CQC report explained · a residential care home
What the CQC found at Vishram Ghar
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors were assured about PPE, testing, social distancing, safe admissions and outbreak management. They were not fully assured that all infection prevention and control procedures were being followed.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, December 2020
Inspected but not rated; inspectors found good COVID-19 controls but shortcomings in infection prevention and cleaning.
This was an unannounced, targeted inspection on 18 November 2020. It followed concerns about infection prevention and control. Inspectors looked at these measures only.
The home had good supplies of protective equipment, regular COVID-19 testing, set staff teams and cleaning routines. Inspectors were assured that shielding, social distancing, admissions, testing and outbreak arrangements were in place.
However, the laundry was not fit for purpose and was being replaced. Some areas needed decoration and sealing to reduce the risk of fluids entering surfaces and spreading infection. The home's checks had not found all these problems.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating. It is not a full assessment of all aspects of care.
COVID-19 testing
People living in the home and staff took part in regular testing. This allowed action to be taken quickly if someone tested positive.
“The provider participated in regular Covid-19 testing of people living in the service and staff.” from the report
PPE supplies and use
The home had plentiful protective equipment, and staff used it appropriately. Used equipment was disposed of in pedal bins.
“The provider ensured plentiful supplies of personal protective equipment (PPE).” from the report
Cleaning programme
Domestic staff followed a thorough programme of cleaning and disinfection using approved products.
“Domestic staff had a thorough programme of cleaning and disinfection to deter cross infection and cross contamination within the home.” from the report
Staff working arrangements
Staff worked in set teams and defined areas, which reduced the chance of infection spreading between shift members.
“Staff worked in set teams with staff working in defined areas, which lessened the potential of cross infection within shift members.” from the report
Laundry facility
needs fixingThe existing laundry was not fit for purpose. A new laundry facility was being built at the time of inspection.
“The provider was in the process of building a new laundry facility as the current laundry was not fit for purpose.” from the report
Building defects
needs fixingSome areas needed decoration and sealing to prevent fluids entering surfaces. Inspectors said this could affect cleaning and increase the risk of infection spreading.
“There were other minor areas that required decoration and sealing to prevent the ingress of fluids and the potential for cross contamination.” from the report
Checks did not find problems
needs fixingThe provider's quality checks had not identified the shortfalls found during the inspection. Inspectors were not fully assured about infection prevention and control.
“Quality assurance audits undertaken by the provider, were not effective in identifying the shortfalls found during the inspection.” from the report
- 01Has the new laundry facility been completed and is it now being used?
- 02Which areas needed decoration and sealing, and have all these repairs been completed?
- 03How does the home now check that infection prevention and cleaning standards are being met?
- 04How often are people living in the home and staff tested for COVID-19?
- 05What arrangements are in place if someone tests positive or an infection outbreak occurs?
This was an unannounced targeted inspection of infection prevention and control measures only; the service was inspected but not rated. This explanation was written from the published report of 9 December 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, December 2018
Rated Good overall; inspectors found kind, effective care, but the home was not consistently safe.
This was an unannounced, comprehensive inspection on 30 October 2018. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicines, recruitment, training, complaints and quality records.
The overall rating improved from Requires Improvement at the January 2018 inspection to Good. Inspectors found significant improvements in risk assessments, medicines, care planning, activities and quality monitoring.
Safe was still rated Requires Improvement. Staff were not always deployed effectively, infection control rules were not always followed, and some environmental risks were found. Effective, Caring, Responsive and Well-led were all rated Good.
Personalised care plans
Care plans included people's histories, preferences, routines and cultural or religious needs. They were reviewed when people's needs changed.
“Care plans had been reviewed to ensure they reflected people's current needs.” from the report
Kind and respectful staff
Staff had positive relationships with people and supported their dignity, choices and independence.
“We saw staff interacted with people in a positive and friendly manner and clearly knew people well.” from the report
Medicines generally safe
Staff were trained to administer medicines and used safe procedures. People received their medicines as prescribed.
“There were safe systems in place for the administration of medicines and people received their medicines as prescribed.” from the report
Improved quality monitoring
Audits covered areas such as care records, staffing, infection control, medicines and complaints. Actions were used to make improvements.
“The quality assurance process was more detailed and actions were taken in a timely manner.” from the report
Supervision and staff deployment
seriousStaff were sometimes busy, and communal areas were not always supervised consistently. This could affect safety and people's opportunities for engagement.
“Staff were not always deployed effectively or safely to provide appropriate supervision and engagement for people.” from the report
Infection control practice
seriousSome staff did not follow the home's rules about jewellery and wearing gloves when serving food. Inspectors said this could create a risk of injury or cross infection.
“These examples demonstrated instances where staff were placing themselves and people at risk of injury or cross infection.” from the report
Environmental hazards
seriousInspectors found hot exposed pipes, an unsecured wardrobe and an unsafe mirror. These were addressed or referred for action during the inspection.
“The mirror was not secured and the corners were damaged and sharp.” from the report
Activities not always consistent
needs fixingActivities were not provided when the activities worker was absent. There was also no planned schedule or full record of how people were engaged.
“If the activities person if on a day off, there are not activities as we don't really have time.” from the report
- 01How do you make sure communal areas are supervised consistently, including when staff are busy?
- 02What checks now confirm that staff follow infection control rules about jewellery and gloves?
- 03How are activities provided when the activities co-ordinator is absent?
- 04How do you check and record that transdermal medicine patches remain in place?
- 05How do you ensure food and fluid intake records are totalled accurately?
This was an unannounced comprehensive inspection covering all five rating areas, with additional detailed work on oral health support. This explanation was written from the published report of 29 December 2018 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 Vishram Ghar
6 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 14 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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