CQC report explained · a residential care home
What the CQC found at The Shelley Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People's risks were assessed and managed, including risks from falls. Medicines were administered safely and staffing levels were sufficient.
- Effective?
- Good
- People received care based on assessments of their needs and choices. They had suitable food, access to healthcare professionals and support with consent and decision-making.
- Caring?
- Good
- Staff were kind, patient and respectful. People and relatives said they were involved in care decisions, and inspectors saw people's privacy and independence being supported.
- Responsive?
- Good
- Care plans contained personalised information and activities were offered daily. People could choose whether to join activities, go on outings or spend time in their rooms.
- Well-led?
- Good
- The home had introduced stronger audits and systems to monitor quality and safety. Communication with families had improved since the previous inspection.
What inspectors found, May 2022
The Shelley Care Home was rated Good; inspectors found safe, kind and personalised care, with improvements since the last inspection.
Inspectors visited the home without warning on 12 and 13 April 2022. They spoke with three people, two relatives and staff. They reviewed care plans, medicine records, recruitment files and records about how the home was managed.
People were found to be safe. Risks such as falls were assessed and managed, medicines were given as prescribed, staffing was sufficient and infection control arrangements were in place. People were supported to make choices, eat well and access healthcare.
Inspectors found kind and respectful staff, personalised care and a range of activities. Families were kept informed, including after falls or medicine delays. The home had improved from Requires Improvement at the previous inspection and was no longer in breach of regulations.
Falls and medicines safety
The home had improved its approach to falls and medicines. Staff used care plans, sensor mats, falls monitoring and electronic medicine records to reduce risks.
“The process for administering medicines within specific time frames, such as for Parkinson's disease, had been reviewed.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors observed staff being patient, kind and sensitive to people's wishes.
“People were looked after by kind and caring staff, who were patient in their approach and treated people with dignity and respect.” from the report
Personalised support
Care plans included people's preferences, communication needs and past lives. Staff supported people to make choices and maintain their independence.
“People received personalised care that met their needs and choices.” from the report
Improved management
The home had acted on the previous inspection. New audits and monitoring systems were being used to identify and address issues.
“Robust systems had been implemented to monitor and measure the service and to drive continuous improvement.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you monitor and reduce the risk of falls for my relative?
- 02How do you make sure medicines that must be given at specific times are not delayed?
- 03Are any required DoLS authorisations still waiting for approval, and how are these followed up?
- 04How will you review my relative's end of life wishes with us?
- 05How will you keep us informed if my relative falls, becomes unwell or has a medicine delay?
This was an unannounced follow-up inspection after the previous Requires Improvement rating, covering all five key questions and infection prevention and control arrangements. This explanation was written from the published report of 11 May 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, March 2021
The Shelley Care Home was rated Requires Improvement; inspectors found serious gaps in falls management, Parkinson's medicines and quality checks.
This was an unannounced focused inspection on 24 November and 21 December 2020. Inspectors spoke with people, staff and managers, reviewed care, medicines, falls and management records, and observed infection control.
The home was not always safe. Risks from falls were not fully assessed, some falls were not followed up properly, and Parkinson's medicines were sometimes given late. Most staff had not received training in falls management or Parkinson's disease.
Infection control measures were effective and staffing levels were considered sufficient. People said they were happy and felt safe, and staff were described as kind and supportive.
The overall rating fell from Outstanding at the previous inspection to Requires Improvement. Only Safe and Well-led were inspected this time. The other ratings were carried forward from earlier inspections.
Infection control
Inspectors were assured that the home had effective measures to prevent and manage infection, including COVID-19 precautions, cleaning and protective equipment.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Staffing and recruitment
Inspectors found staffing levels sufficient for people's needs. The recruitment records checked included the necessary safety checks.
“Staffing levels were sufficient to meet people's needs.” from the report
People felt safe
People told inspectors they were happy living at the home and felt safe. They could raise concerns or suggestions at residents' meetings.
“People were happy living at the home and felt safe.” from the report
Supportive staff culture
Staff said they felt supported and valued. Staff meetings took place and suggestions were recorded and acted on.
“Staff enjoyed working at the home.” from the report
Parkinson's medicines were late
seriousThree people did not always receive Parkinson's medicines at the prescribed times. One person's medicine was late on 13 occasions, by between 56 minutes and more than two hours.
“There were numerous occasions when this person's medicine was not administered at the time prescribed.” from the report
Quality checks missed problems
seriousAudits did not identify the late medicines or check all refrigerated medicines. The falls tracker also did not always match the accident records.
“The provider had failed to implement robust auditing systems to identify areas in need of improvement.” from the report
Training gaps
needs fixingNo staff had received falls management training, and only one staff member had received Parkinson's awareness training. This could affect how staff supported people's needs.
“Despite the high number of falls at the home resulting in four notifications of serious injury to people, no staff had received falls management training.” from the report
- 01How are falls risks assessed and reviewed after every fall, including falls in communal areas?
- 02What is the procedure after someone hits their head, and when is medical advice sought?
- 03How do you ensure Parkinson's medicines are given at the prescribed times?
- 04What falls management and Parkinson's disease training has each relevant staff member now completed?
- 05How do your current audits check falls records, medicine timings and refrigerated medicines?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 4 March 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 Shelley Care Home
4 rated inspections over 6 years: the service has slipped, from Outstanding to Good.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Requires improvementdown from OutstandingSafe: Requires improvementWell-led: Requires improvement
- July 2018Outstandingstayed OutstandingSafe: OutstandingEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- December 2015OutstandingSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: GoodWell-led: Outstanding
- November 2013
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 7 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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28 live-in carers within about an hour of West Sussex
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 £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
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.