CQC report explained · a nursing home
What the CQC found at Becket House Nursing 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, February 2022
Rated Requires Improvement overall; inspectors found safe care and good leadership, but only Safe and Well-led were checked.
This was an unannounced, focused inspection on 13 January 2022. One inspector and one Expert by Experience spoke with three people, three family members and five staff. They also checked care records, medicines records, recruitment files and quality monitoring records.
The inspectors rated Safe as Good. They found enough staff, safe recruitment, well-managed risks, safe medicines systems and strong infection control. People were supported to keep in touch with relatives during the COVID-19 pandemic.
The inspectors rated Well-led as Good. People, relatives and staff spoke positively about the management. Audits, feedback and action plans were being used to monitor and improve the service.
The overall rating remains Requires Improvement because this was a focused inspection. The other three areas were not inspected during this visit, so their earlier ratings were carried forward. The home had improved since the previous inspection and was no longer in breach of the earlier staffing regulation.
Staffing had improved
Inspectors found enough staff on duty and saw that call bells were answered promptly. Recruitment checks were in place, including DBS checks and registration checks for nursing staff.
“There were sufficient numbers of staff who had been safely recruited to meet people's needs.” from the report
Risks were managed
Care records identified risks such as falls, pressure ulcers and poor nutrition. The home made referrals to health professionals when people's risks increased.
“Risks to people's safety were assessed and well managed, and people's care plans detailed current risks and individual needs.” from the report
Medicines and infection control
Medicines were ordered, stored and given safely. Inspectors were also assured that infection prevention measures, testing, protective equipment and visiting arrangements were being managed safely.
“Medicines were managed safely, and infection control measures were robustly followed.” from the report
Positive leadership
People, relatives and staff were positive about the manager and said staff felt supported. The home used audits, surveys and action plans to identify and address improvements.
“There was a vast range of regular audits that were completed, and action plans were put into place when areas needed to be addressed.” from the report
A question about night staffing
minorOne staff member raised concerns about staffing at night. The manager said night staffing had been assessed as safe and regularly worked night shifts, but this is worth asking about.
“Most staff told us there were adequate numbers to meet people's needs. One raised concerns about staffing at night.” from the report
- 01How many staff are planned for each night shift, and how do you respond if someone is absent?
- 02What were the previous ratings for Effective, Caring and Responsive, and what has changed in those areas since the last full inspection?
- 03How do you check that care plans remain up to date when a person's risks or needs change?
- 04How are relatives told about changes in visiting arrangements or infection outbreaks?
- 05What actions from your audits are currently being monitored, and how can relatives see the results?
This was a focused inspection of Safe and Well-led, including infection control; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 5 February 2022 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, September 2019
Rated Requires Improvement; inspectors found kind care, but staffing, activities, communication and management checks were not consistently good enough.
This was an unannounced planned inspection on 22 July 2019. Inspectors spoke with people, relatives and staff, observed care, checked records and toured the home.
The home was caring, and people were treated with kindness, dignity and respect. Medicines were managed safely, risks were assessed, staff were trained, and people could access healthcare.
However, there were not enough staff to fully meet people's needs, including support at mealtimes and with activities. People's rooms were sometimes cluttered, some toilets and commodes were dirty later in the day, and communication information was not always provided in suitable formats.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were also rated Requires Improvement. Caring was rated Good. The previous overall rating was Good in January 2017, so the overall position had worsened.
Kind and respectful care
Staff formed warm relationships with people and understood their likes and dislikes. Inspectors saw people being treated with dignity and asked for their consent.
“Staff had developed kind and supportive relationships with people.” from the report
Safe medicines
Medicines were given safely, records were completed accurately and staff had received medicines training. Audits were carried out to look for errors.
“People continued to receive their medicines safely.” from the report
Trained staff
Staff received induction, ongoing training and regular supervision. Records supported what staff told inspectors.
“People were supported by staff who received training to develop and maintain the skills they needed to support them.” from the report
Healthcare support
Staff noticed changes in people's health and helped them access doctors and other professionals. The home worked with services including dieticians and specialist nurses.
“Staff supported people with their health needs and were alert to changes in people's health.” from the report
Too few staff
seriousStaffing levels were not sufficient for people's needs. This affected support at mealtimes, time spent with people and the delivery of activities.
“Staffing levels were not sufficient to fully meet people's needs.” from the report
Limited activities
needs fixingThere was no set activities programme, and inspectors saw no activities taking place during the visit. Many people were asleep or watching television.
“There was no set programme for activities and no timetable available for people to check what activities were taking place on the day.” from the report
Cleaning and environment
needs fixingSome toilets and commodes were dirty in the afternoon. Inspectors also found cluttered rooms, a bicycle in an en-suite shower room and a broken bath panel.
“We found several dirty toilets and commodes in the afternoon after housekeeping staff had finished their duties.” from the report
Communication formats
needs fixingPeople were not always given menus, complaints information or other documents in formats suitable for their communication needs. Menus were not shown before meals.
“People were not always provided with information in a suitable format about things such as the complaints procedure, menu's and service users guide.” from the report
Weak improvement tracking
needs fixingThe home completed regular quality audits but did not record the actions taken. The checks also failed to identify several problems found by inspectors.
“There was no record of any improvements undertaken as a result of the quality audits demonstrating a lack of managerial oversight.” from the report
- 01How many staff are currently on duty during busy periods, especially at mealtimes, and how is this matched to people's changing needs?
- 02What regular activities are now available, who leads them, and how can residents see the activities timetable?
- 03What action has been taken to keep toilets and commodes clean throughout the day?
- 04How are menus, complaints information and other documents provided in formats that meet each person's communication needs?
- 05How do quality audits now record actions, deadlines and checks that improvements have been completed?
This was an unannounced planned inspection covering all five key questions, including the premises and the care provided; the previous overall rating was Good. This explanation was written from the published report of 4 September 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.
Every inspection of Becket House Nursing Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2022Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- January 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014Inspected but not rated
- September 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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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