CQC report explained · a residential care home
What the CQC found at Washwood Healthcare Service
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2020
Grassmere Residential Care Home was rated Requires Improvement; inspectors found kind, responsive care but continuing safety and management problems, and it is no longer in special measures.
Inspectors visited on 5 and 9 March 2020. They spoke with people, relatives, staff and healthcare professionals, observed care and reviewed care and management records. The inspection was planned because the home had previously been rated Inadequate.
The home had improved since the previous inspection. People were treated with kindness and respect, their care plans were more personalised, medicines were managed safely, and staff worked with healthcare professionals. People also spoke positively about the food and activities.
However, infection control problems remained. Inspectors also found uneven flooring, limited staff knowledge of the Mental Capacity Act, and quality checks that had not found important problems. The home remained in breach of regulations about safe care, good governance and reporting incidents.
The overall rating improved from Inadequate to Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement. The home left special measures, but the provider must still make further improvements and remains subject to a registration condition.
Kind and respectful care
People said staff listened to them and treated them respectfully. Inspectors also saw staff promoting independence and involving people in daily tasks.
“People told us they were happy living at the home and felt staff respected their choices.” from the report
More personalised care plans
Care plans had been rewritten to give staff clearer information about people's preferences and support needs. They were reviewed when people's needs changed.
“Since the last inspection care plans had all been rewritten to include more personalised information on the support required by people.” from the report
Medicines managed safely
Records showed people received their medicines at the right time. Medicines were stored safely and staff had relevant training.
“Records showed people received their medication at the right time. Medicines were stored safely, and staff received training in how to support people with their medicine as prescribed.” from the report
Food and healthcare support
People gave positive feedback about the meals. Staff supported a person with a fortified diet and worked with healthcare professionals when people's health changed.
“We received positive feedback about the food, with people telling us they liked the meals provided.” from the report
Infection control
seriousInspectors found damaged or unsuitable bins, worn surfaces and poor storage practices. The home's checks had not identified these issues, creating a risk of cross-infection.
“We found the provider's systems and processes to ensure effective infection control measures required further improvement and this was a continued breach of regulation 12 safe care and treatment.” from the report
Weak quality checks
seriousAudits did not identify several problems found during the inspection, including infection control concerns and missed notifications. This meant the provider could not show that action was being taken reliably and promptly.
“The processes in place to monitor, audit and assess the quality of the service being delivered had not been effective in identifying all areas requiring improvement and ensuring action was taken in a timely way.” from the report
Uneven flooring
needs fixingUneven flooring in a communal corridor and garden walkway posed trip risks. Some repair work had started, but further work was still needed.
“However, we still found that the flooring in one communal corridor of the building was uneven and posed a trip hazard.” from the report
Staff knowledge of consent law
needs fixingStaff understood the importance of asking for consent, but those spoken with had limited knowledge of the Mental Capacity Act and how it applied to individual people.
“However, staff spoken with had limited knowledge of the MCA and how this impacted on the care provided to individual people.” from the report
Missed incident notifications
seriousTwo Deprivation of Liberty Safeguards authorisations had not been reported to the CQC within the required time.
“We found that two significant events (DoLS authorisations) had not been reported to us in a timely way as required.” from the report
- 01What has been done to repair the uneven flooring in the corridor and garden walkway?
- 02How do you now check that toilets, bins, handrails and other areas meet infection control standards every day?
- 03What extra training have staff received about the Mental Capacity Act and making best-interest decisions?
- 04How do you make sure all required CQC notifications, including Deprivation of Liberty Safeguards authorisations, are sent on time?
- 05What activities are now available for people who need more support to take part?
This was a planned inspection covering all five key questions, and it looked at both the premises and the care provided; the inspection followed the home's previous Inadequate rating and special measures status. This explanation was written from the published report of 4 April 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 2019
Rated Inadequate and placed in special measures; inspectors found serious safety, care planning, premises and management problems.
This was an unannounced inspection on 16 and 17 July 2019. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care plans, medicines records, staff files and management records.
The home was rated Inadequate overall. Safe and well-led were Inadequate. Effective, caring and responsive were rated Requires Improvement. Inspectors found risks were not always assessed properly, care plans were out of date, and the building and infection control needed improvement.
There were some positive findings. Staff were generally kind and respectful, people received medicines safely, and staffing levels appeared sufficient on the inspection days. However, the weaknesses were serious enough for the home to be placed in special measures.
Staff understood safeguarding
Staff could recognise signs of abuse and explain how they would report concerns. Records showed safeguarding training had taken place.
“People were supported by staff who understood the signs of abuse and appropriate action to take should they have concerns.” from the report
Enough staff on inspection days
People said they did not usually wait long for support. Inspectors saw enough staff on duty to meet people's needs during the inspection.
“People told us they did not have to wait long for care and support and we observed that on the day of inspection there were enough staff on duty to meet people's needs.” from the report
Medicines were given safely
Inspectors found that medicines were given as prescribed and daily records showed when people had received them. Staff had medicines training.
“People received their medicines safely and as prescribed.” from the report
Kind interactions
Inspectors observed positive, kind interactions. Staff used people's names and showed familiarity with how some people communicated.
“Staff treated people with care and respect.” from the report
Access to health services
People could access health professionals when needed. Staff monitored health needs and contacted relatives and professionals about changes.
“People had access to healthcare services when required to promote their health and well-being.” from the report
Risks were not managed properly
seriousSome risk assessments lacked clear guidance, including for behaviour, falls and nutrition. Staff were not always confident about how to keep people safe.
“the risk to this person had not been reduced and staff had no clear guidance on how they could provide better support to this person.” from the report
Unsafe and poorly maintained areas
seriousInspectors found exposed electrical wires, uneven floors and a broken garden door that could not be locked. Other areas needed repair or refurbishment.
“there were exposed electrical wires, floors were uneven in places and presented a trip hazard” from the report
Infection control problems
seriousPaper towels and hand sanitiser were not available. Waste disposal and cleanliness were also poor in some areas, increasing the risk of infection.
“This meant that people and staff could not be assured that their hands were sanitised and this increased the risk of cross infection.” from the report
Activities did not match interests
needs fixingActivities were not planned around people's life histories, tastes or interests. People and relatives said more activities were needed.
“We did not see activities or hobbies that were person-centred.” from the report
Management checks were ineffective
seriousAudits failed to identify important problems with care records, the premises, training and infection control. Staff also reported a lack of leadership and direction.
“audits had failed to identify that the training provided wasn't consistently effective in providing staff with the right skills to meet people's needs.” from the report
- 01What action has been taken to update every person's risk assessment and care plan when their needs change?
- 02Have the exposed wires, uneven floors, broken garden door and other maintenance problems been repaired?
- 03How are paper towels, hand sanitiser and waste disposal now checked and kept available?
- 04How are people and relatives involved in writing and reviewing care plans and choosing activities?
- 05What management checks are now used to make sure problems with care, training, premises and infection control are found promptly?
This was a planned, unannounced inspection covering all five key questions, following a previous Good rating and a change in ownership and management. This explanation was written from the published report of 24 September 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 Washwood Healthcare Service
2 rated inspections over a year: the service has improved, from Inadequate to Requires improvement.
- April 2020Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2019InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2018
Registered with the Care Quality Commission on 18 July 2018.
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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