CQC report explained · a residential care home
What the CQC found at Bell House Care Home Limited
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2022
Inspected but not rated; inspectors found continued unsafe medicines management after a previous Inadequate rating.
This was an unannounced targeted inspection on 13 April 2021. A pharmacist specialist checked whether medicines were being managed safely. Inspectors spoke with senior staff, reviewed the home's medicine systems and checked records for six people.
The home had not made enough improvement. Some people did not receive medicines as prescribed. Records for creams and patches were incomplete, stock discrepancies were not investigated, and night staff were not trained to give medicines.
The service was inspected but not rated at this visit. The previous overall rating was Inadequate, published on 18 June 2021, and the home remained in breach of Regulation 12.
Medicine audits took place
The clinical lead audited the medicine system weekly and monthly. However, these checks failed to identify problems found by inspectors.
“The clinical lead had audited the medicine system weekly and monthly, but no issues were identified.” from the report
A medicines policy existed
The home had a medicines policy, although it was undated and needed updating to reflect current practice.
“There was a medicine policy in place, but this was not dated and needed to be updated” from the report
Medicines were not always given correctly
seriousPeople did not always receive their medicines as prescribed. This was the main issue identified by inspectors and was linked to a continued breach.
“People did not always get their medicines as prescribed.” from the report
Cream and patch records were incomplete
seriousBody maps and patch records were missing in some cases. Some cream applications were signed for before the creams had been applied.
“Administration on the day of our visit had been signed for on the topical medicine administration record (MAR) before they had been applied.” from the report
Stock problems were not investigated
seriousStaff found discrepancies in medicine stock, but these were not passed on for investigation. This meant the manager could not be assured that medicines had been given correctly.
“Where stock balance discrepancies were found by staff during the process of medicine administration these were not escalated for investigation” from the report
Policy was out of date
minorThe medicines policy was not dated and referred to a remedy the home no longer kept. It did not fully reflect current practice.
“There was a medicine policy in place, but this was not dated and needed to be updated to reflect current practice in the home” from the report
- 01What has changed since the inspection to make sure people receive every medicine as prescribed?
- 02How are cream applications, body maps and patch rotation now recorded and checked?
- 03How are medicine stock discrepancies investigated and reported to the manager?
- 04Are all night staff now trained and authorised to give medicines when required?
- 05When was the medicines policy updated, dated and checked against current practice?
This was an unannounced targeted inspection of medicines management under Regulation 12; the whole Safe question and the other key questions were not reviewed, so the service was inspected but not rated. This explanation was written from the published report of 24 May 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, March 2022
Rated Requires Improvement; the home made important improvements and left Special Measures, but safety and management still need strengthening.
The CQC carried out an unannounced focused inspection. It looked mainly at whether people were safe and whether the home was well-led. The inspector spoke with people, relatives and staff, and checked care, medicine and management records.
The home had improved since its previous Inadequate rating. Risks were identified and acted on, medicines and staffing had improved, and safeguarding systems were in place. People and relatives generally said the home felt safe, and the home was clean and tidy.
Some problems remained. Staff did not always wear face masks correctly, repositioning checks were not fully recorded, and some areas needed redecoration. The CQC rated both Safe and Well-led as Requires Improvement.
The home had previously been in Special Measures after the June 2021 inspection. It is no longer in Special Measures and was no longer breaching regulations at this inspection, but the CQC will continue to monitor it.
Improved staffing
The inspector found enough staff to meet people’s care needs, and call bells were answered without excessive delays. Training completion rates were high.
“There were sufficient numbers of staff to meet people's care needs.” from the report
People felt safe
People and relatives generally said the home was a safe place. Safeguarding records supported this.
“People and relatives agreed the home was a safe living environment.” from the report
Better management checks
The home used regular audits to identify actions and inspectors saw evidence that these actions were followed up.
“A regular system of audits covering areas such as care plans, pressure wounds and dining experience was used to identify actions which we could see were followed up.” from the report
Positive atmosphere
Inspectors found a calm atmosphere and a sense of teamwork. Staff showed an understanding of people’s individual needs.
“There was a positive culture in the home and a sense of teamwork.” from the report
Masks were not always used correctly
needs fixingSome staff pulled their masks down while speaking to a person who had difficulty hearing. The manager agreed to review this practice.
“We observed some staff were not using their face mask correctly.” from the report
Repositioning records were incomplete
needs fixingNightly checks were not routinely recorded. The CQC recommended that the home include these checks in its oversight systems.
“We found nightly repositioning checks were not routinely completed.” from the report
Some areas needed redecoration
minorThe living environment still needed improvement. A rolling refurbishment programme was due to start in January 2022.
“We saw some redecoration was needed in the home.” from the report
One medicine authorisation needed clarification
needs fixingA GP had authorised crushing one person’s medicines, but the records did not say which medicines this applied to. The manager was asked to follow this up.
“A GP had authorised the crushing of one person's medicines, although there was no detail which medicines this applied to.” from the report
- 01What has been done since the inspection to make sure all staff wear face masks correctly?
- 02How are nightly repositioning checks now recorded and checked by managers?
- 03What improvements have been made to the areas that needed redecoration?
- 04How are night-time staffing levels checked against people’s needs?
- 05Which medicines can be crushed, and how is the required authorisation recorded?
This was an unannounced focused inspection covering Safe and Well-led; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 1 March 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.
Every inspection of Bell House Care Home Limited
7 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- May 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
Read what inspectors found at Bell House Care Home Limited →
- March 2022Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Bell House Care Home Limited →
- June 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- March 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015
Report published without a new overall rating.
- September 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 20 June 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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