CQC report explained · a residential care home
What the CQC found at Melton Short Breaks Service
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There had been multiple medicine errors, including missed epilepsy medicine, and not all medicine checks or competency checks were completed. Risk records and care records were sometimes unclear, and inspectors found a restriction that negatively affected a person.
- Effective?
- Requires improvement
- Some staff did not have up-to-date moving and handling or other training. Mental capacity records and best interest decisions were incomplete or conflicting, so staff did not always have clear guidance about consent and support.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Relatives gave positive feedback and said people were supported to be independent where appropriate.
- Responsive?
- Requires improvement
- Care plans did not always record people's religious, sexuality and other personal needs well enough. Complaints and staff concerns were not always followed by effective action, although people had communication passports and a wide range of activities.
- Well-led?
- Requires improvement
- Quality checks did not reliably identify or fix problems with medicines, care planning, risk management, training and mental capacity assessments. Staff described weak leadership, confidentiality concerns and a culture where they did not feel able to challenge poor practice.
What inspectors found, March 2024
Melton Short Breaks Service is Rated Requires Improvement; inspectors found kind care but serious problems with medicines, consent, training and leadership.
Inspectors visited on 15 and 17 November 2023. They reviewed five people's care records, medicines records, audits, complaints, accidents and recruitment files. They spoke with one person, three relatives, two health professionals and nine staff.
The home was caring and relatives said their loved ones were well cared for and enjoyed staying there. People had varied activities, accessible spaces, good food choices and support with communication. Visitors were welcomed.
However, medicines were not always managed safely and there had been several medicine errors. Records about risks, care needs and mental capacity were sometimes unclear or conflicting. Some staff training was out of date or missing. Inspectors also found weak leadership, poor oversight and concerns about safeguarding, consent and personalised care. The overall rating and the ratings for Safe, Effective, Responsive and Well-led were Requires Improvement. Caring was rated Good.
Kind and respectful care
Inspectors found that people were treated with kindness, dignity and respect. Relatives spoke positively about the care and support.
“People were treated with kindness by staff who delivered care.” from the report
Activities and relationships
People were offered varied activities and trips, including opportunities linked to their social and cultural interests. There was also plenty to do inside the home.
“People experienced a wide and varied programme of opportunities in regard to how they chose to spend their time.” from the report
Accessible environment
The building had accessible bedrooms, wet rooms, communal areas, a sensory room and a garden. Inspectors found it exceptionally clean and tidy.
“The environment was exceptionally clean and tidy.” from the report
Communication support
Communication passports explained people's preferred ways of communicating. Easy-read staff profiles helped people know who might support them.
“People had communication passports in their files which explained how they preferred to communicate with staff and others staying at the service.” from the report
Food and cooking
People had food and drinks available and staff understood their dietary needs and preferences. People were encouraged to cook and bake to build confidence and skills.
“People were encouraged and supported to cook and bake during their stay.” from the report
Medicine safety
seriousThere had been multiple medicine errors. Checks were not always completed properly, investigations missed important information, and some staff had gaps in their medicine competency records.
“Medicines were not always managed safely. Multiple medicine errors had occurred.” from the report
Safeguarding and restrictions
seriousInspectors found a restriction that negatively affected a person. Staff had not identified it before the inspection, despite having safeguarding training.
“People were not always protected from the risk of abuse and improper treatment.” from the report
Staff training
seriousSome staff lacked evidence of moving and handling training, and other training was out of date. Planned supervised medicine sessions were not always completed.
“Staff did not always have sufficient training to be able to meet people's needs.” from the report
Leadership and oversight
seriousAudits did not reliably find or address problems. Staff said they could not always challenge leaders, and some concerns were not dealt with correctly.
“The provider had failed to operate effective quality assurance systems to assess and monitor the safety and quality of people's care.” from the report
Personalised care records
needs fixingRecords did not fully explain some people's religious needs or how they preferred to identify and be supported. This could make person-centred support more difficult.
“There were shortfalls in how people's needs were identified, particularly in respect of protected equality characteristics.” from the report
- 01What changes have been made to prevent further medicine errors, and how are staff's medicine skills checked now?
- 02How do you make sure every person has a clear mental capacity assessment and a recorded best interest decision where needed?
- 03Which staff are trained in moving and handling and in each person's specific care needs, and how do you track overdue training?
- 04How are safeguarding concerns and restrictive practices identified, reported and reviewed?
- 05What has changed in your audits and complaints process so that repeated concerns, such as missing personal belongings and inaccurate care records, are acted on?
This was a comprehensive inspection covering all five key questions, with visits on 15 and 17 November 2023 and inspection activity continuing until 24 November 2023. This explanation was written from the published report of 16 March 2024 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, October 2018
Melton Short Breaks Service was rated Good; inspectors found safe, kind and personalised care, with earlier problems improved.
This was an announced, comprehensive inspection on 10 September 2018. One inspector spoke with a person using the service, the manager and staff, and contacted the local authority. The inspector reviewed care records, medicines, staffing, complaints, incidents, safety checks and quality monitoring.
All five areas were rated Good: safe, effective, caring, responsive and well-led. People were protected from known risks, received their medicines as prescribed, and were supported by trained staff. Their dietary, health, communication and personal care needs were understood.
People and relatives were involved in planning short breaks. Staff supported people's choices, privacy, dignity and interests. The home offered communal areas, a sensory room and a garden, and had systems for complaints and feedback.
At the previous inspection in May 2017, the service was rated Requires Improvement because of medicines storage, records of best interest decisions and missed notifications to CQC. Inspectors found these improvements had been made and sustained.
Medicines improved
The home had introduced daily temperature checks and improved medicines processes after problems found at the previous inspection.
“We found at this inspection that arrangements for management of medicines was safe.” from the report
Personalised care
Care plans included people's interests, communication styles and preferences. People and their families helped plan each short break.
“People's care plans demonstrated how the registered manager and staff had taken time to get to know people and had involved them and their families in planning their care.” from the report
Respect and privacy
People's privacy and dignity were protected, including during personal care and when staff supported them with medicines.
“All 12 people said that they liked the staff that supported them and that their privacy was always respected.” from the report
Activities and choice
People were supported to take part in activities they enjoyed and to build skills, such as shopping and using public transport safely.
“People were supported to take a more active role in shopping, for example learning where to shop for specialised food items.” from the report
Quality improvement
The manager and provider used audits and feedback to improve medicines systems, activities and recreational facilities.
“The quality assurance procedures were used to drive improvements and follow through on feedback from people who used the service” from the report
Inspectors raised no specific concerns in this report.
- 01How will you update my relative's care plan and communication information before each short break?
- 02How will you check and record that my relative's medicines are stored correctly and given on time?
- 03What training do staff have for my relative's health conditions, communication needs and any equipment they use?
- 04How will you support my relative's dietary, cultural and activity preferences during their stay?
- 05How can my relative or our family raise a complaint, and how will we be told what action was taken?
This was an announced comprehensive inspection covering all five key questions, and the report gives a rating of Good for each one. This explanation was written from the published report of 5 October 2018 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 Melton Short Breaks Service
4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- March 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 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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