CQC report explained · a residential care home
What the CQC found at Wolston Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2023
Rated Good overall; inspectors found kind, effective care, but medicines and some risk records were not always safe.
This was an unannounced focused inspection on 11 December 2023. Inspectors spoke with 8 people, 6 staff members, the manager and the provider. They reviewed 9 people's care records, medicines records, staff recruitment files and quality checks.
The overall rating was Good. Effective and well-led were rated Good. Safe remained Requires Improvement because some medicines were not managed or recorded correctly, and some individual risks were not recorded consistently. The report says the home was no longer in breach of the regulations found at the previous inspection.
People told inspectors they felt safe and were pleased with the care. Staff were described as kind and attentive, and inspectors found enough staff. The home was clean, people had access to health care, and managers had made improvements to audits and action plans.
Fire safety improvements were still being managed, including replacing fire doors and improving signs. The manager said action had also been taken after the inspection to address medicines, risk records and other recording issues.
Kind and attentive staff
Staff knew people well and were described as kind and attentive. People spoke positively about the care and said they felt safe.
“People were supported by staff who knew them well and staff were kind and attentive.” from the report
Enough suitable staff
Inspectors found enough staff to meet people's needs. Recruitment included checks such as references and DBS checks.
“There were enough staff on duty to support and meet people's needs.” from the report
Improved management checks
The provider and manager had introduced more regular and structured checks. These produced action plans, and inspectors saw evidence that actions had been completed or were being progressed.
“Completed audits resulted in action plans and those actions were compiled onto a 'master' action plan for the registered manager to work from.” from the report
Good support with health and daily needs
Staff supported people to access health services and followed advice about modified diets and choking risks. Care plans were updated when people's needs changed.
“People's needs were assessed and care and support was delivered in line with current standards to achieve effective outcomes.” from the report
Medicines were not always managed safely
seriousA pain patch was not applied as directed, a controlled medicine was not accurately counted, and improvements were needed to labelling and discarding medicines. The manager said these matters were addressed after the visit.
“People were supported to receive their medicines in a way that was not always safe.” from the report
Some risk records were inconsistent
needs fixingSome people's risks were better recorded than others. Inspectors said more guidance was needed for risks including diabetes, catheter care and fire safety for people who smoked or used electronic cigarettes.
“We found no evidence of harm to people, but risks to some people could be further reduced.” from the report
Fire safety work was still under way
needs fixingThe provider was still updating or replacing fire doors and improving signs. The fire authority was being kept informed and the home had increased fire drills and fire warden training.
“The provider had timescales to make improvements to the fire safety of the home.” from the report
Some people wanted more meal choice
minorMost people enjoyed their meals, but some said there was not always a choice. Meal feedback was discussed at regular meetings.
“Most people told us they enjoyed their meals, some people said there was not always a choice.” from the report
- 01What checks now confirm that pain patches are applied as directed and controlled medicines are counted accurately?
- 02How will you keep risk assessments up to date for diabetes, catheter care and people who smoke or use electronic cigarettes?
- 03What is the timetable for replacing or updating the fire doors and signs, and what has been completed?
- 04How do you make sure people have a meaningful choice of meals?
- 05How are the new medicine and record-keeping audits checked to make sure improvements continue?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating was calculated using previous ratings for the questions not inspected. This explanation was written from the published report of 30 December 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, January 2023
Rated Requires Improvement; inspectors found staffing and support strengths, but ongoing risks with medicines, premises, infection control and governance.
This was an unannounced focused inspection over two days. Inspectors spoke with people, relatives, staff and a health professional. They observed care and reviewed care, medicines, maintenance, staffing and management records.
The home had enough staff and people were generally supported in a timely way. Staff received training and worked with health professionals. People and relatives spoke positively about the care, staff and food.
However, inspectors found important safety problems. These included unsafe fire risk management, medicines not always stored or given safely, areas that were not clean, and weak checks on risks and incidents. The home remained in breach of two regulations and was rated Requires Improvement overall, as well as for Safe, Effective and Well-led.
Enough staff
Inspectors found enough staff to meet people's needs safely, and people were supported without staff appearing rushed.
“There were enough staff to meet people's needs safely.” from the report
Training and induction
Staff received induction, ongoing training and supervision. Training had been added for staff supporting people with mental health conditions.
“Staff received relevant, ongoing refresher training for their roles.” from the report
Health support
The home worked with GPs, district nurses and other health professionals to support people's health and wellbeing.
“Staff worked with other health professionals to help ensure people received support that met their health needs.” from the report
Food and choice
People had choices about meals and where to eat. Relatives were generally satisfied with the food, and special diets were shared with kitchen staff.
“People were provided with regular drinks and snacks and were given choices about where they wanted to eat their meals.” from the report
Positive relationships
People and relatives described staff as friendly, attentive and welcoming. Relatives said communication with the home was good.
“People and their relatives told us about their relationship with staff, and communication with the home, was good.” from the report
Medicines
seriousSome medicines were stored above the recommended temperature, some topical medicines were not recorded, and one prescribed medicine was not given when records showed it was needed.
“People did not always receive their prescribed medicines.” from the report
Cleanliness and infection control
seriousSome areas were not clean and some parts were not in good enough repair to be cleaned properly. Legionella prevention measures were also not effective.
“Some areas of the home were not clean.” from the report
Weak quality checks
seriousAudits had not identified several safety problems. The home also had not properly analysed falls or three infectious disease outbreaks to reduce the chance of them happening again.
“Systems and processes had failed to identify where the storage of medicines needed to be improved, and that people were not always receiving their prescribed medicines.” from the report
Fluid monitoring
needs fixingFluid charts did not consistently show the total amount taken or whether staff needed to offer more. This could increase the risk of dehydration.
“Fluid charts did not always document the amount of fluid offered to people and whether their recommended daily intake of fluid was being met to prevent de-hydration.” from the report
- 01What work has been completed to make the fire doors, fire exits and fire risk assessments safe, including the risks from smoking and the laundry area?
- 02How are you now checking medicine storage temperatures and recording every prescribed medicine, including topical and as-required medicines?
- 03What changes have you made to cleaning, repairs and Legionella controls since the inspection?
- 04How do you now review fluid charts each day and act when someone is not drinking enough?
- 05What action was taken in response to the CQC warning notice, and what evidence can you show that the problems have been fixed?
This was a focused inspection of Safe, Effective and Well-led; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 12 January 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.
Every inspection of Wolston Grange
6 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2023Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- January 2023Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2019Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
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.
- May 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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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At least 100 live-in carers within about an hour of Warwickshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
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