CQC report explained · a residential care home
What the CQC found at Weston House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found ineffective infection control, cleanliness problems, environmental risks, incomplete risk information, gaps in recruitment checks and medicines concerns. Staff understood safeguarding procedures and people were able to receive visitors.
- Effective?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Quality checks and governance systems were not strong enough to identify and reduce risks. The manager was responsive to feedback, but the provider remained in breach of the good governance regulation.
What inspectors found, March 2024
Rated Requires Improvement; inspectors found risks from infection control, safety checks, medicines records and weak oversight, with warning notices issued.
This was an unannounced focused inspection. Inspectors visited on 13 December 2023 and continued inspection activity until 9 January 2024. They spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home was not always safe. Inspectors found poor cleanliness and infection control in parts of the building, safety risks that checks had missed, incomplete medicines information and gaps in recruitment records. Care plans and risk assessments were not always accurate or up to date.
The home was also not consistently well-led. Quality checks did not identify or resolve important risks, and there was no registered manager in post at the time. The manager responded to some issues quickly, but the report says the home had not made enough improvement since the previous inspection and remained in breach of regulations.
The overall rating was Requires Improvement. Only Safe and Well-led were inspected during this visit. The other ratings carried over from the previous inspection, and the home had been rated Requires Improvement at its last two inspections.
Staff knew people well
Staff understood people's risks and knew how to keep them safe. People, relatives and staff were positive about the management.
“Staff knew people well. People, staff and relatives felt positive about the home management.” from the report
Safeguarding awareness
Staff understood different types of abuse, knew how to report concerns and felt able to raise issues with senior people.
“Staff understood how to keep people safe from the risk of abuse.” from the report
Person-centred care plans
Although some risk information was out of date, inspectors found that care plans were person-centred and included people's beliefs and preferences.
“People's care plans were person-centred and contained information about their personal beliefs and preferences.” from the report
Working with other services
Staff made referrals when needed and followed recommendations from other professionals.
“Referrals were made to other professionals when required and staff followed their recommendations.” from the report
Infection and cleanliness
seriousCleaning and hygiene were not effective throughout the building. Inspectors found issues in the kitchen, toilets and bathrooms, including mould and dirty communal chairs, putting people at risk of infection.
“Infection prevention and control was not effective throughout the building which meant people were at risk of catching and spreading infections.” from the report
Safety checks missed risks
seriousChecks did not identify gaps in radiator covers or an unlocked cupboard containing pipework. These issues could have exposed people to hot surfaces or other dangers.
“This meant people were at risk of accessing hot surfaces and potentially scalding or burning themselves.” from the report
Weak governance
seriousThe provider's checks did not give enough oversight of cleanliness, safety or medicines records. This was a continued breach of the good governance regulation.
“Governance systems were not robust enough to demonstrate oversight of the service to make sure people were safe.” from the report
Medicines information
needs fixingThere were stock discrepancies and some 'when required' medicines protocols lacked important details. One person's information did not explain their inhaler arrangements or reflect a medicines change.
“Medicines were not always safely managed.” from the report
Recruitment records
needs fixingSome staff files did not show a clear record of references or health screening. The provider also lacked a process for situations where potential employees were known to the manager.
“We found a lack of audit trail when staff references had not been received.” from the report
Mental capacity records
needs fixingMental capacity assessments were not decision-specific and did not contain enough detail. This meant people were not always supported in line with the Mental Capacity Act principles.
“Mental capacity assessments were not decision-specific and lacked detail.” from the report
- 01What has been done to remove mould, rust, dirt and other infection risks in the kitchen and bathrooms?
- 02How are radiator covers, cupboards and other environmental risks now checked and recorded?
- 03How do you make sure 'when required' medicines protocols contain enough information and that medicine stock is accurate?
- 04What checks are now completed before staff start work, including references, health screening and DBS information?
- 05Who is currently responsible for management, and when will the manager's CQC registration application be decided?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 23 March 2024 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, April 2020
Rated Requires Improvement; inspectors found kind staff and a clean home, but important risks and management systems were not handled well.
This was an unannounced inspection on 23 January 2020. Inspectors spoke with six people and six staff, and checked care records, medicines records, staff files and management records.
The main concerns were incomplete guidance about medicines taken when needed, weak records about mental health risks, and a lack of training about self-harm and suicide risks. Care plans did not always explain people's needs or preferences clearly. The home also failed to notify CQC about some Deprivation of Liberty Safeguards outcomes.
People said they felt safe and that staff were kind. The home was clean, there were enough staff, people could access healthcare and activities, and staff supported independence. However, all five areas were rated Requires Improvement, down from Outstanding in all five areas at the previous inspection in 2017.
Kind staff
People said staff were caring, respectful and supportive. Inspectors saw staff offering choices and encouraging independence.
“People told us staff treated people in a kind and caring way.” from the report
People felt safe
People told inspectors they felt safe in the home. Staff understood how to recognise and report abuse.
“People told us they felt safe living at Weston House.” from the report
Clean home
The home was clean and free from bad smells. Staff used protective equipment appropriately.
“The home was clean and free from odours and people told us the home was always clean.” from the report
Enough staff
Inspectors saw enough staff available to support people. Recruitment checks were also carried out.
“People were supported by enough staff who were available to support them.” from the report
Healthcare and community links
People could access health professionals, activities and the local community. Some people were supported towards greater independence in the community.
“People had access to a range of health services, and referrals had been made to relevant professionals as and when required.” from the report
Medicine guidance
seriousSome medicines taken when needed did not have clear instructions explaining when they should be given or how a person's need might appear. This created a risk that medicines would not be given as prescribed.
“There was a risk of these medicines not being given as prescribed if an unfamiliar staff member was administering medication.” from the report
Mental health risks
seriousRisk assessments and care plans did not consistently explain how staff should recognise a decline in mental health. Staff had not been trained specifically to support people at risk of self-harm or suicide.
“Staff were not trained to support people who were at risk of self-harm or suicide, which put people at risk of not receiving the appropriate care and support when needed.” from the report
Weak quality checks
seriousAudits did not identify problems with care plans, medicines or people's preferences. There was no action plan or accident and incident trend analysis to show how risks were being reduced.
“There was a lack of quality assurance and governance systems in place.” from the report
Incomplete care plans
needs fixingCare plans did not always record people's social needs, preferences or how they wanted to be supported. People also said they had only occasional conversations about their care.
“However, they did not always reflect people's social needs.” from the report
End of life planning
needs fixingThe home was still working on funeral plans and recording people's wishes about treatment at the end of life. CQC recommended that it seek guidance on this.
“We recommend the provider seeks guidance to ensure people's wishes are recorded in relation to their end of life care including funeral plans and DNAR's.” from the report
DoLS notifications
seriousThe management team had not sent CQC the required notifications about the outcomes of some legal safeguards applications.
“The management team failed to notify CQC of the outcomes of DoLS applications as required by law.” from the report
- 01What has changed in the care plans to show each person's mental health warning signs, risks and coping strategies?
- 02How are staff trained to support people who may self-harm or be at risk of suicide?
- 03How do staff decide when to give each person's PRN medicine, and where are the instructions kept?
- 04What action plan is now in place to monitor care plans, medicines, accidents and incidents?
- 05How are people's end of life wishes, funeral plans and DNACPR decisions being recorded?
This was an unannounced planned inspection covering all five CQC questions, and it looked at both the care and the premises. This explanation was written from the published report of 2 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.
Every inspection of Weston House
4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- March 2024Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2020Requires improvementdown from OutstandingSafe: Requires improvementWell-led: Requires improvement
- July 2017Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- May 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 8 December 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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At least 100 live-in carers within about an hour of Stoke-on-Trent
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Most charge £980 to £1,190 a week. 93 can care for a couple. 9 years' experience on average.
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“She maintained a great environment for mum both with the tidiness and cleanliness of the house and Mum and with her caring and understanding attitude.”
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