CQC report explained · a residential care home
What the CQC found at 50 Burton Road
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were not always protected from risks, cross-infection or missed medical appointments. Medicines were managed safely and staff knew people well.
- Effective?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Management and quality checks had not reliably identified or fixed problems with care plans, appointments and infection control. Relatives and staff reported improvements since the new registered manager started.
What inspectors found, October 2020
50 Burton Road was rated Requires Improvement; inspectors found safety and management checks were not reliable enough, although medicines and staff knowledge were strengths.
This was a focused inspection after concerns about safety and staffing. Inspectors visited on 10 and 11 August 2020. The first visit was unannounced.
They observed care, spoke with relatives and staff, and reviewed care plans, medicines records, staff recruitment files and management checks. They found that risks were not always assessed properly, some medical appointments had been missed, and infection control rules were not always followed.
The home was rated Requires Improvement overall. Safe and well-led were both rated Requires Improvement. The other areas were not inspected during this visit, so their previous ratings were used in the overall rating.
Medicines
Medicines records matched stock levels and administration was clearly recorded. Guidance was in place for medicines given when needed.
“Stock levels matched records and the administration of medicines were clearly recorded for people.” from the report
Staff knew people
Staff understood people's health conditions, risks and signs of distress, even where care plans were not fully up to date.
“Staff were aware of people's risks, such as specific health conditions or situations which may cause some people to become agitated.” from the report
Safeguarding
Staff knew how to recognise and report abuse, and safeguarding referrals had been made when needed.
“People were protected from abuse.” from the report
Recent improvements
Relatives and staff said management had improved since the new registered manager started. Staff were involved in suggesting and reviewing changes.
“Relatives and staff had positive feedback about the management of the home and the positive changes which had occurred since the registered manager had started.” from the report
Risks and appointments
seriousRisk assessments and care plans were not always accurate or up to date. Some people missed important health appointments, including dental and specialist appointments.
“Risks were not always accurately assessed and planned for and people were not always protected.” from the report
Infection control
seriousStaff did not always wear face masks correctly or consistently. Broken bin pedals also meant some bin lids had to be touched after hand washing.
“People were not always protected from cross contamination.” from the report
Staffing variation
needs fixingThere were enough staff at the time of inspection, but staffing numbers varied. Staff said they could feel stretched when fewer staff were working or people needed more support.
“Some days we are overstaffed and some we are understaffed.” from the report
Weak checks
seriousThe home's quality systems had not fully identified and fixed problems. The provider had an action plan, but some issues remained after new processes were introduced.
“Quality assurance systems had failed to fully implement and embed actions to ensure people's care was sufficiently monitored.” from the report
- 01How are medical and dental appointments now recorded, followed up and checked so that none are missed?
- 02How do you make sure risk assessments and care plans are kept up to date for each person?
- 03What checks now confirm that staff wear personal protective equipment correctly and consistently?
- 04How many staff are scheduled on each shift, and what happens when several people need one-to-one or additional support?
- 05What action from the provider's plan has been completed since this inspection, and what is still outstanding?
This was a focused inspection of Safe and Well-led only; the other key questions were not inspected and their previous ratings were carried over. This explanation was written from the published report of 3 October 2020 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, March 2018
50 Burton Road was rated Good; inspectors found safe, caring and personalised support with good management.
The inspection was unannounced and took place on 13 February 2018. Inspectors observed care, spoke with relatives and staff, and reviewed care records, staff recruitment and training records, medicines systems and quality checks.
The home supported six people with learning disabilities and associated conditions. Inspectors found enough staff, safe medicines systems, suitable staff checks and clean surroundings. People were supported to make choices, stay in touch with relatives, use health services and take part in activities in the community.
Staff were described as kind and respectful. Support plans were detailed and personalised. The manager and provider used audits, feedback and action plans to monitor and improve the service.
The home kept its overall Good rating from the previous inspection in January 2016. All five areas inspected were rated Good. The report did not identify any breached regulations or enforcement action.
Enough staff
Staffing was planned around people's different routines and activities. Inspectors saw people being supported to go out and take part in community activities.
“There are enough staff to support people. Everyone has different activities and there are a lot of community ones as well.” from the report
Safe medicines
Staff were trained and checked as competent. Records showed when medicines were given, and stock balances checked by inspectors matched the records.
“Medicine administration record were kept and we saw that staff signed when people had taken their medicine and kept a running total of the balance after administration.” from the report
Community involvement
People had daily activity plans based on their interests. They were supported with college, holidays, community activities and developing daily living skills.
“Each person had a daily activity plan that was based on their interests and choices.” from the report
Good involvement and oversight
Relatives and representatives were consulted about the service. The manager completed monthly quality audits and kept an action plan for improvements.
“Quality audits were undertaken each month by the registered manager.” from the report
Makaton training not yet complete for everyone
minorMost people used some Makaton to communicate, but a few staff had not completed this training at the time of the inspection. Further training was planned.
“We have training coming up for a few staff that haven't done it yet.” from the report
- 01Which staff have completed Makaton training, and how will my relative communicate with staff who have not completed it?
- 02How will my relative's daily activity plan be created and reviewed around their interests and choices?
- 03How will relatives be told about changes in care, health concerns or healthcare appointments?
- 04How are medicines checked and what would happen if a dose was missed or recorded incorrectly?
- 05How will the home involve me in decisions if my relative cannot communicate their views verbally?
This was an unannounced comprehensive inspection covering all five CQC questions, including care, records, staffing, medicines and quality monitoring. This explanation was written from the published report of 20 March 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.
Every inspection of 50 Burton Road
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- October 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Goodstayed GoodSafe: GoodWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Registered with the Care Quality Commission on 8 May 2014.
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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