CQC report explained · a residential care home
What the CQC found at Wirral Christian Centre Trust Limited
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found problems with medicine storage, administration and written guidance. They also found that people's temperatures were not being checked twice daily as current guidance required.
- Effective?
- Good
- This key question was not rated during this focused follow-up inspection.
- Caring?
- Good
- This key question was not rated during this focused follow-up inspection. People and relatives nevertheless gave positive feedback about the care.
- Responsive?
- Good
- This key question was not rated during this focused follow-up inspection.
- Well-led?
- Requires improvement
- The home had introduced regular audits and made several improvements, but the audits did not identify the medicine problems found by inspectors.
What inspectors found, February 2022
Requires Improvement; the home is no longer in special measures, but medicines were not always managed safely.
This was an unannounced follow-up inspection on 11 January 2022. Inspectors spoke with seven people, six relatives, the registered manager and three staff members. They reviewed care records, medicine records, staff files, audits, health and safety checks, infection control arrangements and other documents.
The home had improved since its previous inspection. People and relatives said they felt safe and had seen major improvements. There were enough staff, recruitment checks were completed, infection control arrangements were in place, and staff understood safeguarding procedures.
There were still important problems with medicines. Medicine storage temperatures were not fully monitored, some instructions were unclear, and not all staff knew all the relevant procedures. Audits had not identified these problems. People's temperatures were also checked once a day rather than twice daily as guidance required.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The home had previously been rated Inadequate and placed in special measures, but it improved enough to leave special measures. It was still in breach of Regulation 12 about safe care and treatment.
Enough staff
Inspectors found enough staff on duty, and people said staff were available when they needed help. Recruitment checks had also been completed.
“There were sufficient numbers of staff on duty during the inspection and people told us staff were always available when needed.” from the report
People felt safe
People and relatives said the home felt safe and that things had improved greatly.
“People and their relatives told us Orton House was a safe place to live.” from the report
Infection control
The home had suitable infection control policies, PPE and testing arrangements. Inspectors were assured that PPE was being used safely and effectively.
“We were assured that the provider was using PPE effectively and safely.” from the report
Positive management changes
People, relatives and staff described major improvements since the new manager started. Staff said they were supported and could raise concerns.
“Feedback regarding the management and quality of service people received was extremely positive from staff, people living in the home and their relatives.” from the report
Action taken during inspection
The manager responded quickly when inspectors raised a medicine problem, and the instructions for one medicine were changed.
“The registered manager took prompt action to respond to the issues identified on the inspection.” from the report
Medicine safety breach
seriousMedicine storage and administration were not always safe. Some guidance was unclear, a medicine trolley was not secured, and not all staff knew the relevant procedures.
“Failure to ensure the safe management of medicines is a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Medicine checks did not find problems
needs fixingThe home had regular audits, but these did not identify the medicine issues found during the inspection.
“Although audits were completed regularly, they did not highlight the issues we identified with the management of medicines during the inspection.” from the report
Temperature checks
needs fixingPeople's temperatures were checked once a day, although current guidance said this should happen twice a day.
“Although people had their temperature checked each day to monitor for potential signs of infection, current guidance states this should be done twice per day.” from the report
One care plan was out of date
minorOne person's care plan had not been updated to include advice from another health professional. Staff knew the advice and the person was receiving the recommended care.
“However, one person's care plan had not been updated to reflect advice provided by another health professional.” from the report
Further building work needed
needs fixingSome work was still needed on fire doors and electrical cables, although this was planned or already under way.
“There were some further actions required, such as work on the fire doors and replacement of electrical cables, and these were either planned or already in process.” from the report
- 01What has been done to make sure medicine storage temperatures are monitored wherever medicines are kept?
- 02How are staff now being checked to ensure they understand the procedures for homely remedies, as-needed medicines and covert medicines?
- 03How is the medicine trolley secured and how are controlled medicines kept safely before administration?
- 04How are regular audits now checking for the medicine problems found at this inspection?
- 05Are people's infection-monitoring temperature checks now being completed twice a day?
This was an unannounced follow-up inspection focused on Safe and Well-led, including infection prevention and control; the other key questions were not rated in this report. This explanation was written from the published report of 11 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, August 2021
Rated Inadequate and remains in special measures; inspectors found serious risks in medicines, care records, infection control and management.
This was an unannounced targeted follow-up inspection on 10, 14 and 15 June 2021. Inspectors checked whether earlier action had been taken, including action linked to safe care, governance, staffing and training. They reviewed care and medicines records, spoke with people, relatives and staff, and checked infection control.
The home remained Inadequate overall. Safe and Well-led were both rated Inadequate. Inspectors found that risks were not properly assessed or monitored, medicines were not managed safely, and care records did not always give staff accurate guidance.
The home was clean and staff were seen being kind and caring. There were enough staff on duty during the visits. However, infection control systems, staff training, records, audits and leadership were not reliable enough to protect people from avoidable harm.
This was the second Inadequate rating since 2020. The home was still breaching regulations about safe care and treatment and good governance. It remained in special measures.
Clean environment
The home was clean, and staff used suitable methods to help prevent infection spreading.
“The service was clean, and staff used appropriate techniques to prevent the spread of infection.” from the report
Kind staff
Inspectors saw staff treating people kindly and people and relatives said they felt positive about the service.
“Staff were observed to be kind and caring and people” from the report
Staff available
There were enough staff on duty to meet people's needs during the inspection visits.
“On the day we visited, there were enough staff on duty to meet people's needs.” from the report
Visits supported
Inspectors were assured that visits were being facilitated in line with the guidance in place at the time.
“We were assured the provider was facilitating visits for people living in the home in accordance with the current guidance.” from the report
Unsafe medicines
seriousRecords did not show reliably whether people had received the right medicines. Allergies, timings, storage temperatures and instructions for some medicines were not recorded safely.
“The management of medication was unsafe. This was a breach of Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Poor risk management
seriousStaff did not always have accurate guidance about people's risks and care needs. Some health needs were not monitored properly and professional advice was not always followed.
“Staff did not have adequate information or guidance about people's needs, risks or the care they required in order to ensure their health and safety was maintained.” from the report
Weak management checks
seriousAudits and new systems failed to identify serious shortfalls. Records and oversight were not strong enough to show that care was safe.
“The governance arrangements in place were not robust, managerial oversight was poor and record keeping was not always adequately maintained.” from the report
Infection control gaps
seriousCOVID-19 procedures, testing records, PPE use, clinical waste arrangements and staff training were not consistently managed.
“The provider had failed to follow government guidelines on infection prevention and control putting people at risk of infection.” from the report
Activities could improve
minorSome relatives felt people needed more access to activities and social support.
“People told us they were happy, some relative's felt that access to activities could be improved.” from the report
- 01What has changed since June 2021 to make sure medicines, allergies, timings and storage are recorded and checked safely?
- 02How are people's risks, pressure care and moving and handling needs assessed, updated and communicated to staff?
- 03How do you now check that care records accurately show the care each person has received?
- 04What infection control training has every staff member completed, and how are testing, PPE and clinical waste checks monitored?
- 05What action has been taken to improve management oversight and to meet the continuing breaches of Regulations 12 and 17?
This was an unannounced targeted follow-up inspection focused mainly on Safe and Well-led, with staffing, training and infection control also considered; it did not provide ratings for Effective, Caring or Responsive. This explanation was written from the published report of 25 August 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 Wirral Christian Centre Trust Limited
7 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- February 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Wirral Christian Centre Trust Limited →
- August 2021Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
Read what inspectors found at Wirral Christian Centre Trust Limited →
- January 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- May 2019Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 24 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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Most charge £980 to £1,230 a week. 37 can care for a couple. 8 years' experience on average.
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