CQC report explained · a residential care home
What the CQC found at The Poplars
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, and staff understood safeguarding, risk management and medicines procedures. Fire safety checks had been completed after problems found at the previous inspection.
- Effective?
- Good
- This area was not inspected during this visit. The previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this visit. The previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- Care and support were personalised to people's needs, communication methods and preferences. People were supported with activities, relationships, community access and complaints.
- Well-led?
- Good
- Governance systems, audits and management oversight were effective. The provider had addressed the previous breach about monitoring and improving quality and safety.
What inspectors found, March 2022
Rated Good; inspectors found safe, kind and personalised care, with clear improvements since the last inspection.
The inspection was unannounced and took place on 09 February 2022. One inspector spoke with people living at the home, relatives and staff. They reviewed care, medicine and management records, and checked infection control.
Inspectors found that people were safe and supported by staff who understood their needs. People had choice and control over their lives, including how their rooms and shared spaces were arranged. Staff supported communication, activities, health appointments and contact with relatives.
The home had improved from Requires Improvement at the previous inspection in 2019. The earlier breaches had been resolved. The home was rated Good overall, and Safe, Responsive and Well-led were rated Good.
This was not a full review of all five areas. Effective and Caring were not inspected during this visit, so their previous ratings were used in the overall rating.
Choice and independence
People were involved in decisions about the home and had control over their daily lives, including personalising their rooms and choosing shared furniture.
“The service supported people to have the maximum possible choice, control and independence.” from the report
Personalised communication
Staff used people's preferred communication methods, including sounds, body language, pictures and symbols. Information was also provided in formats people could understand.
“People had individual communication plans and communication passports that detailed effective and preferred methods of communication, including the approach to use for different situations.” from the report
Kind and respectful care
Inspectors saw staff respond to people's individual needs and protect their privacy and dignity.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Activities and relationships
People were supported to follow their interests, attend activities and keep in touch with friends and relatives. The home also helped people try new activities in the community.
“People were supported to participate in their chosen social and leisure interests on a regular basis.” from the report
Improved management systems
The provider had acted on the previous inspection findings. Audits and other checks were being used to monitor safety and care quality.
“Governance processes were effective and embedded into practice.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you make sure my relative's communication plan is followed by permanent, new and temporary staff?
- 02What activities and community visits could my relative take part in, and how would you support their choices?
- 03How are medicines reviewed, especially if medicines might affect behaviour?
- 04How will the change in manager be managed while the new manager completes registration with CQC?
- 05How are relatives involved in care planning, service user voice meetings and decisions about improvements?
This was a targeted inspection of infection control and a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings carried over. This explanation was written from the published report of 10 March 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, June 2019
The Poplars was rated Requires Improvement; inspectors found kind and effective care, but weaknesses in safety, records and management.
This was an unannounced inspection on 21 and 22 May 2019. One inspector visited the home, spoke with three people, three relatives, managers and staff, observed care, toured the premises and checked care and management records.
People were treated with kindness and respect. There were enough staff, people had access to food and healthcare, and staff supported choice, independence and activities. The effective and caring questions were rated Good.
The safety, responsive and well-led questions were rated Requires Improvement. Inspectors found gaps in some medicines records, cleaning, fire evacuation checks and care information. Communication with relatives and management arrangements were also inconsistent.
The overall rating fell from Good at the previous inspection, published on 23 November 2016. The provider breached Regulation 17 because its systems for checking and improving quality and safety were not working effectively.
Kind and respectful staff
Inspectors saw warm and encouraging interactions. People and relatives said staff were caring and kind, and people's privacy and choices were respected.
“Staff were caring, and people were treated with respect and kindness.” from the report
Enough staff
The home had recruited new staff and had suitable staffing levels to meet people's needs. It had not needed to use agency staff.
“There were now enough staff who had the right knowledge and skills to meet people's needs in a personalised way.” from the report
Support for health and diet
People were supported to plan meals, eat and drink well, use healthcare services and take part in healthy activities.
“People were supported to have access to a varied and nutritious diet.” from the report
Choice and communication
People were involved in decisions about their care and could choose how to spend their time. Staff understood people's individual communication needs.
“People were able to choose how and where they spent their time.” from the report
Weak quality checks
seriousThe systems used to monitor and improve the home did not reliably identify or fix problems. This was the subject of a legal breach.
“The systems and processes for assessing, monitoring and improving the quality and safety of the services provided for carrying on the regulated activities had not been operated effectively.” from the report
Incomplete medicines records
needs fixingThere were gaps in medicines records, although stock levels suggested the medicines had been given. Guidance was missing for some medicines used when needed.
“There were some gaps in the medicines records which the provider's audit had not identified.” from the report
Cleaning and infection control
needs fixingThe laundry room and kitchen needed a deep clean. Inspectors said this created a risk to infection control.
“The laundry room and kitchen were in need of a deep clean and posed a risk to infection control.” from the report
Fire evacuation practice
seriousNot all staff had taken part in a fire evacuation, and night-time fire conditions had not been covered.
“The provider had not ensured that all staff had taken part in a fire evacuation or that night time fire conditions had been considered.” from the report
Care information and communication
needs fixingSome health care information was not detailed enough for new staff who did not yet know people well. Relatives also reported inconsistent communication and too many management changes.
“We saw information on some healthcare needs such as ear, ear and nail care was not in place or robust enough to ensure staff could meet people needs” from the report
- 01What has been done to make sure every 'as and when' medicine has clear guidance for staff?
- 02Have all staff now completed fire evacuation practice, including arrangements for night-time conditions?
- 03How are cleaning checks for the kitchen and laundry room completed and followed up?
- 04How have care records been improved so new staff have clear information about every person's health and personal care needs?
- 05Who is managing the home now, and how will relatives be kept informed about changes and concerns?
This was an unannounced inspection of the care provided and the premises, covering all five CQC questions and the overall rating. This explanation was written from the published report of 26 June 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.
Every inspection of The Poplars
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- March 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 31 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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