CQC report explained · a residential care home
What the CQC found at Reach Bierton Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks, accidents, safeguarding and medicines were managed appropriately. However, some staff had worked beyond the organisation's guidance on extra hours, although the manager introduced manual rota checks.
- Effective?
- Good
- Staff had suitable induction, training, supervision and support. People's health, nutrition, communication and decision-making needs were identified and met.
- Caring?
- Good
- Staff were kind, patient and engaging. Inspectors saw positive relationships, respect for privacy and dignity, and support for people's independence.
- Responsive?
- Good
- Care plans were detailed, person-centred and updated when needs changed. People had choices, accessible information, activities and ways to raise concerns.
- Well-led?
- Good
- The home was managed openly, with audits, meetings, feedback systems and accessible managers. Records had improved and were secure, organised and up to date.
What inspectors found, November 2018
Reach Bierton Road is rated Good; inspectors found safe, kind and personalised care, with some smaller safety and cleanliness issues to address.
This was an unannounced, comprehensive inspection on 8 and 9 October 2018. One inspector spoke with people living in the home, relatives, staff and professionals. They also reviewed care plans, medicines records, staff files, incident reports, audits and the building.
The home supported eight people. Inspectors found that people were safe, treated kindly and supported by staff who knew them well. Medicines, risks, health needs and nutrition were managed appropriately. People had personalised care plans, communication support and access to activities and community services.
The home had improved since the previous inspection, when it breached three regulations. Inspectors found those requirements had been met. The overall rating was Good, and each of the five areas was also rated Good.
Kind and respectful care
Inspectors observed staff being gentle, patient and reassuring. People had warm relationships with staff, and their privacy and dignity were promoted.
“Throughout the inspection we observed positive engagement between staff and the people they supported.” from the report
Safer medicines systems
Medicines were stored securely, records had no gaps, and staff had guidance for medicines given when needed. Staff competence was checked regularly.
“Medicines were stored appropriately and kept secure.” from the report
Personalised support
Care plans described people's needs and preferences in detail. People were supported to make everyday choices and to take part in activities, education and community life.
“Care plans were detailed and specific as to the care to be given.” from the report
Improved management
The home had improved its records, audits and reporting systems since the previous inspection. Managers were described as approachable and responsive.
“At this inspection we found improvements were made to records.” from the report
Staff working hours
needs fixingSome staff were scheduled to work beyond the organisation's own limits, and this had not been noticed. The manager agreed to check rotas manually in advance.
“The rotas showed some staff were not working to the guidance and this had gone unnoticed.” from the report
Small environmental risks
needs fixingA portable electrical heater was being used without a risk assessment at the time of the visit. The manager said a risk assessment was added after the inspection.
“There was no risk assessment to address potential risk of its use.” from the report
Cleaning standards
minorInspectors found dirt around the cooker and dishwasher, and dusty, stained skirting boards. The manager agreed these areas should be cleaned and monitored.
“There was a build-up of dirt on the floor around the cooker, dishwasher and skirting boards were dusty and stained.” from the report
Fire safety recommendations
needs fixingAn external health and safety audit had made recommendations, including on fire door guards and risk assessments. Inspectors found no evidence that these had yet been acted on, although discussions were continuing and a fire officer visit had been arranged.
“There were no indications those recommendations had been acted on.” from the report
- 01How do you now check rotas to make sure staff do not exceed the organisation's limits on extra hours and consecutive long days?
- 02What action was taken after the external health and safety audit, especially about fire door guards and fire risk assessments?
- 03Has the portable heater risk assessment been completed, and how is its use monitored?
- 04What cleaning checks are now in place for areas around the cooker, dishwasher and skirting boards?
- 05How will you develop more in-house activities for people who spend more time at the home?
This was an unannounced comprehensive inspection covering all five questions and checking improvements required after the previous inspection. This explanation was written from the published report of 1 November 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.
What inspectors found, October 2017
Rated Requires Improvement; inspectors found kind and responsive care, but serious problems with safety, medicines, records and oversight.
This was an unannounced comprehensive inspection on 11 and 12 September 2017. Inspectors spoke with people, relatives, staff and a visiting professional. They reviewed care plans, medicine records, staff files, incident reports and audits, and observed care.
People were described as happy with their care. Staff were kind and knew people well. People’s health, nutrition, activities and day-to-day choices were supported. The ratings for Effective, Caring and Responsive were Good.
The home was not always safe or well-led. Accident and incident reports were not properly reviewed or reported. Medicine records and storage were not always safe. Some risks were not managed as care plans required, and records were not always up to date or secure. The provider’s audits had not found these problems.
The overall rating was Requires Improvement. This was a fall from Good at the previous inspection in August 2015. The report identified three breaches of regulations.
Kind and respectful staff
Inspectors saw staff being gentle, encouraging and caring. People’s privacy was promoted and staff supported everyday choices.
“Staff were kind, engaging, encouraging and gentle in their approach.” from the report
Good knowledge of people
Staff knew people’s likes, dislikes, communication needs and support needs. Relatives said they were happy with the care.
“People told us they felt safe living at the home. Relatives told us they felt reassured their family members were safe.” from the report
Health and nutrition support
People had access to health professionals, health checks and medicine reviews. Meals were planned around people’s choices, and weights were monitored.
“When staff have had any worries about health they have been prompt in contacting either the GP or myself” from the report
Activities and community life
People had individual activity programmes and access to day centres, college, exercise, social activities and community outings.
“They had access to day centres and college and were involved in arts and crafts and cookery sessions there.” from the report
Incidents were not properly reviewed
seriousReports about unexplained bruising, an incident between two people and an allegation about staff shouting were not investigated or referred where required. A choking incident was also not fully recorded or followed up.
“However they were not reviewed by a manager. Therefore incidents such as unexplained bruising, an incident between two people and an allegation of a staff member shouting at people were not investigated” from the report
Medicine safety and records
seriousThe medicine cabinet key was kept in an unlocked cupboard, despite this being raised during the inspection. Some medicine records were incomplete or did not reflect changes, and there was no clear protocol for one as-required medicine.
“Improvements were required to medicine management. Risks to people were identified but not all risks were managed in line with the guidance in people's care plans.” from the report
Risks were not always managed correctly
seriousStaff did not follow the guidance for adding thickener to fluids, which inspectors said had the potential to put a person at risk of choking.
“Staff were aware of the risks people presented with however they failed to follow guidance in relation to thickeners in fluids which had the potential to put that person at risk.” from the report
Records were incomplete and insecure
needs fixingSome personal care and medicine records were incomplete or out of date. Daily records and archived records were left in places that were not secure, creating a risk to confidentiality.
“Records required for regulation were not suitably maintained, secure and fit for purpose.” from the report
Management checks were not effective
needs fixingAudits did not identify the medicine and care plan problems. Accident and incident trends were not analysed to help prevent repeat incidents.
“However the medicine audits failed to identify the issues we found with medicines.” from the report
- 01How are accident and incident reports now reviewed, investigated and referred to safeguarding teams or CQC when needed?
- 02How do you keep the medicine cabinet key secure, and how do you check that medicine records are complete and up to date?
- 03What has changed to make sure staff follow the guidance for thickened fluids and other identified risks?
- 04How are daily records, care plans and archived records now kept accurate, current and secure?
- 05Is the manager now registered with the Commission, and what action from this inspection has been completed?
This was an unannounced comprehensive inspection covering all five rating areas and reviewing the overall rating. This explanation was written from the published report of 7 October 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 Reach Bierton Road
3 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 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.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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