CQC report explained · a residential care home
What the CQC found at Viera Gray House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2023
Viera Gray House is rated Requires Improvement; safety and management improved after an Inadequate rating, but inspectors need to see these changes continue.
This was an unannounced focused inspection in April 2023. Inspectors visited the home, spoke with people, staff and professionals, observed care, and checked care plans, medicines records, recruitment files and quality checks.
The home had improved since the previous inspection. Inspectors found better safeguarding, medicines management, staffing, training, risk plans and oversight. People said they felt safe and were treated with respect. The home was clean and infection control arrangements were suitable.
The home was no longer in Special Measures and was no longer rated Inadequate. However, it was still rated Requires Improvement for Safe and Well-led because inspectors had not yet seen consistent good practice over a long enough period. There was also no registered manager in post.
Medicines
Medicines systems had improved. Inspectors found no recording errors or omissions in the electronic medicines records they checked, and observed medicines being given safely.
“Medicines systems were now well-organised, and people received their medicines as they were prescribed.” from the report
Staffing
Inspectors found enough staff to meet people's needs. Recruitment checks, induction and training systems were also in place.
“There were enough staff working in the care home to meet people's needs.” from the report
Cleanliness
The home was clean, and inspectors were assured that infection prevention arrangements were being followed.
“The care home looked and smelt hygienically clean.” from the report
Risk records were not always current
needs fixingAlthough care plans had improved, several professionals said they had still found discrepancies or plans that were not up to date. Managers agreed to keep reviewing and improving them.
“We are still finding discrepancies in risk assessments and management plans not being up to date.” from the report
No registered manager
needs fixingThe home did not have a registered manager, although this is legally required. A newly appointed manager was expected to apply for registration.
“All the positive comments made above notwithstanding the care home remains without a registered manager, which the provider is legally required to have in post to oversee the delivery of regulated activities at this location.” from the report
Open investigations
needs fixingAt the time of the inspection, investigations by the police, coroner and local authority were still open. The report does not give their outcomes.
“At the time of our inspection there were open safeguarding investigations being conducted by the police, the coroner and local authority.” from the report
- 01Has the manager now applied to become registered with the CQC, and who is responsible for the home until this is complete?
- 02How do you check that every person's risk assessment and management plan is up to date?
- 03What changes have been made to prevent the safeguarding concerns described in the report from happening again?
- 04How have staffing levels and the use of temporary agency staff changed since the inspection?
- 05What were the outcomes of the open safeguarding investigations mentioned in the report?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 27 May 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, December 2022
Rated Inadequate and placed in special measures; inspectors found serious safety, staffing, medicines and leadership failures.
This was an unannounced focused inspection on 11 and 13 October 2022. Two inspectors spoke with people, relatives, staff and health professionals, and reviewed records and the service’s systems.
Inspectors found people were at risk of harm. Risk assessments were missing or not detailed enough, some incidents and safeguarding concerns were not handled properly, staffing levels were too low in parts of the home, and medicines were not always given as prescribed.
Leadership and oversight were also inadequate. Audits had not found important problems, records were not always available after a cyber-attack, staff were not always confident to report poor practice, and recommendations from health professionals were not always followed.
The home was rated Inadequate overall, and Inadequate for Safe and Well-led. This was a change from Good at the previous inspection, published on 7 October 2021. The other three key question ratings were carried over because they were not inspected.
Infection control
Inspectors were assured that the home followed current infection prevention and control guidance, including safe visiting, use of protective equipment and managing outbreaks.
“The provider followed current guidance on the management of infection prevention and control.” from the report
People’s choices
Inspectors found that people were supported to make choices and that staff sought consent. Mental capacity and liberty safeguards were being used appropriately.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Recruitment checks
The recruitment records inspectors reviewed showed that suitable checks had been completed before staff were employed.
“Pre employment checks undertaken by the provider ensured only suitable staff were employed.” from the report
Some positive feedback
The previous quality questionnaire contained favourable views about support, cleanliness, atmosphere and how promptly requests were dealt with.
“We reviewed the 2021 questionnaire and found responses were favourable in relation to the level of support provided, cleanliness of the service, atmosphere and requests being dealt with promptly.” from the report
Risk of harm and abuse
seriousPeople were not always protected from abuse. Physical assaults had occurred, some were not reported to the relevant safeguarding team, and staff confidence in reporting poor practice was mixed.
“People were not always protected against the risk of abuse as the staff did not have the necessary skills and experience to keep people safe.” from the report
Weak risk assessments
seriousRisk assessments did not always explain clearly how staff should respond to behaviours that could cause harm. Staff had also not received the planned physical intervention training at the time of inspection.
“The provider continued to fail to develop robust risk assessments.” from the report
Medicines not always given safely
seriousOne person had not received medicines for 14 days despite the prescribing GP’s recommendation. Inspectors also found no person-specific protocols for medicines given when needed.
“Prior to the inspection we were made aware of an incident whereby one person receiving respite at the service, had not received their medicines for 14 days” from the report
Too few staff
seriousStaffing was not sufficient in some parts of the home. Some people waited for personal care and meals, and people could wait a long time for help.
“This had resulted in some people not receiving support with personal care until 10.30am.” from the report
Poor management oversight
seriousAudits did not identify the problems found by inspectors. Records were missing or difficult to access, and the home had not adequately addressed concerns from previous inspections.
“There was an embedded culture whereby there were systematic and widespread failings in the overall management and oversight of the service.” from the report
Closed culture and weak learning
needs fixingStaff were not always confident about speaking out. The home did not consistently learn from incidents or follow recommendations from health professionals.
“The culture within the service was impacted by the poor oversight and leadership, and records showed and a staff member told us, there was a closed culture at Viera Gray House.” from the report
- 01How many staff are now allocated to each wing in the mornings, including the Wren unit?
- 02What current risk assessments and staff training are in place for people whose behaviour may put others at risk?
- 03How do you check that every person receives their medicines as prescribed, including medicines given when needed?
- 04What safeguarding incidents have occurred since the inspection, and how are they reported and reviewed?
- 05What urgent conditions has the CQC imposed, and what progress has been made against the required action plan?
This was an unannounced focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 31 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.
Every inspection of Viera Gray House
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2022Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- October 2021GoodSafe: Requires improvementWell-led: Good
- March 2021Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- May 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015
Registered with the Care Quality Commission on 17 November 2015.
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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