CQC report explained · a nursing home
What the CQC found at Weatherstones House Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were protected from abuse, and medicines and risk assessments had improved. However, recruitment checks were not always recorded before staff started, deep-cleaning schedules were not always followed, staffing levels were inconsistent and incident records lacked detail.
- Effective?
- Good
- This key question was not rated in this inspection.
- Caring?
- Good
- This key question was not rated in this inspection, although people and relatives spoke positively about the caring nature of staff.
- Responsive?
- Good
- This key question was not rated in this inspection.
- Well-led?
- Requires improvement
- Oversight, records and training monitoring had improved, and the manager worked well with other agencies. However, quality systems still needed to be developed, checked against current guidance and sustained in daily practice.
What inspectors found, January 2022
Weatherstones House Nursing Home is rated Requires Improvement; inspectors found better safety and management, but some important systems were not yet reliable.
The inspection took place on 15 and 24 November 2021. One inspector visited, spoke with people, relatives and staff, checked care and medicine records, reviewed recruitment files and looked at how the home was managed.
There were enough care staff to meet people's needs, and people and relatives spoke positively about the care. Medicines, risk assessments, care plans and COVID-19 arrangements had improved. However, staff recruitment records were incomplete, deep cleaning was not always completed and accident and incident records lacked detail.
The home had improved from its previous Inadequate rating and was no longer breaching regulations. It was also taken out of Special Measures. The overall rating and both inspected areas, Safe and Well-led, were Requires Improvement, meaning inspectors found progress but not enough consistent assurance that the home was always safe or well managed.
Caring staff
People and relatives spoke highly of the staff's care and compassion. Relatives said they felt confident that people were safe and well supported.
“It is an exceptionally caring home, the care the carers give is very good.” from the report
Improved care records
Care plans had been updated and were more detailed. They included appropriate risk assessments and reflected people's care needs more accurately.
“Care plans had been updated and contained up to date and appropriate risk assessments to meet people's care and support needs.” from the report
Medicines management
The management of medicines given when needed had improved. Staff had guidance, recorded why medicines were given and were appropriately trained.
“People received medication from appropriately trained staff.” from the report
Family involvement
Relatives were consulted about care plans and said they were kept informed. People's wishes about seeing relatives were recorded.
“Relatives felt informed and consulted.” from the report
Recruitment checks
seriousThe home could not show in staff files that all required security checks had been completed before staff were deployed. Full work histories had not always been obtained.
“Recruitment processes were not robust. Evidence the required security checks had been completed prior to staff being deployed, was not available in staff files.” from the report
Deep cleaning
needs fixingDomestic staff vacancies meant deep-cleaning schedules were not always followed. The provider said it was recruiting and had moved some cleaning to night-time.
“Although, improvements had been made to the cleanliness, deep cleaning schedules had not always been followed.” from the report
Incident records
needs fixingAccidents, incidents and unexplained injuries were recorded and reviewed, but the records did not contain enough detail to show how risks could be reduced.
“However, records were not sufficiently detailed and needed to improve.” from the report
Management oversight
needs fixingQuality assurance systems had improved but were not yet fully developed or embedded in daily work. The provider was advised to seek guidance on measuring safety and quality against current guidance.
“However, these systems needed to be further developed to make sure they measured against current guidance and are embedded and sustained over time.” from the report
- 01How do you now make sure all security checks and full work histories are completed and recorded before staff start work?
- 02Have the domestic staff vacancies been filled, and how do you check that deep cleaning is completed on schedule?
- 03What dependency tool do you use to decide how many staff are needed for the people living here?
- 04How are accidents, incidents and unexplained injuries now recorded and reviewed?
- 05What quality checks are in place to make sure improvements are sustained and measured against current guidance?
This was a planned inspection that rated Safe and Well-led; the report does not give ratings for Effective, Caring or Responsive. This explanation was written from the published report of 13 January 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, July 2021
Weatherstones House Nursing Home was rated Inadequate and placed in special measures; inspectors found serious safety and management failures.
The inspection took place on 13 May 2021. It began as a targeted check of infection prevention during the COVID-19 pandemic. Inspectors widened it to a focused inspection of Safe and Well-led after finding concerns about management oversight.
Inspectors found gaps in medicine records, care plans, risk assessments and fire safety documents. Accidents and incidents were not properly reviewed. Infection control measures were not consistently followed, including cleaning, visitor screening and staff testing records.
The provider's checks and audits had not found these problems. Records were not always complete or accurate, and there was not enough oversight while the registered manager was absent and then left. These failures placed people at risk of harm and breached Regulations 12 and 17.
There were also some positive findings. Staffing and recruitment were safe at the inspection, people said staff were kind, and regular medicines were stored and managed safely. The overall rating changed from Good at the previous inspection, published on 29 November 2018, to Inadequate.
Safe recruitment
The required identity and security checks were completed before staff were employed.
“Recruitment processes were safe. Appropriate pre-employment checks were carried out to ensure that only suitable people were employed.” from the report
Staffing at inspection
There were enough staff on duty to meet people's needs during the inspection, although staffing levels were inconsistent at other times.
“There were sufficient numbers of staff on duty to meet people's needs at the inspection.” from the report
Regular medicines
Inspectors found that regular medicines were given by trained staff and stored securely.
“People received their regular medication from appropriately trained staff. These medicines were stored securely and managed safely.” from the report
People felt safe
People and a relative told inspectors they felt safe or believed their relative was safe.
“People told us they felt safe. One person told us; "Yes I feel safe. They come quite quickly when I use my call bell".” from the report
Medicine records and guidance
seriousStaff lacked guidance for some as-needed medicines, reasons for giving them were not recorded, and topical cream records had many gaps. Inspectors could not be assured that these medicines were given as prescribed.
“The management of 'as required medicines' (PRN) was ineffective. Staff did not have access to guidance for when PRN medicines, such as painkillers, could be administered.” from the report
Risks and fire safety
seriousCare plans did not always contain current risk assessments. Accident reviews, fire risk assessments and personal evacuation plans were not sufficient to show that risks had been reduced.
“The fire risk assessment, emergency evacuation risk assessment and peoples' personal evacuation plans (PEEPS) were not up to date.” from the report
Infection control
seriousCleaning schedules were insufficient, deep cleaning was not taking place and visiting areas and high-touch points were not cleaned as required. Some COVID-19 checks were also missing or not consistently recorded.
“There were insufficient cleaning schedules and deep cleaning was not taking place. This placed people at increased risk of infection.” from the report
Weak management checks
seriousThe provider's audits did not identify important shortfalls in care, medicines, training, accidents, incidents and fire safety. This meant risks were not properly managed.
“There had not been sufficient oversight of the safety and quality of the service being provided for people. This placed people at risk of harm.” from the report
Safeguarding and reporting
seriousSome unexplained bruising was not reported to the local safeguarding team as required. The provider also did not always inform CQC and other relevant agencies about accidents and incidents.
“When incidents of unexplained bruising had occurred, these had not been reported to the local authority safeguarding team in line with local protocols.” from the report
- 01What evidence can you show that gaps in topical cream and as-needed medicine records have been corrected?
- 02Are current care plans, risk assessments, fire risk assessments and personal evacuation plans now complete and checked?
- 03How are accidents, incidents and unexplained injuries now reviewed, and when are they reported to safeguarding teams and CQC?
- 04What cleaning schedules are now used for the visiting pod, high-touch points and deep cleaning?
- 05How are you checking staff training, medicine records and care records so that problems are found quickly?
This was a targeted COVID-19 infection control inspection that was widened to a focused inspection of Safe and Well-led; the other three key questions were not assessed. This explanation was written from the published report of 9 July 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 Weatherstones House Nursing Home
4 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- January 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Weatherstones House Nursing Home →
- July 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
Read what inspectors found at Weatherstones House Nursing Home →
- November 2018Goodstayed GoodSafe: GoodWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 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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84 live-in carers within about an hour of Cheshire West and Chester
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 £1,260 a week. 76 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
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.