CQC report explained · a nursing home
What the CQC found at Wellington Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were administered safely, infection controls were in place, and there were enough suitable staff.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- People received personalised care, their plans were reviewed, and staff supported their communication, relationships, interests and end of life wishes.
- Well-led?
- Requires improvement
- The home had a positive culture and staff felt supported, but quality monitoring was not always robust and did not identify some inconsistent practice or inaccurate records.
What inspectors found, July 2023
Rated Good; inspectors found safe, personalised care, but quality checks and some records needed improvement.
This was an unannounced focused inspection on 7 June 2023. Inspectors reviewed Safe, Responsive and Well-led. They spoke with people, relatives and staff, observed care, and checked care plans, staff records and management records.
The home was rated Good overall. Safe and Responsive were rated Good. Inspectors found that risks were assessed, medicines were given safely, staffing was sufficient, and people received personalised care from staff who knew them well. People also had activities, community links and support to plan end of life care.
Well-led was rated Requires Improvement. Quality monitoring had not found some inconsistent practice, inaccurate records, gaps in medicine risk checks, or incomplete employment checks. The provider said these issues had been addressed after the inspection. The overall rating remained Good, partly because ratings for areas not inspected carried over from the previous inspection.
Managing risks
Inspectors found that risks such as choking, malnutrition, pressure wounds and mobility problems were assessed, reviewed and managed. The home also used incident reviews to reduce risks.
“Risks to people were assessed, monitored and managed effectively.” from the report
Personalised care
Care plans reflected people's needs and preferences. Staff knew people well and supported them to remain independent and involved in decisions about their care.
“People were receiving a personalised service from staff who knew them well and understood their needs.” from the report
Activities and community links
People were supported to maintain relationships, take part in activities and follow interests that mattered to them, including religious and cultural activities.
“There was a range of activities and opportunities for social and culturally relevant events.” from the report
End of life support
The home helped people plan their end of life care. Inspectors found examples of detailed plans that considered personal, religious and cultural wishes.
“Records included advanced care plans for some people identifying what was important to them and how they wished to be cared for.” from the report
Quality checks
needs fixingThe provider's checks did not always identify inconsistent practice and inaccurate records. This led to a Requires Improvement rating for Well-led.
“Systems for monitoring quality were not always robust and this had led to some inconsistent practice.” from the report
Medicine risk records
needs fixingSome risks linked to medicines were missing from the medicine audit process. Inspectors found no negative impact, but staff might not have had all the information needed to manage those risks.
“Some shortfalls in records had not been identified through the provider's quality monitoring process.” from the report
Safeguarding process
needs fixingA complaint about a staff member's conduct was resolved through the complaints process, but the provider had not considered whether its safeguarding policy should also have been followed.
“There had been a failure to consider whether the provider's safeguarding policy should have been followed.” from the report
Employment checks
needs fixingThe registered manager did not have a consistent system to confirm that all staff employment checks had been completed. The home said this had been addressed after the inspection.
“The registered manager did not have a consistent system for ensuring that all checks had been completed.” from the report
- 01What changes have you made to quality monitoring since the inspection, and how do you check that they are working?
- 02How do you now record and audit risks linked to people's medicines?
- 03How do you decide whether a complaint about staff conduct also needs to be referred through safeguarding procedures?
- 04Can you confirm that all required employment and background checks for current staff are complete?
- 05Which parts of the previous inspection rating were carried forward because they were not reviewed this time?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 26 July 2023 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
Wellington Grange: Rated Good overall, but inspectors found that staff deployment sometimes caused people to wait too long for care.
This was the home's first inspection. Inspectors visited on 19 and 20 September 2017, then returned on 12 December 2017 because the first visits could not be completed. They spoke with people living there, relatives and staff, and checked care records, medicines, staffing, training, complaints and quality monitoring.
The overall rating was Good. Inspectors found kind and respectful care, personalised care plans, suitable staff training, safe medicines management, good support with food and health care, and a wide range of activities. People and relatives generally spoke positively about the staff and management.
Safe care was rated Requires Improvement. Staff numbers had increased, but they were not always deployed effectively, especially on the top floor and at night. Some people waited too long for call bells to be answered or for help with personal care. After the inspection, the home reported changes including pagers for staff and an additional early-morning staff member.
Kind and respectful care
Inspectors observed staff being gentle, attentive and patient. People said staff protected their dignity, privacy and choices.
“People were treated with kindness and their dignity and privacy was protected.” from the report
Personalised support
Care plans included people's routines, interests, religious or cultural needs and preferences. Staff responded when people's needs changed.
“People's care was personalised and staff were responsive to changes in people's needs.” from the report
Training and health support
Staff received training relevant to people's needs, including dementia, moving and handling and clinical subjects. People were supported to see health professionals when needed.
“People were supported by staff who received the training and support they needed.” from the report
Activities and community links
The home offered group activities, individual support, outings and links with local organisations. Staff also supported people who were socially isolated.
“Staff had made links within the local community and staff had developed positive working relationships with partner agencies.” from the report
Safe medicines and risk management
Inspectors found that medicines were stored, administered and recorded safely. Risks such as falls, pressure damage and choking were assessed and managed.
“Medicines were managed safely.” from the report
People sometimes waited too long
needs fixingStaff were not always deployed effectively, particularly on the top floor where many people needed two staff. Some people waited too long for call bells to be answered or for personal care.
“One report confirmed that over a month, approximately twenty per-cent of call bells had taken more than five minutes to be answered.” from the report
Food had received some complaints
minorMost people liked the food and inspectors saw people offered choice and support. However, some people were less positive, and staff said food was the subject of most complaints, although improvements had been made.
“Some people were less positive and their comments included, "The food isn't as good as when I was first here,” from the report
- 01How do you now make sure staff are deployed safely on the top floor, especially when many people need two staff?
- 02What are the current call-bell response times during the day and at night?
- 03How have the pagers and additional early-morning staff member changed people's waiting times?
- 04What action has been taken in response to complaints about the food, and how do you check whether people are now satisfied?
- 05How do you make sure the staffing changes remain consistent over time?
This was the home's first comprehensive inspection and covered all five key questions, using visits on three dates because the initial inspection could not be completed. This explanation was written from the published report of 4 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Wellington Grange
2 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018GoodSafe: Requires improvementResponsive: GoodWell-led: Good
- March 2016
Registered with the Care Quality Commission on 23 March 2016.
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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