CQC report explained · a residential care home
What the CQC found at Barchester Tower
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable staffing, safeguarding training, infection control measures and risk assessments. They found four medicines recording errors, but established that medicines had been given as prescribed.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found regular staff support, care planning reviews and management audits. The home sought feedback and worked with health professionals.
What inspectors found, February 2023
Rated Good; inspectors found safe, kind care and improved management, but medicines records and some care documentation needed attention.
This was an unannounced focused inspection on 5 January 2023. One inspector spoke with people, staff, the registered manager, relatives and health professionals. They observed care and reviewed records, medicines, recruitment files and management checks.
The home was rated Good for Safe and Well-led. Inspectors found that people were protected from abuse, infection risks were managed, staffing was suitable and medicines were generally given as prescribed. People and relatives gave positive feedback about the care.
There were some shortfalls. Four medicines record errors were found, although inspectors could establish that the medicines had been given as prescribed. One accident was missing from the analysis, and some care plans did not include details of what could trigger anxiety or distress.
The previous rating was Requires Improvement, published in December 2020. The provider had completed an action plan, and inspectors found enough improvement for the service to be no longer in breach of the regulation identified previously. The overall rating changed to Good, partly using ratings from the earlier inspection because not all areas were inspected this time.
People felt safe and cared for
People told inspectors they had no concerns and felt well cared for. Relatives and health professionals also gave positive feedback.
“People told us they had no concerns and felt well cared for.” from the report
Infection control
The home had infection control arrangements, used protective equipment appropriately and kept the environment clean and tidy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Choice and independence
Staff offered people choices and supported them to spend their time as they wished while remaining safe.
“We observed staff offering people choice throughout the day. People were supported to remain as independent as possible whilst remaining safe.” from the report
Suitable staffing
Inspectors found staffing levels suitable for people's needs. Recruitment checks and staff induction arrangements were in place.
“Staffing levels were appropriate to meet people's needs.” from the report
Medicines records
needs fixingFour errors were found on medicines administration records after the home changed pharmacy. Inspectors said these were documentation errors and found that medicines had been given as prescribed.
“We found 4 errors on the MAR. These errors were in relation to documentation only and we were able to determine that medicines had been given as prescribed.” from the report
Care plans did not record some triggers
needs fixingCare plans for people who could become anxious or agitated did not always describe their specific triggers. The manager said this information would be added.
“Care plans for people who may become anxious or agitated did not include details of specific triggers for people.” from the report
Accident analysis
minorOne accident from September 2022 had not been included in the accident analysis. Inspectors said this was an oversight and had not caused further risk.
“We found one accident which had not been included in the analysis in September 2022.” from the report
Some checks were not recorded
minorThe registered manager carried out daily checks around the home, but these checks were not always documented.
“The registered manager completed daily walkaround checks of the home, although these were not always documented.” from the report
- 01What checks are now in place to prevent errors on medicines administration records?
- 02How will you make sure each person's triggers for anxiety or distress are recorded in their care plan?
- 03How are accidents and incidents analysed, and how do you make sure none are missed?
- 04How are daily checks of the home recorded and followed up?
- 05What were the previous ratings for Effective, Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 3 February 2023 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, December 2020
Barchester Tower was rated Requires Improvement; inspectors found infection-control gaps despite safe staffing, medicines and kind care.
Inspectors made unannounced visits on 04 November 2020 and 13 November 2020. They spoke with people, staff, relatives and health and social care professionals. They reviewed care records, medicines records, recruitment records and management documents.
The main concern was infection prevention and control. There was no cleaning schedule for areas such as touch points. Staff did not know all the required arrangements for COVID-19 waste, and plans were not clear for supporting people who could not isolate safely.
The home had enough staff, managed medicines well and understood people's risks. Inspectors also found kind relationships and a positive culture. However, quality checks and some records had not identified or dealt with all the problems found.
The overall rating changed from Good to Requires Improvement. Safe and Well-led were both rated Requires Improvement. This was a focused inspection of those two areas, while the other ratings were carried forward from the previous comprehensive inspection.
Enough staff
Inspectors found enough staff on each shift and saw staff respond to people promptly.
“Throughout the inspection we saw staff attending to people in a timely way.” from the report
Medicines managed well
Staff were trained and assessed before giving medicines. Medicines were stored securely and given at suitable times.
“People received their medicines at the right times to ensure choice, safety and effectiveness.” from the report
People were known well
Staff understood people's needs and inspectors saw warm, caring relationships between staff and people living in the home.
“We observed an open and caring relationship between people and staff.” from the report
Risks understood
Staff could explain how they supported people's mobility and other health needs safely.
“Staff were aware of the risks associated with supporting people and were able to tell us how these were managed.” from the report
Infection-control gaps
seriousThere was no cleaning schedule for touch points. Staff were not clear about COVID-19 waste arrangements, and contingency plans did not explain how to support people who could not isolate.
“These lack of guidance and processes meant the provider could not be assured that IPC procedures were following government guidance and best practice.” from the report
Quality checks missed problems
needs fixingThe home's audits did not identify all the infection-control issues found by inspectors. A cleaning schedule identified as needed in May 2020 had still not been implemented.
“The system had not identified all of the concerns we found in relation to IPC.” from the report
Incomplete records
needs fixingSome medicine records had missing signatures or unclear information. A handwritten entry had not been checked by a second staff member, as the home's policy required.
“Improvements were needed to some aspects of record keeping.” from the report
- 01What cleaning schedule is now in place for touch points and other areas, and how is completion checked?
- 02How are COVID-19 waste and clinical waste stored and disposed of, including the required waiting period?
- 03What is the current plan for supporting someone who is symptomatic and walks with purpose or cannot isolate in their room?
- 04How do you check that handwritten medicine records, conflicting instructions and cream applications are recorded correctly?
- 05What actions were included in the improvement plan requested by CQC, and has the home had its follow-up inspection?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 16 December 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.
Every inspection of Barchester Tower
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 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.
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Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
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