CQC report explained · a residential care home
What the CQC found at Wickham Care 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
- Some risks were not identified or recorded, and fire evacuation arrangements and staff competence were not safe. Safeguarding investigations were incomplete for 2 of 7 incidents, although medicines were mostly administered safely.
- Effective?
- Requires improvement
- Most staff had suitable training, but there were gaps in fire awareness, safeguarding and moving and handling. Induction evidence was missing for some staff, including agency staff, and the rating fell from Good at the previous inspection.
- Caring?
- Good
- No separate rating was given in this report. Inspectors said care was kind and staff understood and responded to people's individual needs.
- Responsive?
- Good
- No separate rating was given in this report. Staff communicated in ways that met people's needs and supported people to take part in activities.
- Well-led?
- Requires improvement
- Quality checks did not identify the problems found by inspectors, and investigations were not always robust. Relatives had mixed views about management and communication.
What inspectors found, October 2023
Willowmead Care Home rated Requires Improvement; inspectors found kind care and enough staff, but safety, training and management checks were not reliable.
This was an unannounced inspection after concerns about safeguarding and risk. Inspectors spoke with people, relatives and staff, observed care, and checked care files, staff records, medicines and quality checks.
The home had enough staff on duty during the inspection, and people were treated kindly. Staff understood people's needs, supported activities and helped people with food, drink and healthcare. Infection control arrangements were also judged suitable.
However, some risks were not properly assessed or recorded. Fire evacuation skills were not safe, some safeguarding incidents were not fully investigated, and agency staff checks and training records were incomplete. Medicines were generally given safely, but some were not stored securely and some instructions for 'when required' medicines were missing.
The overall rating remains Requires Improvement. Safe and well-led also remained Requires Improvement, while effective fell from Good at the April 2022 inspection. This was the home's second consecutive Requires Improvement rating.
Kind, individual care
People were treated kindly. Staff understood people's needs and respected their choices where possible.
“People received care that was kind. Staff understood and responded to people's individual needs.” from the report
Staff available
Inspectors saw enough staff on duty to meet people's needs during both inspection days. Most people and relatives also said there were enough staff around.
“Our observations during both days of inspection demonstrated there were enough staff on duty to meet people's needs.” from the report
Food and drink
People were supported with their dietary and hydration needs. Meals offered choices and were presented in ways that reflected people's preferences.
“People were supported to eat and drink enough to meet their dietary and hydration needs.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including enough protective equipment.
“We were assured the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Risk and fire safety
seriousSome care risks were not properly assessed or recorded. Fire drill records showed that staff were not competent to evacuate people safely, and no remedial action had been taken.
“Fire drill records between May and July 2023 demonstrated staff's competence to undertake an evacuation in a fire emergency was inadequate and unsafe.” from the report
Weak quality checks
seriousThe provider's own monitoring did not identify the problems found by inspectors. This meant there was not reliable oversight of care quality and safety.
“The provider had failed to identify the concerns and areas for improvement found as part of this inspection from their own quality assurance processes.” from the report
Training and agency staff
needs fixingSome training, induction and supervision records were incomplete. Agency staff were widely used, and the provider did not have profiles for all agency staff to show equivalent recruitment checks.
“Not all agency staff deployed to Willowmead Care Home had evidence of having completed an induction prior to the commencement of their first shift.” from the report
Medicines storage
needs fixingSome medicines were not locked away securely, and not all 'when required' medicines had clear protocols for staff to follow.
“Not all medicines were stored securely to prevent others not authorised from accessing them.” from the report
- 01What has been done to make sure every resident's risks, including catheter and distress-related risks, are fully recorded and reviewed?
- 02How have fire evacuation training and drills been improved, and how do you check that every staff member is competent?
- 03How are safeguarding incidents now investigated, followed up and reviewed with agency providers?
- 04How do you check that agency staff have completed induction and have the required recruitment checks before their first shift?
- 05What has changed in medicines storage and in the written instructions for 'when required' medicines?
This was an unannounced full inspection prompted partly by safeguarding and risk concerns; Safe, Effective and Well-led were rated, while no separate ratings were given for Caring or Responsive. This explanation was written from the published report of 13 October 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
Willowmead Care Home is rated Requires Improvement; inspectors found kind care, but safety and management systems were not always effective.
This was an unannounced focused inspection after concerns about the building, infection control, medicines and whether staff were kind and caring. Inspectors visited on 17 August 2022 and contacted relatives on 25 August 2022.
The home was caring, and medicines were managed safely by trained staff. Relatives and staff spoke positively about the manager, and inspectors saw respectful and kind interactions.
Safety and leadership were rated Requires Improvement. Inspectors found broken or missing fixtures, concerns about the storage of hoist slings, bathrooms needing attention and some staff not wearing face masks effectively. The repairs and sling storage were addressed during or shortly after the inspection, but quality checks had not always led to action.
The overall rating changed from Good at the previous inspection, published on 1 June 2022, to Requires Improvement. This inspection covered Safe, Caring and Well-led only. The other question ratings were carried forward from the previous inspection.
Kind and respectful care
Inspectors saw staff asking permission before care, protecting people's privacy and treating people respectfully. Relatives also described staff as kind and caring.
“We found no concerns and all the staff without exception were kind and caring and showed empathy towards the people they supported.” from the report
Medicines managed safely
Staff who gave medicines were trained and competent. Records were completed correctly and medicines were stored safely.
“People received their medicines safely, by appropriately trained staff.” from the report
Enough staff available
Inspectors found enough staff to meet people's needs. Relatives said staff were usually available to help.
“There were sufficient staff to support people's needs.” from the report
Manager approachable
Relatives and staff spoke positively about the manager's openness and approachability. The manager had introduced improvements, including more activities.
“People and staff spoke highly of the registered manager, and about how approachable they were.” from the report
Building safety defects
seriousInspectors found missing or broken fixtures, including a missing toilet seat and an unsealed floor. Some unused rooms were open without handles or locks, creating a risk of people entering unnoticed. These issues were fixed during the inspection or shortly afterwards.
“We found some broken fixtures and fittings that posed a risk to people's safety, however, these were rectified either on our day of inspection or shortly afterwards.” from the report
Hoist sling storage
needs fixingHoist slings were not named and were kept in a communal area, increasing the risk of cross infection. They were moved to people's bedrooms after the inspection.
“People's hoist slings were not named and were kept in a communal area which increased the risk of cross infection.” from the report
Infection control practice
needs fixingSome staff were not wearing face masks effectively, although training and protective equipment were in place.
“However, some staff were not wearing face masks effectively.” from the report
Checks did not always lead to action
needs fixingThe provider's audits had identified some concerns, but the manager had not acted on all of them. Inspectors said more time was needed for these systems to become firmly established.
“The quality manager had raised some of our concerns in a recent audit however, some of these had not been actioned by the registered manager.” from the report
Mixed communication with professionals
minorFeedback about communication with other health professionals was mixed. The provider said it was working to build these relationships and provide a more joined-up approach.
“We received mixed feedback about how the service communicates with other professionals.” from the report
- 01What checks now make sure broken fixtures, bathrooms and unused rooms are made safe quickly?
- 02Where are people's hoist slings stored now, and how are they labelled and kept separate?
- 03How do you check that staff wear face masks correctly when required?
- 04Which concerns from the recent audits are still outstanding, and who is responsible for completing them?
- 05How have communication and working relationships with health professionals improved since this inspection?
This was an unannounced focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their ratings were carried forward from the previous inspection. This explanation was written from the published report of 6 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 Wickham Care Home
6 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- October 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2022Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- April 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodWell-led: Good
- April 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017
Registered with the Care Quality Commission on 19 May 2017.
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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