CQC report explained · a residential care home
What the CQC found at The Mellows
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Medicine records were not always accurate, and some incidents had not been referred to the safeguarding team. Risk assessments were in place, but monitoring instructions were not always clear.
- Effective?
- Good
- People received care from trained and knowledgeable staff. The home supported people with food, drink, healthcare and choices, although monitoring was needed to make sure people received the meal they had chosen.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward.
- Responsive?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward.
- Well-led?
- Good
- The manager was visible and responsive, staff felt supported, and audits were completed. Meetings with residents and relatives were not always held regularly.
What inspectors found, July 2022
The Mellows was rated Good overall, but inspectors found safety improvements were still needed, especially with medicines and some incident referrals.
This was an unannounced focused inspection over three days. Inspectors spoke with people, relatives, staff and visiting professionals. They reviewed care records, risk assessments, medicine records, recruitment files and management records.
The home was rated Good overall. Effective and well-led care were rated Good. Safe was rated Requires Improvement, meaning some aspects were not always safe and there was limited assurance about safety.
Inspectors found enough staff, suitable recruitment checks, good staff training and positive relationships with people. People generally felt safe, and relatives and professionals gave positive feedback.
The main problems were gaps and inconsistencies in medicine records, unclear monitoring instructions for some risks, and accidents or incidents that had not all been referred to the safeguarding team. The manager started extra checks and agreed to address these issues.
Enough staff
Inspectors found there were enough staff to meet people's needs and keep them safe. People and relatives also described seeing familiar staff around the home.
“There are staff around when I need them.” from the report
Trained staff
Staff had the training and knowledge needed for their roles. Inspectors also heard that staff received additional training in areas including catheter, continence and pressure care.
“People received effective care from staff who were supported to obtain the knowledge and skills they needed to provide good care.” from the report
Kind relationships
Inspectors saw staff engaging with people and asking about their lives. They described these interactions as kind and caring.
“During our observations we observed staff engaging with people, asking them about their family and friends and interactions were kind and caring.” from the report
Positive healthcare support
Staff worked with health professionals and responded promptly when help was requested. Healthcare professionals gave positive feedback about the home's support.
“The staff are very helpful, and very good with residents.” from the report
Medicine records
needs fixingSome medicine records had gaps and did not always match the medicines available. This meant the home did not have fully reliable records showing medicines had been managed correctly.
“Medicine related records were not always accurate. We found some gaps in records and some medicines did not always reconcile.” from the report
Risk monitoring
seriousSome care plans did not clearly explain what monitoring staff needed to complete. For one person at risk of pressure ulcers, records had significant gaps in repositioning.
“Staff were recording when they had repositioned this person but, on some occasions, there were significant gaps.” from the report
Safeguarding referrals
seriousNot all accidents and incidents had been referred to the relevant safeguarding authority. The manager agreed to make some referrals retrospectively.
“Not all accidents and incidents had been referred to the relevant safeguarding authority.” from the report
Meal choices
minorPeople were offered two meal choices, but inspectors found that one choice had changed and it was unclear whether people had been told.
“The second choice had been changed and the cook was unaware if people had been informed.” from the report
- 01What changes have been made to ensure medicine records are complete and always match the medicines being given?
- 02How do you now decide when an accident or incident must be referred to the safeguarding team?
- 03How are care plans checked to make sure repositioning and other risk monitoring instructions are clear?
- 04How do you make sure residents are told when their chosen meal is changed?
- 05When was the last meeting for residents and relatives, and how often will these meetings now be held?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 26 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, December 2019
Rated Good overall, but safe care Requires Improvement because recruitment checks and some fire safety practice were not fully robust.
This was an unannounced inspection over three days. Inspectors spoke with people living in the home, relatives and staff. They observed care and reviewed care records, staff files, medicines, training, complaints and quality checks.
The home was rated Good overall. Effective, caring, responsive and well-led care were all rated Good. People were treated kindly, their needs were understood, and they had enough food, drink, activities and access to healthcare.
Safe was rated Requires Improvement. Not all recruitment checks were completed before one new staff member started. Night staff had not taken part in a fire drill since May 2017. The manager said immediate improvements would be made.
The report also identified improvements needed in end of life records and training, complaint investigations, some staff training records and accessible information. No regulations were reported as breached, but the CQC made recommendations.
Kind and respectful care
People and relatives were positive about the care. Inspectors saw staff treating people with kindness, dignity and compassion.
“We observed many examples whereby people were treated with kindness and compassion.” from the report
Enough staff and safe medicines
Inspectors found enough staff to meet people's needs and saw call alarms answered promptly. Medicine records checked were in good order and staff were trained and assessed as competent.
“The deployment of staff during both days of inspection was appropriate and there were enough staff to meet people's needs.” from the report
Food, choice and activities
People could choose where to eat and were offered a choice of meals and drinks. They were supported to join activities in the home and local community.
“People were offered a choice of drinks and meals throughout the day.” from the report
Improvement since the last inspection
The Effective rating improved from Requires Improvement to Good. The home had also been redecorated and refurbished, and had acted on the earlier lack of choice over meals and drinks.
“At this inspection we found enough improvement had been made.” from the report
Accessible management
People, relatives and staff described the home as well led. The manager was available to them and quality checks were used to monitor the service.
“Staff told us the registered manager's office door was always open.” from the report
Recruitment checks
seriousNot all required checks had been completed before a new staff member started work. The CQC recommended that recruitment checks follow the required legal schedule.
“However, not all relevant checks were completed before a new member of staff started working at the service and improvements were required.” from the report
Fire evacuation practice
seriousNight staff had not taken part in a fire drill since May 2017. The fire drills also did not allow staff to practise using fire equipment during an evacuation.
“Though day staff had participated in regular fire drills, night staff had not since May 2017.” from the report
Complaint investigations
needs fixingPeople felt able to complain, but complaint records did not always show a thorough investigation, how conclusions were reached or that outcomes were completed.
“Improvements were required to ensure all elements of a complaint were robustly investigated to show how conclusions were reached and outcomes completed.” from the report
Training and information records
minorThe training matrix was not up to date, some staff had not started or completed the Care Certificate, and agency staff files did not show training details. Menus and activity information were not available in easy-read or large-print formats.
“The training matrix was not up-to-date at the time of our visit to The Mellows and demonstrated not all staff training was in date.” from the report
- 01Have all required recruitment checks now been completed before staff start work, and how do you check this?
- 02When was the most recent fire drill involving night staff, and have staff practised using fire equipment?
- 03How are end of life wishes, pain and symptoms now recorded and shared with staff?
- 04How do you investigate complaints and record the conclusions and any completed actions?
- 05Can you show how staff training is kept up to date, including agency staff and the Care Certificate?
This was an unannounced inspection covering all five CQC questions, with the home, care provided, records, staff files, medicines, complaints and quality systems reviewed. This explanation was written from the published report of 21 December 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.
Every inspection of The Mellows
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- July 2022Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Goodstayed GoodSafe: Requires improvementEffective: GoodWell-led: Good
- May 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2015Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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