CQC report explained · a nursing home
What the CQC found at Bloomfield
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and care plans explained how to reduce harm. Medicines, safeguarding, infection control and recruitment checks were managed safely.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found that managers carried out regular quality and safety checks, submitted statutory notifications as required and supported staff.
What inspectors found, August 2023
Bloomfield is rated Good; inspectors found safe care and stronger management, but people and staff gave mixed views about staffing levels.
This was an unannounced focused inspection on 17 and 18 July 2023. Inspectors spoke with 25 people, 8 relatives, 15 staff and one healthcare professional. They also checked care records, medicines records, audits and meeting minutes.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, safeguarding procedures were understood and infection controls were in place. People said they felt safe.
The last rating was Requires Improvement, with a breach because statutory notifications had not always been sent to the CQC. Inspectors found this had been corrected, and the home was no longer in breach.
This inspection only assessed Safe and Well-led. The ratings for the other three areas were carried over from the previous inspection when calculating the overall Good rating.
Risk management
Risk assessments covered issues such as falls, choking, malnutrition and skin damage. Care plans gave staff clear instructions to reduce risks.
“Risk assessments in relation to people's support needs were in place and reviewed regularly.” from the report
Safe medicines
Medicines were stored safely, reviewed regularly and supported by clear instructions for medicines given when needed.
“Medicines were regularly reviewed.” from the report
Improved leadership
The home had improved since the last inspection. Managers had better oversight of quality and were submitting required notifications consistently.
“At this inspection, we found statutory notifications were submitted consistently in line with regulatory requirements.” from the report
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infections, including safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Mixed views about staffing
needs fixingSome people and staff said there were not enough staff on some days. The registered manager said staffing had recently been increased in one area and was reviewed against people's needs.
“There is definitely not enough staff, they are pushed to the limit.” from the report
- 01How many staff are planned for each shift, and how do you respond when there is a shortage?
- 02What staffing changes were recently made in the area where staffing was increased?
- 03How do you check that risk assessments and care plans remain up to date?
- 04How do you make sure statutory notifications continue to be submitted on time?
- 05When will Effective, Caring and Responsive be inspected again?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 12 August 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, November 2020
Rated Requires Improvement; inspectors found people were safe, but management systems did not always record, report and learn from concerns properly.
This was a focused inspection on 15 September 2020. Inspectors looked mainly at whether people were safe and whether the home was well-led. They spoke with people, relatives and staff, and checked care records, staff files, incident records, medicines records, meetings and audits.
The home was rated Good for Safe. People and relatives said they felt safe. Staffing was considered safe, staff responded promptly, medicines were generally managed safely, and infection control measures were in place.
The home was rated Requires Improvement for Well-led. Some safeguarding concerns were not recorded or fully reported. Required notifications were missed, and information about legal safeguards was not always accurate or up to date. The home also needed to improve how it shared learning from incidents.
The overall rating changed from Good at the previous inspection to Requires Improvement. The other three areas were not inspected during this visit, so their previous ratings were used in the overall rating.
People felt safe
People and relatives told inspectors they felt safe. Staff understood how to recognise and report abuse.
“People and relatives told us they felt the service was safe.” from the report
Staffing and response
Staffing was kept at the level the provider considered safe. Inspectors saw staff respond promptly when people needed help.
“We observed staff responded promptly when people required staff support.” from the report
Infection control
The home was clean and tidy. Inspectors found measures for preventing and managing infection, including testing, PPE and social distancing.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Positive culture
People, relatives and staff described a positive atmosphere. People said they felt able to raise concerns.
“There was a positive atmosphere and culture within the service which was recognised by staff, relatives and people.” from the report
Missed notifications
seriousFour safeguarding notifications and one notification about a deprivation of liberty safeguard had not been submitted as required. This was a breach of Regulation 18.
“Notifications were not always submitted as required.” from the report
Safeguarding records
seriousOne safeguarding concern was not documented and other reporting processes were incomplete. The home needed to improve how concerns were recorded, reported and followed up.
“One safeguarding concern not documented and others where the reporting process had not been fully completed.” from the report
Learning from incidents
needs fixingInformation about some incidents and safeguarding concerns was not consistently shared with staff or discussed in meetings. This delayed learning and action to reduce future risks.
“Communication to share and learn from when things had gone wrong were not consistently effective.” from the report
Medicines records
needs fixingFor one person, the record for an as-required medicine did not always show the amount given or carry the total forward. This meant stock and effectiveness could not be checked accurately.
“For one person the medicines total had not been carried forward and the amount given was not always recorded.” from the report
Legal safeguard records
needs fixingThe overview of deprivation of liberty safeguards included outdated information and did not reliably track expiry dates, renewals or notifications. The provider made immediate changes, but one person’s information was still inaccurate.
“An overview of Deprivation of Liberty Safeguards (DoLS) was not up to date and accurate.” from the report
- 01What changes have you made to make sure every safeguarding concern is recorded, reported and followed up promptly?
- 02How do you now check that all required CQC notifications are submitted without delay?
- 03How are deprivation of liberty safeguard expiry dates, renewals and notifications monitored?
- 04How do staff meetings record incidents, agreed actions and lessons learned?
- 05How do you check that medicines records show the correct stock and amounts given?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 11 November 2020 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 Bloomfield
9 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- August 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2020Requires improvementdown from GoodSafe: GoodWell-led: Requires improvement
- April 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2018Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2016Requires improvementstayed Requires improvementSafe: Inadequate
- November 2016Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014Inspected but not rated
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 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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