Last updated: 10 February 2026
"Staff feel supported with positive activities feedback, but poor night staffing, unsafe medicines and weak leadership hold it back."
Medicines were not always managed and administered safely. We found breaches in regulations linked to safe care and treatment, governance and staffing. Risks to people were not always well managed or planned for.
Most feedback from staff indicated they felt supported. However, we found staff had not always been provided with the training to complete their jobs safely. Staff felt that the registered manager had made improvements and encouraged them to speak up but evidence of confidence to raise issues was lacking.
Through the night only 2 staff members were on duty. The communication between them was via their personal mobile phones and staff told us that when in bedrooms supporting people, they were unable to hear the call bells of other people.
Senior staff had not received an assessment of their competency in administering medicines for over a year. Staff did not know if anyone using the service were subject to a Deprivation of Liberty Safeguards order (DoLS).
The registered manager and nominated individual had poor management and oversight of essential areas of care delivery. The registered manager left their post after our second inspection day.
We received positive feedback regarding activities that were organised within the home. Staff told us that they were generally too busy, particularly in the morning, to engage in activities.
Not enough staff at night, only two on duty so they cannot hear call bells and falls go unwitnessed.
Through the night only 2 staff members were on duty... staff told us that when in bedrooms supporting people, they were unable to hear the call bells of other people, including emergency bells.
Medications not handled safely, with wrong storage and staff missing training on basics like refrigeration.
Medicines was not stored at the correct temperature. This included medicines which required refrigeration. Senior staff had not received an assessment of their competency in administering medicines for over a year.
Poor leadership oversight, with the manager unable to spot risks or issues independently and then quitting after inspection.
The registered manager and nominated individual had poor management and oversight of essential areas of care delivery. The registered manager left their post after our second inspection day.
AI Generated
Last inspected: January 2025
Management Quality
Well-led: Requires improvement
Direct feedback from current and former employees

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