CQC report explained · a nursing home
What the CQC found at White Windows
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, August 2023
Rated Inadequate and placed in special measures; inspectors found serious problems with safety, medicines, staffing and management.
This was an unannounced follow-up inspection. Inspectors visited on 8 and 19 June and 7 July 2023. They spoke with people and relatives, observed care, spoke with staff and checked care, medicines, staffing and management records.
The home was not always safe. Risk assessments were not always followed, medicines were not securely stored or recorded, cleaning was poor and there were not always enough staff. People were also left waiting for care and some were not supported safely with eating and drinking.
The ratings were Inadequate for Safe and Well-led, and Requires Improvement for Effective, Caring and Responsive. The overall rating fell from Requires Improvement at the previous inspection. The home remained in breach of regulations and was placed in special measures.
Kind interactions
Inspectors saw some kind and caring interactions. Most people said staff were kind and caring, and relatives generally spoke positively about the staff.
“We observed some kind and caring interactions between staff and people.” from the report
People felt safe
People living at the home told inspectors they felt safe, and staff knew what to do if they thought someone was at risk.
“People living at the home told us they felt safe.” from the report
Family involvement
Relatives said they felt involved in their family member's care and were asked for their views about changes.
“People's families felt involved in the care and support of their relatives.” from the report
Complaints process
People felt able to raise concerns with the manager or deputy, and complaints were handled according to the home's policy.
“Complaints were managed and responded to in line with the provider's complaints policy.” from the report
Risks were not followed
seriousInspectors saw staff fail to follow risk assessments for choking and eating support. One person ate alone when their plan required supervision and food to be cut up.
“People were at risk of choking as measures in place to reduce this risk were not followed.” from the report
Medicines were not secure
seriousThe medicines fridge and medicines room were left unlocked, and some medicine records were inaccurate. Some topical medicines were also not recorded clearly.
“Medicines were not always stored safely.” from the report
Poor cleanliness
seriousInspectors found dirty bathrooms and equipment, dust and cobwebs, damaged surfaces and out-of-date cleaning schedules. There were not always enough cleaning staff.
“We were not assured that the provider was promoting safety due to poor hygiene practices being followed at the service.” from the report
Not enough staff
seriousPeople sometimes waited for call bells to be answered and some said they had been incontinent because of the delay. Staffing was also not sufficient to maintain cleanliness or provide activities.
“Staffing levels were not always sufficient to meet people's needs.” from the report
Limited activities and choice
needs fixingPeople were not consistently supported to go out, shop, follow their interests or work towards independence. Records showed very limited activities for some people.
“The service was unable to demonstrate they were providing person centred care and supporting people to engage in activities socially and culturally relevant to them in line with the principles of right support, right care, right culture.” from the report
Weak oversight
seriousAudits did not identify or fix important problems. The provider had not addressed shortfalls from the previous inspection, and the manager did not complete daily checks of cleanliness and safety.
“Shortfalls identified at the last inspection had not been addressed.” from the report
- 01What action has been taken to make sure staff follow choking, falls, nutrition and other risk assessments every time?
- 02How are medicines now kept secure, and how are topical medicines and administration records checked?
- 03What staffing levels are now in place for care, cleaning and activities, especially when agency staff are needed?
- 04How are people being supported to choose activities, go into the community and work towards greater independence?
- 05What evidence can you show that the warning notices and problems from the previous inspection have been addressed?
This was an unannounced follow-up inspection that covered the home, its care and infection prevention and control; the agency service registered at the same address was not being provided. This explanation was written from the published report of 22 August 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, October 2022
Rated Requires Improvement; inspectors found risks in care, medicines, dignity and management systems.
This was an unannounced inspection on 16 and 24 August 2022. Inspectors spoke with people, relatives and staff, and reviewed care plans, medicines records and management documents.
The home was not always safe. Risk assessments and food and fluid records were incomplete, medicines records were not always accurate, and some bedrooms had dirty bedding or damaged equipment. Some people also experienced delays with call bells and support to use the toilet.
Inspectors found caring relationships and some good staff training, but people were not always treated with dignity or involved in their care plans. Activities and care planning did not consistently meet people's individual needs.
All five areas were rated Requires Improvement. This means there were important shortfalls and limited assurance that people were consistently safe and receiving good-quality, person-centred care.
Staff knew people well
Staff could describe people's likes and dislikes and had formed caring relationships with people and relatives.
“Staff we spoke to were knowledgeable about people's likes and dislikes and gave us examples how they ensured choice and control.” from the report
Training was monitored
Most staff had completed required training, including specialist training. Staff said they felt supported by the acting service manager.
“We saw evidence the provider monitored staff training requirements and there was good compliance with training required.” from the report
Complaints were addressed
The home had systems to record, respond to and learn from complaints and concerns.
“There was evidence to support complaints and concerns were being addressed in an open and transparent way.” from the report
Some individual support was positive
The home adapted the dining arrangements for one person and helped another person attend a relative's wedding.
“One person told us how they had been supported to attend their relative's wedding and how happy that had made them feel.” from the report
Risks were not consistently managed
seriousSome people did not have the risk assessments or monitoring needed for their health and safety. This included risks linked to behaviour, malnutrition and food and fluid intake.
“Inconsistent care records meant there was not always evidence to demonstrate risks to people's health and safety were being effectively assessed, monitored and mitigated.” from the report
Medicines records were incomplete
seriousRecords did not always show that creams had been applied or that medicine patches were rotated safely. Medication audits did not always lead to completed corrective action.
“Records to show topical preparations such as creams were being applied were not always completed; therefore, we were not assured people were receiving these medicines as prescribed.” from the report
Dignity and privacy were not reliable
needs fixingOne person said staff did not arrive quickly enough to help them use the toilet. Another person was left visible from the corridor while using a bathroom.
“One person had been supported to the toilet but the door to the bathroom had been left open meaning the person was clearly visible from the corridor.” from the report
People were not always involved
needs fixingCare plans and risk assessments did not clearly show people's or relatives' involvement. Some people also said they were bored or wanted more say in activities.
“Care plan reviews did not clearly record how people and relatives had been involved in the review process.” from the report
Quality checks missed problems
seriousThe home's audits and governance systems did not consistently identify or correct safety and care concerns. This was a breach of Regulation 17.
“The provider had failed to ensure that systems for auditing the safety and quality of the service were sufficiently robust to identify risks to people's safety and welfare.” from the report
- 01What action has been completed to make medicines records, including cream and patch records, accurate and regularly audited?
- 02How do you now identify and monitor risks such as malnutrition, complex behaviour and low food or fluid intake?
- 03How do you ensure people receive prompt toileting support and have privacy when using the bathroom?
- 04How are people and relatives involved in writing and reviewing care plans and risk assessments?
- 05What progress has been made with the action plan and with appointing a registered manager?
This was an inspection of the care home and all five key questions; the registered personal care service for people living in their own homes was not providing personal care at the time. This explanation was written from the published report of 27 October 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.
Every inspection of White Windows
6 rated inspections over 7 years: the service has slipped, from Requires improvement to Inadequate.
- August 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2019Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- January 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2019
Registered with the Care Quality Commission on 4 December 2019.
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 Calderdale
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. 87 can care for a couple. 12 years' experience on average.
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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.