CQC report explained · a residential care home
What the CQC found at Patron House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found kind care and safe medicines, but concerns about staffing and food choices.
The inspection was unannounced and took place on 13 July 2022 and 20 July 2022. Inspectors spoke with people, relatives, staff and professionals. They observed care and checked care, medicine, training, recruitment and management records.
People said they felt safe and supported. Staff were kind and caring. Medicines were managed safely, staff were trained, and the home worked well with health professionals.
Inspectors found that staffing was not always enough at busy times. People were delayed getting meals, and some people had limited choice when they did not like the food offered. Staff morale was also low.
This was a focused inspection of Safe, Effective and Well-led. All three were rated Requires Improvement. The overall rating fell from Good at the previous inspection on 5 December 2019.
Kind and caring staff
People felt safe and supported. Inspectors observed respectful interactions and received positive feedback about staff.
“People felt safe and supported by staff who were kind and caring.” from the report
Medicines managed safely
Medicines were stored securely, staff were assessed as competent, and records showed people received their medicines as required.
“Staff undertook training, which included an assessment of their competence. This ensured they were demonstrating a good understanding of how to administer medicines safely.” from the report
Health professional support
The home worked with GPs, nurses, social workers and other professionals. Referrals were made in a timely way.
“Referrals to health professionals were made in a timely way. People could see visiting health professionals such as GP's, community nurses and social workers.” from the report
Safe recruitment and care planning
Recruitment checks were completed before staff started. Care plans recorded people's needs and included recognised assessment tools.
“Checks included references, identity and leave to remain checks, work history and a full Disclosure and Barring Service (DBS) check.” from the report
Staffing levels
needs fixingPeople were not always supported by enough staff. Inspectors saw people delayed at mealtimes while staff dealt with other needs, and the report includes a recommendation about staffing.
“People were therefore delayed with their teatime meal whilst staff rectified the situation.” from the report
Limited food choice
needs fixingMeals were sometimes small, and alternatives were not always available when people did not like what was served. Inspectors found gaps between the planned menu and the food available.
“There were no sandwich fillings, yoghurts or puddings in line with what was on the planned menu and there were no alternatives for people to choose from if they did not like what they were served.” from the report
Low staff morale
needs fixingStaff morale was low and some staff said they did not enjoy coming to work. The provider showed inspectors actions intended to improve this.
“Staff morale was low. Staff told us they did not enjoy coming to work” from the report
Management did not identify concerns
needs fixingThe home's monitoring systems had not picked up or dealt with the staffing and food concerns raised during the inspection.
“There were systems and processes in place to assess and monitor the quality of the service, but these had not been effective in identifying or addressing the concerns people and staff raised with us regarding staffing or food at the home.” from the report
Infection control on arrival
needs fixingStaff did not ask inspectors for evidence of a negative lateral flow test, despite the guidance in place at the time. The provider later gave assurance about staff understanding of the guidance.
“Staff did not ask for evidence of a negative Lateral Flow Tests on our arrival.” from the report
- 01What changes have you made to staffing levels and cover at busy times, especially during meals?
- 02How do you provide alternatives when someone does not like the planned meal?
- 03How are portion sizes and individual nutrition needs now checked?
- 04What actions have been taken to improve staff morale and make sure staff can get management support during the afternoon?
- 05How do you now check that infection control guidance for visitors and professionals is being followed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected during this visit. This explanation was written from the published report of 8 March 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, December 2019
Patron House was rated Good; inspectors found safe, kind and personalised care, with good management and no breaches reported.
This was an unannounced, planned comprehensive inspection on 17 and 18 July 2019. One inspector spoke with people living at the home, relatives and staff. They reviewed care records, medicines, staff recruitment and training, the building and management records.
The home provided accommodation and personal care for up to 12 older people. Ten people lived there during the inspection. Inspectors found that people were relaxed, comfortable and confident. Medicines were managed safely, risks were assessed, staffing was sufficient and the home was clean.
Inspectors found that care met people's health needs and was based on their choices. People were supported to eat well, see health professionals, stay independent and take part in activities. Staff were described as kind and respectful.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous inspection in 2016 was also rated Good.
Kind and respectful staff
People and relatives gave positive feedback about staff. Inspectors found staff understood people's needs and treated them warmly and respectfully.
“Everyone we spoke with agreed that staff were caring and kind.” from the report
Safe medicines
Medicines were stored, ordered, disposed of and given safely. Staff responsible for medicines had training and regular competency checks.
“Medicine Administration Records (MARs) were completed and audited appropriately.” from the report
Personalised support
Care plans included people's relationships, interests, routines, likes and dislikes. People were supported to choose activities and access the community.
“People were supported in activities of their choice. This included accessing the local community, shopping, and places of interest.” from the report
Good oversight
The home used regular audits and meetings to check the quality of care and identify improvements. Staff were able to raise concerns and ideas.
“Quality assurance systems were in place and based upon regular, scheduled audits, which identified any action required to make improvements.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you support my relative if their needs become more complex, given that the home does not provide nursing care?
- 02How do you make sure staffing remains consistent and that there are enough staff when several people need support at the same time?
- 03How will you involve my relative and our family in reviewing their care plan and making changes?
- 04What activities and outings are currently available, and how do you support people who want to stay independent?
- 05If my relative may lack capacity for a decision, how will you involve them, their representative and the local authority where needed?
This was an unannounced comprehensive inspection covering all five CQC questions, and the report says the building and care provided were both looked at. This explanation was written from the published report of 5 December 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.
Every inspection of Patron House
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 7 February 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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40 live-in carers within about an hour of Bristol, City of
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.
Most charge £1,020 to £1,300 a week. 34 can care for a couple. 11 years' experience on average.
“She became a good friend to my mother in law, chatting with her, dancing with her, knitting with her and the list goes on”
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
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.