CQC report explained · a residential care home
What the CQC found at Take A Break With Choices
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and managed, staffing levels were sufficient, recruitment was safe and medicines were managed properly. Infection control systems were in place and staff used appropriate protective equipment.
- Effective?
- Good
- People's needs were assessed before their stay and care plans contained detailed, person-centred information. Staff training was up to date, nutritional needs were met and the service worked with health and social care professionals.
- Caring?
- Good
- People were treated with compassion, kindness, dignity and respect. They were involved in care decisions and encouraged to be as independent as possible.
- Responsive?
- Good
- Care was adapted to people's choices and changing needs. People had support to communicate, maintain family relationships and take part in activities and outings.
- Well-led?
- Good
- Inspectors found an open and inclusive culture, stronger management systems and evidence that incidents, complaints and audits were used to improve care. The previous Regulation 17 breach had been resolved.
What inspectors found, April 2020
Take A Break With Choices was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous Requires Improvement rating.
Inspectors made an unannounced visit on 11 March 2020. They spoke with people using the service, a relative, staff and healthcare professionals. They also observed care and checked care plans, medicines records, recruitment files, training records and management documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found suitable staffing, safe medicines systems, clean premises, person-centred care and good support for people's health, communication, relationships and activities.
The previous inspection rated the service Requires Improvement in Safe and Well-led. These areas improved to Good because the provider had strengthened care planning, paperwork, checks and management systems. The home was not providing end-of-life care to anyone at the time, so this was not fully tested.
Safe medicines practice
Inspectors observed medicines being given competently and found that records were complete. Staff had regular medicines training and competency checks.
“Medicines were managed safely. We observed medicines being administered in the care home competently and records had been fully completed.” from the report
Individual support
Care plans recorded people's wishes, preferences and support needs. Staff adapted their approach to each person, including communication and cultural needs.
“Care plans included detailed information about people's health, personal information, their wishes and the best ways to support people.” from the report
Kind and respectful care
People were treated with compassion and supported to make decisions about their care. Staff encouraged independence and respected privacy and dignity.
“There was a strong belief within the staff team that people were encouraged to be as independent as possible.” from the report
Activities and relationships
People were supported to keep in touch with family and friends and could take part in activities and outings such as baking, karaoke and swimming.
“People had a wide range of organised activities and outings they could access.” from the report
Improved management
Management systems, records and checks had improved since the previous inspection. The provider used audits, complaints and incident reviews to support learning.
“At this inspection we found the provider was now meeting this regulation and was no longer in breach of Regulation 17.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess my relative's needs and risks before their first respite stay, and how will you review these if their needs change?
- 02How will you communicate with my relative if they need communication aids or information in a particular format?
- 03What activities and outings would be suitable for my relative, and how would extra staffing be arranged if needed?
- 04How will my family be involved in care planning and decisions if my relative cannot make a particular decision?
- 05How will you support my relative's medicines, diet, oral health and contact with healthcare professionals during their stay?
This was an unannounced inspection of all five CQC questions, covering the care home, its premises and personal care; nobody was receiving end-of-life care at the time, and the report also notes personal care for one person in their own home. This explanation was written from the published report of 16 April 2020 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 2019
Rated Requires Improvement; inspectors found kind, person-centred care but safety checks and quality records were not consistently reliable.
The inspection was unannounced and took place on 31 January 2019. Inspectors spoke with people using the home, a relative, staff and a visiting professional. They reviewed all five care files, staff records, medicines records, safety records and audits.
There had been improvements since February 2018. Fire safety actions had been completed, water temperatures were being checked, staff had food hygiene training, medicines systems and risk assessments were in place, and all staff had current DBS checks.
Some risks remained. One sink was too hot, unsafe toiletries and razors were stored in an unlocked cupboard, and there were minor infection control issues. Some audits had been completed with dates in the future, so inspectors could not rely on them.
The home was rated Good for Effective, Caring and Responsive. It was rated Requires Improvement for Safe and Well-led, making the overall rating Requires Improvement. This means the home was providing some good care, but improvements were still needed and the provider had to report what action it would take.
Kind and respectful care
People were happy and inspectors saw care delivered with kindness and compassion. Privacy, dignity and equal treatment were respected.
“We observed people being cared for with kindness and compassion and people's privacy and dignity were respected.” from the report
Activities and choice
People were supported to pursue interests, attend college or work, choose meals and make decisions about their daily routines.
“People were given choices as to how they furnished their bedrooms, what time they got up or went to bed, the interests they pursued and what they wanted to eat and drink.” from the report
Improvement since the previous inspection
The provider had completed many actions from the previous inspection, including fire safety work, regular water checks, food hygiene training and improved medicines arrangements.
“Since that inspection the provider had completed an improvement action plan and we found improvements had been made in a number of areas.” from the report
Hot water and unsafe bathroom items
seriousWater from one sink was too hot to keep hands under. Used toiletries and razors were kept in an unlocked cupboard, creating avoidable risks.
“The water in this sink was tested by both inspectors and was too hot to keep your hands under.” from the report
Infection control
needs fixingStaff did not use protective aprons while cooking, and a cloth towel was being used where paper towels were available. Inspectors said these issues could contribute to the spread of infection.
“We saw a staff member cooking lunch for the people who used the service, but no personal protective equipment (PPE), such as plastic aprons, were used.” from the report
Unreliable audits
seriousSeveral checks had been completed for dates after the inspection. This meant the records could not be verified and raised concerns about whether other audits were accurate.
“This meant that quality checks were not being completed truthfully at the service and called into question other audits which may not have been accurate.” from the report
Inconsistent care records
needs fixingSome care files contained conflicting information about the help people needed, catheter use and whether someone could bear weight. The manager agreed to update the information.
“We saw that there was some information in the care files which was conflicting.” from the report
- 01What action was taken to make the hot water safe after the inspection?
- 02How are used razors, toiletries and other potentially unsafe bathroom items now stored and disposed of?
- 03What changes were made to infection control, including the use of protective aprons and paper towels?
- 04How do you now make sure audits and daily checks are completed on the correct dates?
- 05Were all the conflicting details in care plans corrected, and how are care records kept up to date when people's needs change?
This was an unannounced inspection covering all five CQC questions; it followed a previous inspection in February 2018 and included records, observations and discussions with people, staff and others. This explanation was written from the published report of 13 March 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 Take A Break With Choices
7 rated inspections over 5 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2016Requires improvementstayed Requires improvementWell-led: Requires improvement
- June 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Registered with the Care Quality Commission on 29 July 2013.
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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At least 100 live-in carers within about an hour of Bolton
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 £980 to £1,260 a week. 92 can care for a couple. 10 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.