CQC report explained · a residential care home
What the CQC found at L'Arche Bognor Regis Bethany
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Rated Requires Improvement and placed in special measures; inspectors found serious weaknesses in risk management, care planning and leadership, although staff were kind and people were supported by enough staff.
This was a follow-up comprehensive inspection after serious concerns at the previous inspection. The inspection took place on 23 February 2023 and 02 March 2023. Inspectors reviewed records, medicines, staffing and the premises, and spoke with people and staff.
The home was still not meeting important standards. Risk assessments and medicines records were not reliable enough. Care plans did not always describe people's needs accurately, and some people were not getting the activities they wanted. Quality checks had not found or fixed these problems.
All five areas were rated Requires Improvement except Well-led, which was rated Inadequate. The overall rating remained Requires Improvement. The home was placed in special measures because an inadequate rating had continued across two comprehensive inspections.
Kind relationships
Inspectors saw warm interactions. People said staff were kind, compassionate and respectful, and supported their privacy and independence.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Enough staff
There were enough staff to meet people's needs safely. Staff had time to talk with people, prepare meals together and support outings.
“People told us there were enough staff to support them in the way that they wanted.” from the report
Safeguarding improved
Staff knew how to recognise and report abuse. Previous concerns about restrictive practices had been addressed.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 13.” from the report
Some environmental improvements
The home had new flooring, easier-to-clean furnishings and a secure front door. People had helped choose decorations and furnishings.
“At this inspection improvements had been made to the safety of the environment.” from the report
Health risks not managed well
seriousImportant risks, including epilepsy, diabetes, constipation, allergies and mobility, were not always covered by complete and clear plans. This meant staff might not recognise deterioration or know what action to take.
“There was a continued failure to manage risks.” from the report
Medicines records and checks
seriousAs-required medicines were given without clear protocols or records explaining why they were needed. Some handwritten medicine instructions were incomplete or written in pencil.
“This meant people could not be assured of receiving PRN medicines in line with the prescriber's instructions.” from the report
Care plans were inaccurate
seriousCare records did not always reflect people's needs, dietary requirements or required health checks. This included missing or conflicting information about nutrition, skin health, weight and blood pressure.
“Care plans failed to reflect accurate information about people's needs or appropriate guidance to support the person well.” from the report
People's goals not always followed
needs fixingPeople were involved in some activities, but some had not had opportunities to do things they wanted, such as bowling and swimming.
“People told us there were going out more but had not had the opportunity to do some of the things they told us they would like to do at the last inspection such as bowling and swimming.” from the report
Weak management oversight
seriousQuality checks did not reliably identify problems or make sure improvements lasted. Behaviour incidents, medicines, risks and care records were not monitored robustly enough.
“There was a continued failure to ensure adequate systems to assess, monitor and improve the quality and safety of services provided.” from the report
- 01What new risk plans are now in place for epilepsy, diabetes, constipation, allergies and mobility, and how are staff checked that they follow them?
- 02How are as-required medicines authorised, recorded and checked before they are given?
- 03How will you involve my relative in reviewing their care plan and setting goals that reflect their interests and choices?
- 04What arrangements are now in place for activities such as swimming and bowling?
- 05What quality checks now monitor medicines, incidents, care records and behaviour support, and what happens when a problem is found?
This was a comprehensive follow-up inspection, unannounced on the first day and announced on the second, covering all five key questions and infection prevention and control. This explanation was written from the published report of 30 June 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, September 2022
L'Arche Bognor Regis Bethany was rated Requires Improvement, with unsafe practices and inadequate leadership affecting people's choice, care and safety.
Inspectors visited without notice on 26 and 27 May 2022. They spoke with all six people living at the home, four relatives and eight staff. They reviewed care, medicine and management records, including six care records and three medicine records.
The home was rated Requires Improvement overall. Safe, Effective, Caring and Responsive were all Requires Improvement. Well-led was Inadequate. Inspectors found poor risk planning, unsafe medicine arrangements, restrictive practices, weak care records, limited activities and a home that was poorly maintained.
There were also positive findings. Staff communicated well with people using Makaton, pictures and speech. People were treated warmly, had access to health professionals and felt able to raise concerns. However, the provider had not made sure these strengths were supported by reliable systems and effective oversight.
Communication support
Staff understood people's individual communication methods. Inspectors saw people communicating effectively using Makaton, pictures, body language and speech.
“Throughout the inspection we observed people communicating effectively with staff using Makaton sign language, pictorial prompts and verbal speech.” from the report
Kind interactions
Staff showed warmth, patience and respect. People appeared comfortable with staff and relatives spoke positively about the care.
“We observed people receiving kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Access to healthcare
People were supported to attend health appointments and to receive help from other health and social care professionals.
“Records confirmed people had access to other health and social care professionals when necessary.” from the report
Raising concerns
People knew how to complain, and relatives said concerns were dealt with quickly. The provider recorded complaints and shared learning with staff.
“Complaints were recorded and responded to in line with the organisations policies and procedures.” from the report
Safe recruitment
The home maintained safe staffing levels and carried out recruitment checks, including for bank staff.
“Safe recruitment checks were undertaken on all staff including bank staff to ensure they were safe to work at the service.” from the report
Missing risk information
seriousImportant risks linked to seizures, diabetes, allergies, food intolerance and breathing problems were not always assessed or recorded. Staff knowledge about these risks was inconsistent.
“Some risks associated with medical conditions such as seizures, diabetes, allergies and food intolerances had not been considered or shared.” from the report
Unsafe medicines management
seriousInspectors found out-of-date medicines and a large amount of unlogged medicine awaiting disposal. One person struggled to swallow a tablet, but alternative forms had not been considered.
“Medicines held in the medicine's fridge were several months out of date.” from the report
Restrictive practices
seriousPeople were restricted from ordinary choices, including access to a television remote, food and going out alone, without clear evidence of agreement or best-interest decisions.
“The provider had failed to identify discrimination against service users on grounds of protected characteristics” from the report
Limited personal choice
needs fixingPeople were often limited to group activities and were not consistently supported to follow interests such as swimming, church, work, shopping or evening outings.
“People consistently told us they were bored and wanted to go out and do more.” from the report
Poor environment
seriousThe home was not well maintained or well furnished. Inspectors saw damaged flooring and a hole in the stair carpet that could cause a trip.
“The condition of the premises and equipment meant the environment was hard to keep clean and safe.” from the report
Weak management oversight
seriousAudits and checks failed to identify serious problems. The home also lacked a registered manager during the inspection and had been without a manager between September 2021 and March 2022.
“The provider had failed to establish systems and processes to assess and improve the quality and safety of the service provided or to assess and monitor risks.” from the report
- 01What risk plans are now in place for seizures, diabetes, allergies, food intolerance, breathing problems and choking?
- 02How are out-of-date and unwanted medicines now checked, recorded and disposed of?
- 03How are people involved in agreeing restrictions, best-interest decisions and plans for positive risk-taking?
- 04What individual activities, work or volunteering opportunities are now available for each person, and how are staffing levels arranged for them?
- 05What repairs and improvements have been made to the flooring, furniture and other parts of the home?
This was an unannounced inspection of all five key questions, including infection prevention and control, and the CQC reviewed both the premises and the care provided. This explanation was written from the published report of 1 September 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of L'Arche Bognor Regis Bethany
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at L'Arche Bognor Regis Bethany →
- September 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at L'Arche Bognor Regis Bethany →
- September 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- October 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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