CQC report explained · a nursing home
What the CQC found at Walton Park 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, August 2023
Rated Good overall; inspectors found safe, kind and personalised care, but leadership and record checks still needed improvement.
This was an unannounced follow-up inspection on 11 July 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment checks, training, staffing and management records.
People were protected from harm, received their medicines safely and had enough staff support. Inspectors also found that staff understood people's needs, respected their choices and dignity, and provided personalised care. Food, healthcare access, activities and visiting arrangements were also viewed positively.
The overall rating improved from Requires Improvement to Good since the previous inspection. Safe and Effective also improved to Good. Caring and Responsive remained Good. Well-led stayed at Requires Improvement because management changes had delayed some improvements, and checks of records and medicines systems were not yet consistently effective.
People felt safe
People and relatives told inspectors they felt safe. Staff understood safeguarding procedures and individual risks, and incidents were reviewed for lessons.
“People were protected from abuse and neglect and felt safe in the home.” from the report
Kind and respectful staff
People and relatives described staff as caring and attentive. Inspectors observed staff protecting people's privacy and dignity.
“Staff treated people with respect and protected their dignity.” from the report
Personalised care
Care plans included people's preferences, interests, communication needs and wishes. Staff supported people to make choices and have control over their daily routines.
“People's care was personalised to their needs and wishes.” from the report
Improved staff training
Training and induction had improved since the previous inspection. Staff completed courses covering areas such as dementia, falls, medicines and infection control.
“The management team had now closely monitored staff training completion and further training needs.” from the report
Better culture and consistency
People, relatives and staff said the culture and consistency of the staff team had improved. Staff said managers were approachable and listened to concerns.
“People, their relatives and staff told us the culture of the home had significantly improved thanks to ongoing support of the deputy manager and better consistency of staffing.” from the report
Leadership still inconsistent
needs fixingThe home had experienced several management changes, and improvements were not yet fully established. There was no registered manager in post at the inspection.
“The management team had improved the governance and oversight systems in the home but not all improvements had been fully embedded.” from the report
Some care records needed follow-up
needs fixingOne person's record had not received a formal review promptly after a change in needs. The care plan was updated immediately after the inspection.
“We found one example where the quality review was not always followed up by the management in a timely way which meant this person's record still required a formal review.” from the report
Medicines records were not fully reliable
needs fixingAudits had identified gaps in signatures, unclear instructions and problems recording medicines entering and leaving the home. Inspectors found no evidence that people had been harmed.
“This meant issues around gaps in staff signatures on topical medicines administration charts or on booking medicines into the home, some unclear instructions in people's records and stock return issues had not been resolved.” from the report
Activities and refurbishment still developing
minorThe programme of events and one-to-one activities was being reviewed. Refurbishment was ongoing, including work intended to improve the environment for people living with dementia.
“The home offer of events and one to one support with individual interests was being developed by the new activities and lifestyle staff.” from the report
- 01What is the current progress of the action plan for medicines records, including staff signatures, medicines stock and clear instructions?
- 02Who is responsible for checking that care plans are formally reviewed promptly when people's needs change?
- 03What is the current position on the registered manager application?
- 04How will you make sure recent improvements remain consistent after the changes in the management team?
- 05What activities and one-to-one support are now available for people who do not join group events?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also checked under Safe. This explanation was written from the published report of 11 August 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, February 2023
Walton Park Care Home is rated Requires Improvement; inspectors found improvements but ongoing risks in staff training, records and management checks.
This was an unannounced focused inspection on 23 January 2023. Inspectors spoke with people, relatives and staff, observed care, and checked medicines, care records, staff files and management records.
The home had enough staff on duty overall, and people generally said they felt safe. However, some staff had not received training for the needs of people with dementia, epilepsy, learning disabilities or autism. Some care records, medicines records and checks on accidents were also incomplete or not up to date.
The home had improved its environment, cleanliness, fire safety and management oversight. Staff and relatives said communication and the atmosphere had improved. However, the provider had not fixed all the problems identified at earlier inspections.
The overall rating remains Requires Improvement. Safe, Effective and Well-led were each rated Requires Improvement. Caring and Responsive were not inspected in this visit, so their earlier ratings were carried forward.
Enough staff overall
Inspectors found enough staff to support people during the inspection. The use of temporary staff had also reduced.
“There were enough staff to support people.” from the report
People felt safe
People and relatives generally said they felt safe. Staff understood how to raise safeguarding concerns, and concerns raised during the inspection were acted on.
“People explained to us they felt safe when receiving care.” from the report
Improved home environment
Refurbished rooms and smaller communal areas made the home more comfortable and better suited to some people's mobility needs. Cleanliness, maintenance and fire safety had also improved.
“People told us they really liked the new environment, which was more homely, comfortable and clean.” from the report
Better communication and support
Staff said management was more visible and supportive. Relatives said they felt welcome and well informed.
“The atmosphere and culture in the service had improved since our last inspection.” from the report
Support with food and healthcare
People were offered varied meals and help to eat and drink. Staff contacted healthcare professionals when people's needs changed.
“People were provided with a varied menu that supported them to maintain a balanced diet.” from the report
Staff training gaps
seriousSome staff had not received training for important needs present in the home, including dementia, epilepsy, learning disabilities and autism. The report says this could put people at risk of avoidable harm.
“Not all staff received relevant training to their roles, which put people at risk of avoidable harm.” from the report
Care records were not reliable enough
seriousSome records did not reflect people's changing needs or give staff clear guidance. In one case, staff offered food that was recorded as unsafe for that person.
“People's care records were still not robust enough and not always up to date.” from the report
Medicines records had gaps
seriousSome topical medicines and patch records were not signed consistently. Instructions for some anticoagulant medicines had not been updated after prescribing changes.
“The records of administration of some medicines were not consistently well kept.” from the report
Management checks were not effective enough
seriousAudits and reviews had not consistently found or dealt with problems quickly. The provider remained in breach of the good governance regulation.
“The provider had failed to ensure their governance systems were used effectively.” from the report
Staff deployment and call bells
needs fixingMorning support with breakfast and medicines was delayed on the inspection day. Some people said call bells could take several minutes or longer, and the home did not monitor response times.
“The provider did not monitor call bell response times and used a basic dependency algorithm to establish staffing levels.” from the report
Mental capacity records
needs fixingRecords of some mental capacity assessments and best-interest decisions were still incomplete. The CQC repeated its recommendation for improvement.
“Not all records of mental capacity assessments were in place or in line with the MCA Code of Practice requirements.” from the report
- 01What training have all staff now completed for dementia, epilepsy, learning disabilities and autism?
- 02How do you now make sure every person's care plan reflects changes in their health, mobility, diet and risks?
- 03What checks are now in place to make sure medicines charts and prescribing instructions are complete and up to date?
- 04How do you monitor call bell response times and make sure morning medicines and breakfast support are not delayed?
- 05What evidence can you show that the breaches of Regulations 17 and 18 have been fully addressed?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 28 February 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.
Every inspection of Walton Park Care Home
6 rated inspections over 6 years: the service has held its Good rating throughout.
- August 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2023Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- July 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017
Registered with the Care Quality Commission on 26 May 2017.
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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