CQC report explained · a nursing home
What the CQC found at Water Royd Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2019
Water Royd Nursing Home is rated Good; inspectors found safe, kind care and clear improvements since the previous inspection, with some records and activities needing attention.
This was a planned inspection after the home was previously rated Requires improvement. Inspectors visited on 8 and 25 January 2019. They spoke with people living at the home, relatives, staff and healthcare professionals, and checked care, medicine and staff records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found medicines were now managed safely, staffing and recruitment were suitable, and people were treated with kindness, dignity and respect.
There were some shortfalls. Drinks were not always available between meal and drinks trolley times. One care plan had not been updated after a significant change, and information about end of life wishes was limited. The manager took some immediate action during the inspection.
Medicines were improved
The previous medicines breach had been resolved. Inspectors found medicines were safely managed, with trained nurses administering them and regular checks taking place.
“Medicines were safely managed and were administered by nurses who had received specific training.” from the report
Kind and respectful care
Inspectors saw warm interactions. People were treated with dignity, supported to make choices and helped to keep their independence.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Good care planning
Most care plans gave staff useful information about people's needs, routines, preferences and interests. Staff said they used these plans to understand people better.
“People's care plans were detailed and contained information about people's needs.” from the report
Strong management checks
The manager was visible and approachable to staff. Audits covered care plans, falls, medicines and the premises, and action was taken when improvements were found.
“The quality assurance system included checks of care plans, falls, medicines and the premises.” from the report
Drinks were not always available
needs fixingInspectors did not see drinks available around the home between meal and drinks trolley times. This could particularly affect people who found it difficult to ask for a drink.
“There was a lack of drinks available to people around the home outside of meal and drink trolley times” from the report
Care records were not always updated promptly
needs fixingOne person's care record and moving and handling assessment had not been updated after a significant change. The manager said this would be dealt with, and inspectors saw it had been corrected on the second day.
“People's care and support needs were not always assessed and reviewed in a timely manner.” from the report
End of life wishes needed more detail
needs fixingCare plans contained limited personal information about people's wishes for end of life care. The manager agreed to work on gathering this information.
“We found care plans contained limited person-centred information relating to end of life wishes.” from the report
Activities were mixed
minorThe home had a weekly activities programme, but people and relatives gave different accounts of how much was available. Some people were reported to be bored or to spend much of the day watching television.
“We received varied feedback from people and relatives regarding the range and access to activities provided at the home.” from the report
- 01How do you make sure drinks are available to people between meal and drinks trolley times?
- 02How quickly are care plans and moving and handling assessments updated after a person's needs change?
- 03What activities would be available for my relative, and how would you respond if they became bored or did not want to join group activities?
- 04How will you record and regularly review my relative's personal wishes for end of life care?
- 05How will relatives be kept informed and given a chance to speak with the manager about their relative's care?
This was a planned inspection of all five areas of the care home, including the premises and care provided; the home had previously been rated Requires improvement and the medicines breach had been removed. This explanation was written from the published report of 6 March 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.
What inspectors found, March 2018
Water Royd Nursing Home was rated Requires Improvement; inspectors found kind, responsive care but unsafe medicines management and weak quality checks.
Inspectors carried out an unannounced, comprehensive inspection on 20 February 2018. They spoke with people living there, relatives, staff and healthcare professionals. They observed care and meals, checked care plans and sampled medicines records.
The home was rated Good for effective, caring and responsive care. People generally felt safe and well cared for. Inspectors found enough staff, suitable training, good access to healthcare, varied food and activities, and respectful support.
The home was rated Requires Improvement for safe and well-led care. One person missed a medicine for five days, and records for prescribed creams were not always accurate. Quality checks had not identified these problems. The overall rating fell from Good at the previous inspection in September 2015.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff treating people with dignity and tailoring support to their preferences.
“During our inspection we observed positive interactions between staff and people who used the service.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment records included references, identity checks and criminal record checks.
“We found staffing levels were sufficient to meet the needs of people who used the service and records we saw supported this.” from the report
Training and healthcare
Staff had completed relevant training and received supervision. People had access to a range of healthcare professionals when needed.
“This meant staff received the training, supervision and appraisal they needed to provide people with effective care.” from the report
Activities and personalised support
The home offered activities such as exercise, music, games and trips out. Staff knew people's interests and encouraged them to take part.
“People living in the home were offered a range of social activities.” from the report
Clean and suitable environment
The home was clean, tidy and warm. Areas had been adapted to support people living with dementia.
“We looked around the home and found the premises to be clean, tidy, clutter free and warm.” from the report
Medicines were not always safe
seriousOne person did not receive a prescribed medicine for five days. Records for prescribed creams were sometimes signed before checks were made, and some signatures were missing.
“We concluded the management of medicines was not always carried out in a safe way.” from the report
Quality checks missed medicines problems
needs fixingThe home had audits and action plans, but its medicines audit did not identify the problems inspectors found.
“The medication audit had not identified the concerns we found during this inspection.” from the report
Some care records needed updating
minorSome profile sheets were incomplete. One care plan did not explain how staff should respond if medicines were refused, and repositioning records were not always recorded consistently.
“Most care plans we saw were up to date and contained relevant information, although updating was required in some of the care plans.” from the report
- 01How do you now check that every prescribed cream has been applied and recorded by the correct staff member?
- 02What action was taken after one person missed their medicine for five days?
- 03How do you make sure medicines audits identify problems before they affect residents?
- 04Have all care plans and profile sheets been updated, including instructions about refused medicines?
- 05How is repositioning recorded now so that staff use the same part of the electronic system?
This was an unannounced comprehensive inspection covering all five key questions; the previous inspection in September 2015 had rated the home Good in all five areas. This explanation was written from the published report of 28 March 2018 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 Water Royd Nursing Home
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 11 November 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.
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