CQC report explained · a nursing home
What the CQC found at Whitstable 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
- Care plans and records did not always give staff enough detail or show that essential care had been completed. Inspectors also found a delay in reporting one safeguarding concern and an infection control risk involving urine bags.
- Effective?
- Requires improvement
- Best-interest decisions and the reasons for some restrictive care were not always recorded. Staff training, food and drink support, and contact with healthcare professionals were positive.
- Caring?
- Good
- This question was not inspected during this focused visit. The report says ratings for questions not inspected were carried over from the last inspection.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report says ratings for questions not inspected were carried over from the last inspection.
- Well-led?
- Requires improvement
- Quality checks had not identified important shortfalls, and previous efforts had not improved staff record keeping enough. The manager had taken some action after the inspection.
What inspectors found, March 2023
Requires Improvement; inspectors found unsafe gaps in care records, risk management and decision-making, although staffing and medicines support were generally good.
This was an unannounced focused inspection on 9 January 2023. One inspector spoke with people, relatives and staff, observed care, and checked care plans, medicines records, staff recruitment files and management records.
The home was rated Requires Improvement overall, with Safe, Effective and Well-led also rated Requires Improvement. Inspectors found that risks were not always described in enough detail, care records were sometimes inaccurate or incomplete, and some decisions about restrictive care were not properly recorded.
There were also positive findings. Inspectors found enough staff, safe medicines management, appropriate staff training and good links with health professionals. People and relatives said they felt safe, and improvements had been made to activities and the menu after feedback.
The previous overall rating was Good in 2019. This focused inspection changed the overall rating to Requires Improvement. The home was asked for an action plan, and the CQC said it would monitor progress with the provider and local authority.
Staffing
Inspectors found enough staff to meet people's needs. Regular agency staff were used when permanent staff could not cover shifts.
“There were enough staff to meet people's needs.” from the report
Medicines
Medicines were managed safely by nursing staff. Guidance for medicines given when needed was clear and detailed.
“Medicines were managed safely.” from the report
Training and support
Staff received role-appropriate training, induction and regular supervision. Staff said the manager was supportive.
“Staff received regular supervision to discuss their practice and any training needs they had.” from the report
Healthcare support
People were referred to healthcare professionals when their needs changed, and staff followed the advice given.
“People had been referred to healthcare professionals when their needs changed.” from the report
Listening to people
The home acted on feedback about activities and food. More outings, arts and crafts, board games and homemade soup were introduced.
“There had been regular resident and staff meetings.” from the report
Incomplete risk guidance
seriousSome care plans did not explain important details needed to move people safely, manage oxygen equipment or respond to a power cut.
“However, the guidance did not always contain all the detail staff needed to keep people safe.” from the report
Care records
seriousRecords did not always show that essential care had happened. One person had not been repositioned for up to nine hours, and catheter bag changes were not recorded consistently.
“There was a risk people had not received the care required to keep them safe and well.” from the report
Consent and restrictive care
seriousThe reasons for using a lap strap and giving medicine in food were not properly recorded as best-interest decisions.
“Best interest decisions had not always been recorded to show how these decisions were made and why.” from the report
Quality checks
needs fixingThe home's audits had not reliably found the problems inspectors identified. Staff record keeping remained poor despite earlier discussions.
“However, this had not always been effective at identifying shortfalls such as those found at this inspection.” from the report
Infection control
needs fixingNight urine collection bags were left hanging on people's beds, which inspectors said created an infection control risk.
“Night urine collection bags were left hanging on people's bed.” from the report
- 01How do you now make sure repositioning, catheter bag changes, blood sugar checks and insulin timings are recorded accurately?
- 02What detailed instructions are now in place for hoist sling use, oxygen equipment maintenance and action during a power cut?
- 03How are best-interest decisions recorded for lap straps, medicines given in food and any other restrictive care?
- 04What checks now identify missing or inaccurate care records before they put people at risk?
- 05How do you make sure safeguarding concerns are reported promptly to the local safeguarding authority?
This was an unannounced focused inspection of Safe, Effective and Well-led, with infection prevention and control also reviewed; Caring and Responsive were not inspected and ratings for uninspected questions were carried over from the previous inspection. This explanation was written from the published report of 4 March 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, December 2020
Whitstable Nursing Home was inspected but not rated; inspectors were assured that infection control measures were in place.
This was an unannounced, targeted inspection on 26 November 2020. It followed information of concern about infection prevention and control.
Inspectors found that the home had measures to reduce infection risks. These included suitable protective equipment, social distancing arrangements, visitor controls, testing and isolation for new admissions.
The home was rated "Inspected but not rated". This means the inspection looked at infection control measures only and did not provide an overall quality rating.
Protective equipment
Stocks of the required protective equipment were maintained. Staff used and disposed of it correctly.
“Stocks of the right standard of personal protective equipment (PPE) were well maintained and staff used and disposed of it correctly.” from the report
Visitor safety
The home used screens and separate entrances to help reduce contact and maintain social distancing during visits.
“Large Perspex screens were used during visits to maintain social distancing.” from the report
Safe admissions
People coming from hospital needed a negative Covid-19 test before discharge, and new arrivals isolated in their rooms for 14 days.
“New people moving into the service had a 14 day period of isolation in their room, minimising the risk of infection spread to other people.” from the report
Clear guidance
Instructions about PPE and infection control procedures were displayed clearly and were available in picture format.
“Guidance on the use of PPE and current IPC procedures were clearly visible across the service and available in picture format.” from the report
Inspectors raised no specific concerns in this report.
- 01Are the PPE stocks, testing arrangements and infection control procedures still maintained as described in the report?
- 02How are visits managed now, including the use of screens, social distancing and visitor access?
- 03What isolation arrangements are used for people moving into the home from hospital or elsewhere?
- 04How does the home manage an infection outbreak and keep families informed?
- 05When was the wider quality of care last assessed, since this inspection did not rate caring, responsive, effective or well-led care?
This was an unannounced targeted inspection of infection prevention and control measures only, so the service was inspected but not rated overall. This explanation was written from the published report of 10 December 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 Whitstable Nursing Home
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- March 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2016Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: InadequateWell-led: Inadequate
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- September 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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