CQC report explained · a nursing home
What the CQC found at Tweedmouth House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were safeguarded from abuse and risks were assessed and reviewed. Inspectors found safe medicines management, enough trained staff, improved fire safety and suitable infection control arrangements.
- Effective?
- Good
- This key question was not inspected during this visit. The previous rating was carried forward into the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. The previous rating was carried forward into the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. The previous rating was carried forward into the overall rating.
- Well-led?
- Good
- Managers understood their roles, had improved systems and documented lessons learned. People, relatives and advocates were involved in changes such as menus and activities.
What inspectors found, December 2022
Rated Good; inspectors found safe care and stronger management after the previous Requires Improvement rating.
The inspection took place on 28 November 2022. Inspectors spoke with people, relatives, staff and a visiting professional. They observed care and checked care records, medicines records, staff files and management records.
This was a focused inspection of Safe and Well-led. Inspectors found people were protected from abuse, risks were assessed, medicines were managed safely and there were enough trained staff. Infection control, visiting arrangements and fire safety had also improved.
The home had a positive culture. Managers had acted on the previous inspection's action plan and improved its systems. The ratings for Safe and Well-led changed to Good.
The other three key questions were not inspected at this visit. Their previous ratings were used when calculating the overall Good rating.
Safeguarding
Inspectors found that people were protected from abuse. Safeguarding incidents were reported and staff had received extra training.
“People were safeguarded from the risk of abuse. Safeguarding incidents were reported to the relevant authorities.” from the report
Medicines
Medicines were stored, recorded and given safely. Staff received training and regular audits were used to address problems.
“Medicines were managed and stored safely. Medicines records were well maintained.” from the report
Staffing and infection control
Inspectors found enough appropriately trained staff and safe recruitment. Infection control measures and visiting arrangements were in place.
“There were enough appropriately trained staff to care for people safely.” from the report
Improved management
The management team had acted on the previous inspection and put an action plan into practice. Staff described the culture as supportive.
“Lessons learnt were documented and actions had been put in place.” from the report
Kind and person-centred care
Inspectors observed staff treating people kindly and supporting their independence. Changes were made in response to people's feedback.
“Staff treated people kindly, and promoted their independence, this was observed throughout the inspection.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current ratings for Effective, Caring and Responsive, which were not inspected during this visit?
- 02How have you continued to check that safeguarding incidents are reported and acted on?
- 03How do you review medicines audits and make sure any problems do not happen again?
- 04What fire safety improvements have been completed since the previous inspection, and are any further works planned?
- 05How do you involve people and relatives in menus, activities and plans to support people going out?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 16 December 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 2022
Rated Requires Improvement; inspectors found staffing and relationships were positive, but safety checks, safeguarding and management systems were not reliable enough.
This was an unannounced inspection carried out on 9, 15 and 24 September 2021. It started as a targeted check of infection control during the coronavirus pandemic, but was widened to a focused inspection of Safe and Well-led after inspectors found other concerns.
There were enough staff, recruitment checks were safe and medicines were generally managed safely. Inspectors saw kind and positive interactions, and people, relatives and health professionals mostly spoke positively about the care.
However, inspectors found weaknesses in safeguarding, risk assessments, fire safety, infection control records, accident records and the systems used to check the quality and safety of the home. The overall rating fell from Good at the previous inspection to Requires Improvement.
Enough staff
Inspectors found enough staff to meet people's needs, and recruitment procedures were safe.
“There were enough staff deployed to meet people's needs.” from the report
Positive care
Inspectors saw positive interactions between staff and people. People and health professionals also spoke positively about the home.
“We observed positive interactions between staff and people.” from the report
Working with professionals
Staff worked with health and social care professionals to support people's care and treatment.
“I find that the nursing staff and manager work well with me and refer residents to me for input and advice” from the report
Safeguarding reports
seriousNot all safeguarding incidents were reported to the appropriate agencies, including CQC. This meant external agencies could not check whether suitable action had been taken.
“Not all safeguarding incidents had been reported to the appropriate agencies including CQC.” from the report
Risk and fire safety
seriousSome risks involving pressure-relieving mattresses and bed rails had not been fully assessed. Fire safety shortfalls led to visits by the local authority fire safety team and a schedule of urgent works.
“They identified further shortfalls and issued the provider with a schedule of works which needed to be completed as soon as possible” from the report
Incidents not reported to CQC
seriousA police incident and safeguarding allegations were not notified to CQC as required. The provider received a fixed penalty notice for this.
“We had not been notified of a police incident and safeguarding allegations.” from the report
Infection control records
needs fixingRecords about admissions, risk assessments and visitor testing were incomplete or inconsistent, so they did not fully show that best practice was followed.
“There were shortfalls and inconsistencies with infection control records relating to the admission procedure, the assessment of risk and testing for visitors.” from the report
- 01What fire safety work from the schedule issued by the fire safety team has been completed, and what remains outstanding?
- 02How are safeguarding concerns now recorded and reported to CQC and other appropriate agencies?
- 03How are risks involving pressure-relieving mattresses and bed rails assessed and reviewed?
- 04How do you check that all accidents and incidents are recorded and properly analysed?
- 05What changes have been made to infection control records for admissions, risk assessments and visitor testing?
This began as a targeted infection control inspection but was widened to a focused inspection of Safe and Well-led; the other key question ratings were not given in this report. This explanation was written from the published report of 29 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.
Every inspection of Tweedmouth House
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- September 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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