CQC report explained · a nursing home
What the CQC found at The Old Rectory Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough suitably qualified staff, safe recruitment, appropriate infection control and medicines given on time. Risks, accidents, safeguarding concerns and equipment checks were being managed.
- Effective?
- Requires improvement
- This question was not assessed in detail during this focused inspection. Its rating was carried forward from the previous comprehensive inspection.
- Caring?
- Good
- This question was not assessed in detail during this focused inspection. Its rating was carried forward from the previous comprehensive inspection.
- Responsive?
- Good
- This question was not assessed in detail during this focused inspection. Its rating was carried forward from the previous comprehensive inspection.
- Well-led?
- Good
- Inspectors found stronger management oversight, effective audits, action plans and improved records. Relatives and staff also reported better communication and morale.
What inspectors found, July 2021
The Old Rectory Nursing Home was rated Good; inspectors found major improvements in safety, management and record keeping.
This was an announced focused inspection on 18 June 2021. The inspector reviewed care, medicines, management and safety records, spoke with staff and the registered manager, and obtained views from three relatives.
The home was rated Good for Safe and Well-led. Inspectors found enough trained staff, safe recruitment, timely medicines, clean premises and suitable infection control. Risks, accidents and equipment checks were being managed.
Management and oversight had improved significantly. A new manager and management team had introduced audits and action plans, which improved records and the quality and safety of care.
The previous rating was Requires Improvement, with a breach of Regulation 17. The provider was no longer in breach at this inspection, and the overall rating changed to Good. The other three question ratings were carried forward from the previous comprehensive inspection.
Improved management
A new manager and management team had strengthened oversight. Audits and action plans were being used to identify and address shortfalls.
“Significant improvements had been made in the management presence and oversight of the service.” from the report
Safe staffing
Inspectors found enough suitably qualified and experienced staff on duty. Training coverage and the training schedule had improved.
“Sufficient numbers of suitably qualified and experienced staff were on duty to meet people's needs.” from the report
Infection control
Staff used PPE appropriately, cleaned their hands after direct contact and followed cleaning schedules. The premises were clean and hygienic.
“Improvements had been made and staff were following national guidance for preventing and controlling the risk of infection.” from the report
Medicines management
Medicines were stored safely and given on time. Records for as-required medicines had clearer instructions for staff.
“Medicines were stored safely and administered on time.” from the report
Family communication
Relatives said communication had improved and that they were involved in care discussions and given opportunities to share their views.
“People and their relatives had been provided with the opportunity to give their views of the service through various channels.” from the report
Inspectors raised no specific concerns in this report.
- 01How have the audit systems and action plans been maintained since the inspection?
- 02How do you make sure medicines prescribed for use as required are given only when the recorded guidance applies?
- 03How often will staff check my relative, and how will those checks be recorded?
- 04How will you manage my relative's specific risks, such as falls or pressure damage?
- 05How do you keep relatives informed about accidents, incidents or changes in care needs?
This was a focused inspection of Safe and Well-led; the other three question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 20 July 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.
What inspectors found, November 2020
Overall rated Requires Improvement, with Inadequate leadership and continuing concerns about governance, infection control and staff training.
This was an unannounced focused inspection on 21 August 2020 by two inspectors. They checked whether the home had followed its improvement plan, looking only at Safe and Well-led. They reviewed care, medicines and management records, observed care and spoke with staff and three relatives.
The home was clean and hygienic. There were enough staff, recruitment was safe, and people received medicines on time from trained nurses. Relatives described staff as kind and caring, and said their loved ones felt safe.
However, some staff did not use protective equipment or hand hygiene correctly. There were gaps in moving and handling training, some risk assessments and medicines guidance were out of date, and the home did not always review risks properly.
Leadership was rated Inadequate. There had been no provider oversight between March and August 2020 and no registered manager since June 2019. Audits, action plans, records and opportunities for people and relatives to give feedback were not managed reliably. The overall rating remained Requires Improvement, as it had at the previous inspection.
Kind and trusted staff
Relatives spoke highly of the staff team and trusted them to care for their loved ones. Staff worked long hours during the pandemic so people could be supported by staff who knew them.
“Relative's spoke highly of the caring nature of the staff team who they trusted.” from the report
Clean premises
Inspectors found the home clean and hygienic. Most staff had completed hand hygiene training.
“The premises were clean and hygienic and the majority of staff working at the service had completed 'Hand Hygiene' training.” from the report
Medicines on time
Medicines were stored safely and given on time. Records showed that medicines had been recorded when administered.
“Medicines were stored safely and administered on time.” from the report
Enough staff
Staff and relatives said there were enough staff on duty, and the inspectors' observations supported this.
“Staff and people's relatives felt there were enough staff on duty to meet people's needs.” from the report
Weak leadership and oversight
seriousThe provider did not oversee the home from March to August 2020. Audits, action plans and records were not reliable enough to show that safety was being managed effectively.
“The provider had not made sure there had been adequate management presence and oversight of the service between March and August 2020.” from the report
Continuing governance breach
seriousThe home remained in breach of Regulation 17. Quality checks were missed or incomplete, and identified problems were not always given clear actions, owners or deadlines.
“Not enough improvement had been made at this inspection and the provider was still in breach of regulation 17.” from the report
Infection control practice
needs fixingSome staff did not wear PPE correctly or clean their hands after contact with people or used crockery. The manager said extra support and training would be arranged.
“Some staff were observed not wearing PPE appropriately or sanitizing their hands after direct contact with people or touching used cutlery and plates.” from the report
Training gaps
needs fixingThere were significant gaps in moving and handling training. The manager said this had been affected by pandemic restrictions and had been prioritised for improvement.
“There were significant gaps in the number of staff who had completed moving and handling training.” from the report
Out-of-date care information
needs fixingSome risk assessments and care plans were not reviewed or updated regularly. Staff therefore did not always have accurate guidance about people's current needs.
“Staff did not always have access to clear guidance to follow when supporting people, because care plans did not always accurately reflect people's up-to-date needs.” from the report
- 01What actions have you taken to meet the continuing breach of Regulation 17, and what evidence can you show us?
- 02Who is currently responsible for provider oversight and management, given that there was no registered manager at the inspection?
- 03Have all staff completed moving and handling training, and how do you check that their practice is safe?
- 04How do you now check PPE use and hand hygiene, and what happens if staff do not follow the required procedures?
- 05How are care plans, risk assessments, audits and action plans kept accurate, reviewed and completed on time?
This was a focused inspection of Safe and Well-led only; the other question ratings from the previous comprehensive inspection were carried forward. This explanation was written from the published report of 19 November 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 Old Rectory Nursing Home
7 rated inspections over 5 years: the service has improved, from Inadequate to Good.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Old Rectory Nursing Home →
- November 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
Read what inspectors found at The Old Rectory Nursing Home →
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 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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