CQC report explained · a residential care home
What the CQC found at Buckingham Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2023
Rated Requires Improvement; inspectors found infection control and management weaknesses, alongside some kind care and improving systems.
This was an unannounced inspection. Inspectors visited on 7 March 2023, with inspection activity running from 3 to 17 March. They spoke with people, relatives, staff and a visiting professional, and reviewed care, medicines, recruitment and management records.
The home had an infection outbreak affecting residents and staff. Inspectors found areas needing deep cleaning, poor arrangements for infected laundry, and PPE that was not always available or used correctly. They also found that staff were not always deployed well enough to respond quickly on one unit.
People generally received their medicines and a balanced diet, and staff understood safeguarding and best-interest processes. However, records about risks, care preferences, medicines, nutrition and staff support were not always detailed or complete. Some issues were corrected immediately, but inspectors said improvements needed to be sustained.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Effective and Well-led were all rated Requires Improvement. The report does not give ratings for Caring or Responsive.
Safeguarding
Staff understood how to report abuse and other safety concerns. Safeguarding concerns had been reported appropriately.
“Staff told us they had received training in safeguarding and knew what procedures to follow if they had concerns about people's safety.” from the report
Medicines usually given correctly
Systems were in place to make sure people received medicines as prescribed. Staff had suitable medicines training and competency checks.
“Systems were in place to ensure people received their medicines as prescribed.” from the report
Respect for people's decisions
The home involved people in decisions and used best-interest processes where someone could not make a particular decision. DoLS applications were made when appropriate.
“Where people were assessed as lacking capacity to make a particular decision, the provider followed best interest processes to protect people's rights.” from the report
Action after inspection findings
The management team responded promptly to issues raised during the inspection and sent confirmation of actions taken.
“The regional management team were responsive to our inspection findings.” from the report
Infection control
seriousDuring an outbreak, some areas needed deep cleaning. PPE and hand sanitiser were not always readily available, PPE was not always used correctly, and infected laundry was stored with non-infected laundry.
“Staff were not always wearing PPE appropriately or changing PPE as guidance recommends.” from the report
Staff deployment
needs fixingPeople, relatives and staff raised concerns about staffing levels and frequent changes in staff. Although rotas matched the dependency tool, staff were not always deployed suitably across the units.
“We noted staff were not always suitably deployed across all units to provide support.” from the report
Care and risk records
needs fixingRisk assessments and care plans did not always explain clearly how risks would be reduced or how each person wanted support. Inspectors also found an incorrect weight-loss record that had not led to action.
“Risks in relation to people's care had been identified and reviewed. However, there was still work required to include more detail on how risks could be mitigated.” from the report
Food and drinks
needs fixingAlternative meals and encouragement were not consistently offered to people who did not eat their meal. Drinks were not routinely available in bedrooms during the visit.
“We recommend the registered manager continue to complete spot checks to ensure encouragement and alternative options are consistently offered at mealtimes.” from the report
- 01What changes have been made to cleaning, PPE use and laundry arrangements since the infection outbreak inspection?
- 02How do you check that enough staff are available and correctly deployed on each unit at busy times?
- 03How are care plans and risk assessments now written to show each person's preferences and the support needed to reduce risks?
- 04What checks make sure drinks, alternative meals and encouragement are offered consistently?
- 05How often are medicines, nutrition, care records and staff supervision audited, and what happens when a problem is found?
This was an unannounced full inspection covering Safe, Effective and Well-led; the report does not give separate ratings for Caring or Responsive. 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, June 2022
Rated Good overall, but well-led Requires Improvement; inspectors found kind care and safety improvements, with some records, staffing and maintenance still needing attention.
This was an unannounced focused inspection. Inspection activity ran from 28 April to 11 May 2022, and inspectors visited the home on 28 April. They spoke with people, relatives, staff and professionals, observed care, and checked care, medicine, staffing and management records.
The home was rated Good for safe and effective care. People said they felt safe and described staff as kind. Medicines were given as prescribed, staff understood people's risks, and infection control procedures were generally followed. However, some care plans and medicine records were not up to date, and staff were not always present in communal areas.
The home was rated Requires Improvement for being well-led. The new management team had made improvements and had an action plan, but some checks had not found poorly maintained areas. Communication with people, mealtime support for people living with dementia, activities and the dementia-friendly environment also needed further improvement.
The previous overall rating was Requires Improvement, published on 8 August 2019. This inspection found improvements, but the report says the new systems still needed to become established and continue consistently.
People felt safe
Everyone spoken with said they felt safe. Staff understood safeguarding procedures and knew how to report concerns.
“Every person we spoke with told us they felt safe living at Buckingham Care Home.” from the report
Kind staff
People and relatives spoke positively about staff. Inspectors also observed kind and caring interactions.
“We observed when staff interacted with people, they were kind and caring.” from the report
Medicines and training
People received medicines as prescribed. Staff had medicines training and competency checks.
“Medication systems were in place, and people received their medication as prescribed.” from the report
Improving management
The new management structure had brought improvements, and staff and relatives said things were getting better.
“The new management team's strategy was to promote a person-centred culture that achieved good outcomes for people.” from the report
Care records were incomplete
needs fixingSome care plans and records about people's risks and needs were still being updated. Staff knew people's needs, but the written information was not always current.
“However, there was still work required to complete all people's plans to ensure documentation was up to date.” from the report
Staff cover in communal areas
seriousInspectors saw people left unsupported in communal areas on occasions. The manager added another staff member and said this would be reviewed.
“However, we found staff were not always deployed effectively.” from the report
Maintenance and infection checks
needs fixingSome storerooms and kitchenettes were poorly maintained and could not be cleaned effectively. The provider said these areas were improved after the inspection.
“The infection control audit was not always effective.” from the report
Dementia support
needs fixingMealtimes were sometimes task-focused, with little interaction. The dementia unit also lacked picture menus and interactive stimulation, and some decoration needed improvement.
“The mealtime experience was not always a pleasant experience for people living with dementia.” from the report
Communication and involvement
needs fixingStaff did not always involve people in decisions or communicate effectively with them. The new manager had identified this and was working to address it.
“However, staff did not always involve people in decisions or communicated effectively with people.” from the report
- 01How do you now make sure every person's care plan and risk information is complete and kept up to date?
- 02What staffing changes ensure people are supervised in communal areas at all times?
- 03How do you check that medicine records, especially 'when required' medicines, are complete?
- 04What improvements have been made to mealtimes, activities, picture menus and stimulation for people living with dementia?
- 05How do your infection control audits now identify and fix maintenance problems in storerooms and kitchenettes?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected in this visit, and the report says ratings for uninspected key questions carry over from the last inspection. This explanation was written from the published report of 1 June 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 Buckingham Care Home
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022GoodSafe: GoodEffective: GoodWell-led: Requires improvement
- November 2020Inspected but not ratedSafe: Inspected but not rated
- November 2020Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Registered with the Care Quality Commission on 11 February 2014.
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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