CQC report explained · a nursing home
What the CQC found at The Poplars Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Staff knew how to recognise and report abuse, medicines were managed safely, and staffing had improved. However, two care plans did not initially give clear guidance about known health needs.
- Effective?
- Requires improvement
- People received support with nutrition, healthcare and staff training. However, the home did not consistently follow the Mental Capacity Act, and five DoLS applications were delayed after earlier authorisations expired.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They were offered choices, involved in care decisions and supported to maintain their independence.
- Responsive?
- Good
- Care was personalised to people's histories, preferences and communication needs. People were supported with relationships, culturally relevant activities and end of life wishes.
- Well-led?
- Requires improvement
- The manager had taken steps to improve the service and involved people, relatives and staff. However, care plan and DoLS checks had not reliably identified or prevented the problems found.
What inspectors found, June 2023
The Poplars Nursing Home: Rated Requires Improvement; inspectors found kind, personalised care, but lawful consent safeguards and some care records needed improvement.
This was an unannounced follow-up inspection on 4 and 8 May 2023. Inspectors spoke with people, relatives and staff. They reviewed care records, medicines records, recruitment files and records about how the home was managed.
The home was rated Good for caring and responsive care. People were treated kindly and with respect. Staff knew people's routines, interests and communication needs. People were supported with food, healthcare, relationships, activities and end of life care.
The home was rated Requires Improvement for safe, effective and well-led care. Some care plans did not give staff enough guidance about known health needs. Five people's Deprivation of Liberty Safeguards authorisations had expired before new applications were made. The home was also still being refurbished.
The provider had improved since the previous inspection and was no longer in breach of the earlier regulations about risk management, medicines, dignity, notifications and governance. However, there was a new breach relating to people being deprived of their liberty without lawful authority. CQC requested an action plan and said it would monitor progress.
Kind and respectful care
People were treated with kindness and respect. Staff promoted dignity, privacy and independence and involved people in decisions about their care.
“People were supported by staff who treated them with respect and kindness.” from the report
Personalised support
Care records included people's backgrounds, important relationships, routines and preferences. Staff used talking boards and other tools to understand people better, including people living with dementia.
“People received personalised care in line with their needs.” from the report
Medicines management
Inspectors found improvements in medicines management. Staff had training and competency checks, and records for medicines given when needed had improved.
“Staff responsible for administering medication had received training, and had their competencies assessed.” from the report
Activities and relationships
People were supported to stay in contact with loved ones and join activities that reflected their social, cultural and religious interests.
“People were supported to maintain relationships and take part in activities which were socially and culturally relevant.” from the report
Expired legal authorisations
seriousFive DoLS authorisations had expired before further applications were made. This meant people may have been deprived of their liberty without lawful authority, and the provider breached Regulation 13.
“There had been a delay in applying for further DoLS authorisations 5 people after their previous DoLS authorisations had expired.” from the report
Incomplete care guidance
needs fixingTwo care plans did not clearly explain how staff should support known health needs. The information was added during the inspection, but the audit system had not identified the problem.
“We found 2 people's care plans did not provide clear guidance for staff to follow when supporting them with known health needs.” from the report
Bedrooms and environment
minorThe home was being refurbished, but some bedrooms still needed work to improve their appearance and make them more homely and comfortable.
“Some people's bedrooms required more work to ensure a homely and comfortable environment.” from the report
- 01Have all five delayed DoLS applications now been authorised, and how do you check that future authorisations do not expire without action?
- 02What changes have you made to care plan audits so staff always have clear guidance for known health conditions?
- 03What refurbishment work remains in people's bedrooms, and when will it be completed?
- 04How do you check that improvements from this inspection are maintained over time?
- 05Who is currently responsible for managing the home, and what is the progress of the application to become the registered manager?
This was an unannounced follow-up inspection covering all five CQC key questions, including infection prevention and control, after the provider's previous action plan. This explanation was written from the published report of 22 June 2023 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, June 2021
Overall rated Requires Improvement, with an Inadequate well-led rating and serious concerns about dignity, safety and management.
Inspectors visited on 17 December 2020. They spoke with seven people, six relatives, 13 staff and two professionals. They reviewed care plans, medicines records, staff files and management records.
The home was not consistently safe, effective, caring or responsive. Inspectors found risks that had not been properly assessed, problems with as-needed medicines, poor evidence of oral care, limited activities and people not always treated with dignity.
The well-led rating fell to Inadequate. The home had not made enough progress since the previous inspection, which was also rated Requires Improvement. Its systems for checking quality and making improvements had not worked effectively.
COVID-19 arrangements
The separate unit for people who had tested positive had systems to reduce the risk of infection spreading through meals and laundry.
“We saw good infection control practices carried out in the self-contained unit supporting people with a positive COVID 19 test.” from the report
Specialist care records
Records for people using PEG feeding were detailed and included daily checks of the PEG site.
“There was a comprehensive care plan which covered all aspects of the care and management of the PEG” from the report
Food and dietary needs
The chef understood individual dietary risks, including choking, allergies and malnutrition. People generally said they had choices of food.
“The chef was knowledgeable about people's individual needs and how to keep them safe from any risks such as choking, allergies and malnutrition.” from the report
Access to healthcare
People were referred to specialist healthcare teams when needed, including dietitians and occupational therapists.
“Records showed that people were referred to specialist teams when required.” from the report
Risks of harm
seriousRisks for a person who might self-harm were not fully assessed or clearly explained to staff. Inspectors found hazardous objects in the person's room, although the home acted immediately after this was raised.
“On the day of inspection, we found hazardous objects in the person's room which they could use to harm themselves.” from the report
As-needed medicines
seriousSome people did not have clear protocols for as-needed medicines. The reason for giving the medicine and its effectiveness were not always recorded or reviewed.
“For some people, there were no protocols in place for staff to follow and the reason why the medicine was being given and the effectiveness was not routinely recorded.” from the report
Privacy and dignity
seriousPeople were not always supported discreetly or given enough privacy. Personal records were left in a communal area and some call bells were not within reach.
“We saw one person using a commode with their bedroom door open.” from the report
Mental capacity and restrictions
seriousThe home used unclear or missing decision-specific mental capacity assessments. It applied for DoLS for people who had been assessed as having capacity.
“Everyone in the service had a DoLS application even if they had been assessed as having the capacity to make a decision about their care and treatment.” from the report
Staffing and waiting times
needs fixingPeople and staff gave mixed views about staffing. Some people regularly waited for call bells or personal care, particularly when staffing was under pressure at night.
“Three people told us they regularly had to wait for the call bell to be answered.” from the report
Activities and social contact
needs fixingSocial distancing meant that most people stayed in their bedrooms, and people and staff said this reduced activities and time with staff.
“One person told us, "I would like to see more going on here.” from the report
- 01What changes have been made to assess and manage risks for people who may self-harm?
- 02How are as-needed medicines now authorised, recorded and reviewed?
- 03How will you make sure call bells are within reach and people's privacy and dignity are protected?
- 04What training do staff now receive for mental health needs and distressed behaviours?
- 05What activities and family involvement are now available, including for care reviews and end-of-life planning?
The inspection was prompted by concerns about people leaving the home, but inspectors assessed all five key questions and also checked infection prevention and control. This explanation was written from the published report of 24 June 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 Poplars Nursing Home
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- May 2013
Registered with the Care Quality Commission on 17 May 2013.
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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