CQC report explained · a residential care home
What the CQC found at Wistaston House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed safely, including incomplete records, limited checks of creams and a medicines room temperature above 28°C. Risk information and fire and safety check records were also not always up to date.
- Effective?
- Good
- People's outcomes were consistently good and the rating improved from Requires Improvement. Staff had induction, training and support, and people were supported to access healthcare and eat and drink enough.
- Caring?
- Good
- People and relatives were positive about the care. Staff respected privacy and dignity, encouraged independence and supported people to make decisions about their lives.
- Responsive?
- Good
- People had choice over their days and took part in activities and community life. However, communication needs were not always recorded clearly enough for newer staff.
- Well-led?
- Requires improvement
- The manager and staff showed a person-centred culture and had introduced an electronic records system. However, audits had not found all the shortfalls, and records about care, risks and safety checks were not consistently reliable.
What inspectors found, November 2023
Wistaston House rated Requires Improvement; inspectors found kind, personalised care but medicines, risk records and checks were not always safe or reliable.
Inspectors visited on 5, 7 and 8 September 2023. They spoke with all six people living at the home, five relatives and 10 staff. They also observed care, reviewed six care records, five staff files and records about how the home was managed.
People told inspectors they felt safe and were positive about the care. Staff treated people with dignity, encouraged independence and supported people to make choices, use the community and keep in touch with relatives. The home was rated Good for effective, caring and responsive care.
There were important weaknesses in safety and management. Medicines records and checks were not always correct. Some risk information and care plans were out of date. Fire and safety checks were not consistently recorded, and the provider's audits had not found all these problems.
The overall rating remains Requires Improvement, as it was at the previous inspection published in November 2019. The home must send an action plan, and the CQC will monitor progress and work with the provider and local authority.
Kind and respectful care
People and relatives spoke positively about the care. Staff respected privacy and dignity and supported people as individuals.
“People were treated with dignity and respect by staff who were knowledgeable about their support needs.” from the report
Choice and independence
People were encouraged to make choices, prepare food, complete household tasks and use the community as independently as possible.
“People were encouraged to have choice and control of their lives.” from the report
Positive relationships
Inspectors saw positive relationships between staff and people. Relatives said staff helped people keep regular contact with them.
“Relatives were complimentary regarding the service and support given to people.” from the report
Staff training and recruitment
Recruitment checks were robust. Staff completed induction and training, including improvements in autism training since the previous inspection.
“Recruitment processes were robust. Checks were carried out to ensure suitable staff were employed.” from the report
Improving leadership
The new manager had introduced an electronic system and had begun making improvements. Staff and people gave positive feedback about changes since the manager started.
“The provider had implemented an electronic management system to support improvement to support plans, record keeping and governance.” from the report
Medicines were not always managed safely
seriousMedicine administration records were incomplete or incorrect, and routine checks had not always found the problems. The medicines room was above 28°C, which put medicines at risk of becoming unsafe.
“Medicines were not always managed safely.” from the report
Out-of-date risk information
seriousSome risk assessments and positive behaviour support plans did not reflect changes in people's needs. This meant staff did not always have current guidance.
“This meant that staff did not have up to date guidance on how to appropriately and safely support the person.” from the report
Safety checks were not reliably recorded
needs fixingWeekly and monthly fire and property safety checks were not consistently recorded. The provider's audits had not identified all the problems found by inspectors.
“Checks relating to fire and safety of the property were not robust.” from the report
Communication records needed updating
needs fixingCommunication needs were not consistently recorded in support plans. The CQC recommended that the manager review and update these plans.
“This meant that newer staff did not have the guidance they needed to effectively communicate with a person.” from the report
Some decision-making records were incomplete
needs fixingCapacity assessments and best-interest decisions did not always follow the Mental Capacity Act principles. Records did not always show advocacy or family involvement.
“Capacity assessments and best interest decisions did not always follow the principles of the Mental Capacity Act.” from the report
- 01What changes have you made to medicines records, stock checks, cream checks and temperature monitoring since the inspection?
- 02How do you make sure risk assessments and positive behaviour support plans are updated when people's needs change?
- 03Can you show us recent records of weekly and monthly fire and property safety checks?
- 04How are communication needs recorded so that new staff know how best to communicate with each person?
- 05What progress has been made with the action plan requested by the CQC, and has the new manager's registration application been completed?
This was a full inspection covering all five key questions and infection prevention and control; inspectors reviewed the care provided and the management of the home. This explanation was written from the published report of 17 November 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, March 2022
Wistaston House was inspected but not rated; inspectors found good infection control and support during COVID-19.
This was a targeted inspection on 8 February 2022. Inspectors checked infection prevention and control during the COVID-19 pandemic. They also asked about staffing pressures and whether these affected the home.
Inspectors were assured that the home was using PPE safely, testing people and staff, supporting safe visits, and following shielding and social distancing rules. They found the home clean and hygienic, with cleaning schedules and extra cleaning processes.
The home supported six people at the inspection and could support up to seven. The inspection did not give an overall rating or ratings for the care questions. Safe was recorded as inspected but not rated.
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infections, including safe PPE use, testing and outbreak planning.
“We were assured that the provider was using PPE effectively and safely.” from the report
Clean environment
The home was clean and hygienic, with cleaning schedules, PPE stations and extra processes for sanitising areas.
“The home was clean and hygienic. Cleaning schedules were in place and PPE stations placed around the home.” from the report
Support for people and relatives
The report says people and relatives were helped to understand COVID-19 policies, isolation processes and ways to stay safe.
“They supported people and their relatives to understand the policies and procedures surrounding protection against COVID 19, the isolation processes and how the service could help them to keep people safe.” from the report
Visiting and communication
Relatives spoke positively about visits and communication with the home.
“Relatives spoke positively about visiting and the communication from the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing staffing pressures, and have they affected people's care?
- 02How often are people using the home and staff tested for infections now?
- 03What PPE supplies and cleaning arrangements are currently in place?
- 04How are visits managed now, including visiting during an outbreak or when someone needs to isolate?
- 05When was the infection prevention and control policy last reviewed?
This was a targeted inspection of infection prevention and control and COVID-19-related staffing pressures; it did not rate the other care questions or the service overall. This explanation was written from the published report of 2 March 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 Wistaston House
2 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- November 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2022Inspected but not ratedSafe: Inspected but not rated
- November 2019Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019
Registered with the Care Quality Commission on 25 January 2019.
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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