CQC report explained · a nursing home
What the CQC found at Hallmark Bucklesham Grange Luxury Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Staff were not always deployed effectively during busy times. Inspectors saw people left unattended in communal areas, and the provider was asked to review staffing levels and deployment.
- Effective?
- Good
- People received suitable food and had access to healthcare professionals, training and support. However, one upstairs dining area was not well organised and some wheelchairs were moved without staff communicating with people.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well, adapted their communication and supported people's independence.
- Responsive?
- Good
- Care records contained detailed guidance about people's individual needs and preferences. Activities were available, but inspectors found fewer structured activities tailored to people living with dementia upstairs.
- Well-led?
- Good
- The new manager was visible, approachable and taking action to address staffing, communication and leadership problems. Quality checks and action plans were in place, although recent management and staff changes had affected consistency.
What inspectors found, April 2020
Rated Good overall, but Safe Requires Improvement because staffing arrangements left some people unattended at busy times.
This was an unannounced inspection on 19 and 28 February 2020. Inspectors spoke with people living in the home, relatives, staff and health professionals. They reviewed care records, medicines records, recruitment files, training records and quality checks.
The home was clean and medicines were given as prescribed. People's risks were assessed, and staff understood safeguarding procedures. However, staff were not always deployed well during busy periods. Some people were left unattended in communal areas, and the inspection found that mealtimes upstairs were not well organised.
People were treated kindly and their care was generally personalised. Staff supported people with food, healthcare, communication, activities and end of life care. The new manager had been in post for four months and was taking action, but there had been recent changes in staff and management.
The overall rating was Good. Safe was rated Requires Improvement, while Effective, Caring, Responsive and Well-led were rated Good. The overall rating had fallen from Outstanding at the previous inspection, published in September 2017.
Kind and respectful care
People described staff as kind and helpful. Inspectors saw positive relationships and staff supporting privacy, dignity and independence.
“People were treated with kindness and compassion. People's care records provided guidance to staff on how to meet their specific needs.” from the report
Medicines and risk management
Medicines were administered as prescribed, including time-sensitive medicines. Individual risks were recorded with clear actions for staff to follow.
“Systems and processes were in place to make sure people received their medicines as they had been prescribed with clear records kept” from the report
Healthcare support
The home made referrals when people's health changed and worked with healthcare professionals. Staff received training relevant to their roles.
“People's care records showed referrals were made when concerns were raised about people's health or wellbeing.” from the report
Manager taking action
The new manager had identified problems with communication, leadership and continuity of care. Inspectors were encouraged by the progress being made.
“We were encouraged with the progress they had made, and which was ongoing to develop the home.” from the report
Staffing and supervision
seriousStaff were not always deployed safely during busy periods. Some people were left without supervision or meaningful interaction in communal areas.
“We saw instances where people on the first floor were left sitting in dining rooms and lounges unsupervised or without meaningful occupation or interaction from staff.” from the report
Communication between staff and families
needs fixingSome relatives had difficulty finding staff to answer questions. Having one nurse cover both floors reduced confidence that messages and information were passed on accurately.
“Some relatives told us that having one nurse on shift to cover both floors affected the communication and they were not confident they received accurate information” from the report
Infection control consistency
needs fixingThe home was clean, but feedback described staff not always following infection control procedures when preparing and serving food. Food and drinks were sometimes left uncovered.
“This included staff not always wearing PPE when preparing and serving food and leaving food and drinks out uncovered for periods of time” from the report
Activities upstairs
minorInspectors did not see structured cognitive or social activities upstairs. Staff and relatives wanted more one-to-one and group activities for people living with dementia.
“However, we did not see any structured cognitive or social activities taking place upstairs.” from the report
- 01What changes were made after the review of staffing levels and staff deployment during busy times?
- 02How do you make sure people on both floors are supervised and supported during mealtimes?
- 03How is information about a resident's health and messages from relatives passed between nurses and shifts?
- 04What infection control checks are now used when food is prepared and served?
- 05What one-to-one and group activities are available upstairs for people living with dementia?
This inspection covered all five CQC questions, with the overall rating based on findings from the unannounced visits on 19 and 28 February 2020. This explanation was written from the published report of 10 April 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, September 2017
Rated Outstanding; inspectors found exceptional caring and leadership, with some care-record and medicines-record issues to address.
Inspectors made an unannounced visit on 7 June 2017. They spoke with people living in the home, relatives, staff and a visiting healthcare professional. They observed care and checked care records, recruitment, training, medicines and quality monitoring.
The home was rated Outstanding overall. Caring and Well-led were Outstanding. Safe, Effective and Responsive were Good. Inspectors found kind and personalised care, enough staff, good training, safe medicines support and strong leadership.
There were some shortfalls. A staff lanyard caused discomfort during a transfer. New electronic records did not always clearly record people's wellbeing or explain food and drink information. There were also early problems recording medicines stock accurately.
Personalised care
Care was shaped around each person's needs, wishes and preferences. Staff knew people well and supported their independence.
“People received exceptional care that was personalised to them, taking account of their individual needs and wishes.” from the report
Kind and respectful staff
Inspectors saw compassionate interactions throughout the visit. People were listened to and their privacy and dignity were respected.
“People were consistently treated with kindness, respect and compassion.” from the report
End of life care
The home worked with hospice and healthcare teams to provide individual support for people approaching the end of their lives.
“The service provided outstanding end of life care. Effective systems and processes including working in partnership with the local hospice were in place to ensure people experienced a comfortable, dignified death in line with their wishes.” from the report
Strong leadership
Managers were visible and approachable. Regular meetings and quality checks helped the different parts of the home work together.
“Bucklesham Grange was exceptionally well led.” from the report
Activities and independence
People could choose whether to join activities and were supported to continue hobbies and relationships that mattered to them.
“The provision of activities was innovative and met people's needs and preferences.” from the report
Lanyard during a transfer
seriousA staff member's lanyard and keys knocked against a person's shoulder and chin during a transfer. The manager said new uniforms with pockets had been ordered.
“However we saw a staff member wearing a lanyard to keep their keys on assisting someone to transfer and their card and keys knocked into the person's shoulder and chin.” from the report
Incomplete care guidance
needs fixingOne care chart did not give staff enough information about how to support a person's needs while waiting for mental health input.
“One person's chart stated 'awaiting MH input'. This did not provide sufficient information for staff in providing care responsive to their needs in the meantime.” from the report
Electronic care records
needs fixingSome daily records focused on completed tasks and did not fully record mood, wellbeing or the support staff had provided. Food and fluid records also did not always match the daily log.
“Because food and fluid charts did not correspond with the daily records log there was no explanation as to why one person's food chart showed they had had nothing for 24 hours.” from the report
Medicines stock records
needs fixingThe new electronic medicines system had initial problems recording disposed medicines and new medicines promptly. Audits and competency checks were being used to identify and address discrepancies.
“Medication audits had identified that there had been some initial problems with managing the stock of medications with not all disposed drugs or new additions being registered in a timely way.” from the report
- 01Have staff stopped using lanyards during transfers, and what arrangements are now used to carry keys?
- 02How do you make sure electronic care records accurately describe a person's mood, wellbeing and the support they received?
- 03How do you investigate and explain any mismatch between food and fluid charts and daily care records?
- 04How are medicines stock records checked to make sure new medicines and disposed medicines are recorded promptly?
- 05How do care plans give staff clear advice when a person is distressed or waiting for input from mental health services?
This was an unannounced inspection of the overall service, covering all five CQC questions and reviewing whether the provider met the relevant legal requirements. This explanation was written from the published report of 13 September 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Hallmark Bucklesham Grange Luxury Care Home
3 rated inspections over 5 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Hallmark Bucklesham Grange Luxury Care Home →
- September 2017Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Outstanding
Read what inspectors found at Hallmark Bucklesham Grange Luxury Care Home →
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 26 September 2012.
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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