CQC report explained · a residential care home
What the CQC found at Breckside Park Residential Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, January 2020
Rated Requires Improvement; inspectors found kind, personalised care, but staffing, cleanliness and management checks were not always reliable.
This was an unannounced inspection on 09 January 2020. Inspectors spoke with people, a visitor and staff, observed care and mealtimes, and checked care, medicines, recruitment and management records.
People were generally happy and inspectors saw warm, respectful relationships. Care was personalised, activities were available, and the home worked well with health professionals. Effective, caring and responsive care were rated Good.
The home was not always safe or well-led. Some people waited more than 45 minutes for help to eat, parts of the home were not clean, and management checks had not always found or fixed problems. Safe and well-led were rated Requires Improvement.
The overall rating fell from Good at the last inspection, published in July 2017. Effective improved from Requires Improvement to Good, while Safe and Well-led fell from Good to Requires Improvement.
Kind relationships
Inspectors saw warm, respectful interactions. People generally said they were happy and well looked after.
“We observed warm and caring interactions between people and staff, which showed they knew each other well.” from the report
Personalised care
Staff knew people's histories and needs. Care plans were person-centred and continued to be developed.
“People felt staff knew their needs well and staff had involved them in care planning, for example in the writing of people's life stories.” from the report
Good health support
The home worked with doctors and other professionals when people needed help. Visiting professionals gave very positive feedback about the care.
“The service worked with a variety of health professionals to promote and maintain people's health and wellbeing.” from the report
Activities and community links
People had group and individual activities, and trips out were becoming more frequent. The home had also improved its garden, patio and dining room.
“Trips out for people had become more frequent. The registered manager and activities coordinator were developing this further.” from the report
Delays at mealtimes
needs fixingAt lunchtime, people who needed help to eat waited over 45 minutes. Inspectors asked the home to review staff planning and deployment.
“For example, at lunchtime we observed that those who required assistance to eat had to wait over 45 minutes to be helped.” from the report
Cleanliness and infection control
needs fixingBathrooms, furnishings and the medicines storage room were not always clean and hygienic. Inspectors recommended stronger monitoring of cleanliness and infection control.
“Parts of the service, including bathrooms, furnishings and the medication storage room, were not always clean and hygienic.” from the report
Weak management checks
needs fixingAudits did not always identify or fix problems, including fire doors, staffing arrangements and cleanliness. Some safety-related records and plans also needed more detail.
“However, the effectiveness of governance systems at times needed to be improved, as issues we highlighted had not always been identified or addressed robustly.” from the report
Fire safety issue
seriousElectrical equipment in the manager's office created a fire risk because the office door was not included in the self-closing door arrangements. The provider said this would be fixed immediately.
“However, this had not included the manager's office, where electrical equipment in use posed a fire risk.” from the report
- 01What has changed to make sure people do not wait for help with eating during busy mealtimes?
- 02What cleaning and infection control checks are now carried out, including in bathrooms and the medicines storage room?
- 03What was done to remove the fire risk in the manager's office, and how is this now checked?
- 04How are audits and governance meetings identifying and fixing problems before they affect people?
- 05How are care plans and risk assessments being improved, including plans for people receiving end of life care?
This was an unannounced planned inspection covering all five key questions, including the care provided and the care home premises. This explanation was written from the published report of 24 January 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.
What inspectors found, July 2017
Breckside Park Residential Home is rated Good overall; inspectors found safe, kind care, but the Effective rating was Requires Improvement.
Inspectors made an unannounced visit on 15 and 19 June 2017. They spoke with people living in the home, staff, the manager and other professionals. They reviewed six care plans, staff recruitment records and other records.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were rated Good. Inspectors found enough staff, improved medicines arrangements, completed fire safety actions, kind staff and better quality checks.
Effective was rated Requires Improvement. Inspectors found that consent and best-interest decisions were not recorded consistently for some people. They also found mixed views about the food and said the food they sampled was bland.
The home had previously been rated Requires Improvement and had breached regulations in several areas. Inspectors found that action had been taken and that the home was no longer in breach of those regulations.
Enough staff
Staffing had improved after the home employed an activities coordinator and laundry assistant. People and staff said there was enough time to meet people’s needs.
“People told us there was enough staff, and the staff we spoke with raised no concerns around staffing levels.” from the report
Kind staff
People spoke positively about the staff. Inspectors observed kind and respectful interactions during the visit.
“We observed staff treating people with kindness throughout the duration of our inspection.” from the report
Improved fire safety
Actions set by the fire service had been completed. Fire equipment, evacuation plans and staff training were checked.
“The actions from the action plan had all been completed.” from the report
Activities and complaints
The home had a varied activities programme and displayed its complaints process. People said they knew how to complain.
“We saw that there was a full and varied programme of activities at the home.” from the report
Improved management checks
Records and quality assurance systems were better than at the previous inspection. The manager and provider carried out regular checks.
“Quality assurance systems had been re-formatted and took into consideration medication, care planning, cleaning, health and safety and staffing.” from the report
Consent and best-interest records
needs fixingFor at least two people who lacked capacity, care plans had been signed as if they agreed to decisions, without a recorded best-interest process. Consent was also not documented consistently.
“Also we did not see consent documented anywhere in people's care plan's, however we did hear staff ask for verbal consent throughout the day.” from the report
Food quality
needs fixingMost people said they enjoyed the food, but inspectors received mixed comments. The food sampled at lunchtime was described as bland.
“We sampled the food at lunch time and found the food was bland.” from the report
Medicine recording
seriousOne person’s medicine administration record was signed before they had taken the tablets. Staff addressed this during the inspection.
“administering medications and signing the MAR chart before the person had taken them is unsafe” from the report
Medicine storage checks
minorThere were gaps in recording the temperature where medicines were stored. New paperwork was introduced during the inspection to improve these checks.
“the staff were not always monitoring the temperature and there were some gaps.” from the report
- 01How do you now record consent for each person’s care and treatment?
- 02What is your process for making and recording best-interest decisions when someone cannot make a particular decision?
- 03What changes have been made to the food since inspectors found it bland and received mixed feedback?
- 04How do you make sure medicines are taken before staff sign the medicine record?
- 05How are care plans checked so that information about people’s needs and preferences stays up to date?
This was an unannounced inspection of the overall quality and safety of the home, covering all five CQC questions and reviewing progress since the previous inspection. This explanation was written from the published report of 18 July 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 Breckside Park Residential Home
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- January 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Breckside Park Residential Home →
- July 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Breckside Park Residential Home →
- June 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 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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