CQC report explained · a residential care home
What the CQC found at Wall Hill Care Home Limited
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2023
Requires Improvement; inspectors found risks with safeguarding, medicines and management systems.
This was an unannounced, focused inspection on 14 November 2023. Inspectors reviewed Safe and Well-led only. They spoke with people, a relative, staff and managers, and checked care records, medicines records, staff files and management documents.
Inspectors found that people were not always protected from abuse or avoidable harm. Safeguarding concerns were not always referred to the local authority. One person also received too much of a medicine, and checks did not identify the error. The medicines trolley was seen unlocked while medicines were being given elsewhere.
There were also problems with management oversight. Audits did not reliably find safeguarding, notification or medicines problems. The provider had not properly analysed accidents and incidents or always followed up actions. The overall rating changed from Good to Requires Improvement. The Safe rating changed to Requires Improvement, while Well-led remained Requires Improvement.
Staffing
Inspectors found enough staff to meet people's needs safely. People did not usually have to wait long for care.
“People were supported by a sufficient number of staff to meet their needs safely.” from the report
Risk planning
Risk assessments guided staff about people's needs and how to reduce risks. Staff were knowledgeable about managing those risks.
“Risk assessments were in place to guide staff how to meet people's needs safely and mitigate risk to them.” from the report
Infection control
The home was clean, regular cleaning was evident and staff used protective equipment in line with guidance.
“People were protected from the risk of infection as staff were following safe infection prevention and control practices.” from the report
People felt included
People said staff listened to them and included them. Staff were described as supportive and approachable.
“People told us they felt included by staff which was important to them.” from the report
Safeguarding referrals
seriousSome concerns about possible abuse or harm were not referred to the local authority as required. Referrals were made retrospectively after inspectors raised the issue.
“People were not always safeguarded from abuse and avoidable harm.” from the report
Medicine error
seriousOne person received three tablets of a medicine in one day when no more than two were prescribed. The error was not identified by the home's checks.
“One person's medication administration record (MAR) showed a 'when required' medicine was prescribed to be administered no more than twice a day, but 3 tablets in 1 day had been administered.” from the report
Medicine storage and recording
seriousThe medicines trolley was observed unlocked while staff were in another room. Some records did not explain why when-required medicines had been given.
“During the inspection, we observed the medicines trolley unlocked whilst a staff member administered medicines in a different room.” from the report
Weak management checks
seriousAudits did not reliably identify risks or show whether actions had been completed. Accidents, incidents and safeguarding concerns were not properly analysed for patterns.
“Systems had not been established to assess, monitor and mitigate risks to the health, safety and welfare of people using the service.” from the report
Expired authorisations
needs fixingSome legal authorisations relating to restrictions on people's liberty had expired. The provider applied for extensions immediately after inspectors raised this.
“Legal authorisations to deprive a person of their liberty were in place but we found some had expired.” from the report
- 01What checks are now in place to prevent medicine errors and make sure the medicines trolley is always locked?
- 02How will you make sure every safeguarding concern is reported to the local authority without delay?
- 03How are accidents, incidents and safeguarding concerns now analysed for patterns and repeat risks?
- 04How do your audits show that identified actions have been completed?
- 05Have all expired DoLS authorisations now been renewed, and how are their dates monitored?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 21 December 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, June 2022
Wall Hill Care Home Limited is rated Good overall; inspectors found safe care but leadership, records and quality checks needed improvement.
This was an unannounced focused inspection on 13 and 14 April 2022. Inspectors looked only at Safe and Well-led. They spoke with people, relatives and staff, and checked care records, medicines, staff files, training and policies.
The home was rated Good for Safe. Inspectors found enough trained staff, safe recruitment, suitable infection control and systems to protect people from abuse. The home had also acted after a serious incident by installing compliant window restrictors and working through fire safety actions.
Well-led was rated Requires Improvement. Quality checks had not always found errors, some care records and risk assessments needed updating, and some required notifications had not been sent to the CQC. The home dealt with the identified issues during or after the inspection, but the CQC said it would continue to monitor the service.
The overall rating stayed Good because the other three areas were not inspected and their previous ratings were carried forward. The previous overall rating was also Good.
Enough trained staff
Inspectors found enough suitably trained staff, with agency staff used when needed. Recruitment checks were completed safely.
“There were enough suitably trained staff. Recruitment was on-going and agency staff were used when needed.” from the report
People felt safe
People and relatives told inspectors they felt safe. Staff understood how to recognise and report abuse.
“People told us they felt safe. One person said, "I absolutely feel safe.” from the report
Infection control
Inspectors were assured that the home used PPE, testing, cleaning and visiting arrangements to reduce infection risks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Learning from incidents
The provider acted after a serious incident by installing compliant window restrictors and continued work on fire safety actions.
“The provider learned lessons when things went wrong and took action to reduce risks to people.” from the report
Quality checks missed errors
needs fixingQuality assurance systems were not always effective. They did not identify some problems with records, medicines and notifications before the inspection.
“Improvements were needed to quality assurance systems as they were not always effective in supporting management to identify errors.” from the report
Care records and risk assessments
needs fixingSome care files did not reflect people's current needs, and some risk assessments lacked enough detail for unfamiliar staff to support people properly.
“The registered manager had not identified some care files required updating to reflect people's current needs.” from the report
Notifications were not consistent
needs fixingSome required notifications had not been sent to the CQC. The outstanding notifications were submitted after inspectors raised the issue.
“We identified some occasions where statutory notifications had not been sent to CQC.” from the report
- 01How often are care files and risk assessments now audited, and how do you make sure they reflect each person's current needs?
- 02What extra checks are now in place to prevent medicine stock discrepancies?
- 03How do you make sure every incident that must be reported is notified to the CQC on time?
- 04How are you now collecting and acting on the views of people living in the home and their relatives?
- 05What fire safety actions from the latest assessment are still outstanding, and when will they be completed?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 25 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 Wall Hill Care Home Limited
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- December 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022GoodSafe: GoodWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- January 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 21 February 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.
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
At least 100 live-in carers within about an hour of Staffordshire
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 £980 to £1,230 a week. 85 can care for a couple. 10 years' experience on average.
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
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.