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Symphony House Nursing Home Requires improvement

We are carrying out a review of quality at Symphony House Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary

Overall summary & rating

Requires improvement

Updated 21 November 2020

About the service

Symphony House is a residential care home that can provide personal and nursing care for older people. The service is registered care to a maximum of 25 people. At the time of inspection 24 people were living at the home.

People’s experience of using this service and what we found

The registered manager had failed to notify the commission when people using the service had died. The registered person is required to notify the commission when people die without delay. 21 deaths had not been reported to the commission since October 2018.

There were systems in place to assess the quality and safety of the service. However, the provider lacked oversight by failing to ensure that notifications were sent to the commission.

People using the service were safe. Staff were trained to safeguard people and knew how to keep them safe from risks to their safety and well-being. The registered manager had arrangements in place to maintain and service the premises and equipment to make sure they were safe. The premises were clean and tidy. Staff followed good practice when providing care and when preparing and handling food which reduced infection risks.

There were enough trained and competent staff to support people. The registered manager carried out safe recruitment checks on staff before they started work to make sure they were suitable for the role. They met with staff regularly to keep them up to date with any changes at the service.

Medicines were safely managed. Systems were in place to regularly check staff competency when administering medications.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 24 September 2019)

Why we inspected

The inspection was prompted in part due to concerns about the lack of statutory notifications received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed following this focused inspection from good to requires improvement. This is because there was a breach of regulations. A breach of any regulation is a ratings limiter. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the well-led section of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Symphony House Nursing Home on our website at


We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach of regulation in relation to notifications of death of a service user at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas



Updated 21 November 2020

The service was safe.

Details are in our safe findings below.



Updated 21 November 2020



Updated 21 November 2020



Updated 21 November 2020


Requires improvement

Updated 21 November 2020

The service was not always well-led.

Details are in our well-led findings below.