Last updated: 10 February 2026
"Staff feel valued with good teamwork and enough people on shift, but unreported serious accidents and staff without training are major concerns."
The management team did not always share reportable incidents with the Care Quality Commission (CQC) and/ or the local authority safeguarding team. For example, we found an incident where a person sustained a head injury which resulted in a hospital visit and this was not reported.
Staff told us, “They have good communication skills, accurate records and strong team and always explain how to do things if we do not understand anything and good teamwork... The managers really care about the residents and staff.”
There were enough staff available to meet people’s care needs... The provider used a staffing calculation tool to ensure safe levels of staffing.
Not all staff had completed the required training. For example, the training completion record showed one staff member had not completed any training courses but had been working at Nelson House for over a year.
Staff were positive about working for the provider and felt well supported by the management team, but the risks we found during this assessment had not been identified by the management team prior to our visit.
They told us, people access regular activities such as swimming, restaurants and shopping. We do a lot of activities with people and go out a lot.
Serious accidents like head injuries not reported to the regulator or council safeguarding team, so risks continue for residents.
we found an incident where a person sustained a head injury which resulted in a hospital visit and this was not reported.
Some staff have no training completed even after working there over a year, leaving gaps in skills.
one staff member had not completed any training courses but had been working at Nelson House for over a year.
Managers missed safety risks like unsafe hot water temperatures and poor follow-up on accidents before the inspection.
staff had checked hot water temperatures monthly, however they had not identified the temperature was not within a safe temperature range... no written evidence the incidents had been investigated.
AI Generated
Last inspected: August 2025
Management Quality
Well-led: Requires improvement
Direct feedback from current and former employees

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