CQC report explained · a nursing home
What the CQC found at Uplands House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
Rated Requires Improvement; care and safety had improved, but important risks and weaknesses in staffing, care planning and oversight remained.
Inspectors made an unannounced follow-up visit on 19 and 20 October 2022. They spoke with 5 patients and 12 staff, reviewed 5 medication records and 7 patient records, toured the ward and checked other documents.
The home had made progress since earlier inspections. It was clean, had installed a new fire alarm system, reduced agency staff use and improved staff training. Patients said they felt safe, and inspectors saw caring and respectful interactions.
However, some bedrooms did not have nurse call alarms and some environmental risks were not fully assessed. Staffing levels did not always reflect patients’ needs, escorted leave was sometimes cancelled, and care plans were not sufficiently personal or focused on recovery and discharge.
The overall rating was Requires Improvement. Safe, Effective, Caring and Well-led were also Requires Improvement. Responsive was Good. The hospital was removed from special measures because of the improvements, but the provider was required to continue making changes.
Clean environment
Inspectors found the ward visibly clean and maintained, with staff carrying out cleaning during the visit.
“Ward areas were clean, maintained and well-furnished.” from the report
Respectful care
Staff engaged more with patients than at earlier visits. Patients said staff treated them well, and inspectors saw respectful interactions.
“We saw that staff were engaging with patients more than on previous visits.” from the report
Risk management
Staff completed regular risk assessments and generally understood individual patients’ risks. Restraint was used only after de-escalation had failed.
“Staff followed best practice in anticipating, de-escalating, and managing challenging behaviour.” from the report
Progress since earlier inspections
The provider had improved training, reduced agency staff use, installed a new fire alarm system and started recruiting clinicians for a fuller team.
“During this inspection we saw that the provider had maintained the improvements we found in June 2022 and had continued to make progress” from the report
Emergency call systems
seriousNot every bedroom had a nurse call alarm, so some patients could not call for help in an emergency. Managers said seven alarms were missing and planned to replace them by 13 December 2022.
“However, this meant that not all bedrooms currently had nurse call alarms for the patients to call for assistance.” from the report
Environmental risks
seriousSome ligature anchor points remained and were not all included in the regular risk assessment. Inspectors also found other risks linked to the building layout and access to stairs.
“There were many potential ligature anchor points throughout the service.” from the report
Staffing and escorted leave
seriousThe staffing system focused mainly on the number of patients, rather than their care needs. Staff said escorted community leave was sometimes cancelled, and cancellations were not recorded properly.
“Staff told us that there was not enough staff on duty and as a result patients had their escorted leave cancelled.” from the report
Care plans
seriousCare plans covered health needs but were not personalised or focused enough on recovery, developing independence or preparing for discharge. Patients’ views were not always recorded.
“However, none of the care plans we reviewed were personalised or recovery orientated.” from the report
Specialist support
needs fixingThere was no clinical psychologist or occupational therapist employed for the ward. This limited support for independence, discharge preparation and emotional difficulties.
“There was no clinical psychologist or occupational therapist employed to work with the patients.” from the report
Governance and records
seriousThe new governance process was not yet working effectively. Managers were not identifying themes from incidents and complaints or routinely checking patient records.
“Therefore, the senior leadership team did not have oversite of the quality and effectiveness of the care provided at the hospital.” from the report
- 01Have all bedrooms now been fitted with working nurse call alarms, and how are patients without one protected in an emergency?
- 02What environmental risks, including ligature anchor points and risks around the stairs, were found after the inspection, and what action has been completed?
- 03How do you now set staffing levels according to each patient’s care needs rather than simply the number of patients?
- 04How do you make sure escorted leave is not cancelled because of staffing, and how are any cancellations recorded and rearranged?
- 05How are patients’ views and recovery goals recorded in care plans, including the skills they need for discharge?
This was an unannounced follow-up inspection of the long-stay or rehabilitation mental health ward for working-age adults, covering all five questions and checking improvements required after earlier inspections. This explanation was written from the published report of 17 January 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, September 2022
Previous rating Inadequate and the service was in special measures; inspectors found some improvements but serious safety and care problems remained.
The CQC made an unannounced focused inspection on 28 and 29 June 2022. It checked whether improvements required after the January 2022 inspection had been made. Inspectors visited both units, spoke with patients, visitors and staff, observed meetings and activities, and reviewed six care records and medicines.
The home was cleaner and better maintained. Risk assessments, care plans, staffing, medicines systems and management checks had improved in some areas. However, risks were not always recorded or managed properly, medicines were not always handled safely, staffing remained a concern, and care was not yet based on a recognised rehabilitation model.
The CQC did not give new ratings in this focused inspection. The previous overall rating of Inadequate, and the previous Inadequate ratings for all five questions, remained in place. The home had been placed in special measures after the earlier inspection. The CQC decided not to take further enforcement action at this point, but said it would continue to monitor the home closely.
Cleaner environment
The wards were cleaner, better maintained and in better overall condition than at the previous inspection.
“Wards were clean, well maintained and fit for purpose.” from the report
Safeguarding
Staff understood how to recognise and report abuse, and safeguarding referrals were made when needed.
“Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.” from the report
Reduced restrictions
Restrictions on smoking had reduced since the previous inspection. Staff used distraction and de-escalation, with restraint used as a last resort.
“Restraint was used as a last resort and staff used distraction and de-escalation techniques to manage these situations.” from the report
Some management improvements
The home had introduced new leaders, meetings, audits and an improvement plan. Most staff said they felt supported by managers.
“Most of the staff we spoke with said that they felt supported by managers.” from the report
Risk management
seriousRisk assessments were not always complete or detailed enough. Staff did not always know the risks for each patient or how to reduce them.
“Staff did not always assess and manage risks to patients and themselves well.” from the report
Medicines safety
seriousSome medicines and prescribing records did not follow the home's policy. The impact of medicines on patients' physical health was not always reviewed properly, and one medicines room was unsafe and lacked privacy.
“The service did not always use systems and processes to safely manage medicines.” from the report
Staffing and handovers
seriousThere were vacancies, particularly for registered nurses, and agency staff sometimes needed supervision. Handover records were incomplete, so staff starting shifts did not always know patients' needs and risks.
“The provider did not ensure that there were sufficient numbers of appropriate skilled and qualified staff deployed on all units at all times to meet the patients’ needs.” from the report
Rehabilitation and activities
needs fixingThe home did not yet use a recognised rehabilitation model. Activities were mainly leisure-based and did not consistently help people build life skills, work or education.
“Although activities were organised, they were not meaningful or support life skills training such as work or education or meaningful activities.” from the report
Same-sex accommodation
seriousThere was initially no female-only lounge in the complex care unit, despite women living there. Staff were not all aware of the risks, although a separate lounge was created during the inspection.
“The service did not fully comply with same sex accommodation guidance.” from the report
- 01What evidence can you show that each patient's risk assessments are complete, detailed and updated after incidents or changes?
- 02How are medicines, expiry dates and physical health checks monitored, especially when a patient refuses checks?
- 03How many registered nurse vacancies remain, and how do you make sure agency staff understand each patient's needs and risks?
- 04What recovery-focused rehabilitation model is now being used, and what work, education or life-skills activities are available?
- 05What has changed since the inspection to ensure care plans involve patients and their families and include clear discharge actions?
This was an unannounced focused inspection checking improvements after the January 2022 inspection; the service was inspected but not rated, so the previous Inadequate ratings remained in place. This explanation was written from the published report of 14 September 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 Uplands House Care Home
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- September 2022Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- April 2022Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- February 2019Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
26 live-in carers within about an hour of Hampshire
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 £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.