CQC report explained · a nursing home
What the CQC found at Wheatfield Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing, recruitment and infection control were managed safely. They also found that lessons from accidents and incidents were shared with staff.
- Effective?
- Good
- This area was not looked at during this focused inspection. The rating from the previous comprehensive inspection was used in calculating the overall rating.
- Caring?
- Good
- This area was not looked at during this focused inspection. The rating from the previous comprehensive inspection was used in calculating the overall rating.
- Responsive?
- Good
- This area was not looked at during this focused inspection. The rating from the previous comprehensive inspection was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found regular audits, an action plan for improvements and an open management approach. People, families and staff could give feedback about the service.
What inspectors found, September 2020
Wheatfield Court was rated Good; inspectors found improvements in safety and management, with no current breaches of regulations.
This was an announced, focused inspection carried out on 28 August, 1 September and 2 September 2020. One inspector spoke with people living at the home, family members, staff and healthcare professionals. Records about medicines, care, recruitment and management were also checked.
The home was rated Good for Safe and Well-led. Inspectors found that medicines were administered and recorded safely, risks were managed, the building was maintained, and there were enough staff. Infection control procedures and protective equipment were also in place.
The home had previously been rated Requires improvement, with breaches relating to safety, staffing, governance and openness. Inspectors found enough improvement had been made and the provider was no longer in breach. The overall rating therefore changed to Good, although some other areas were not reassessed during this inspection.
Safe medicines and staffing
Medicines were administered and recorded safely. Inspectors also found enough staff on duty and suitable checks when new staff were recruited.
“Appropriate arrangements were in place for the safe administration and recording of medicines.” from the report
Improved management
The provider and manager monitored the service through audits and an action plan. Staff said they could raise concerns and felt supported.
“The provider and registered manager monitored the quality of the service to make sure they delivered a high standard of care.” from the report
Infection control
Procedures were in place to reduce infection risks. Staff had training and access to protective equipment.
“Staff had been trained in the use of personal protective equipment (PPE). PPE was readily available for staff” from the report
Inspectors raised no specific concerns in this report.
- 01How do you continue to check that medicines are administered and recorded safely?
- 02How do you make sure there are enough staff on duty at all times, including at night?
- 03What quality audits and action plans are currently in place, and can families see how issues are followed up?
- 04How are residents and families currently asked for feedback, and what changes have been made as a result?
- 05How do you make sure lessons from accidents and incidents are shared with all staff?
This was a focused inspection of Safe and Well-led; the ratings for Effective, Caring and Responsive were carried over from the previous comprehensive inspection. This explanation was written from the published report of 15 September 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, August 2019
Rated Requires Improvement; inspectors found kind and responsive care, but medicines, staff competency, records and management systems were not always safe or effective.
This was an unannounced inspection brought forward because of concerns about the safety of care. Three inspectors visited on 8 and 9 May 2019. They spoke with people, relatives, staff and health professionals, and checked care records, medicines, staffing, recruitment, training, premises and quality checks.
The home was rated Good for Effective, Caring and Responsive. People were treated with kindness and dignity, had personalised care and activities, and received support with food, drink and healthcare. Staff recruitment and training were generally positive, and people said they felt safe.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found medicines were not always managed safely, some risks in the building had not been identified, and clinical staff did not receive the supervision or competency checks needed. Care records were incomplete or inaccurate, and management checks had failed to identify these problems.
This was the third consecutive Requires Improvement rating. The provider had to send CQC an action plan, and CQC said it would continue monitoring the home and revisit it.
Kind and respectful care
Inspectors found a relaxed atmosphere. People, relatives and professionals spoke positively about how staff treated people.
“People were treated with kindness, compassion and dignity.” from the report
Personalised support
Care plans included people's histories, preferences and how they wanted care delivered. People were involved in reviewing their care.
“People received personalised care which was responsive to their needs.” from the report
Good healthcare links
The home worked with health and social care professionals. The enhanced intermediate care area had support from a multi-disciplinary NHS team.
“There was a multi-disciplinary approach to care.” from the report
Medicines were not always safe
seriousOpening dates were missing from some liquid medicines. Some records also lacked instructions for giving medicines when needed.
“Medicines were not always managed safely. Opening dates on liquid medicines was missing.” from the report
Building risks were missed
seriousSome bathroom pull cords were not fully accessible and clinical waste bins could not be securely locked. Environmental checks had not identified all risks.
“The premises were not always safe for people living at the service.” from the report
Nursing competency checks
seriousNursing staff did not receive ongoing clinical supervision or competency checks after a serious incident. There were also no records that agency staff competencies had been checked before care was delivered.
“Nursing staff were not provided with on-going clinical supervisions.” from the report
Care records were incomplete
seriousRecords did not always contain correct or detailed information about people's needs. Minor shortfalls were also found in wound and PEG care records.
“People's care records did not accurately reflect all of their needs.” from the report
Weak quality checks
seriousThe provider's audits and assurance systems did not identify the problems found by inspectors. Not all actions from earlier inspections had been completed.
“The quality and assurance systems in place at the service were not effective as it did not identify the issues we found during the inspection process.” from the report
Learning after serious incidents
seriousThe provider did not fully meet its duty of candour responsibilities. Staff were not given enough support, training or opportunities to reflect after a notifiable incident.
“Staff were not given the opportunity to reflect on their practices as the management team did not share all outcomes or lessons learned with staff.” from the report
- 01How are liquid medicines dated when they are opened, and how do you make sure as-needed medicine instructions are complete?
- 02What checks now confirm that nursing staff and agency staff are competent before they provide care?
- 03How are care records checked for accuracy, including wound care and PEG care information?
- 04What has changed in the quality assurance system since inspectors found that audits had missed important risks?
- 05How do you record and share lessons, training and staff support after a serious incident?
This was an unannounced inspection brought forward because of safety concerns; inspectors looked at the overall service, all five rating areas, the premises and the risks linked to those concerns. This explanation was written from the published report of 14 August 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 Wheatfield Court
5 rated inspections over 5 years: the service has held its Good rating throughout.
- September 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 1 November 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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