CQC report explained · a residential care home
What the CQC found at Whitwood Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, risk assessments, infection control, staffing and recruitment were found to be safe.
- Effective?
- Good
- This area was not inspected during this focused inspection. The report says ratings from the previous comprehensive inspection were used.
- Caring?
- Good
- This area was not inspected during this focused inspection. The report says ratings from the previous comprehensive inspection were used.
- Responsive?
- Good
- This area was not inspected during this focused inspection. The report says ratings from the previous comprehensive inspection were used.
- Well-led?
- Requires improvement
- Management audits and action plans had improved, and staff felt supported. However, the report said improvements still needed to continue and become embedded in practice.
What inspectors found, May 2021
Whitwood Grange is rated Requires Improvement; inspectors found safe care, but management systems still needed to become firmly established.
This was an unannounced focused inspection on 20 April 2021. One inspector spoke with two people and six staff, and checked medicines, care records, recruitment files, training and quality checks.
The home was rated Good for Safe. People felt safe, medicines were managed safely, risks were assessed, infection control was in place and staffing and recruitment were safe.
The home was rated Requires Improvement for Well-led. Management checks had improved and leaders acted on issues, but the improvements needed to continue and become part of everyday practice.
The previous inspection rated the home Inadequate. This inspection found enough improvement in Safe and Well-led for the home no longer to be in breach of the regulations previously identified. The other three areas were not inspected, so their earlier ratings were used in the overall rating.
Safe medicines
Medicines were stored securely and records and guidance were available to help staff administer them correctly.
“Medicines were stored and managed safely.” from the report
Risk management
People had current care plans and risk assessments. Staff knew people well and understood the risks affecting them.
“People had risk assessments and care plans in place. These were up to date and reflective of people's individual needs and risks.” from the report
Safe staffing
Staffing levels matched the home's calculations, and required recruitment checks had been completed before staff started work.
“Recruitment processes were safe with all required checks completed before new staff started employment.” from the report
Respectful support
Staff supported people to make choices and be as independent as possible. Inspectors observed people communicating freely and feeling at ease.
“Staff were person-centred, caring and respectful in their approach.” from the report
Management improvements not yet embedded
needs fixingThe management and checking systems had improved, but the home still needed to show that these improvements would continue consistently.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17, although improvements are required to continue and become embedded into practice.” from the report
Some records needed attention
minorInspectors found minor omissions in recruitment records and an outdated statement of purpose on site. The manager said these would be addressed quickly.
“Where issues had been identified such as; minor omissions in recruitment or the statement of purpose on site not being the most up to date version available, we were assured the manager would react quickly to address them.” from the report
As-needed medicine recording
minorThe manager was asked to make recording clearer by stating the exact number of drops given, rather than recording a range.
“We spoke with the manager about specific recording, for example, the exact number of drops given rather than 'one or two'. Action was taken to address this.” from the report
- 01How have you kept the improved management checks and action plans in place since the inspection?
- 02How do you now check that medicine records state the exact amount given for as-needed medicines?
- 03What checks are made to ensure recruitment records are complete before staff start work?
- 04How do you make sure the statement of purpose and other important documents are kept up to date?
- 05What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 15 May 2021 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, January 2021
Rated Inadequate and placed in special measures; inspectors found serious safety and management failures, despite some medicines being given as prescribed.
This was an unannounced focused inspection on 25 August, 11 September and 29 September 2020. Inspectors looked at Safe and Well-led because of concerns about restraint, staffing, management support, provider oversight and person-centred care. They reviewed care and staff records, spoke with staff and the manager, and contacted relatives and staff afterwards.
The home was rated Inadequate for Safe and Well-led. Inspectors found problems with infection control, medicines storage and records, repairs, recruitment checks, staff training and management oversight. They also found that capacity assessments and some follow-up after incidents were not properly completed.
There were some positive findings. People generally received their medicines as prescribed, and most relatives and staff said people were protected from abuse. However, the overall rating fell from Good at the previous inspection in 2019 because the home could not show that people were consistently safe or receiving well-managed care.
The provider started refurbishment and extra cleaning after the inspection. A new home manager was appointed in October 2020. The home was placed in special measures, meaning the CQC would keep it under review and normally re-inspect within six months.
Medicines usually given as prescribed
Records for three people showed that their medicines were administered as prescribed. Staff had medicines training and their competence had been checked.
“Medication administration records we looked at for three people showed they received their medicines as prescribed.” from the report
Most people felt safe
Most relatives and staff contacted by inspectors said people were protected from abuse, although one relative expressed a different view.
“With the exception of one relative, family members and staff felt people were safe living at Whitwood Grange.” from the report
Some caring staff
Inspectors found that some staff were committed to helping improve the home and caring for the people living there.
“Some staff were very caring and were fully committed to supporting the home manager to improve the running of the home.” from the report
Improvement work began
After the inspection, the provider began refurbishment, improved infection control and arranged extra cleaning support for two weeks.
“Following our inspection, the provider started to refurbish the premises and improve infection control standards.” from the report
Infection control failures
seriousThere were missing toiletries, incorrect mask use, an unclean medicines work surface and unattended cleaning fluids. Cleaning schedules and evidence of enhanced cleaning were not available.
“We observed two staff members not wearing a mask when supporting a person and at other times during the day a staff member was wearing the mask incorrectly.” from the report
Unsafe medicines systems
seriousControlled drugs were not stored correctly. Medicines records, room temperatures and audits were incomplete, and one person was given medicines while in the bath.
“Daily records we looked at for one person showed they were administered medicines whilst they were in the bath which is not safe or dignified.” from the report
Repairs were delayed
needs fixingParts of the home were damaged or worn, including a hole in a lounge ceiling. Risks from delayed repairs had not been assessed.
“Some aspects of the living environment had become damaged. For example, a hole in a lounge room ceiling had been present for several months.” from the report
Weak management oversight
seriousThe provider did not have reliable systems to monitor care, incidents, infection control, capacity assessments or the condition of the home. Records requested by inspectors were missing or incomplete.
“There was a lack of quality oversight and systems were not being used to monitor quality standards.” from the report
Staffing and training concerns
needs fixingThe home relied heavily on agency workers, had a high staff turnover and had gaps in recruitment checks and essential training.
“Training records we looked at showed low completion rates, in particular for understanding the Mental Capacity Act, safeguarding people from abuse and the use of restraint.” from the report
Choice, dignity and contact
seriousInspectors found that people were not always supported with maximum choice, control and independence. One person’s behaviour was reported to have worsened because the provider had not explored enough ways to maintain contact with a relative during the pandemic.
“Our findings demonstrated people did not always receive care which maximised their choice, control and independence.” from the report
- 01What repairs have been completed since the inspection, including the hole in the lounge ceiling and worn carpets?
- 02How are controlled drugs, medicines storage, room temperatures and medicines audits now checked?
- 03What evidence can you show that infection control, PPE use, toiletries and cleaning schedules are now being monitored?
- 04How many permanent and agency staff currently work here, and have all staff completed training in safeguarding, the Mental Capacity Act and restraint?
- 05How are people now supported to make choices, stay in touch with relatives and take part in activities they enjoy?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 16 January 2021 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 Whitwood Grange
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- May 2021Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Inspected but not ratedSafe: GoodWell-led: Requires improvement
- December 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 12 September 2012.
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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