CQC report explained · a residential care home
What the CQC found at Upton Grange Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2020
Upton Grange Residential Home is rated Requires Improvement; inspectors found kind and effective care, but safety records and management checks were not reliable enough.
This was an unannounced inspection on 30 January 2020. The inspectors spoke with 12 people living at the home, four visitors, the manager and six support staff. They reviewed care records, medicines, recruitment files and management records, and observed care.
People generally said they felt safe, comfortable and well cared for. Inspectors found good ratings for effective, caring and responsive care. They praised the food, staff training, communication and the way complaints were handled.
The home was not consistently safe or well-led because important records and checks were incomplete or out of date. These included health and safety checks, risk assessments, care plans, activity records and staffing information. The overall rating fell from Good at the previous inspection, published in July 2018, to Requires Improvement.
Kind and respectful staff
People and relatives gave positive feedback about the staff. Inspectors found that people were treated with dignity and respect.
“People and their relatives said the staff were caring and considerate towards each of them.” from the report
Good food and mealtimes
People praised the home-made food and said there was enough to eat. Inspectors also saw friendly and kind interactions during a mealtime.
“People were complimentary about the food provided and the meal time experience.” from the report
Trained staff
Staff had an induction and training programme and understood how to support people's individual conditions.
“Staff were well trained and knew how to provide the support people needed.” from the report
Complaints were acted on
People knew who to speak to if they had a complaint. The complaints log recorded concerns and actions, with evidence of quick responses.
“We saw evidence of swift responses made by the registered manager for complaints raised.” from the report
Weak quality checks
seriousThe home's monitoring systems did not identify problems with health and safety records, care plans, social support, staffing and complaints information. This was a breach of Regulation 17.
“The service did not have robust processes in place to effectively assess, monitor and improve the quality of the service.” from the report
Incomplete safety records
seriousSome maintenance certificates were missing and risk assessments had not been completed for hazards including uncovered hot radiators. Updated checks were submitted after the inspection.
“Some certificates of maintenance could not be found and risk assessments had not been developed for risks such as uncovered radiators that were hot to touch.” from the report
Unclear staffing calculations
needs fixingPeople did not always know how many staff were on duty. The dependency assessment used to calculate staffing was inaccurate and the supporting records were not clear.
“The records to show how staffing levels were calculated lacked transparency.” from the report
Care records needed updating
needs fixingSome care plans had not been reviewed recently, and some records were difficult to read. The manager said all care records would be reviewed.
“Some records within care plans did not have recent reviews to confirm information was still relevant to a person.” from the report
- 01What safety checks and risk assessments have been updated since the inspection, especially for hot radiators and maintenance work?
- 02How are staffing levels now calculated, and how will residents be told how many staff are on duty?
- 03How do you check that care plans and activity records are reviewed and kept up to date?
- 04What action has been taken in response to the Regulation 17 breach?
- 05How are complaints information and the complaints policy kept accurate and easy for people to understand?
This was a planned but unannounced inspection that looked at the premises and care across all five key questions. This explanation was written from the published report of 1 April 2020 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, July 2017
Rated Good; inspectors found safe, kind and personalised care, with further improvement needed in dementia practice and some records.
This was an unannounced inspection on 20 and 27 June 2017. Inspectors spoke with 13 people living at the home, two relatives, staff and managers. They observed care, checked medicines, reviewed records and toured the building.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, kind and respectful care, personalised care plans, and systems for checking quality.
The inspection followed a February 2016 inspection where the provider had not met requirements in several areas. Inspectors found that the needed improvements had been made. They still identified some areas for further work, including dementia care practice, a small number of medicines record problems and mixed staff views about management support.
Enough staff
Inspectors found staffing levels were sufficient and call bells were answered within a few minutes.
“During this inspection we found there were enough staff available to meet the needs of people living at the home.” from the report
Personalised care plans
Care plans recorded people's preferences, needs and the best way to support them. People were involved in developing and reviewing their plans.
“They were very detailed and included information about what was important to people and how best to support them.” from the report
Kind and respectful care
Inspectors saw positive relationships between staff and people. Privacy, dignity and personal choices were respected.
“We observed that people were treated with dignity and respect.” from the report
Stronger quality checks
The home had introduced more regular audits and reports covering areas such as medicines, care plans, incidents and complaints.
“Quality assurance systems had been implemented more robustly since the last inspection and regularly reviewed the quality of the service provided.” from the report
Dementia care practice
needs fixingAlthough staff had received dementia training, inspectors saw an interaction that could have been handled differently. The manager had identified the need for more development.
“At this inspection we saw that staff had received training in dementia care but found that practice in this area could be improved further.” from the report
Medicines records
needs fixingInspectors found one recording error and one handwritten medicines entry that had not been countersigned. The manager was told about this.
“We noted one recording error and also that one person's medication had been hand written on the MARs but not countersigned to check the accuracy” from the report
Mixed staff views
minorSome staff said they felt unsupported and that concerns had not always been dealt with effectively. Other staff described the manager as supportive and approachable.
“Some staff told us that the registered manager was often very busy and they felt unsupported at times.” from the report
Activities
minorNo activity was taking place during the inspection, and people gave mixed views about the activities available. The report says there was an activities programme and some sessions and outings were arranged.
“During the inspection we found there were no activities taking place and the home was quiet and calm.” from the report
- 01What further dementia care training and support have staff received since the inspection?
- 02How are medicines administration records checked to prevent recording errors and ensure handwritten entries are countersigned?
- 03How many staff are usually on duty during the day and at night, and has the planned recruitment been completed?
- 04What activities are currently available, and how are they adapted for people who prefer different interests or levels of support?
- 05How can staff raise concerns with managers, and how are those concerns followed up?
This was an unannounced inspection covering all five questions and reviewing improvements required after the February 2016 inspection. This explanation was written from the published report of 28 July 2017 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 Upton Grange Residential Home
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- April 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Upton Grange Residential Home →
- July 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Upton Grange Residential Home →
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 24 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.
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