CQC report explained · a nursing home
What the CQC found at Woolton Grange Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found enough staff overall, safe medicines, suitable safeguarding training and a clean, well-maintained building. One person reported not enough staff at night, and the acting manager said staffing was being increased.
- Effective?
- Good
- Staff had effective training and people received support with their health needs. The home worked with health professionals and used detailed assessments. Inspectors recommended improving the quality of one-to-one supervision meetings.
- Caring?
- Good
- People and relatives described staff as caring and welcoming. Inspectors saw people being listened to and treated with dignity and respect, with staff responding to concerns.
- Responsive?
- Good
- Care plans were detailed and person-centred, and the home had improved its response to pressure sore risks and changing health needs. Activities were varied, but people's views were divided and some people said they were bored or wanted more opportunities to go out.
- Well-led?
- Good
- Quality checks and audits had become more effective, and people, staff and visiting professionals spoke positively about the acting manager. Some statutory notifications had not always been sent to the CQC promptly.
What inspectors found, December 2018
Rated Good; inspectors found safer staffing, caring support and stronger management, but activities and some care records needed attention.
Inspectors visited on 31 October, 7 November and 14 November 2018. The first visit was unannounced. They spoke with people living in the home, relatives, staff and visiting professionals, and checked care plans, staff records, training and management audits.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff overall, safe medicines, a clean and safe building, detailed care plans and kind, respectful relationships.
There had been clear improvement since July 2017. Earlier problems with staffing and quality monitoring had been put right, so the home was no longer breaching those regulations. The deputy manager was acting manager and had applied to become registered with the CQC.
Inspectors still found some areas to improve. One person said there were not enough staff at night, one turning chart had significant gaps, and feedback about activities was mixed. Staff supervision records also did not show enough discussion about development and support.
Improved staffing
Inspectors found a calmer home with enough staff overall to meet people's needs promptly. This was a clear improvement from the previous inspection.
“There were enough staff to meet people's needs in a timely manner.” from the report
Kind and respectful care
People described staff positively, and inspectors saw staff listening to people, checking their wellbeing and responding kindly when they were worried.
“People were listened to and were treated with dignity and respect.” from the report
Detailed care planning
Care plans included people's histories, preferences, health needs and risks. They were reviewed and updated when people's needs changed.
“Each person had a detailed and person-centred care plan.” from the report
Safer quality monitoring
The provider had strengthened its compliance team and the home used regular audits and meetings to identify problems and make improvements.
“The systems used to assess and monitor the safety and quality of the service was now more robust.” from the report
Better health support
The home worked with health and social care professionals through regular meetings. Inspectors found improvement in responding to pressure sore risks and other changing health needs.
“The service was now responsive to people's health care needs.” from the report
Food and dietary support
People said they enjoyed the food. The kitchen was clean and stocked, and records covered people's dietary needs, likes and dislikes.
“The kitchen was clean and well stocked.” from the report
Night staffing
needs fixingOne person said there were not enough staff at night, particularly later in the evening and overnight. The acting manager agreed and said the home was increasing staffing from three to four people.
“One person told us that there is not enough staff on duty at night time.” from the report
Incomplete turning record
needs fixingOf four turning charts checked, one had significant gaps showing that care had not always been recorded. Inspectors asked the acting manager to review how these records were checked.
“Three were fully completed and one had significant gaps where it had not been recorded when care was provided or offered.” from the report
Activities did not suit everyone
minorSome people enjoyed the activities, but others said there was little to do, that they were bored or wanted to go out more. The home had not recently reviewed whether activities matched people's preferences.
“Feedback overall about activities and having things to do at the home was divided.” from the report
Supervision records
minorSupervision meetings took place, but the records were repetitive and did not show recent discussion about staff development, effectiveness or support. Inspectors recommended reviewing this process.
“There was no recent evidence that feedback had been sought from staff members, or that their effectiveness or their personal development had been discussed.” from the report
Late notifications
minorThe home sent the required notifications to the CQC, but not always within the expected time. The acting manager said they had not understood which events had to be reported.
“The acting manager had sent through appropriate notifications, but these had not always been in a timely manner.” from the report
- 01How many staff are now on duty in the late evening and overnight, and how is this adjusted when people's needs change?
- 02How are turning charts and other records for pressure sore prevention checked each day?
- 03How do you find out what activities each person enjoys, including opportunities to go outside?
- 04What has changed in staff one-to-one supervision since inspectors recommended improving it?
- 05Who is the current registered manager, and what is the position on the acting manager's application to register with the CQC?
This was an inspection of all five key questions, covering the care provided, the premises, staffing, people's experiences and how the home was managed. This explanation was written from the published report of 18 December 2018 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, November 2017
Rated Requires Improvement; inspectors found kind and personalised care, but staffing, medicines records and quality checks were not reliable enough.
Inspectors visited on 13 and 21 July 2017. The first visit was unannounced. They spoke with people living at the home, relatives, staff and health professionals. They also checked care files, medicines records, staff recruitment files, the building and the care being provided.
The home was rated Good for Effective, Caring and Responsive. People generally received kind care, had personalised care plans, were supported with their health and had food and activities they enjoyed.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found too few staff at busy times, delays in responding to people's needs, missed medicines signatures and quality checks that had not identified problems.
The overall rating was Requires Improvement. The report says the home breached Regulation 17 on good governance and Regulation 18 on staffing. The provider was required to send CQC a report explaining what action it would take.
Kind and dignified care
Inspectors saw staff treating people with kindness and dignity. Staff adapted their approach to people's different preferences and needs.
“We saw that staff treated people with kindness and in a dignified manner.” from the report
Personalised care plans
Care plans included people's preferences, daily routines and personal information. They were reviewed monthly and relatives could be involved.
“The care plans were person centred and gave importance to people's individual needs and preferences.” from the report
Health support
Relatives and visiting health professionals said people's health needs were dealt with promptly. Referrals were made quickly when extra support was needed.
“People were supported with their healthcare needs promptly and effectively.” from the report
Food and nutrition
People and relatives were positive about the food. The home planned for different dietary needs and offered alternatives when requested.
“We saw that the kitchen was clean and food was stored safely.” from the report
Too few staff at busy times
seriousInspectors saw staff were overstretched in the morning. People experienced delays with getting up, using the toilet and receiving other support.
“There was not sufficient numbers of staff available at the home to meet people's needs in a timely manner.” from the report
Medicines recording
needs fixingInspectors found at least 12 missed signatures on one medicines record. The stocks suggested the medicines had been given, but this had not been recorded.
“We saw that there were at least 12 missed signatures for people's medication on the 10 July.” from the report
Quality checks missed problems
seriousThe home's medicines audits did not identify missed signatures or incorrect stocks. The provider's own process for recording medicines errors had not been followed.
“The systems in place to assess, monitor and improve the quality and safety of the service were not always effective.” from the report
Some areas needed cleaning and repair
minorSome window ledges, corridors and staircases were not clean. Inspectors also found clutter, poor radiator covers and tired decoration in some bedrooms.
“There were areas of the home's environment that still required improvement and all areas of the home were not clean.” from the report
Limited community activities
minorFeedback said there were not enough activities outside the home. The manager said a minibus was being arranged for summer outings.
“There was a theme of people not accessing the community.” from the report
- 01How many staff are now scheduled during the morning, and how do you adjust this when more people need two staff members?
- 02What checks now make sure call bells, toileting requests and help with getting up are answered promptly?
- 03How do you make sure every medicine dose is recorded and missed signatures or stock errors are acted on?
- 04What changes have been made to the audit system since the inspection, and how do you know it is finding problems?
- 05What community outings and activities are now available for people who want to leave the home?
This was a comprehensive inspection covering all five questions, with visits on 13 and 21 July 2017; it was the first inspection since the new owner took over. This explanation was written from the published report of 28 November 2017 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 Woolton Grange Nursing Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Inspected but not ratedSafe: GoodResponsive: Good
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2012
Registered with the Care Quality Commission on 5 March 2012.
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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