CQC report explained · a residential care home
What the CQC found at Burridge Farm
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough trained staff, safe recruitment, suitable risk assessments and safe medicines arrangements. The home was clean, and staff understood safeguarding and infection control.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff received induction, training and supervision. Inspectors found that the home was now meeting the legal requirements on consent, following a previous breach of Regulation 11.
- Caring?
- Good
- People appeared relaxed with staff and were treated with dignity and respect. They were supported to make choices, maintain independence and stay in touch with family and friends.
- Responsive?
- Good
- Care plans recorded people's histories, preferences and communication needs. People were supported with personalised activities, community life, relationships and accessible ways to make complaints.
- Well-led?
- Good
- Inspectors found better management systems, regular audits and an open culture where staff and professionals could raise concerns. The new manager was described as knowing people well and understanding their responsibilities.
What inspectors found, March 2020
Rated Good; inspectors found kind, personalised care and clear improvements since the previous inspection.
This was an unannounced inspection on 31 January 2020. One inspector met everyone living at the home, spoke with two people, staff, health and social care professionals, and one relative. They also checked care records, medicines records, staff files and management records.
The home supported six people with learning disabilities and/or autism. Inspectors found that people appeared relaxed and happy. Staff understood people's communication, needs and preferences. People were supported to make choices, build independence, go out, join activities and keep in touch with family and friends.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This means inspectors found people's needs were met through good care and organisation, with people treated with dignity and respect.
The home had previously been rated Requires Improvement and had breached Regulation 11 about consent. At this inspection, the breach had been resolved. The Effective and Well-led ratings improved to Good, while the other ratings remained Good.
Choice and independence
People were supported to make everyday choices and develop life skills. Staff helped people take part in activities and outings in the community.
“People were encouraged to be as independent as possible.” from the report
Kind relationships
Inspectors saw positive interactions between people and staff. Feedback from people, relatives and professionals was very positive.
“People were relaxed and happy with staff, who understood and were attentive to their needs.” from the report
Personalised communication
Care plans explained how each person communicated, including the use of pictures, photos and symbols. This helped staff understand people's wishes and reduce anxiety.
“Each person's care plan had details about how the person communicated and was able to understand.” from the report
Safe medicines
Medicines were stored securely, staff were trained, and audits checked medicines and records. Staff were retrained after errors to reduce the chance of them happening again.
“Medicines were stored safely in a locked cabinet in an area only accessible to staff.” from the report
Improved consent practice
The home had addressed the previous breach about consent. DoLS applications and renewal monitoring were in place, with best-interests decisions recorded where needed.
“At this inspection the service was now meeting the requirements of this regulation.” from the report
Resident meetings were not effective
minorThe manager said resident meetings had not worked well because most people had limited or no verbal communication. The home used key workers and monthly records of people's choices instead.
“The manager said they had tried to have resident meetings but found these had not been very successful as most people had limited or no verbal communication.” from the report
- 01How will you support my relative to express choices if they have limited or no verbal communication?
- 02How are key workers recording and acting on my relative's likes, dislikes and choices?
- 03How do you check that any DoLS authorisation is renewed on time and that its conditions are followed?
- 04What changes have been made since the new management structure was introduced?
- 05How will my relative be supported to take part in activities, clubs and community life?
This was an unannounced comprehensive inspection covering all five CQC questions, the premises and the care provided. This explanation was written from the published report of 13 March 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, February 2019
Rated Requires Improvement; inspectors found safe, kind and personalised care, but legal paperwork for restrictions and some management systems were not reliable enough.
This was an unannounced, comprehensive inspection over 28 and 29 November and 11 December 2018. It followed concerns about restrictions on movement, eating, smoking, shaving and money, staffing levels, and whether staff were listened to. Inspectors spoke with people, relatives, staff, managers and health professionals, and reviewed records.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, safer recruitment, safe medicines, personalised care, kind staff and good support with activities, communication, health and family contact. Safeguarding concerns were later closed by the local authority.
The home was rated Requires Improvement for Effective and Well-led. Some restrictions were not fully recorded as least restrictive or supported by the required best-interest evidence. One DoLS application did not describe all the restrictions. Audits had not found these gaps, and staff meeting records and communication were not always effective.
The overall rating was Requires Improvement. This was the same overall rating as the previous inspection in February 2018. Recruitment had improved, so the Safe rating rose from Requires Improvement to Good and the previous breach of Regulation 19 had been met. The inspectors identified one new breach relating to people's involvement and legal safeguards when restrictions were used.
Kind and respectful staff
People appeared relaxed and happy. Staff understood individual preferences and supported people's dignity, privacy and emotional wellbeing.
“Staff showed kindness and compassion to people and there was a relaxed and happy atmosphere in the home.” from the report
Personalised support
Care plans reflected people's needs, interests and ambitions. Staff supported activities, work opportunities, independence and contact with families.
“Each person had a care plan which was personalised.” from the report
Safer recruitment and staffing
The previous recruitment problem had been addressed. Inspectors found enough staff, including when people needed one-to-one or two-to-one support.
“Checks were now completed prior to staff working with people in the home.” from the report
Safe medicines
Medicines were stored, given and recorded safely. Audits were used to check medicines and staff received further training when records were incomplete.
“The administration, storage, record keeping and auditing of medicines was safe.” from the report
Restrictions were not fully documented
seriousSome restrictions on a person's movement were not supported by enough evidence of best-interest decisions, professional involvement or the least restrictive approach. The inspector found that this could mean restrictions were used without all the required legal safeguards.
“This is a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014” from the report
DoLS information was incomplete
seriousSome DoLS authorisations had expired or were still awaiting assessment. One application did not fully describe the restrictions being used, although managers gave further information during the inspection.
“The application however had not been explicit in describing all the restrictions that were currently being used.” from the report
Management checks missed record gaps
needs fixingQuality audits did not identify the missing detail about restrictions in care plans and DoLS applications. This contributed to the Requires Improvement rating for Well-led.
“This had not been identified as part of any audits undertaken.” from the report
Staff communication
needs fixingSome staff meetings were poorly attended. Minutes did not give enough detail about decisions and actions, and staff said meetings could be changed or cancelled at short notice.
“The minutes did not provide clear information about each agenda item or the decisions and actions that arose as a consequence of the meeting.” from the report
Care plans were not accessible
minorStaff used pictures, storyboards and easy-read sheets when supporting people, but the care plans themselves were not written in a format people could understand.
“However, care plans were not written in format which would support people to understand them.” from the report
- 01What restrictions are currently used for each person, and how are they recorded as being in the person's best interests and least restrictive?
- 02Which DoLS authorisations are now in place, and do they describe every restriction being used?
- 03How do managers check that care plans contain the right legal and professional evidence about restrictions?
- 04How are staff now told about decisions and actions from staff meetings if they cannot attend?
- 05How will people be given care information in formats they can understand?
This was an unannounced comprehensive inspection covering all five key questions and the whole service, following concerns about care practices and restrictions. This explanation was written from the published report of 20 February 2019 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Burridge Farm
4 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Registered with the Care Quality Commission on 23 December 2013.
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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