CQC report explained · a residential care home
What the CQC found at St Bernards Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found delays in dealing with fire safety actions, missing choking guidance, unsafe storage and other weaknesses in medicines management. They also found that one person sometimes waited up to 30 minutes for help after using the nurse call bell.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating carried over from the previous inspection.
- Well-led?
- Requires improvement
- Management checks did not reliably identify problems with medicines, choking guidance, fire safety or infection control. The management team also lacked knowledge of some reporting requirements.
What inspectors found, November 2022
St Bernards Residential Care Home Limited rated Requires Improvement; inspectors found risks with fire safety, medicines and oversight, although people felt safe and supported.
This was an unannounced focused inspection on 10 October 2022. Inspectors looked at Safe and Well-led. They spoke with people, relatives and staff, observed care, and checked care, medicines, fire safety, recruitment and management records.
The overall rating was Requires Improvement. Fire safety actions had not all been completed, information about choking risks was missing, and medicines were not always stored, recorded or managed safely. The home's checks had not found these problems, and safeguarding referrals had not been reported to CQC as required.
People said they felt safe, happy and listened to. Inspectors found enough staff during the visit, safe recruitment, a clean home, welcomed visitors and good work with health professionals. The provider took action after the inspection, but CQC said it would monitor progress and requested an action plan.
People felt safe
People and relatives told inspectors that people felt safe at the home. Staff understood their safeguarding responsibilities.
“People felt happy and safe living at the home.” from the report
Staffing and recruitment
Inspectors saw enough staff on duty during the visit, and recruitment checks were completed safely. Most people and relatives had no concerns about staffing.
“Staff were recruited safely. The provider followed safe recruitment procedures to make sure staff were suitable to work at the home.” from the report
Involvement and culture
People said the home was inclusive and that their views were heard. Relatives could attend family forums and social events.
“People told us the culture at the home was inclusive. Their feedback was listened to and they were involved in running their home.” from the report
Working with health professionals
Staff worked with GPs and district nurses to support people's health and wellbeing. Care records showed this had improved outcomes for people.
“The whole staff team worked with other organisations including GP's and district nurses to support people's health and wellbeing.” from the report
Fire safety
seriousA fire risk assessment listed 12 immediate actions, but some were still incomplete at the inspection. Some staff could not recall fire drills and gave different accounts of what to do in a fire.
“Known fire safety risks had not been mitigated in a timely way.” from the report
Medicines management
seriousRecords and checks did not cover all medicines. Some creams lacked clear instructions, flammable cream risks had not been assessed, and thickening powder was left unlocked and accessible.
“Systems and processes were not sufficient to demonstrate people's medicines were managed and administered safely.” from the report
Management checks
seriousThe home's audits had not identified several safety problems. The provider had also not notified CQC about three safeguarding referrals until inspectors requested this.
“The provider had failed to ensure systems and processes were established and operated effectively at all times to monitor and improve the quality and safety of the service.” from the report
Response times
needs fixingOne person said they sometimes waited up to 30 minutes for staff to respond to the nurse call bell. The home was taking action to locate misplaced pagers.
“a seventh person explained on occasions they did have to wait for up to 30 minutes before staff responded to their requests for assistance when they pressed their nurse call bell.” from the report
- 01What has been done to complete all the fire safety actions, and how are fire drills now recorded for every shift?
- 02How are medicines such as prescribed creams, thickening powders, patches and homely remedies now stored, administered and audited?
- 03What written guidance is now available for staff managing choking risks?
- 04How are safeguarding referrals and other required notifications now identified and reported?
- 05How have you fixed the nurse call bell and pager problem, and what are current response times?
This was a focused inspection of Safe and Well-led only; the other key question ratings carried over from the 2019 inspection. This explanation was written from the published report of 11 November 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.
What inspectors found, March 2021
Inspected but not rated; inspectors were assured that St Bernards Care Home had suitable infection prevention and control measures.
The inspection took place on 4 March 2021 and was announced. It was a targeted inspection during the coronavirus pandemic, focused on infection prevention and control.
Inspectors were assured that the home managed visitors, social distancing, shielding, admissions, protective equipment and testing safely. They were also assured that the home had suitable cleaning, hygiene and outbreak arrangements.
The home supported contact with relatives through video calls and virtual forums. Inspectors also saw thoughtful touches at mealtimes and a video tour for people considering moving in.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating for the home overall.
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infection, including safe visiting, testing, protective equipment and outbreak planning.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Clean environment
The home was clean and used a machine for deep cleaning areas that were difficult to sanitise by other methods.
“The environment was clean and a 'fogger' cleaning machine was used to complete deep cleans.” from the report
Contact with relatives
People were supported to keep in touch with important people through video calls and virtual forums.
“People were supported to maintain contact with others who were important to them in a variety of ways including video calls.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current arrangements for visitors and how are visitors screened for infection?
- 02How are people admitted safely, including anyone returning from hospital?
- 03How often are staff and residents tested, and what happens if someone tests positive?
- 04How is protective equipment used and checked in daily care?
- 05What is the latest full CQC rating for the home in the areas not covered by this inspection?
This was a targeted inspection of infection prevention and control under the Safe question only; the service was inspected but not rated and the other four questions were not assessed. This explanation was written from the published report of 18 March 2021 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 St Bernards Care Home
3 rated inspections over 6 years: the service has slipped, from Outstanding to Requires improvement.
- November 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- June 2019Gooddown from OutstandingSafe: GoodWell-led: Requires improvement
- June 2016OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- September 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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