CQC report explained · a nursing home
What the CQC found at Wilton House Residential and 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
- Infection control was not safe enough, including the use of protective equipment and arrangements for people with COVID-19. Regular medicines were given when needed, but instructions for some medicines were missing or out of date.
- Effective?
- Good
- This question was not included in this focused inspection.
- Caring?
- Good
- This question was not included in this focused inspection, although people and relatives gave examples of kind and person-centred care.
- Responsive?
- Good
- This question was not included in this focused inspection.
- Well-led?
- Requires improvement
- Management systems did not always identify, record or complete improvements. Infection control problems continued after they had been raised.
What inspectors found, February 2022
Wilton House Residential and Nursing Home is rated Requires Improvement; inspectors found serious infection control problems and weaknesses in management checks.
This was an unannounced inspection on 11 and 13 January 2022. It followed concerns about infection prevention and control. Inspectors spoke with people, relatives and staff, and reviewed care, medicines, recruitment and management records.
Inspectors found that staff did not always use protective equipment safely. People with COVID-19 were seen eating with others, and infection risks were not properly controlled. These problems continued on the second visit after they had been raised.
The home had systems for safeguarding, risk assessments, recruitment and regular medicines. However, instructions for medicines to be given when needed were not always recorded. Management checks did not reliably record actions or show that improvements had been completed.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe and well-led were both rated Requires Improvement. This inspection only rated those two areas.
Regular medicines
People received their regular medicines on time from trained and competent staff.
“People received their regular medicines when they needed them by staff who were trained and competent to administer medicines.” from the report
Risk and safeguarding
People had individual risk assessments and staff knew how to respond to safeguarding concerns. Call bells were answered promptly.
“People had call bells in the event of needing urgent assistance. We found that staff were responding to these in a timely manner.” from the report
Recruitment
The home used pre-employment checks, including references and DBS checks. People living in the home were involved in interviews.
“There was a robust recruitment process in place, and this helped ensure only suitable staff were employed.” from the report
Staff support
Staff said morale was good and that the manager was supportive and approachable.
“Staff felt the registered manager was supportive and approachable.” from the report
Working with professionals
The manager worked with health professionals and gave examples of this helping people receive appropriate input.
“The registered manager gave examples of how they had regular input from other organisations and health professionals.” from the report
COVID-19 infection control
seriousStaff did not always put on or remove protective equipment safely. People who had COVID-19 were seen eating with others, increasing the risk of infection.
“People were not kept safe from exposure to the virus.” from the report
Medicines given when needed
needs fixingInstructions for medicines given when needed were missing or not up to date. This could make it unclear to new staff when and how to give them.
“Without PRN protocols in place to support the use of these medicines we could not be confident assured that new staff would be able to understand when and how to use this medicine.” from the report
Management checks
needs fixingAudits and quality checks did not always record what needed to be done or whether actions were completed. Lessons were discussed, but actions were not always put into practice.
“The management team did not consistently capture actions to introduce improvements.” from the report
Staff availability
needs fixingInspectors saw little interaction between staff and people while staff managed immediate needs. Some people and relatives felt staff did not always have enough time to listen or provide support.
“Records and observations showed little interaction with people and staff as the staff were trying to manage individuals immediate support needs.” from the report
- 01What action has been taken since the inspection to make sure staff put on and remove PPE correctly?
- 02How are people with COVID-19 kept separate from other residents, including during meals?
- 03Can you show us the current instructions for each medicine given when needed, and explain how staff follow them?
- 04How do your audits record actions, deadlines and proof that improvements have been completed?
- 05How do you check that there are enough staff to support people who are isolating and those who need time and attention?
This was a focused inspection of Safe and well-led, prompted by infection control concerns; the other three question ratings were not given in this report. This explanation was written from the published report of 16 February 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.
What inspectors found, December 2019
Rated Good overall, but inspectors found inconsistent leadership and a serious delay after a person went missing.
This was an unannounced planned inspection on 27 November and 5 December 2019. Inspectors spoke with people living at the home, relatives and staff. They reviewed care, medicine, recruitment and management records, and observed care and activities.
The home was rated Good for Safe, Effective, Caring and Responsive. People were generally safe and received kind, personalised care. Medicines were managed safely, risks were assessed and people were supported with healthcare, activities and relationships.
Well-led was rated Requires Improvement. Inspectors found staff did not always feel supported by the registered manager, management roles were not always clear and there was limited management presence at weekends. They also found a delay in contacting emergency services after a person went missing.
The overall Good rating means inspectors found the main areas of care were of a good standard, but the home needed to improve its leadership and oversight. The overall rating had stayed Good since the previous inspection, although well-led had fallen from Good to Requires Improvement.
Kind and respectful care
People and relatives gave positive feedback about the care. Staff generally treated people with kindness, respect and compassion.
“People and their relatives told us that the staff were kind and caring.” from the report
Safe medicines management
People received medicines as prescribed. Staff had regular medicine training and checks, and records were completed.
“Medication audit checks showed there had been no medication concerns during the last year.” from the report
Personalised support
Staff knew people's preferences and care needs. People were encouraged to make choices and remain as independent as possible.
“People received care that was responsive to their changing needs.” from the report
Activities and relationships
People were encouraged to take part in activities and maintain interests. Inspectors saw people enjoying activities during the visit.
“People were supported and encouraged to pursue interests and participate in activities which were available.” from the report
Delay after a person went missing
seriousInspectors found that emergency services were not involved quickly enough after a person went missing. They said this caused an unnecessary delay in finding the person and providing treatment.
“There had been a delay in involving the emergency services and this had resulted in an unnecessary delay in the person being located and receiving appropriate treatment.” from the report
Inconsistent leadership
needs fixingStaff did not always feel supported or included by the registered manager. Management responsibilities were not always clear, and there was limited management presence at weekends.
“The service management and leadership was inconsistent.” from the report
Waiting at busy times
needs fixingThere were enough staff overall, but people sometimes had to wait for help when demand was highest. Staff could be stretched at these times.
“However, people told us they sometimes had to wait to be assisted at busy times.” from the report
Tired areas of the building
minorInspectors found that some areas needed updating, redecoration and a deeper clean. The home provided a refurbishment plan after the inspection.
“The home looked 'tired' in places and would benefit from redecoration.” from the report
Dining experience
minorLunch was described as task-focused, with little social interaction. People were not shown the available food choices before being served.
“However, there was little social interaction in the dining room during lunch service.” from the report
- 01What changes have been made to make sure emergency services are contacted without delay if someone goes missing?
- 02Who is responsible for management at weekends, and how is management oversight maintained when the person in charge is also working on the floor?
- 03How are staff being supported to feel included and empowered by the management team?
- 04What progress has been made with the refurbishment and deeper cleaning plan?
- 05What changes have been made to make mealtimes more social and to help people choose their food?
This was an unannounced planned inspection covering all five CQC questions; the overall rating remained Good, while the well-led rating fell from Good to Requires Improvement. This explanation was written from the published report of 24 December 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 Wilton House Residential and Nursing Home
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Wilton House Residential and Nursing Home →
- December 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
Read what inspectors found at Wilton House Residential and Nursing Home →
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- December 2015Inspected but not ratedSafe: Requires improvementWell-led: Requires improvement
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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