CQC report explained · a residential care home
What the CQC found at Five Bells Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments, recruitment checks and medicines systems were generally effective. However, there were concerns about staffing levels, storage of equipment and some environmental repairs.
- Effective?
- Good
- People received suitable food and had access to healthcare professionals. Staff followed the Mental Capacity Act principles, although some work on the environment, training leadership and staff appraisals was still outstanding.
- Caring?
- Requires improvement
- Staff were described and observed as kind and compassionate, but people were not always treated with dignity or given support suited to their individual abilities.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People were supported with their interests, independence, complaints, communication needs and end-of-life wishes.
- Well-led?
- Good
- The registered manager was visible and approachable, and people, relatives and staff could give feedback. However, accident and incident findings were not formally escalated to the provider or senior management team.
What inspectors found, March 2019
Five Bells Residential Care Home was rated Good; inspectors found improved safety and kind care overall, but dignity and some staffing arrangements needed attention.
This was an unannounced comprehensive inspection on 7 and 8 August 2018. One inspector spoke with people living in the home, staff, visitors and a healthcare professional. They reviewed care plans, medicines records, staff files, complaints information and quality checks.
The home was rated Good overall. Safe, effective, responsive and well-led were rated Good. Inspectors found improvements since the previous inspection, including safer premises, better risk management and safe medicines handling. However, there were not always enough housekeeping and catering staff, and some equipment and maintenance issues remained.
Caring was rated Requires Improvement because people were not always treated with dignity and respect. Inspectors saw meals presented in an unsuitable way and saw that a person was not given equipment that could have helped them eat independently. The home was no longer in breach of Regulation 12, which had been breached at the previous inspection.
Safer care
The home had made significant improvements since the previous inspection. Risk assessments were detailed, staff understood safeguarding, and safety checks were up to date.
“At this inspection we found that the provider had made significant improvements and was no longer in breach of regulation 12.” from the report
Medicines
Medicines, including controlled drugs, were administered by competent staff. Records showed no gaps and included photographs, allergy information and special instructions.
“We found that people's medicines, including controlled drugs were managed consistently and safely by competent staff.” from the report
Personalised care
People and relatives were involved in care planning. Care plans focused on individual needs, choices, independence and wellbeing.
“Individual care plans are now easier to find. They are more in-depth.” from the report
End-of-life support
People could record their wishes, and staff worked with health professionals to support comfort and dignity at the end of life.
“People at the end of their life were supported to have a comfortable, pain free and dignified death.” from the report
Leadership and feedback
The manager was visible and approachable. People, relatives and staff were invited to meetings and surveys, and staff meetings gave people a chance to speak up.
“The registered manager was a visible and approachable leader.” from the report
Staffing cover
needs fixingInspectors found that there were not always enough housekeeping and catering staff. Care staff sometimes had to prepare and serve the evening meal, and shifts were not always covered when staff were sick.
“The provider did not ensure that there were appropriate numbers of housekeeping and catering staff.” from the report
Dignity at mealtimes
needs fixingSome people were not given meals or drinks in a respectful and suitable way. One person was not initially given a plate, tray, napkin or suitable cup.
“Staff had failed to treat people with dignity and respect.” from the report
Support with eating
needs fixingA person with dexterity difficulties struggled to eat because the suitable plate was not provided at first. The manager acted after inspectors raised this.
“We noticed this person's frustration and informed the registered manager.” from the report
Equipment storage
needs fixingWheelchairs and scales were stored in ways that created hazards. The scales blocked access to a fire extinguisher until they were moved during the inspection.
“The sit on scales were stored in the corridor outside the office, blocking access to the fire extinguisher.” from the report
Incident oversight
needs fixingThe manager reviewed accidents and incidents, but there was no formal process to pass the findings to the provider or senior management. This meant important patterns might not be fully assessed.
“However, the provider did not have formal system or process in place to escalate these findings to the provider or senior management team.” from the report
Maintenance and cleanliness details
minorSome areas needed decoration, and a cracked staff toilet sink had not yet been replaced. Inspectors also noted clutter in one bedroom and a sloped corridor without warning signs.
“People told us that they were happy with the standard of cleanliness in the service, but the home would benefit from being painted.” from the report
- 01How many housekeeping and catering staff are scheduled on each shift, and what happens when someone is off sick?
- 02How do you check that every person is given meals, drinks and eating equipment in a dignified way?
- 03What equipment is available for people who have difficulty using normal plates or cutlery?
- 04Have the cracked sink, damaged paintwork, bedroom clutter and sloped corridor been dealt with since the inspection?
- 05How are accidents, falls, infections and skin tears now reported to the provider and senior management?
This was an unannounced comprehensive inspection covering all five CQC questions; two people living under tenancy agreements who did not receive personal care were not included in the report. This explanation was written from the published report of 23 March 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.
What inspectors found, May 2017
Rated Requires Improvement; inspectors found kind care and safe medicines, but avoidable risks, poor records and weak oversight remained.
This was an unannounced comprehensive inspection on 19 April 2017. Inspectors visited because they had received concerns that people might not be receiving safe care. They spoke with people living in the home, relatives and staff, observed care, checked care records and reviewed management records.
The home was rated Requires Improvement overall. Safe, Effective, Responsive and Well-led were also rated Requires Improvement. Caring was rated Good. Inspectors found kind staff, enough care staff on duty, safely managed medicines and good support with healthcare. However, people were not always protected from avoidable accidents, parts of the home were not clean and some staff checks and training were incomplete.
The home was in breach of Regulation 12 because risks from accidents and avoidable harm had not been properly addressed. Inspectors also found unreliable records about food, drink and weight, limited activities, incomplete care assessments and quality checks that had not brought problems to light or got them fixed quickly.
Kind and respectful care
Inspectors saw staff treating people with compassion and respect. Staff supported privacy and took time to talk with people about things that mattered to them.
“We saw that people were treated with compassion, kindness and respect.” from the report
Medicines managed safely
Medicines were stored securely and staff had suitable training. Records showed that people had received their prescribed medicines correctly during the week before the inspection.
“There were reliable arrangements for ordering, storing, administering and disposing of medicines.” from the report
Enough staff on duty
The inspection found that care staff shifts had been filled and call bells were answered quickly. People received prompt help with needs such as using the bathroom.
“We concluded that there were sufficient care staff on duty to provide people with the care they needed.” from the report
Healthcare and legal rights
Staff arranged healthcare appointments when needed. The home also made the required applications for people subject to Deprivation of Liberty Safeguards.
“People said and records confirmed that they received all of the help they needed to see their doctor and healthcare professionals including dentists and opticians.” from the report
Risks from accidents
seriousPeople were not consistently protected from avoidable harm. Inspectors found an access security issue, two unguarded hot radiators and windows without suitable safety latches.
“People had not always been protected from the risk of avoidable accidents.” from the report
Cleanliness and recruitment checks
needs fixingSome carpets and communal toilet facilities were dirty or in poor condition. Employment histories and one required recruitment check had not been completed correctly for two new care staff.
“These shortfalls increased the risk that people would acquire avoidable infections.” from the report
Food, drink and weight records
needs fixingRecords did not reliably show what some people had eaten and drunk. Some people had not drunk enough over several days, and weight checks were not consistently offered or analysed.
“This oversight made it more difficult for care staff to establish if the people concerned were eating and drinking enough.” from the report
Too few activities
needs fixingPeople had limited chances to pursue hobbies or join social events. Inspectors saw many people spending time alone, and records showed that activities were often not provided.
“It is a long day here with usually nothing but the television.” from the report
Weak quality checks
needs fixingThe home's checks had not found or fixed several problems, including safety hazards, hygiene, nutrition records, staff training, activities and fire safety checks. People and relatives were not fully involved in improving the home.
“Quality checks had not always resulted in problems in the running of the service being quickly put right.” from the report
- 01What has been done to guard the hot radiators, make the windows safe and resolve the access security issue?
- 02How are food, drink and weight records now checked, and what happens when someone is not eating or drinking enough?
- 03Have all care staff completed the training identified as necessary, including training about nutrition, mobility, infection control and fire safety?
- 04What regular activities and opportunities for hobbies are now available, and how are people's interests recorded?
- 05How do you now make sure quality checks identify and quickly fix problems, including fire safety and cleanliness?
This was an unannounced comprehensive inspection covering all five rating areas, following an earlier comprehensive inspection on 14 September 2016. This explanation was written from the published report of 26 May 2017 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 Five Bells Residential Care Home
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
Read what inspectors found at Five Bells Residential Care Home →
- May 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Five Bells Residential Care Home →
- December 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 16 March 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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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
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.