CQC report explained · a residential care home
What the CQC found at Bearwardcote Hall Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, July 2019
Bearwardcote Hall Residential Home was rated Good overall, but inspectors found that leadership and checking systems required improvement.
This was an unannounced planned inspection on 19 June 2019. Inspectors spoke with six people, four relatives and five staff. They reviewed care records, medicines records, recruitment and supervision files, and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines practice, suitable training, kind interactions, personalised care plans and a range of activities. The home also supported people's health needs and dietary choices.
Well-led was rated Requires Improvement. Some audits did not identify missing or outdated risk information, incomplete care planning checks or cleaning and maintenance issues. End of life care plans were also not fully embedded.
The overall rating remained Good. Effective improved from Requires Improvement at the previous inspection, while Well-led fell from Good to Requires Improvement.
Kind relationships
Inspectors saw staff treating people with kindness and respect. People were encouraged to make their own decisions about daily life.
“We observed kind and respectful interactions with people encouraging people to make their own decisions in their daily choices.” from the report
Improved training and consent
Staff had training suited to their roles, including additional health-related training. The home had improved its capacity assessment records since the last inspection.
“At our last inspection we recommended the provider consider current guidance on capacity assessments. The provider had made improvements.” from the report
Choice and activities
People could choose meals and how to spend their day. The home provided activities and had responded to requests for more practical activities.
“People had been supported to access a range of activities, these were provided by different visiting people or ex staff who had a varied programme of activities.” from the report
Management checks missed problems
needs fixingSome audits did not identify issues that needed action. These included outdated care records, missing risk information and weaknesses in cleaning and maintenance checks.
“However, some audits were not in place or used affectively.” from the report
Some risk information was not updated
needs fixingSome risk assessments had not been updated after people's health needs changed or after a fall. There were also no diabetes risk assessments covering action for blood sugar readings outside safe levels.
“Some people had diabetes, there was no risk assessments to reflect the action which should be taken should a person have blood sugar reading above or below the safe reading for that person.” from the report
End of life plans incomplete
needs fixingEnd of life care plans were not yet fully part of the care planning process. The provider agreed to review and embed this work.
“End of life care plans had not been fully embedded in the care planning process.” from the report
- 01How do you now check that care plans and risk assessments are updated when a person's needs change or after a fall?
- 02What diabetes risk assessments are now in place, and what action would staff take if blood sugar readings were outside the safe range?
- 03Have end of life care plans been completed and discussed with residents and relatives?
- 04What changes have been made to the audit system since the inspection?
- 05Have the cleaning schedules and the bath with peeling enamel been dealt with?
This was an unannounced planned inspection covering all five CQC questions, including both the premises and the care provided; Effective improved from the previous rating, while Well-led deteriorated. This explanation was written from the published report of 11 July 2019 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 2016
Rated Good overall; inspectors found safe, kind and personalised care, but legal safeguards and capacity assessments needed improvement.
Inspectors visited the home without warning on 1 November 2016. They spoke with five residents, two relatives, five care staff, managers and a visiting health professional. They also observed care and checked four people's care records and the home's management records.
The home was rated Good overall. Safe, caring, responsive and well-led were rated Good. Inspectors found enough staff, safe medicines systems, kind relationships, personalised care plans and systems to improve quality.
Effective was rated Requires Improvement. Capacity assessments did not consider specific decisions in enough detail. The home had also not followed the conditions of one legal authorisation restricting a person's liberty, so the restrictions may not have been lawful.
Risk management
The home had improved how it assessed and reviewed risks. Staff followed plans and checked whether actions were working.
“Risks to people's health and wellbeing were assessed, actions were put in place to reduce them and their effectiveness was monitored and regularly reviewed.” from the report
Kind relationships
Inspectors saw caring and respectful support. Residents were offered choices and their privacy, dignity and independence were respected.
“We saw kind, caring relationships between staff and the people they supported.” from the report
Personalised care
Staff knew residents' likes, dislikes and routines. Care plans were person-centred, reviewed regularly and changed when people's needs changed.
“Records that we looked at demonstrated that care plans were regularly reviewed and families were included in any changes to the plans.” from the report
Quality improvement
New checks were used to review accidents, falls and care plans. Inspectors found that the home had acted on information and feedback to make improvements.
“At this inspection we saw that a new audit system had been implemented to review accidents and incidents.” from the report
Capacity assessments
seriousSome assessments used the same questions for each person and did not consider the particular decision involved. This made it unclear whether decisions were made in residents' best interests.
“The assessments were not detailed and did not look at specific decisions and so it was not clear if they were made in people's best interests.” from the report
Liberty safeguard conditions
seriousThe home had not acted on the conditions attached to one authorisation restricting a person's liberty. Inspectors said the restriction may therefore not have been lawful.
“This meant that the safeguards to deprive the person of their liberty may not have been followed, and the restrictions may not have been lawful.” from the report
- 01How do you now assess a person's capacity for each particular decision?
- 02How do you check that any conditions attached to a liberty restriction are followed?
- 03What action has been taken to make sure restrictions on residents' liberty are lawful?
- 04How are falls, accidents and other risks reviewed, and what changes have followed?
- 05How are families involved when care plans or residents' needs change?
This was an unannounced inspection of the overall service, covering all five CQC questions and including observations, discussions and checks of care and management records. This explanation was written from the published report of 1 December 2016 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 Bearwardcote Hall Residential Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Bearwardcote Hall Residential Home →
- December 2016Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Bearwardcote Hall Residential Home →
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 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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