CQC report explained · a nursing home
What the CQC found at Buckingham Lodge Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Staff were not always visible in communal areas and some people were left unsupervised or did not receive enough support at mealtimes. Medicines were generally managed safely, but checks and records for some risks and as-required medicines needed improvement.
- Effective?
- Requires improvement
- People's needs were assessed, but the home did not always identify when it could no longer safely meet a person's needs or provide enough support to help someone settle. Care and wound records did not always explain decisions and reviews fully.
- Caring?
- Good
- People and relatives said staff were kind, caring and respectful. Staff supported people to make day-to-day choices and encouraged independence.
- Responsive?
- Requires improvement
- Activities were available, but activity staff were stretched and some people needed more encouragement or more suitable sensory and social support. Records did not always describe people's needs and changes in enough detail or on time.
- Well-led?
- Good
- The manager had created more stability through recruitment, training and coaching. Audits, incident reviews and governance meetings helped identify risks and improvements, although the new culture was still developing.
What inspectors found, January 2023
Buckingham Lodge Care Home was rated Requires Improvement; inspectors found kind care and stronger leadership, but gaps in safety, records and activities.
Inspectors visited over two days in October 2022. The first day was unannounced and the second was announced. They observed care, checked medicines and records, spoke with people, staff, relatives and a visiting professional.
People were generally treated with kindness, dignity and respect. The home was clean and well maintained. Leadership and quality checks were considered good, and recruitment had improved, with the home no longer relying on agency staff.
However, staff were not always visible in communal areas, some people did not receive enough support at mealtimes, and person-centred care was not yet consistent. Records did not always clearly show people's changing needs, risks or the care provided. Activities and sensory support did not meet everyone's needs.
The overall rating of Requires Improvement means the home was not consistently providing safe, effective and responsive care. Caring and Well-led were rated Good, while Safe, Effective and Responsive were rated Requires Improvement.
Kind and respectful care
People and relatives described staff as kind and respectful. Inspectors also saw staff speaking respectfully to people.
“During our observations on both days we observed staff speaking with people respectfully.” from the report
More stable staffing
The home had recruited staff and was no longer reliant on agency workers. This had helped create more stability, although some newer staff were still developing their skills.
“She had a fully recruited staff team, for the first time in many years this service was no longer reliant on agency staff.” from the report
Strong oversight
The manager used audits, incident reviews and meetings to monitor quality and identify patterns or actions to reduce risks.
“There were good systems in place to monitor the quality and safety of the service.” from the report
Clean and maintained environment
Inspectors found the environment safe, clean and well maintained. Relatives also spoke positively about cleanliness.
“The domestic staff worked tirelessly to keep the service clean.” from the report
Choice and independence
People were supported to make daily choices, including about meals. Relatives described staff helping people maintain independence and build confidence.
“Staff supported people to make day to day choices in a way that was appropriate to their needs.” from the report
Supervision and mealtime support
seriousStaff were not always visible in communal areas, and some people were left unsupervised or became distressed. Not everyone received the support they needed to eat well at lunchtime.
“This meant people were left unsupervised and we noted some people became distressed.” from the report
Medicine safety checks
seriousThe home could not show that blood glucose machines were calibrated as required. Some records about blood-thinning medicines and as-required medicines were also incomplete.
“The service was unable to demonstrate that blood glucose monitoring machines were being calibrated as required to ensure accurate blood glucose readings.” from the report
Care records
needs fixingRecords did not always show changes in people's needs or risks clearly, fully or promptly. Inspectors also found wound documentation did not always explain who had been consulted or what options had been considered.
“Actions were not always identified in relation to a change of need and, or risk.” from the report
Activities and sensory support
needs fixingActivities reached only a small number of people, and some people needed more encouragement. Inspectors found insufficient attention to sensory needs and social stimulation for some people.
“Planned activities whilst stimulating for some only involved a small number of people.” from the report
Person-centred care not consistent
needs fixingSome staff practice was task-focused rather than centred on each person's preferences and needs. The manager was working to improve this, but the approach was not yet embedded.
“Though our observation we found some staffs practice was task focused” from the report
- 01How do you make sure people are supervised in communal areas throughout the day, including before lunch?
- 02What checks are now in place to calibrate blood glucose monitoring machines and record why as-required medicines are given?
- 03How do you keep care records up to date when a person's needs or risks change?
- 04What individual activities and sensory support are available for people who do not join group activities or who have sight or communication difficulties?
- 05What progress has been made in making person-centred care consistent across all staff?
This was a first comprehensive inspection under the new provider, covering all five key questions, with medicines and infection prevention and control also examined. This explanation was written from the published report of 25 January 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.
Every inspection of Buckingham Lodge Care Home
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2020Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2021
Registered with the Care Quality Commission on 23 February 2021.
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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13 live-in carers within about an hour of Norfolk
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.