CQC report explained · a residential care home
What the CQC found at Warrington Residential and Dementia Care
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks such as falls, choking and leaving the home were assessed, staff had safeguarding training and medicines were generally managed safely. Some staff identification records were not signed and dated correctly, and medicine fridge records did not include minimum and maximum temperatures.
- Effective?
- Good
- People received suitable assessments, training and support with food, drinks and healthcare. The rating improved from Requires Improvement to Good. One flu vaccination had not followed the correct consent process, and the manager said this would not happen again.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were supported to make choices, remain independent and take part in everyday activities at their own pace.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. The home offered activities, one-to-one time and support for communication, complaints and end-of-life wishes. One evacuation record did not fully reflect a person's anxious behaviour and was updated after this was raised.
- Well-led?
- Good
- Inspectors found approachable management, good teamwork and systems for checking care, medicines, infection control, falls and complaints. People, relatives and outside professionals were able to give feedback and said communication was good.
What inspectors found, March 2020
Warrington Residential and Dementia Care rated Good; inspectors found safe, kind and personalised care, with a few records needing improvement.
This was an unannounced inspection on 25 and 26 February 2020. Inspectors spoke with seven people living in the home, four relatives, 10 staff and three health and social care professionals. They also checked care records, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found staff knew people well, treated them respectfully and supported them to make choices. They described the home as relaxed, calm and strongly person-centred.
There were a few issues that were corrected or were being addressed during or after the inspection. These included incomplete identification checks in some staff files, incomplete fridge temperature records for medicines and one example where the correct consent process was not followed for a flu vaccination.
The overall rating remained Good, as it was at the previous inspection in 2013. The Effective rating improved from Requires Improvement to Good.
Kind, person-centred care
Staff knew people's histories, preferences and dementia needs. They supported people to make choices and adjusted care as their needs changed.
“The service demonstrated a strong person-centred culture.” from the report
Respect and dignity
Staff asked permission, did not rush people and supported privacy, independence and personal presentation.
“People were treated with the utmost dignity and respect during care interactions and in general daily interactions.” from the report
Well-trained staff
New staff received induction and shadowing. Training records showed training in areas including dementia, safeguarding and person-centred care, with two training officers supporting development.
“People's needs were met by staff who had access to the training they needed.” from the report
Good communication and teamwork
Staff shared information at handovers and worked with health and social care professionals. Relatives could give feedback through meetings, questionnaires and direct contact.
“The management and staff worked well with external professionals and we received positive feedback from professionals about this service.” from the report
Activities and daily choice
People could join activities such as singing, crafts and exercise, or receive one-to-one time if they preferred quieter support.
“The service provided a varied programme of activities that people were encouraged to participate in.” from the report
Staff identification records
minorSome staff files showed that original identification documents had been seen, but the records were not signed and dated to confirm this. The manager said a full audit would be completed.
“These were not signed to say the original had been seen and the date of this.” from the report
Medicine fridge records
needs fixingThe fridge temperature was recorded daily, but the minimum and maximum temperatures were not recorded. A new template was introduced after inspectors raised this.
“The fridge temperature was being recorded daily, however only the actual temperature reading was recorded and not the minimum and maximum temperature during each day.” from the report
Consent for a flu vaccination
needs fixingIn one case, a staff member signed consent for a person's flu vaccination. The manager said the correct capacity and best-interest process would be followed in future.
“The manager was unaware of this event.” from the report
Evacuation information
needs fixingOne person's evacuation form did not record their anxious behaviour and gave a low anxiety score. The report says this was updated after the inspection.
“One person's personal evacuation form did not record their anxious behaviours and scored the person as having low anxiety.” from the report
Choice of cakes
minorAll cakes were being made gluten free to support people on a gluten-free diet. Inspectors said this did not give other people a fair choice, and the manager said it was addressed immediately.
“This would not be fair to people who might not want a gluten free cake.” from the report
- 01Can you show us how you now check and record original identification documents in every staff file?
- 02How are minimum and maximum medicine fridge temperatures recorded and checked now?
- 03How do you assess capacity and record best-interest decisions before vaccinations or other treatment?
- 04How is a person's anxiety and behaviour included in their personal emergency evacuation plan?
- 05What food choices are available for people who do not need a gluten-free diet?
This was an unannounced planned inspection covering all five CQC questions, with the previous overall rating from 2013 and the Effective rating from Requires Improvement reviewed. This explanation was written from the published report of 28 March 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, September 2017
Warrington Lodge was rated Good overall, but inspectors found important gaps in mental capacity decisions and nutrition records.
Inspectors visited on 10 and 11 August 2017. The first day was unannounced. They spoke with people, relatives, staff and health professionals. They reviewed seven care plans, training records, rotas, policies and quality checks. They also observed care and looked around the home.
The home was rated Good for safe, caring, responsive and well-led care. Inspectors found enough staff, safe medicines systems, kind interactions and personalised care. People had access to healthcare, activities and food suited to their needs.
The effective rating was Requires Improvement. Inspectors found two cases where best interest decisions were made before mental capacity assessments. They also found that some records did not clearly show how weight loss and missed meals were being monitored and acted on.
An overall Good rating means inspectors judged the service to be performing well overall, but the Requires Improvement rating shows that some areas needed prompt improvement.
Safe medicines
Inspectors observed a safe medicine round. Records checked had no gaps, and topical medicines were recorded fully.
“Medicine administration records (MAR) included any known medicine allergies and a photo of the person for easy identification of the person.” from the report
Kind and respectful care
People described staff as caring, friendly and willing to listen. Inspectors saw positive interactions and a calm atmosphere.
“People were treated with kindness and compassion. We saw some positive interactions between staff and people using the service.” from the report
Personalised care
Care plans included people's routines, preferences, interests and communication needs. Relatives were involved in reviews where appropriate.
“Care plans were person centred, monitored monthly and reviewed with people and where appropriate their relatives.” from the report
Dementia-friendly setting
The building used signs, colours, memory boxes and points of interest to help people find their way around.
“The home was designed for people living with dementia. There were signs to help people find their way around.” from the report
Mental capacity decisions
needs fixingTwo people had best interest decisions made before their mental capacity had been assessed. The home agreed to complete the assessments and change its guidance.
“We found two examples when best interest decisions was taken before capacity assessments were undertaken.” from the report
Monitoring weight loss
needs fixingOne person's care plan did not clearly bring together the actions needed for a high risk of malnutrition. Food intake records were not always complete.
“The food intake records were not always completed and information was not included on the actions taken when meals were declined.” from the report
Outings and activities
minorSome people and staff said they wanted more outings. One record showed a person had spent a lot of time watching television or listening to music.
“More outings for those that don't go out much.” from the report
- 01How do you make sure a mental capacity assessment is completed before any best interest decision is made?
- 02How do you now monitor weight loss, food intake and meals that are declined?
- 03What individual activities and outings are currently available for people who do not join group activities?
- 04How are relatives involved in care plan reviews and decisions about care?
- 05What improvements have been made since the August 2017 inspection?
This was a comprehensive inspection covering all five key questions; the first day was unannounced. This explanation was written from the published report of 13 September 2017 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 Warrington Residential and Dementia Care
3 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Warrington Residential and Dementia Care →
- September 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Warrington Residential and Dementia Care →
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 17 August 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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