CQC report explained · a residential care home
What the CQC found at 10 Beeches Road
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some staff did not always follow care plans, allergy information was inconsistent, and medicine practices were not always safe. Fire evacuation arrangements and handwashing facilities also needed attention.
- Effective?
- Good
- Staff understood mental capacity and liberty safeguards, had relevant training, and supported people's nutrition and access to healthcare.
- Caring?
- Requires improvement
- Relatives described kind care and encouragement of independence, but inspectors found that people's privacy and dignity were not always maintained.
- Responsive?
- Good
- Care was personalised. People were supported with communication, daily choices, family relationships and activities that interested them.
- Well-led?
- Requires improvement
- Management checks did not reliably identify risks in medicines, records or care-plan practice. There was no registered manager, and this meant the provider was not meeting a registration condition.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found kind, person-centred support but concerns about medicines, dignity and management checks.
The inspection took place without notice on 4 September 2019. One inspector spoke with staff and managers, reviewed care, medicine and staff records, and later spoke with two relatives. The home supported two people with learning disabilities and autistic spectrum disorder.
Inspectors found good practice in effective and responsive care. People were supported to make choices, communicate in different ways, maintain relationships and take part in activities. Staff understood safeguarding, had relevant training and worked in a person-centred way.
However, safety checks did not always identify risks. Medicine records and allergy information were not always correct, some medicines were not dispensed in line with best practice, and staff did not always follow care plans. People's privacy and dignity were not always protected. There was no registered manager.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe, Caring and Well-led were rated Requires Improvement, while Effective and Responsive remained Good. The provider was asked for an action plan and CQC said it would monitor progress and re-inspect.
Safeguarding
Staff had safeguarding training and could explain how they would recognise and report abuse or other concerns.
“People were protected from potential abuse and avoidable harm by staff that had regular safeguarding training.” from the report
Choice and control
People were supported to make decisions and were cared for in the least restrictive way possible, using best-interest decisions when needed.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Personalised support
Care plans included people's preferences, and staff supported their choices about daily activities, food, clothing and routines.
“People's care plans held information regarding their personal preferences, likes and dislikes and people who were important to them.” from the report
Relationships and activities
People were supported to keep in touch with family and to take part in activities they chose.
“People were supported to maintain relationships with families and develop friendships where appropriate.” from the report
Medicine and allergy safety
seriousMedicines taken outside the home were not always labelled with administration instructions. One prescribed cream was out of date, and allergy information was inconsistent across records.
“Medicines were not always dispensed inline with best practice guidance.” from the report
Weak management checks
seriousAudits did not identify important problems with medicines, allergies or staff following care plans. CQC said this placed people at risk and found a breach of good governance.
“Systems and processes were not robust enough to demonstrate safety was effectively managed.” from the report
Privacy and dignity
needs fixingStaff sometimes entered a person's bedroom to use the ensuite when that person was out, rather than using the staff bathroom.
“Staff did not always maintain people's privacy and dignity.” from the report
Complaint records
minorThe outcomes of two of three formal complaints were not recorded. A relative also said they did not always receive feedback about specific concerns.
“Formal complaints had been logged but outcomes for two out of three complaints were not recorded.” from the report
- 01What has been done to make sure allergy information is identical and up to date in medicine records, hospital passports and care plans?
- 02How are medicines checked now, including creams and medicines prepared for short trips outside the home?
- 03How do you check that staff follow each person's care plans and risk assessments in practice?
- 04Who is currently responsible for managing the home, and what progress has been made towards having a registered manager?
- 05How are privacy and dignity protected when people are out of the home, and how are complaints and their outcomes recorded?
This was an unannounced inspection of the care home, including both the premises and the care provided, and it considered all five key questions. This explanation was written from the published report of 18 October 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, March 2017
Rated Good overall; inspectors found safe, caring and personalised support, but the home's management checks needed improvement.
The inspection was unannounced and took place on 08 February 2017. One inspector met both people living at the home, observed their support and spoke with relatives, staff and the registered manager. Records on medicines, care, risks, incidents, complaints, staffing, training and quality checks were also reviewed.
Inspectors rated the home Good for Safe, Effective, Caring and Responsive. They found enough trained staff, safe recruitment, support with medicines and risks, good access to health care, and care that respected people's choices, privacy, dignity and independence. People were supported with activities they enjoyed and to keep in touch with family.
The Well-led rating was Requires Improvement. Quality checks did not always find problems. Inspectors found out-of-date creams, missing notifications about approved DoLS applications and the home's rating was not displayed as required. The manager took action on these issues during or after the inspection, but the auditing system had not identified them earlier.
Kind and respectful care
Staff were friendly, patient and considerate. They respected people's communication needs, privacy, dignity and personal choices.
“People's individuality, independence, privacy and dignity was respected and promoted.” from the report
Personalised support
Staff knew people's routines, preferences and ways of communicating. People were involved in decisions about their care and daily lives.
“People received individualised care and support, because staff involved them in planning their care and supported them to take part in activities that they enjoyed.” from the report
Skilled staff
Staff had training relevant to the needs of the two people, including autism, epilepsy, communication and behaviour support. Supervision and appraisals were up to date.
“People were supported by staff who had the skills and knowledge to meet their complex needs.” from the report
Quality checks missed problems
needs fixingAudits and other checks were in place but did not reliably identify issues that needed fixing. This included medicines checks, DoLS notifications and displaying the rating.
“The systems in place to audit the quality of the service were not always effective because they did not identify where some improvements were needed.” from the report
Out-of-date creams
needs fixingInspectors found some creams and ear oil were out of date. The manager removed them during the inspection and later dated items after seeking pharmacy guidance.
“We found some body creams and oil for a person's ears was out of date.” from the report
Missing notifications and displayed rating
needs fixingThe home had not told CQC about approved DoLS applications as required. Its CQC rating was also not displayed correctly at the time of inspection.
“The provider had not notified us when applications had been approved as is required and the registered manager told us they would do this retrospectively.” from the report
- 01How are short-term creams and other applications now checked for opening dates and expiry dates?
- 02Have all approved DoLS applications now been notified to CQC, and who checks that this is done?
- 03How often are quality audits reviewed, and how do you make sure they identify problems rather than simply record that checks were completed?
- 04What arrangements are in place when the registered manager is working at the other home?
- 05How do you use feedback from people and relatives to make improvements, and can you give a recent example?
This was an unannounced inspection covering all five CQC questions, based on observations, discussions with people, relatives, staff and the manager, and a review of care, medicines and management records. This explanation was written from the published report of 29 March 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 10 Beeches Road
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- October 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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