CQC report explained · a nursing home
What the CQC found at The Old Rectory
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2019
Rated Good; inspectors found safe, kind and personalised care, and said medicines recording had improved.
This was an unannounced inspection on 26 June 2019. Two inspectors spoke with six people, two relatives and five staff. They reviewed care plans, medicine records, staff files, training information and management records.
The inspectors found that people felt safe and comfortable. There were enough staff, risks were assessed, medicines were managed safely and the home appeared clean. Staff were described as kind, respectful and familiar with people's needs and preferences.
People had choices about food, activities and their daily routines. Staff worked with health professionals and supported people to access healthcare. Care plans were personalised and people and relatives were involved in reviews.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Safe had improved from Requires Improvement at the previous inspection. The other four ratings remained Good.
Improved medicine checks
The home had introduced new checks since the previous inspection. Inspectors found that a possible medicine error had already been identified and addressed.
“There were improvements that had been made since the last inspection and new procedures put in place to identify medication errors quickly.” from the report
Kind and respectful staff
Staff were seen responding kindly to people and asking for consent before providing support. Relatives said people were treated with respect.
“All the staff here always put us and our wishes first and it makes us feel like we really matter.” from the report
Personalised care
Care plans recorded people's likes, dislikes, backgrounds and routines. People and families were involved in creating and reviewing care plans.
“People's care plans detailed preferences, likes and dislikes.” from the report
Good links with health services
Staff noticed changes in people's needs and made health referrals in a timely way. The report also says a GP visited weekly.
“Staff and management liaised with a range of health and social care professionals to ensure people's individual needs were met.” from the report
Positive management culture
People, relatives and staff felt listened to. The home used meetings, surveys and audits to gather views and act on feedback.
“People and family members spoke positively about the registered manager and communication.” from the report
Inspectors raised no specific concerns in this report.
- 01What medicine checks are now carried out, and how are errors recorded, explained and followed up?
- 02What is the current plan for recruiting permanent nurses, and how are nursing needs covered while recruitment continues?
- 03How often are care plans reviewed, and how will you make sure new preferences or changes in health are recorded?
- 04How will you discuss and record my relative's wishes about end of life care?
- 05How can relatives raise concerns, and how will they be told what action has been taken?
This was an unannounced inspection covering all five CQC questions and both the care and premises; the previous rating was Good, except Safe, which had been Requires Improvement. This explanation was written from the published report of 7 August 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.
What inspectors found, January 2017
Rated Good overall; inspectors found kind, responsive care, but medicines management required improvement.
The inspection took place on 31 October and 18 November 2016. The first visit was unannounced. Inspectors spoke with 15 people, two relatives, the manager and eight staff. They observed care, looked at three care records, checked the building and reviewed medicines and other records.
People generally felt safe and well cared for. Inspectors found enough staff, good risk assessments, safe recruitment and suitable safeguarding arrangements. Staff were kind, respectful and knew people well. Care plans were detailed and regularly reviewed. People could take part in activities, keep in touch with family and access healthcare.
The main problem was medicines management. Records for some boxed medicines did not match the quantities held, and audits did not regularly check these medicines. This meant the home could not always confirm from its records that medicines were being given as prescribed.
The overall rating was Good. However, Safe was rated Requires Improvement. Effective, Caring, Responsive and Well-led were all rated Good. The previous inspection in July 2014 found that the provider met the regulations inspected.
Kind and respectful care
Inspectors saw staff treating people with kindness, dignity and respect. Staff knew people well and offered choices about daily care.
“Staff knew people well and treated people with kindness, dignity and respect.” from the report
Individual care planning
People's needs were assessed before they moved in. Care plans were detailed, individualised and reviewed every month.
“The plans were individualised, including detailed information that helped staff to effectively support and care for them.” from the report
Activities and relationships
People could take part in activities, go into the local community and maintain contact with relatives and friends.
“Activities were also used to help keep people connected to the local community and their family and friends.” from the report
Supportive leadership
Staff felt supported by approachable managers and described good teamwork. The home had systems for checking quality and following up actions.
“Staff consistently told us that they worked well as a team and expressed confidence in the high quality of care provided to people staying at the Old Rectory.” from the report
Medicine records did not always match supplies
seriousRecords for some medicines supplied in original containers did not match the quantities held. Audits also missed regular checks of boxed medicines, so the home could not always confirm that records matched the medicines available.
“The records for medicines supplied in their original containers did not consistently correspond with the quantities of medicines being kept on behalf of people using the service.” from the report
Some people wanted more activities
minorTwo people said they would like more activities in the evenings and at weekends. This feedback was passed to the manager during the inspection.
“Two people using the service said they would welcome more activities in the evenings and at weekends.” from the report
- 01What changes have been made to make sure boxed medicines are recorded accurately?
- 02How often are all medicines, including those in original boxes, now audited?
- 03What evidence can you show that medicine quantities match the records and prescribed doses?
- 04What evening and weekend activities are currently offered?
- 05How are care plans and medicines checks reviewed by managers now?
This was a planned inspection covering the overall service and all five CQC questions, including care, staffing, medicines, records, premises and management systems. This explanation was written from the published report of 27 January 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 Old Rectory
2 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 27 April 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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