CQC report explained · a residential care home
What the CQC found at Bishops Corner
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2017
Rated Good overall; inspectors found safe, kind and responsive care, but the management structure still required improvement.
This was an unannounced, comprehensive inspection on 4 September 2017. Inspectors spoke with five people living at the home and four staff. They reviewed care records, medicines records, staff files, complaints, accidents and quality checks.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, safe medicines systems, suitable training, personalised support and kind treatment. People were supported with their nutrition, health appointments, activities and relationships.
Well-led was rated Requires Improvement. There was no registered manager, and the acting manager was sharing time across three services. New support systems were being put in place, but some roles had not yet been filled and the arrangements needed to be sustained.
The home had previously been rated Requires Improvement and had breached five regulations at the January 2017 inspection. Inspectors found that the provider had addressed those issues and was meeting the regulations at this inspection.
Safe staffing
The provider used recruitment checks and staffing levels were adjusted to people's needs, activities and one-to-one support requirements.
“There were enough staff to meet people's needs.” from the report
Personalised support
Care plans included detailed information about people's health, communication, preferences and ways to reduce anxiety.
“People received care which was assessed, planned and reviewed to ensure their needs were met and to reflect their preferences.” from the report
Kind relationships
Inspectors saw staff listening patiently, responding to concerns and supporting people in a relaxed manner.
“Staff were seen to provide care in a kind and caring manner.” from the report
Activities and independence
People chose from varied activities and were supported to attend work placements, go out and maintain independence.
“People spent time doing the things they wanted to do.” from the report
Improvements made
The provider had addressed the problems found at the previous inspection, including nutrition, dignity, safe care and person-centred support.
“We found that appropriate actions had been taken and issues had been addressed.” from the report
Unsettled management
needs fixingThere was no registered manager, and the acting manager was dividing time between three services. Some support roles were still unfilled.
“The management structure at Bishops Corner was not yet fully established.” from the report
Improvements needed to last
needs fixingNew quality checks and leadership arrangements had been introduced, but inspectors said they needed to be maintained and monitored.
“However, these improvements now needed to be sustained and reviewed as the service continued to develop and improve.” from the report
- 01Has the acting manager now registered with CQC, and who is responsible for the home when they are working at the other two services?
- 02Have all the planned management and support roles now been recruited?
- 03How do you check that the improvements to nutrition monitoring and personalised care are still being followed?
- 04What quality checks are carried out, how often are they reviewed, and what happens when a shortfall is found?
- 05How are staffing levels arranged when people need one-to-one support or attend activities and appointments?
This was an unannounced, full comprehensive inspection covering all five CQC questions and checking improvements made since the January 2017 inspection. This explanation was written from the published report of 13 October 2017 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, February 2017
Rated Requires Improvement; inspectors found kind staff but unsafe support, poor records and inadequate leadership.
This was an unannounced, comprehensive inspection on 5 and 6 January 2017. Inspectors spoke with eight people living at the home, nine staff and other health professionals. They reviewed care records, medicines, staff files, accident reports and quality checks.
The home was not consistently safe, effective, caring or responsive. Inspectors found unclear and inconsistent one-to-one support, poor monitoring of nutrition, gaps and errors in care records, and problems protecting people's privacy and dignity. Staff changes had also caused anxiety for some people.
The well-led rating was Inadequate. There had been no registered manager in post, leadership had changed several times, and the provider's checks had not found or fixed important problems quickly enough. The provider breached five regulations, including safe care, person-centred care, dignity, nutrition and good governance.
Kind staff
Staff knew people well and were described as kind and compassionate. People appeared comfortable approaching staff and spending time with them.
“Staff knew people well and displayed kindness and compassion when supporting people.” from the report
Safe medicines
Medicines were stored securely and staff were trained and assessed as competent. Records showed medicines were generally given in line with prescriptions.
“There were safe and effective systems in place to manage people's medication.” from the report
Independence and activities
People were supported to attend activities, work placements, health appointments and community events. Staff encouraged people to develop their independence.
“People were encouraged and supported to remain as independent as possible.” from the report
Staff support
Staff received training, supervision and opportunities to discuss incidents. A new manager had been appointed and staff hoped this would bring more consistent leadership.
“Staff felt supported and meetings took place to gain feedback from people, relatives and staff.” from the report
Inconsistent one-to-one support
seriousPeople assessed as needing one-to-one support did not have clear guidance, and staff understood the arrangements differently. One person was seen without the required support, creating a safety risk.
“This meant people were not getting the support they had been assessed as needing to keep them safe and supported at all times.” from the report
Nutrition was not managed reliably
seriousCalorie intake was not recorded, staff gave conflicting information about how one person's low weight was being managed, and required dietician referrals had not been made.
“No information had been documented to show how people's specific dietary needs were being managed and reviewed.” from the report
Poor care records
needs fixingCare plans were incomplete, out of date or inconsistent. Some records were undated or had the wrong name, and important health information was missing.
“This meant that it was not apparent what the persons current care and support needs were.” from the report
Privacy and dignity
seriousStaff discussed people's care in communal areas where others could hear. Dining furniture was uncomfortable and had been raised by residents several times without a timely response.
“This was an area that needed to be improved to ensure people's privacy and dignity was maintained at all times.” from the report
Unstable leadership
seriousThere had been several leadership changes, high staff turnover and no registered manager at the time of inspection. The provider's audits had not ensured that known problems were fixed promptly.
“There had been a lack of consistent leadership at Bishops Corner. The provider had not maintained adequate oversight during this time.” from the report
Incidents not always reported
seriousDaily records described incidents such as aggression and shouting, but staff had not always completed incident forms. This meant managers did not have a full picture of risks.
“These incidents had not been recorded on an incident form and the acting manager was not aware this had occurred.” from the report
- 01How is one-to-one support currently set out in each person's care plan, and how do you check it is provided at all times?
- 02How are people's calorie intake, weight and individual nutritional needs recorded and reviewed now?
- 03What changes have been made to ensure care plans contain current information about health conditions, communication, capacity and restrictions?
- 04How are privacy and dignity protected when staff discuss care needs or take telephone calls?
- 05What action has been taken following the Warning Notice, and how is the provider checking that improvements are completed promptly?
This was an unannounced comprehensive inspection covering all five key questions, with ratings given for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 24 February 2017 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 Bishops Corner
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- October 2017Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 14 February 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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19 live-in carers within about an hour of East Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.