CQC report explained · a residential care home
What the CQC found at The Berkeley
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Known health, fire and scalding risks were not always properly assessed or reduced. Medicine records still had missing signatures, although staffing, infection control and safeguarding arrangements were judged positively.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- Management systems did not reliably identify or correct gaps in records, risk assessments, incident reporting, legal authorisations or staff training. The provider began introducing new systems after the inspection.
What inspectors found, February 2023
Requires Improvement; inspectors found gaps in risk records, medicines records and management oversight, although people were supported by staff who knew them well.
This was an unannounced focused inspection on 23 and 27 January 2023. One inspector spoke with people, relatives and staff, and reviewed care records, medicines records, staff files and management records.
The home was not always safe. Some known health, fire and scalding risks had not been properly assessed or reduced. Medicine records still had missing signatures, and not all staff had training for people's health needs. The provider put some missing risk assessments, risk controls and training in place after the inspection.
The home was also not well-led. Records were incomplete or inaccurate, some incidents were not recorded, and checks had not identified important risks. The overall rating changed from Good at the previous inspection in 2018 to Requires Improvement. There was one legal breach relating to management oversight and governance.
Staff availability
There were enough staff to keep people safe and meet their individual needs. People and the inspector observed that staff were available when needed.
“We found sufficient staff were deployed to maintain people's safety and meet individual needs.” from the report
Staff knew people well
Staff understood people's individual risks and how to protect them from abuse. People told inspectors they felt safe.
“People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse.” from the report
Positive staff culture
People and relatives were positive about staff attitudes. Staff said they felt supported and able to raise concerns.
“The provider manager worked hard to instil a culture of care in which staff valued and promoted people's individuality, protected their rights and enabled them to develop and flourish.” from the report
Infection control
Inspectors were assured about infection prevention, the use of protective equipment and the home's ability to manage an infection outbreak.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Risk assessments
seriousSome known health risks had not been recorded, and fire and scalding risks had not been properly reduced before the inspection. The provider put risk assessments and strategies in place afterwards.
“People were at risk from known health conditions as staff did not have the information recorded to support them safely.” from the report
Medicines records
needs fixingAudits had already found missing signatures, but missing signatures were still occurring. The report says medicines management needed improvement.
“Audits completed had identified missing signatures previously, however, missing signatures were still occurring.” from the report
Management oversight
seriousChecks did not reliably identify missing or incorrect information, environmental risks, unrecorded incidents or training gaps. This was the subject of the legal breach.
“The provider had failed to have robust systems and processes to assess, monitor and improve the service.” from the report
Staff training
needs fixingNot all staff had training in epilepsy, diabetes, learning disabilities or autism. New training was allocated after the inspection.
“We found not all staff had training in epilepsy, diabetes, learning disabilities or autism.” from the report
Incomplete records
needs fixingHealth appointments, care plans, risk assessments, daily notes, handovers and some incidents were not consistently recorded. DoLS referrals also did not always contain the correct restrictions.
“We found details of people's health appointments were not consistently recorded, care plans and risk assessments held incorrect or had missing information within them and there were gaps in the recording of people's daily notes and handover documents.” from the report
- 01What has changed since the inspection to make sure every person's health, fire and scalding risks are assessed and reviewed?
- 02How do you now check that medicine records are complete, including signatures?
- 03Which staff have completed training in epilepsy, diabetes, learning disabilities and autism, and how is this kept up to date?
- 04How do you make sure daily notes, handovers, care plans, risk assessments and incidents are recorded accurately?
- 05What progress has been made on the action plan for the Regulation 17 breach, and when will its effectiveness be reviewed?
This was a focused inspection of Safe and Well-led only; the other question ratings were carried forward from the previous inspection in 2018. This explanation was written from the published report of 17 February 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 2018
Rated Good; inspectors found safe, kind and person-centred care, with minor issues addressed during the visit.
This was an announced, comprehensive inspection on 30 October 2018. Inspectors visited the home, observed care, spoke with people, relatives, staff and a health professional, and reviewed care plans, recruitment, training, medicines, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from harm, received their medicines safely, and were supported by trained staff.
People were treated with kindness and respect. Staff supported people to make choices, remain as independent as possible, take part in activities, maintain relationships and access health care.
The overall rating remained Good, as it had been at the previous inspection. Inspectors found no serious risks or concerns, although they noted some minor shortfalls and said action was taken during the inspection.
Kind and respectful care
Inspectors saw staff treating people warmly and respectfully. The home had a relaxed and happy atmosphere.
“People were treated with kindness, compassion, dignity and respect.” from the report
People's safety
Risks such as epilepsy, falls, medicines and behaviours that challenge were assessed and monitored. Inspectors found suitable staffing and safe recruitment checks.
“Risks to people's safety were assessed and closely monitored.” from the report
Choice and independence
People were asked for consent and supported to make choices. Staff helped people take part in activities and live as independently as possible.
“People were supported to have choice and control of their lives” from the report
Personalised support
Care plans were tailored to individual needs, preferences and communication. People and, where appropriate, relatives helped develop and review them.
“Each person had a care plan tailored to meet their individual needs.” from the report
Responsive management
The registered manager was visible and approachable. Quality checks were used to identify improvements, and concerns were said to be dealt with promptly.
“Robust systems were in place to monitor the quality of the service.” from the report
Design and best-practice guidance
minorThe report says the home was not initially developed and designed in line with Registering the Right Support and other best-practice guidance. Inspectors also said people were given choices and encouraged to be independent in the community.
“The service provided was not initially developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance.” from the report
Minor maintenance and paperwork
minorInspectors highlighted areas of damp on the ground floor and amendments needed to best-interest paperwork. The home brought forward maintenance and made paperwork changes on the day.
“the service brought forward planned maintenance work for areas of damp on the ground floor and made some amendments to people's best interest paperwork.” from the report
- 01What has been done about the areas of damp on the ground floor, and how is this checked now?
- 02How do you make sure best-interest decisions are recorded correctly and reviewed when people's circumstances change?
- 03How would you support my relative to make choices and remain as independent as possible?
- 04How would you adapt communication and care planning to my relative's particular needs?
- 05How do you monitor medicines, staffing levels and changes in people's risks?
This was a comprehensive inspection of the home, including all five CQC questions; seven of the up to ten people living there were receiving regulated personal care. This explanation was written from the published report of 6 December 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 The Berkeley
4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2018Goodstayed GoodSafe: GoodWell-led: Good
- May 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of West Northamptonshire
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 £1,280 a week. 87 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
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.