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.
What inspectors found, January 2022
Rated Good; inspectors found safe, effective care and improved management, but some people reported delays in getting support.
This was an unannounced focused inspection on 18 January 2022. Inspectors spoke with two people, nine relatives and eight staff. They observed care and checked care, health and medicines records, policies and audits.
The home was rated Good for Safe, Effective and Well-led. Inspectors found that risks, safeguarding, medicines, infection control and staff training were managed effectively. People were supported to make choices, and staff worked with health professionals.
Some relatives and staff said there were not always enough staff and that people sometimes waited for support. Inspectors did not see this during the visit and found no evidence that anyone had come to harm because of staffing.
The previous rating was Requires Improvement, published in October 2021, and there had been a breach of Regulation 17. Inspectors found enough improvement had been made and that the home was no longer in breach.
Safeguarding and risk management
Staff understood how to recognise and report abuse. Risk assessments and incident reporting helped reduce risks and support learning when things went wrong.
“Systems to assess, monitor and reduce risks to people were effective.” from the report
Medicines and infection control
Medicines were stored, administered and disposed of safely. Inspectors were also assured about infection prevention, personal protective equipment, testing and visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staff skills and healthcare
Staff had training and could explain how they met people's needs. The home worked with dieticians, speech and language professionals and other healthcare staff.
“Staff received appropriate training and had the skills they required to meet people's needs.” from the report
Improved management
The provider had strengthened its quality checks since the previous inspection. Staff had clearer roles, and the management team used daily meetings and an improvement plan.
“At this inspection we acknowledged enough improvements had been made and the provider was no longer in breach of regulation 17.” from the report
Choice at mealtimes
People had choices of food and drink, could request a different meal and were not rushed while eating.
“People had choices and access to food and drink throughout the day.” from the report
Possible delays in support
needs fixingSome relatives and staff felt staffing levels were not always enough and that people sometimes waited for support. Inspectors did not observe this during the visit and found no evidence of harm from staff shortages.
“Some relatives and staff told us they did not feel there were enough staff across the service” from the report
Staff supervision
minorStaff gave mixed feedback about supervision. Some felt meetings were useful, while others said they had not had many; the manager had a plan to address this.
“We received mixed feedback from staff around supervision, some staff felt they were valuable whilst some had not had many.” from the report
- 01How do you use the dependency tool to decide staffing levels on each shift?
- 02How do you check that people are not waiting too long for support?
- 03How often will staff receive supervision meetings, and how will you check that this is happening?
- 04What improvements are still outstanding on the service improvement plan?
- 05Has the manager's application to become the registered manager now been completed?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 29 January 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, October 2021
The Old Rectory Nursing Home was rated Requires Improvement; inspectors found enough staff and kind care, but cleanliness, medicines records and quality checks needed improvement.
This was an unannounced focused inspection. Inspectors visited on 18 August 2021 and reviewed activity up to 25 August. They spoke with people, relatives and staff, observed care, and checked care, medicines, incident and management records.
The home had enough staff, staff understood safeguarding, and medicines were stored and given safely. However, some areas were cluttered, unclean or poorly maintained. Best-interest decisions about medicines were not always properly recorded.
The home had quality checks, but they had not found all the problems inspectors identified. The provider dealt with many cleanliness issues immediately and produced an action plan, but CQC found that improvements were not yet sustained. The overall rating stayed Requires Improvement, as it had at the previous inspection.
Enough staff
Inspectors saw staff available in communal areas and responding to people's needs in a timely way. Recruitment checks were also completed before staff started work.
“There were enough staff employed to meet people's needs.” from the report
Kind, person-centred care
Inspectors observed individualised support. People and relatives praised the staff and said people were well looked after.
“People told us the staff were lovely. Relatives praised the staff.” from the report
Safeguarding and risk management
Staff knew how to recognise and report abuse. Risks were recorded with actions for staff to follow, and incidents were reviewed for lessons.
“Risks were identified, and the care plans detailed actions to take to mitigate and manage risks.” from the report
Safe medicine administration
Medicines were stored correctly and inspectors observed staff administering them safely. Staff had medicine training, with further training being provided for the new electronic system.
“Medicines were stored correctly, and we observed safe administration of medicines by staff.” from the report
Cleanliness and maintenance
needs fixingSeveral corridors, storerooms, sluices and cupboards were cluttered and could not be cleaned effectively. Some equipment and wall tiles were damaged or poorly maintained.
“We found the environment was not always maintained to a good standard of cleanliness.” from the report
Medicines decisions not fully recorded
needs fixingWhen people could not make decisions about their medicines, the home did not always record how their best interests had been considered.
“We found best interests' decisions were not fully documented to ensure medicines were administered in people's best interests.” from the report
Quality checks missed problems
seriousThe home's monitoring systems did not identify all the issues found by inspectors, including infection control and best-interest records. CQC said the improvements needed to become established in everyday practice.
“The systems in place to monitor and improve the quality of the service were not effective.” from the report
- 01What has been done to keep corridors, storerooms, sluices and cupboards clean and uncluttered?
- 02How are damaged equipment and wall tiles checked and repaired so they can be cleaned properly?
- 03How do you record best-interest decisions when someone cannot decide about their medicines?
- 04What changes have been made to quality audits so they identify infection control and care-record problems?
- 05What evidence can you show that the improvements identified after this inspection have been sustained?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 7 October 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.
Every inspection of The Old Rectory Nursing Home
6 rated inspections over 6 years: the service has held its Good rating throughout.
- January 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Old Rectory Nursing Home →
- October 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at The Old Rectory Nursing Home →
- December 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 10 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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