CQC report explained · a residential care home
What the CQC found at Wisden Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2020
Rated Requires Improvement; inspectors found kind care and good support, but people were put at risk by weak safety checks.
The inspection was unannounced and took place on 31 December 2019. Inspectors spoke with 12 people, four relatives and five staff. They observed care and reviewed care, medicine, recruitment and management records.
People were mainly happy with the care. Staff were kind, respectful and attentive. The home provided activities, support with healthcare and end of life care. The ratings for Effective, Caring and Responsive were Good.
Safety was not always well managed. One person was given food that did not match their choking risk assessment. Inspectors also saw unsafe moving and handling. The home remained in breach of Regulation 12 because its checks had not found these problems.
The overall rating remained Requires Improvement, as did Safe and Well-led. Responsive improved from Requires Improvement to Good, while Effective and Caring stayed Good. The provider was due to discuss improvements with CQC and be monitored before a further inspection.
Kind and respectful staff
People said staff were kind and respectful. Inspectors observed positive, attentive and reassuring interactions.
“People told us that staff were kind, attentive and respectful.” from the report
Support to avoid isolation
The home offered group and one-to-one activities. A scheme prompted staff to visit people who spent time in their rooms.
“We reviewed a book for someone at the end of a corridor and saw that there were regular entries throughout the day.” from the report
Good end of life support
End of life plans recorded people's wishes. The home also used a scheme involving relatives in choosing comforting items.
“The service had developed a 'yellow basket' scheme.” from the report
Food safety guidance was not followed
seriousOne person assessed as needing minced and moist food was given salad, then later food including gammon and sweetcorn. Staff needed management intervention twice.
“One person was not supported in accordance with their choking risk assessment.” from the report
Moving and handling practice
seriousInspectors saw staff lifting or supporting people under their arms without aids. Staff needed supervision and reminders about assessing equipment needs.
“Staff did so without the use of aids by lifting or supporting people under their arms.” from the report
Management checks missed problems
needs fixingThe home's checks had not identified the meal service and moving and handling issues found during inspection. The provider also failed to send the required action plan to CQC.
“Their internal systems had not identified some of the issues we found.” from the report
Some people had to wait for help
needs fixingSix of the 12 people spoken with said they sometimes had to wait for support. Views from relatives and staff about staffing levels were mixed.
“Six out of 12 people told us they sometimes had to wait.” from the report
DoLS process applied too widely
needs fixingApplications had been made for everyone rather than only people who lacked capacity. Inspectors said this had not affected people's rights or freedom, but the process needed correcting.
“The principles were not applied in relation to DoLS.” from the report
- 01How are you checking that each person's choking and dietary guidance is followed at every meal?
- 02What supervision and equipment checks are now in place for moving and handling?
- 03How will you show that your audits identify problems before CQC or relatives find them?
- 04How do you make sure people can choose when to get up, go to bed or have a shower?
- 05What support is available for people with impaired sight to take part in activities?
This was an unannounced planned inspection covering all five key questions, with the previous ratings used as the reason for inspection. This explanation was written from the published report of 8 February 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.
What inspectors found, January 2019
Wisden Court was rated Requires Improvement; inspectors found kind and effective care, but concerns about medicines, staffing at busy times, care records and management checks.
The inspection was unannounced and took place on 27 November 2018. Two inspectors spoke with people living there, a relative, staff and managers. They reviewed seven people's care information and records about how the home was managed.
People generally said they felt safe and cared for. Staff were trained and supported, people enjoyed their meals, had access to health professionals and were treated with kindness and respect. Activities had improved since the previous inspection.
However, medicines were not always managed safely. Some people had to wait for support when staff were busy, and some risks were not recorded or acted on clearly enough. Care plans and checks by managers did not always ensure that care was delivered as planned.
The overall rating was Requires Improvement. Effective and Caring were rated Good. Safe, Responsive and Well-led were rated Requires Improvement. The home had improved its previous concerns about personalised care, care planning and activities, but new concerns had emerged.
Kind and respectful care
People described staff as kind and helpful. Inspectors saw that privacy and dignity were respected, and people were involved in decisions about their care.
“People told us that staff were kind and they enjoyed living at the service.” from the report
Staff training
Staff received training, regular supervision and an induction. Inspectors found that staff felt supported and people felt staff had the right skills.
“People were supported by staff who received training and regular supervision.” from the report
Improved activities
Activities had improved since the last inspection. They involved more people, happened more often and reflected what people enjoyed.
“At this inspection we found that these now included more people, were more regular and were activities that people enjoyed.” from the report
Food and health support
People enjoyed the food and were offered choices. People also had access to GPs and other health and social care professionals.
“People enjoyed their meals and maintained a healthy diet.” from the report
Medicines were not consistently safe
seriousThree of 10 boxed medicines checked did not match the records. One medicine had been given at the stronger dose twice, and a medicines trolley was unsecured to the wall in a communal area.
“Medicines management needed to be improved to reduce the risk of any medicine errors.” from the report
Staffing at busy times
seriousPeople sometimes waited for drinks or support, and some were left unsupervised in communal areas. The report also linked busy periods and reduced staffing with falls that needed further review.
“Staff prioritised personal care which meant people were waiting for drinks and were left unsupervised in communal areas.” from the report
Risk information was incomplete
seriousSome assessed risks did not have clear records of the actions needed to reduce them. Examples included pressure sores, poor eating and drinking, and falls.
“People had their individual risks assessed and these risks were reviewed monthly. However, where some people were assessed as being at risk, the process taken to mitigate the risks were not always documented.” from the report
Care plans were not always followed
needs fixingCare plans were more personalised, but inspectors found examples where people's recorded preferences were not followed or were not clearly confirmed as a choice. One person had no completed care plan for their first two weeks.
“Although this issue had been addressed at the time of writing this report, a more structured system should be in place to ensure that information about people's needs is always available should it be needed to be referred to.” from the report
Quality checks did not find problems
needs fixingThe home had audits and checks, but these did not reliably identify problems with medicines, staffing, care plans or person-centred care.
“Although there was a clear management structure in place and there were tools available for monitoring, these were not effectively used.” from the report
Complaint responses could be more helpful
minorComplaints were investigated and answered, but some replies could sound harsh. One relative felt senior staff did not always work collaboratively with families to resolve concerns.
“However, the tone of some of these responses could come across as quite harsh and the content would benefit from being softened so people can feel confident with raising concerns.” from the report
- 01How are medicines checked now, and how do you make sure the medicine supplied and the medicine record always match?
- 02How many staff are normally deployed during mornings, evenings, nights and weekends, when the report found people could be waiting or left unsupervised?
- 03How do you make sure every new resident has a completed care plan before staff need to rely on it?
- 04How are risks such as falls, pressure sores and poor eating or drinking recorded, reviewed and acted on?
- 05How are complaints from relatives handled, and how do you make sure replies are collaborative and not perceived as harsh?
This was an unannounced inspection covering all five key questions and the overall rating, with the previous inspection's improvements in care planning, personalised care and activities also reviewed. This explanation was written from the published report of 3 January 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 Wisden Court
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- February 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 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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