CQC report explained · a residential care home
What the CQC found at The Place Up Hanley
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were protected from abuse and infection risks, and staff recruitment checks were completed. However, some medicines guidance, care plans and risk assessments were incomplete or had not been updated after incidents.
- Effective?
- Good
- People had access to healthcare professionals, enough food and drink, and support suited to their needs. Training gaps remained, and one person needed a capacity assessment for covert medicines, but action was taken.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- The manager was open to feedback and external support was being used to improve the home. However, new quality systems were not yet embedded, some records were incomplete and relatives gave mixed feedback about communication.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found improvements, but medicines records, care plans and quality checks still needed strengthening.
This was an unannounced focused inspection on 6 April and 22 April 2022. Inspectors reviewed care and medicine records, safety checks, staff recruitment and quality records. They spoke with staff, health professionals, relatives and the registered manager. They could not have detailed conversations with people living in the home because of their needs.
The home had improved since the previous inspection. Medicines were stored correctly and records were better, but some guidance and recording were still incomplete. Some care plans and risk assessments had not been updated after incidents. Two people did not have all the required decision-specific mental capacity assessments at the time of inspection, although action was taken afterwards.
Safe and well-led were rated Requires Improvement. Effective was rated Good. The overall rating remained Requires Improvement because the inspection was focused and previous ratings for questions not inspected were used. The home was no longer breaching regulations.
Protection from abuse
Staff understood different types of abuse and knew how to report concerns. Safeguarding referrals had been made when needed.
“Staff knew about the different types of abuse, how to recognise these and understood their responsibility to report concerns.” from the report
Infection control
Inspectors were assured that the home used suitable infection prevention measures, including safe visiting, equipment and testing arrangements.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Improved staff support
Staff said they felt more supported under the manager. Meetings and supervision gave staff opportunities to raise concerns.
“Very much more supported now – the registered manager has approached staff members to say if they have concerns come and tell them, that speaks volumes.” from the report
Medicines records
seriousSome 'when required' medicines lacked enough guidance. Two liquid medicines did not have opening dates, and one allergy was not recorded on the medicine administration record.
“Guidance for 'when required' medicine was not always in place or did not contain enough detail.” from the report
Care plans after incidents
seriousRecords did not always explain distressed behaviour in enough detail. Some care plans and risk assessments were not updated after incidents, including a fall.
“Records which documented people had been distressed had not always been reviewed and there was no evidence learning from these incidents had been incorporated into people's care plans.” from the report
Mental capacity assessments
seriousTwo people did not have all the necessary decision-specific capacity assessments at the time of the inspection. The manager provided evidence that the issues were later addressed.
“One person did not have their decision specific capacity assessed prior to a DoLS application being made.” from the report
Quality checks
needs fixingNew quality assurance systems had been introduced but were not yet fully embedded. The manager accepted that the systems were still a work in progress.
“The registered manager was open and honest about the quality assurance systems which had been recently introduced and their use had not been fully successful or fully embedded yet.” from the report
- 01How do you now make sure care plans and risk assessments are updated after falls, distressed behaviour or other incidents?
- 02How do you check that 'when required' medicine instructions contain enough detail for each person?
- 03How are medicine opening dates and allergies recorded and checked?
- 04What is the current position on decision-specific mental capacity assessments and covert medicines?
- 05How will you improve communication with relatives about incidents and changes in care?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected during this visit, and previous ratings for questions not inspected were carried forward. This explanation was written from the published report of 7 June 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, April 2021
Rated Requires Improvement; inspectors found unsafe medicines management, gaps in risk and consent checks, and weak oversight, although staffing and safeguarding were better.
This was an unannounced focused inspection on 2 and 17 February 2021. Inspectors looked at Safe, Effective and Well-led after concerns about incidents and earlier breaches. They spoke with staff, the manager, a health professional and relatives, and checked care, medicines, recruitment and management records.
The home had enough staff and safe recruitment checks. People were protected from abuse, had enough food and drink, and could access health professionals. Relatives and staff generally found the new manager approachable.
However, medicines were not always managed safely. Risk plans and new people's care plans were not always updated promptly. Capacity and consent checks were not always completed correctly. Training gaps, infection control paperwork and quality checks also remained.
The overall rating stayed at Requires Improvement, as did Safe, Effective and Well-led. Caring and Responsive were not inspected during this visit, so their earlier ratings were used in the overall result.
Enough staff
Inspectors saw staff available in communal areas and people did not have to wait long for support. Recruitment checks were completed.
“People did not have to wait long for support and there enough staff to meet people's needs.” from the report
Safeguarding
Staff understood different types of abuse and how to report concerns. The home made safeguarding referrals when needed.
“People were protected from abuse. Relatives told us they felt people were safe and staff knew how to raise safeguarding concerns.” from the report
Food and drink
People had choices at mealtimes and their dietary needs were checked. Inspectors saw staff supporting people with food appropriately.
“People had enough to eat and drink and had choices at mealtimes.” from the report
Approachable new manager
Relatives and staff spoke positively about the new manager, who was clarifying staff roles and spending time on supervision.
“Relatives commented they felt able to approach the manager and felt positively about them.” from the report
Health support
People were supported to access other health professionals. A health professional said referrals were timely and appropriate.
“The health professional said referrals for their support were timely and appropriate.” from the report
Medicines safety
seriousMedication records contained gaps and unclear instructions. Inspectors found risks involving duplicate entries, patches, allergies, opened eye drops and fridge temperatures.
“Medicines were not managed safely. There were gaps in records without explanation and the omissions noted below.” from the report
Risk and care planning
seriousPlans were not always updated when people's health or behaviour changed. A new person's care plans were largely incomplete three weeks after moving in.
“Risks to people's health and wellbeing had not always been assessed and planned for.” from the report
Consent checks
seriousDecision-specific capacity assessments were not always completed before applications about living at the home, care or restrictions. This was a breach of the consent regulation.
“People did not always have their decision specific capacity assessed prior to applications being made.” from the report
Weak quality checks
seriousAudits and other governance systems failed to identify important problems, including medicine safety issues. The provider had not consistently learned from earlier findings.
“Quality assurance systems were not always effective at identifying concerns and ensuring people always received safe care.” from the report
Training and infection records
needs fixingThere were significant gaps in staff training and some infection policies were out of date. Staff also needed to improve hand hygiene after touching masks.
“There were still significant gaps in staff training and staff having their training refreshed.” from the report
Mixed communication
minorSome relatives felt kept up to date, while others did not. The home also had not fully documented individual staff infection risks.
“We received mixed feedback regarding communication. Some relatives felt they had been kept up to date, whereas other had not.” from the report
- 01What has changed to prevent medicine errors, including unclear instructions, missing allergy information and poor fridge-temperature records?
- 02How do you now make sure risk assessments and care plans are updated promptly when a person's needs change?
- 03How are decision-specific capacity assessments completed before any application about a person's care or restrictions?
- 04How are audits now checking that problems are found and fixed, rather than repeated?
- 05What is the current position on staff training, infection-control policy updates and individual staff risk assessments?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 14 April 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 Place Up Hanley
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- July 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2017GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2015
Registered with the Care Quality Commission on 2 September 2015.
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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At least 100 live-in carers within about an hour of Stoke-on-Trent
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 £1,190 a week. 93 can care for a couple. 9 years' experience on average.
“She's shown compassion, patience and a level of understanding that no other carer has given.”
“She maintained a great environment for mum both with the tidiness and cleanliness of the house and Mum and with her caring and understanding attitude.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.