CQC report explained · a nursing home
What the CQC found at Wantage Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were given safely, and staff understood safeguarding procedures. Staffing was increased during the inspection after concerns were raised about pressure on staff.
- Effective?
- Good
- People's needs were assessed before admission and care was planned using current guidance. People were supported with food, drink, healthcare and decisions about their care.
- Caring?
- Good
- This question was not assessed during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not assessed during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found clearer management arrangements and much better quality checks. People, relatives and staff gave positive feedback about the new management team and the changes made.
What inspectors found, October 2021
Wantage Nursing Home was rated Good; inspectors found major improvements, but staffing pressures and dementia-friendly changes still needed attention.
This was an unannounced focused inspection on 1 and 8 September 2021. Inspectors reviewed records, medicines, infection control, staffing and the way the home was managed. They spoke with people, relatives and staff, and observed care.
The home was rated Good overall, with Safe, Effective and Well-led also rated Good. Inspectors found safe medicines systems, suitable risk assessments, trained staff and improved checks on care quality.
There were still some concerns. On the first inspection day, people and staff said there were not always enough staff, although staffing was increased before the second day. The home was also still improving its environment for people living with dementia.
The previous overall rating was Requires improvement, published in June 2019. The home had breached Regulation 17 at that time. Inspectors found enough improvement had been made and the home was no longer in breach.
Safer medicines
Medicines were administered as prescribed and records were accurate. Staff had training and their competence was checked regularly.
“We observed staff administering medicines to people in line with their prescriptions. There was accurate recording of the administration of medicines.” from the report
Improved oversight
The home had introduced stronger audits and monitoring systems. These helped managers identify concerns and respond more quickly.
“The provider's quality assurance systems had significantly improved.” from the report
Respect for decisions
Staff understood how to support people who might lack capacity. Inspectors found that best-interest decisions and people's rights were handled appropriately.
“Staff had a particularly good understanding of when the principles of the Mental Capacity Act should be applied.” from the report
Food and mealtimes
People were supported to eat and drink in a dignified way. Meals were not rushed, and people could choose to eat in their rooms.
“Mealtimes were set to suit people's individual needs, were not rushed and people were supported by staff who provided personal support.” from the report
Positive management changes
Inspectors saw a calmer atmosphere and effective teamwork. Relatives and staff described better communication and support since the new manager took over.
“There was a clear management and staffing structure and staff were aware of their roles and responsibilities.” from the report
Staffing pressure
needs fixingOn the first day, people, relatives and staff said there were not always enough staff. Inspectors saw staff working continuously, although the provider increased staffing before the second inspection day.
“On the first day of the inspection we saw staff worked continuously and were task orientated.” from the report
Staff supervision
minorThe manager was still completing staff supervision meetings. One staff member said these meetings had not taken place for a long time.
“The registered manager was in the process of completing staff supervisions.” from the report
- 01How many staff are planned for each shift, including weekends, and how do you change this when people's needs increase?
- 02What staffing changes made after the first inspection day are still in place?
- 03What improvements for people living with dementia have been completed since the inspection, and what remains to be done?
- 04How often do staff receive supervision and appraisals now?
- 05How are the new quality audits used to identify and fix problems in people's care?
This was a focused inspection of Safe, Effective and Well-led only; the ratings for Caring and Responsive were carried over from the previous comprehensive inspection. This explanation was written from the published report of 21 October 2021 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 2019
Rated Requires Improvement; inspectors found kind, responsive care, but medicines records, dietary assessments and quality checks were not always reliable.
This was an unannounced inspection on 24 and 29 April 2019. Inspectors observed care, spoke with 19 people, 10 relatives, staff and a professional, and checked care, medicines, recruitment and management records.
The home had enough staff, and people were protected by risk assessments, safeguarding procedures and infection controls. People described kind and respectful care. Inspectors also found good support with food, activities, healthcare, personal choices and complaints.
However, some topical medicines records were incomplete or not checked as required. One dietary decision was not supported by a recorded assessment. The home’s quality checks had not found these problems, which led to one breach of the regulations.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also Requires Improvement, while Caring and Responsive were Good. This was a fall from Good at the previous inspection, published on 17 February 2017.
Kind, respectful staff
People were treated warmly and respectfully. Staff knew people well and supported their dignity, privacy and independence.
“We observed staff were kind and compassionate and showed they had formed a strong relationship with people and knew them well.” from the report
Enough staff
Inspectors found staffing levels were sufficient and saw staff respond promptly to people who needed support.
“We observed, and staffing rotas confirmed, there were sufficient staff to meet people's needs.” from the report
Personalised care
Care plans gave staff detailed information about people's preferences, daily support and health needs. People and relatives said the service responded to them.
“People were supported by staff who had a good understanding of their care and support needs and personal preferences.” from the report
Choice and activities
People could choose meals and how to spend their day. Activities were flexible and included entertainment and trips outside the home.
“There was a wide range of activities offered that included entertainment and external trips.” from the report
Medicines records
seriousSome handwritten topical medicine records were not signed or checked by a second person. Records also did not always show whether medicines had been applied or refused, although inspectors were confident people had received medicines as prescribed.
“TMAR were not always completed to show when topical medicines had been applied or refused'.” from the report
Dietary assessment
needs fixingOne person was receiving a modified diet without a recorded assessment explaining how the decision had been made or whether it was in the person's best interests.
“There was no record, assessment or evidence of how this decision had been made and if it was in the person's best interests to receive this level of support.” from the report
Quality checks
seriousThe home's monitoring systems had not identified the medicines and dietary shortfalls. This resulted in a breach of Regulation 17.
“The systems in place to monitor the quality of service were not always effective.” from the report
Dementia-friendly environment
minorSome parts of the home had not been decorated in line with good practice for helping people living with dementia feel stimulated and oriented. The provider said plans were in place to address this.
“We observed parts of the home where the environment for people living with dementia had not been decorated in line with good practice guidance for helping people to be stimulated and orientated.” from the report
- 01What changes have you made to signing, checking and completing topical medicine records?
- 02How do you now record assessments and best-interest decisions when someone needs a modified diet?
- 03What action did you send to CQC after the Regulation 17 breach, and what evidence can you show that it was completed?
- 04How do your current audits identify medicines, dietary and other care-record problems before they affect people?
- 05What improvements have been made to the areas used by people living with dementia?
This was an unannounced comprehensive inspection covering all five key questions; the previous overall rating was Good. This explanation was written from the published report of 19 June 2019 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 Wantage Nursing Home
6 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementstayed Requires improvementSafe: Requires improvement
- April 2016Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 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.
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
38 live-in carers within about an hour of Oxfordshire
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 £1,300 a week. 32 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.