CQC report explained · a residential care home
What the CQC found at Breton Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found safe staffing, recruitment, medicines practice, risk management and 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, although inspectors observed warm and compassionate interactions.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- The registered manager was in post and staff showed a caring culture, but governance checks were inconsistent and did not always identify inaccurate or incomplete records.
What inspectors found, March 2023
Breton Court is rated Good overall, with kind and safe care but weaknesses in management checks and records.
Inspectors visited after an earlier uncompleted visit because people at the home had COVID. They completed the inspection on 7 February 2023 and finished their inspection activity on 10 February. They spoke with people, relatives and staff, observed care, and checked care, medicine and management records.
The home was rated Good for Safe. Inspectors found enough suitably recruited and trained staff, safe medicines practice, suitable infection control, and good arrangements for managing risks. People said they felt safe and were supported to keep their independence.
The home was rated Requires Improvement for Well-led. The registered manager was in post and staff were caring and supportive, but checks did not always identify problems with records. A falls risk assessment had not been updated, and medicine records contained discrepancies.
The overall rating stayed Good because only Safe and Well-led were inspected during this visit. The other key question ratings were carried forward from the previous inspection in 2018.
Kind, individual care
People and relatives gave positive feedback about staff being kind, patient and attentive. Staff understood people's individual communication needs.
“Right Care: People received kind and compassionate care.” from the report
People felt safe
People said they felt safe. Staff understood safeguarding procedures and knew how to raise concerns.
“People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's basic care needs. Staff were trained and medicines were prescribed, administered, recorded and stored safely.
“People were supported by staff who followed systems and processes to prescribe, administer, record and store medicines safely.” from the report
Family involvement
Families were involved in care planning and were welcomed when visiting. The home also supported contact by telephone and video calls.
“People were encouraged and supported to have visitors at the home.” from the report
Inconsistent management checks
needs fixingThe home's governance systems did not consistently identify risks or keep records accurate and up to date. This included a falls risk assessment that did not reflect a change in mobility.
“For example, governance processes had failed to identify a person falls risk assessment had not been updated to reflect changes in their mobility.” from the report
Medicine records
needs fixingAudits did not identify recording discrepancies in two people's medicine administration records. The report does not say that people were harmed, but this needs close monitoring.
“Medicine audits had failed to identify recording discrepancies in two peoples medicine administration records (MAR)” from the report
Care records did not show all support
minorSome positive interactions and support were not recorded in daily care entries. This made it harder for the provider's records to demonstrate the care being given.
“Such interactions were not always recorded within the daily entries of peoples care records.” from the report
- 01What changes have you made to make sure falls risk assessments are updated promptly when someone's mobility changes?
- 02How do you now check medicine administration records and make sure discrepancies are found and corrected?
- 03How do you make sure daily care records reflect the support and activities people receive?
- 04What evidence can you show that the Well-led rating has improved since this inspection?
- 05Which current ratings were not assessed during this inspection and are based on the 2018 inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried forward from the 2018 inspection. This explanation was written from the published report of 25 March 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, July 2018
Breton Court is rated Good overall; inspectors found safe, kind and responsive care, but management systems and the lack of a registered manager need improvement.
The inspection was unannounced and took place on 29 June 2018. One inspector spoke with people living in the home, relatives and staff, observed care, checked care records and reviewed management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found safe medicines practice, enough staff, suitable training, respectful care, support with health needs and personalised activities.
The home was rated Requires Improvement for Well-led. Quality checks had improved but had not always found and fixed problems quickly. There was also no registered manager at the time of the inspection.
The overall rating was Good. This means the home met the relevant standards overall, but the management weaknesses needed attention. The rating had improved from Requires Improvement at the previous inspection in March 2017, when five regulations had been breached.
Safe care
Inspectors found that risks had been assessed and managed. Staff had improved guidance on fire safety, mobility and health conditions.
“Risks to people's safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected.” from the report
Medicines
Medicines were stored securely, kept at the correct temperature and given by trained staff who had been assessed as competent.
“Medicines were safely managed in line with national guidelines.” from the report
Kind and respectful care
Staff supported people sensitively and promoted their dignity, privacy and independence. People were also helped to make choices about their daily routines.
“People's privacy and independence were respected and promoted.” from the report
Activities and interests
People were offered group and one-to-one activities, including music, artwork, gentle exercise and outside entertainment.
“All in all there was a lively and engaged atmosphere in the service that promoted people's wellbeing.” from the report
Management oversight
needs fixingThe home's monitoring systems had improved but had not always identified and resolved problems quickly enough. Further progress was needed to make improvements last.
“Nevertheless, we noted that these improvements had not been wholly successful given the shortfalls we have described earlier in this report had not been quickly put right.” from the report
No registered manager
needs fixingThere had been no registered manager for more than 12 weeks before the inspection. The report says the application process had not been started quickly enough, although an application was then in progress.
“There was no registered manager and there had not been a registered manager in post for more than 12 weeks before our inspection visit.” from the report
Building maintenance
minorSome outside window frames were rotten or had peeling paint, making the building look run-down. The provider said replacement work was planned for completion by 1 October 2018.
“On others some of the wood was rotten.” from the report
Bathroom hygiene
minorCord pulls in communal bathrooms were not clean or easy to clean, increasing the risk of avoidable infection. The provider said they would be replaced.
“However, light cord pulls in communal bathrooms were not easily cleanable and were not clean.” from the report
- 01Has the manager's application to become registered with the CQC been completed, and who is responsible for the home while this is resolved?
- 02How do you now check that problems found through audits are fixed quickly and remain fixed?
- 03Were the communal bathroom cord pulls replaced, and how are infection-control checks recorded now?
- 04Were the rear window frames replaced as planned by 1 October 2018?
- 05How are residents and relatives involved in reviewing care plans, complaints and proposed improvements?
This was an unannounced inspection covering the overall service and all five quality questions, including care, records, staffing, premises and management systems. This explanation was written from the published report of 31 July 2018 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 Breton Court
4 rated inspections over 8 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2018Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2012
Registered with the Care Quality Commission on 20 January 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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