CQC report explained · a residential care home
What the CQC found at 46 Bath Road
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2018
Rated Good; inspectors found safe, kind and personalised care, but staffing vacancies limited some people's outings.
This was an unannounced inspection on 21 and 29 August 2018. The inspector reviewed three people's records and records about the home, spoke with staff, managers, relatives and health professionals, and observed people receiving care.
All five areas were rated Good: safe, effective, caring, responsive and well-led. Medicines were being managed safely, staff understood people's needs, and people were treated with dignity and respect.
The home had improved from Requires Improvement at the previous inspection in July 2017. Earlier problems with medicines, fire drills, temperature checks and quality checks had been addressed, and the legal requirements had been met.
There were still three staff vacancies. Bank and agency staff helped cover shifts, but people could not always go out because some staff were unfamiliar with their needs or could not drive.
Safer medicines
Medicine information was updated for each person. A second staff member checked medicines and daily stock checks were completed.
“This meant people could be assured their medicines were managed safely and they were receiving them at the appropriate times.” from the report
Personalised support
Staff knew people's preferences, routines, histories and communication methods. People were involved in everyday choices about food, clothing and how to spend their time.
“Staff were knowledgeable about the people they supported.” from the report
Kind relationships
People appeared relaxed with staff and were treated with dignity. The home supported friendships, family contact and links with the local community.
“All staff there have always been very caring and showed genuine warmth for people” from the report
Improved oversight
The home had introduced regular audits, action plans and new recording systems. The report found that previous safety and quality problems had been addressed.
“At this inspection we found improvements had been made, for example, in medicines management and completing the checks as described above.” from the report
Staff vacancies
needs fixingThere were three staff vacancies and a heavy reliance on bank and agency staff. When temporary staff were unfamiliar with people, outings could not always take place.
“This meant people could not always go out if staff were not familiar to the service and knew the people well.” from the report
Missed one-to-one hours
needs fixingTwo people had additional one-to-one hours for social activities, but they received fewer hours than planned in the months reviewed. The manager was keeping a record of the shortfall and planned to address it.
“There were shortfalls in the hours that people were receiving because there was not always a member of staff with the skills to support them.” from the report
- 01How many staff vacancies are there now, and how are you reducing reliance on bank and agency staff?
- 02How do you make sure temporary staff know each person's needs, communication methods and routines before working alone?
- 03Have the missed one-to-one social activity hours been provided, and how are planned outings monitored now?
- 04How often are medicines, hot water, food temperatures and fire safety checks reviewed?
- 05Have all care plans been updated so they reflect each person's current home, needs and relationships?
This was an unannounced inspection covering all five CQC questions, following a Requires Improvement rating in July 2017. This explanation was written from the published report of 18 September 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, August 2017
Rated Requires Improvement; inspectors found kind, person-centred care, but medicines and quality checks were not always safe or effective.
This was an unannounced inspection on 26 and 27 July 2017. One inspector spoke with people, staff, the manager, relatives and health professionals. They reviewed care records, medicine records, staffing information, policies and training records, and observed care.
The home supported up to six people with learning disabilities. Inspectors found caring, effective and responsive support. Staff knew people well, treated them with respect, supported activities and involved people and relatives in care decisions.
The overall rating was Requires Improvement. Medicines were not always managed safely. Some health and safety checks, including fire drills, hot water and food temperature checks, were not completed as required. The provider's own checks had not found these problems.
The previous inspection in May 2015 rated the home Good. The report says some problems were dealt with shortly after this inspection, but the provider was still required to send an action report and the CQC said it would check that action was taken.
Kind and respectful staff
People appeared comfortable with staff, who knew their likes, dislikes, routines and personal histories. Staff supported people with patience and respect.
“People were treated with kindness and compassion by staff.” from the report
Individual choices
People were involved in decisions about food, clothes, activities and where they spent their time. Staff used different methods to help people who could not communicate verbally.
“Staff sought to understand what was wanted and how they could help people.” from the report
Good activities and community links
People took part in activities based on their interests, including trips, arts and crafts, coffee mornings, church services and day services.
“From the conversations with people, activities were organised based on each person's interests and hobbies.” from the report
Staff consistency and support
There were sufficient staff and familiar bank staff were used. Staff received training, handovers and support relevant to people's needs.
“There were sufficient, skilled and experienced staff working at 46 Bath Road.” from the report
Medicine records
seriousStaff did not always record when liquid medicines and creams were opened. Some handwritten medicine entries were not checked and one medicine change was not dated. One person was given a drink that could interact with their medicine because the guidance was missing.
“People's medicines were not always managed safely.” from the report
Weak safety monitoring
seriousSome required checks had not been completed, including hot water, food temperatures and first aid boxes. Four staff had not taken part in a fire drill within the required period.
“The checks that were being done on the quality and safety of the service were not always effective.” from the report
Quality checks missed problems
seriousThe provider's checks did not identify the medicine and health and safety shortfalls. Fluid charts were completed but staff did not add up intake to help identify when more fluids were needed.
“These checks had also not identified medicines such as liquids had a clear date of when opened.” from the report
People's suggestions not always followed up
needs fixingOnly one house meeting had taken place that year, although meetings had previously been planned four times a year. Staff could not remember whether some requested activities had happened.
“There was a risk that if suggestions were not acted upon people would not continue to voice their opinions or make suggestions.” from the report
- 01What has changed since the inspection to make sure liquid medicines and creams are dated when opened?
- 02How are medicine changes and handwritten Medicine Administration Record entries checked now?
- 03When was the last fire drill, and how do you make sure all staff complete drills at the required intervals?
- 04How are hot water, food temperatures, first aid boxes and fluid charts checked and reviewed by management?
- 05How do you record and follow up people's suggestions from house meetings?
This was an unannounced inspection covering all five CQC questions and reviewing the overall quality and safety of the home. This explanation was written from the published report of 26 August 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 46 Bath Road
3 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 11 November 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of South Gloucestershire
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 £1,020 to £1,280 a week. 32 can care for a couple. 11 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.