CQC report explained · a residential care home
What the CQC found at Bishops Gate
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found sufficient staffing, safe medicines systems, appropriate risk assessments and effective infection control.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward.
- Well-led?
- Good
- Management systems had improved. Registration information was up to date, required notifications were submitted and audits were used to identify improvements.
What inspectors found, January 2023
Bishops Gate rated Good; inspectors found safe, kind and person-centred care, with better management oversight than at the previous inspection.
One inspector visited on 15 December 2022. They spoke with four people, six staff members and three relatives. They also reviewed care and medicine records, staff recruitment files, policies and quality checks.
The home was rated Good overall and Good for Safe and Well-led. Inspectors found enough staff, safe medicine systems, suitable risk assessments and effective infection prevention measures. People were supported to make choices, stay independent and take part in activities.
This inspection did not assess all five areas. The Effective, Caring and Responsive ratings were carried over from the previous inspection. The home had been rated Good overall at that inspection in 2017, while Well-led has improved from Requires Improvement to Good.
Choice and independence
Staff supported people to make choices, control their lives and remain as independent as possible.
“There are good choices, it's just great living here.” from the report
Safety and staffing
The home had enough staff, including one-to-one support where assessed as necessary. Staff understood people's individual risks and how to protect them.
“There were sufficient staff to keep people safe, provide one-to-one support for people and to take part in activities.” from the report
Improved oversight
Leadership had improved since the previous inspection. The home used audits covering nutrition, medicines, care plans and activities.
“Regular audits of people's nutritional plans, medication, care plans and activities were all completed.” from the report
Involvement of people and relatives
People helped review their support and took part in choosing new support workers. Relatives said they were kept informed and involved.
“I'm involved all the time. It feels like an extended family unit rather than a residential home.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you manage my relative's Prader-Willi Syndrome and the risks linked to food and overeating?
- 02If my relative needs one-to-one support, how will you provide it at all the required times?
- 03How would you support my relative to manage or take their own medicines safely?
- 04How will my relative be involved in keyworker meetings, activities and decisions about their support?
- 05How do your audits identify and correct problems in care plans, nutrition, medicines and activities?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their ratings were carried over from the previous inspection. This explanation was written from the published report of 17 January 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, September 2017
Rated Good overall; inspectors found safe, effective, kind and responsive care, but the home’s leadership required improvement.
This was an unannounced, full inspection on 11 August 2017. Inspectors spoke with four people living at the home, relatives and staff. They reviewed care records, medicines records, recruitment files, accidents, complaints and quality checks.
The inspectors found that people were safe and supported by staff who understood their needs, including the risks linked to Prader-Willi Syndrome. Care plans and risk assessments were regularly reviewed. People were involved in choices about their care, food, activities and daily routines.
The home was rated Good for Safe, Effective, Caring and Responsive. It was rated Requires Improvement for Well-led because the CQC registration information did not match the current management structure. The provider had started steps to correct this and had plans to strengthen oversight.
The previous inspection in August 2016 rated the home Requires Improvement, although there were no breaches. This inspection found that earlier improvements had been sustained.
Safe, individual support
Risk assessments were tailored to each person and updated as their health, behaviour and activities changed. Staff supported people to take part in activities while managing risks.
“Risk assessments were individualised and person centred and had been reviewed and updated regularly” from the report
Practical Prader-Willi support
The home had detailed nutrition plans, calculated calorie needs and monitored people’s weight. Staff understood the importance of managing food and nutrition safely.
“Everyone had a nutritional care support plan, these were personalised and included directions for staff to follow if the person's weight went above or below the calculated level.” from the report
Kind and respectful care
People had positive relationships with staff. Staff respected privacy, knocked before entering bedrooms and encouraged independence.
“Staff treated people in a kind and considerate manner.” from the report
Choice and activities
People were involved in daily decisions and had access to activities, work placements and outings. Staff encouraged participation while respecting people’s choices.
“People had a variety of 'in house' and external activities offered” from the report
Management registration was out of date
needs fixingThe registered manager was no longer working at the home, but the CQC registration information had not yet been updated. The provider had begun the process of correcting this.
“The provider had not ensured that the management structure at Bishops Gate had been appropriately updated to ensure registration was clear and accurately reflected the management structure at the service.” from the report
Family communication could improve
minorRelatives said communication had improved, but they felt it still needed to become more consistent and clear. The provider had identified this as an area for improvement.
“Although they felt that improvements were taking place all relatives felt that communication between them and the home could still improve further.” from the report
Provider oversight was still developing
needs fixingThe home had audits and quality checks, but the provider was making further changes to ensure oversight remained consistent after changes to senior roles.
“We discussed with the provider the importance of ensuring that provider oversight remained consistent to enable them to have an accurate picture of the service and the care being provided.” from the report
- 01Has the acting manager now been registered with the CQC, and does the registration information accurately reflect who is in charge?
- 02How often do the operations director or quality improvement lead now visit the home, and what do they check?
- 03How will you keep relatives informed and make communication consistent and clear?
- 04How are each person’s calorie needs, weight and nutrition plan reviewed, especially when their health or activities change?
- 05How do you support people to take part in activities and make choices while managing the risks linked to Prader-Willi Syndrome?
This was an unannounced full comprehensive inspection covering all five key questions; the previous inspection was in August 2016. This explanation was written from the published report of 19 September 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 Gate
4 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- January 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- September 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Registered with the Care Quality Commission on 26 March 2012.
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.