CQC report explained · a nursing home
What the CQC found at Bletchley House Residential Care and Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2023
Rated Requires Improvement; inspectors found improvements since the last inspection, but medicines storage, activities and management arrangements still needed attention.
This was an unannounced follow-up inspection over three days. Inspectors reviewed care and medicine records, recruitment files, audits and safety records. They spoke with people, relatives and staff, and observed care.
The home was rated Requires Improvement for Safe and Well-led. Medicines were generally managed better than at the previous inspection, but some eye drops were not stored in a fridge as instructed. Risks linked to anticoagulants were also missing from some care plans, although this was corrected after the inspection.
People said staff were kind and attentive, and inspectors found safe recruitment, suitable infection control and systems for learning from incidents. However, people did not always have enough chances to take part in activities or spend time as they wished. There was also no registered manager in post, which prevented a Good rating for Well-led.
Kind and attentive staff
People told inspectors that staff were kind and attentive to their needs.
“People told us staff were kind and attentive to their needs.” from the report
Safer recruitment
The provider carried out employment history, reference, identity and DBS checks before staff were recruited.
“The provider ensured staff were recruited safely by undertaking robust pre-employment and identity checks.” from the report
Infection control
Inspectors were assured that the home used protective equipment properly and had arrangements for managing infection risks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Learning from incidents
The home tracked accidents and incidents, shared learning with staff and used action plans to reduce risks.
“Lessons were learnt when things went wrong. The provider had systems in place to share any learning within the service.” from the report
Medicine storage
needs fixingSome eye drops were not kept in a fridge as the manufacturer instructed. The provider acted immediately to obtain a new supply.
“Medicines were not always stored correctly. For example, we found eye drops were not stored in a fridge as per the manufacturer's instructions.” from the report
Missing anticoagulant risk information
needs fixingSome care plans did not record the risks linked to anticoagulant medicines. The provider put risk assessments in place immediately after the inspection.
“However, risks associated with anticoagulants were not always documented in the care plans.” from the report
No registered manager
needs fixingThere was no registered manager in post at the time of the inspection. The current manager was applying to register.
“The service did not have a registered manager in post which is a regulatory requirement.” from the report
- 01How are medicines, including refrigerated eye drops, checked and stored now?
- 02How are risks for people taking anticoagulants recorded and reviewed?
- 03What activities are available for people who spend time in bed?
- 04When will the manager's application to become registered be completed?
- 05How are staffing levels managed during busy medicine rounds?
This was a focused follow-up inspection of Safe and Well-led; the other key question ratings carried over from the previous inspection. This explanation was written from the published report of 10 May 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, May 2022
Bletchley House Residential Care and Nursing Home was rated Requires Improvement; inspectors found serious medicine and management weaknesses, although people generally felt safe.
This was an unannounced, focused inspection on 30 and 31 March 2022. Inspectors looked mainly at safety and leadership because concerns had been raised about medicines, staffing and management. They spoke with people, relatives and staff, observed care, and checked care records, medicine records, staff files and management information.
The home was not always safe. Medicines were sometimes unavailable or given late, medicine records had errors, and some medicines were not stored securely. Care records and risk assessments were sometimes out of date or inconsistent. Heavy use of agency staff also affected consistency.
Leadership was also rated Requires Improvement. The home had no registered manager since 21 December 2020, managers had changed frequently, and provider checks had not found or fixed important problems. Inspectors found breaches of Regulations 12 and 17 and issued warning notices.
There were some positive findings. People generally said they felt safe, staff understood safeguarding, infection control arrangements were suitable, and the interim manager had started recruiting staff and improving records. The previous overall rating was Good, but this focused inspection changed it to Requires Improvement. Ratings for the other key questions were carried over from the previous inspection.
Safeguarding
Staff had safeguarding training and understood how to recognise and report abuse. Inspectors found that safeguarding concerns had been dealt with appropriately and promptly.
“Staff received training in safeguarding and were knowledgeable on how to identify the signs of abuse and how to report concerns.” from the report
Infection control
Inspectors were assured about the home's arrangements for preventing and managing infection, including the use of protective equipment and support for visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Early improvement work
The interim manager had recognised the staffing problem, recruited new staff and started work to transfer records to an electronic system.
“The interim manager had identified the high use of agency staff as an area that needed to be addressed and had taken action to successfully recruit 11 new staff.” from the report
Medicine safety
seriousSome prescribed medicines ran out or were given at the wrong time. Records were incomplete or signed retrospectively, and medicine errors were not consistently reported or reviewed.
“One person who was receiving time critical medicines did not receive their medicines at the time prescribed.” from the report
Risk information
seriousStaff had to use paper and electronic records, which made information difficult to find. Some risk assessments did not explain the actions needed to reduce known risks.
“At the time of our visit staff were having to use both paper and electronic records making it difficult to find information needed to support people safely.” from the report
Unstable management
seriousManagers had changed frequently and there had been no registered manager since December 2020. Provider audits did not identify important medicine, record and care problems.
“Management of the service had been unstable and numerous managers had been recruited and then left the service.” from the report
Staff consistency
needs fixingThere were enough staff to meet people's needs safely, but the high use of agency staff meant people did not always receive consistent care from staff who knew them well.
“There had been a reliance on a high use of agency staff, which did not ensure consistency for people receiving care and support.” from the report
Activities and food
needs fixingInspectors found limited activities on the nursing floor and ongoing dissatisfaction with meals. It was not clear that people's feedback had led to improvements.
“There remained a high level of dissatisfaction with meals and it was not evident that people's feedback had been used to drive improvement.” from the report
- 01What has been done to make sure medicines are always available, stored securely and given at the prescribed time?
- 02How are medicine errors, missed doses and near misses now recorded, investigated and used to improve practice?
- 03Is there now a registered manager in post, and how long are they expected to remain?
- 04How has the home reduced its use of agency staff, and how will it make sure staff know each person's needs?
- 05What changes have been made to activities on the nursing floor and to the quality of meals?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 14 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.
Every inspection of Bletchley House Residential Care and Nursing Home
7 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Bletchley House Residential Care and Nursing Home →
- May 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Bletchley House Residential Care and Nursing Home →
- March 2021Goodup from Requires improvementSafe: GoodWell-led: Good
- September 2020Requires improvementstayed Requires improvementSafe: Inspected but not ratedWell-led: Good
- May 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017
Registered with the Care Quality Commission on 11 May 2017.
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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