service management and leadership had improved but we need assurances that the service is 'well-led' over a longer period of time.” from the report
- 01What actions are in the current improvement plan, and how will you show that safety improvements have continued since this inspection?
- 02How do you check that care plans and risk assessments remain up to date when a person's needs change?
- 03How do you monitor whether people are achieving good outcomes from their care, including nutrition and hydration support?
- 04What were the previous ratings for Caring and Responsive, and when will these areas next be fully inspected?
- 05How are audits, accidents and incidents reviewed, and how are lessons shared with staff?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 22 September 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.
Every inspection of The Court
4 rated inspections over 6 years: the service has slipped, from Good to Inadequate.
- August 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2020Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- November 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016
Registered with the Care Quality Commission on 11 July 2016.
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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40 live-in carers within about an hour of Wirral
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 £1,230 a week. 37 can care for a couple. 8 years' experience on average.
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“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.”
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