CQC report explained · a nursing home
What the CQC found at Burton Closes Hall Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines, risks, staffing, safeguarding, infection control and emergency arrangements were safely managed. They also found staff were trained and competency checked before giving medicines.
- Effective?
- Good
- This key question was not assessed during this focused inspection. Its rating was carried forward from the last full inspection, but that individual rating is not stated in this report.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its rating was carried forward from the last full inspection, but that individual rating is not stated in this report.
- Responsive?
- Requires improvement
- This key question was not assessed during this focused inspection. Its rating was carried forward from the last full inspection, but that individual rating is not stated in this report.
- Well-led?
- Good
- Inspectors found effective governance, clearer communication and better record keeping. Managers and staff understood their roles, and the home had improved its monitoring of care quality and safety.
What inspectors found, July 2023
Burton Closes Hall Care Home was rated Good; inspectors found clear improvements in safety, medicines, staffing and management since the last inspection.
This was an unannounced, focused inspection on 31 May 2023. Two inspectors spoke with people, relatives, staff and managers. They observed care and checked care plans, medicines records, complaints, staffing records, maintenance records and management audits.
The home was rated Good for Safe and Well-led. Inspectors found that medicines, risks, staffing, infection control and emergency planning were managed safely. They also found effective checks on care quality and clearer management communication.
The previous rating was Requires Improvement, published in August 2022, with breaches of regulations. The provider had completed an action plan. Inspectors found enough improvement had been made and that the home was no longer in breach.
This inspection did not assess Caring, Effective or Responsive. The overall rating used the findings from this inspection together with ratings carried forward from the last full inspection.
Medicines safety
Medicines were managed safely. Staff giving medicines had training and competency checks, and inspectors saw appropriate checks and records.
“People's medicines were safely managed to ensure people received their medicines when they should.” from the report
Staffing improvement
Staffing and team working had improved since the previous inspection. The use of agency staff had reduced from 80% to 10%.
“Following a successful staff recruitment and training drive since our last inspection; effective team working and a reduced use of agency staff, from 80% to 10% was achieved.” from the report
Risk management
Care plans were kept up to date and included safety instructions about areas such as mobility, skin care and nutrition.
“Risks to people's safety were effectively identified and managed.” from the report
Management oversight
The provider had improved its checks on care quality and safety. Inspectors found better communication, decision making and accountability.
“The provider operated effective governance and oversight arrangements for the quality and safety of people's care and to ensure timely service improvement, when needed.” from the report
Positive relationships
Inspectors described a welcoming atmosphere and found that staff knew people well and provided individualised care.
“There was a relaxed, welcoming and friendly atmosphere at the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you now check that medicines are given and recorded safely for my relative?
- 02What staffing levels and skill mix will be available on the shifts when my relative needs care?
- 03How do you keep care plans up to date when a person's mobility, skin, nutrition or health needs change?
- 04What checks have been made since the inspection to make sure the improvements in management and record keeping have continued?
- 05What activities and support are available for my relative, given that Caring, Effective and Responsive were not assessed in this inspection?
This was a focused inspection of Safe and Well-led only; the other ratings used in the overall rating were carried forward from the last full comprehensive inspection. This explanation was written from the published report of 27 July 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, August 2022
Requires Improvement; inspectors found kind care, but serious problems with medicines, fire safety, staffing and management systems.
This was an unannounced focused inspection on 06 June 2022. Inspectors checked whether earlier problems had been fixed, and looked at infection control. They spoke with five people, eight relatives and staff, and reviewed care, medicines, staffing and management records.
The home was not always safe. Medicines were not consistently managed correctly, fire safety improvements had not been completed, and some people waited too long for call bells or help. Records about nutrition, cleanliness and people's legal rights were also not always accurate or complete.
Staff were described as kind, caring and familiar with people. They supported access to health professionals and often provided personalised care. However, the systems for checking quality, managing risks and making improvements were still not effective.
The overall rating remains Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three areas were not inspected during this visit, so their previous ratings were used to calculate the overall rating. The home has had this overall rating for the last two consecutive inspections.
Kind and respectful staff
Staff were kind, caring and knew people well. Inspectors saw positive relationships with people and their families.
“Staff were kind, caring, knew people well and had good relationships with them and their families.” from the report
Personalised support
Staff often provided care in a personalised way and checked people's choices before giving support.
“They were responsive, to ensure people's access to relevant external health professionals when needed and regularly provided care in a personalised way.” from the report
Infection control arrangements
Inspectors were assured about several areas of infection prevention, including visitor safety, admissions, testing and outbreak management.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Medicines were not consistently safe
seriousTwo medicines for one person had run out. Inspectors also found a tablet in a bedroom and incomplete records for skin creams. This created a risk that people did not receive medicines as prescribed.
“People were at risk from unsafe care and treatment because the registered provided had failed to fully ensure the proper and safe management of peoples medicines.” from the report
Fire safety work was overdue
seriousThe home had not completed improvements identified in a fire risk assessment from April 2021. The fire and rescue service later issued a fire safety improvement notice.
“The fire risk assessment identified a list of fire safety improvements needed, of moderate risk.” from the report
Staffing and response times
needs fixingInspectors saw delayed responses to call bells and people left without supervision for long periods. Training and supervision records also showed gaps.
“We observed staff did not always respond in a timely manner when needed, to people's call bells for assistance.” from the report
Weak management checks
seriousThe provider's quality and risk checks did not reliably lead to quick action. Records were sometimes inaccurate, and action plans did not always state who was responsible or when work should be completed.
“The provider's governance arrangements were not effectively operated, to consistently ensure the quality and safety of people's care, timely risk mitigation and drive service improvements when needed.” from the report
Care information was not always accurate
needs fixingInformation about two people's nutritional needs was not recorded accurately. Records also did not always show how decisions about staying in bedrooms had been made lawfully and in people's best interests.
“This meant there was an increased risk to people, of receiving unsafe or ineffective nutrition.” from the report
Some cleanliness was not proactively checked
minorInspectors found that general bedroom and mattress cleanliness was not consistently monitored. The manager said action was taken after the inspection.
“General bedroom and mattress cleanliness and hygiene was not proactively ensured.” from the report
- 01What action has been completed to make sure medicines do not run out and that every dose and skin cream application is recorded correctly?
- 02What work has been completed in response to the fire safety improvement notice, and what remains outstanding?
- 03How many staff are on duty at different times, and how are call-bell response times now monitored?
- 04Which staff have completed training in fire safety, dementia, learning disabilities and mental health needs, and how is supervision provided?
- 05How are care records checked to ensure nutrition instructions and decisions about people's daily living arrangements are accurate, lawful and up to date?
This was a focused inspection of Safe and Well-led, including infection control; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 12 August 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 Burton Closes Hall Care Home
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Burton Closes Hall Care Home →
- August 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Burton Closes Hall Care Home →
- May 2019Requires improvementstayed Requires improvementSafe: GoodWell-led: Requires improvement
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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