CQC report explained · a nursing home
What the CQC found at Warde Aldam
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks were not always properly assessed. Inspectors found gaps in hoist records, problems with fire doors and concerns about cleanliness, although medicines, staffing and safeguarding were managed safely.
- Effective?
- Good
- This question was not assessed during this focused inspection. The report says its rating was carried over from the previous inspection.
- Caring?
- Good
- This question was not assessed during this focused inspection. Inspectors did see people treated with kindness and respect.
- Responsive?
- Good
- This question was not assessed during this focused inspection. The report says its rating was carried over from the previous inspection.
- Well-led?
- Requires improvement
- Management systems did not reliably identify risks or drive improvements. People, relatives and staff were positive about the manager, but the action plan had not yet become established practice.
What inspectors found, September 2022
Warde Aldam is rated Requires Improvement; inspectors found people were usually safe and treated kindly, but safety checks and records were not reliable enough.
This was an unannounced, focused inspection on 30 August 2022. Inspectors looked only at Safe and Well-led. They spoke with people, relatives, staff and a health professional, and checked care records, staff files, risk assessments and audits.
The home was not always safe. Hoist records did not give enough information, some fire doors were wedged open or needed repair, and some furniture and flooring were visibly dirty or stained. These issues increased the risk of harm or infection. Medicines, staffing, recruitment and safeguarding were found to be managed safely.
The home was not always well-led. Audits did not identify some problems with infection control, fire safety, the environment and care records. People and relatives were positive about staff and management, but improvements were still being put into an action plan and had not yet become established practice. The overall rating changed from Good at the previous inspection to Requires Improvement.
Safeguarding
People were protected from abuse. Staff knew how to report concerns and felt able to do so.
“People were safeguarded from the risk of abuse.” from the report
Medicines
Medicines were stored, given and disposed of safely. Records were accurately completed.
“Medicines were managed safely and people were receiving their medicines as prescribed.” from the report
Staffing
Inspectors found enough staff to meet people's needs, and recruitment checks were completed.
“There were enough staff to meet people's needs.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw people treated with kindness and respect.
“We saw people being treated with kindness and respect.” from the report
Moving and handling records
seriousSome care plans did not explain how hoist slings should be used. The records were updated during the inspection, but this gap could have increased the risk of harm.
“Records for people who required the use of hoists did not always contain enough information to keep them safe.” from the report
Cleanliness and infection risk
seriousInspectors saw unpainted wood, soiled furniture and flooring, and a bad smell in some areas. They said these conditions increased infection risk.
“We observed some areas of unpainted wood and walls, visibly soiled furniture and flooring which created a malodour in the service.” from the report
Fire safety
seriousSome fire doors were wedged open and others needed repair. Staff removed the wedges during the inspection and fire checks were being carried out.
“Fire doors were seen to be wedged open and some fire doors were in need of repair.” from the report
Weak management checks
needs fixingAudits did not identify several problems found by inspectors, including issues with the environment and care records. CQC recommended reviewing the quality monitoring systems.
“Quality assurance systems were not robust enough to drive improvements for people.” from the report
Dementia-friendly information
minorSigns did not always help people find their way around, and menus were not provided in pictures. One relative said their relative did not know where the toilets were.
“Signs were not always used to encourage people to orientate themselves within the service.” from the report
- 01What repairs have been completed to the fire doors, flooring, furniture and walls since the inspection?
- 02How do you now make sure every person's hoist and moving plan gives staff clear, safe instructions?
- 03How are cleanliness and infection control checks recorded, and who reviews them?
- 04How will you show that the quality monitoring action plan is working and that problems are found promptly?
- 05What changes have been made to signs and picture menus to help people living with dementia find their way and make choices?
This was a 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 30 September 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.
What inspectors found, March 2021
Warde Aldam was inspected but not rated; inspectors found strong infection control and support for people's social contact during Covid-19.
This was an announced, targeted inspection on 24 February 2021. Inspectors looked at how the home prevented and controlled infection during the coronavirus pandemic.
Inspectors were assured that the home managed visitors, PPE, testing, admissions, social distancing and cleaning safely. The home had enough PPE, staff had infection control training, and policies were up to date.
The home also supported people's social and emotional wellbeing through telephone and video calls, a newsletter, social media groups and a heated visiting pod. This inspection was not rated, so it does not provide a current overall rating or ratings for all five areas of care.
Infection control
The home had systems to reduce the risk of visitors bringing in or spreading Covid-19. Inspectors were assured that PPE, testing and infection procedures were being used appropriately.
“There were systems and processes in place, in line with guidance, to ensure visitors to the home did not introduce and spread Covid-19.” from the report
Clean environment
Inspectors found the home clean and well maintained, with enhanced cleaning schedules in place.
“The care home was clean, well maintained and odour-free. There were enhanced cleaning schedules in place.” from the report
Social contact
The home offered several ways for people to keep in touch with relatives and others, including a heated visiting pod.
“Alternative forms of maintaining social contact were in place, including regular telephone and video calls, a newsletter and social media groups.” from the report
Inspectors raised no specific concerns in this report.
- 01How are visits arranged now, and what PPE or other infection control measures are currently required?
- 02How often are people living at the home and staff tested for infections?
- 03What social contact options are available now for relatives who cannot visit in person?
- 04When was the most recent infection prevention and control audit, and what actions followed it?
- 05What is the home's latest full inspection rating for the areas not covered by this inspection?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; it was inspected but not rated and did not assess all five areas of care. This explanation was written from the published report of 16 March 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.
Every inspection of Warde Aldam
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- February 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 10 November 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.
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