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CQC report explained · a residential care home

What the CQC found at The Bungalow

Requires improvementpublished 10 February 2021, 5 years ago

Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
People were protected by trained staff and there were enough staff on duty, but fire safety information was out of date, some staff risk assessments were missing and there was confusion about recording as-required medicines.
Effective?
Good
This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
Caring?
Good
This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
Responsive?
Good
This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
Well-led?
Requires improvement
Management and leadership were inconsistent. Inspectors found a developing closed culture, gaps in staff supervision and quality problems that should have been identified sooner.
The latest report, explained

What inspectors found, February 2021

The Bungalow was rated Requires Improvement; inspectors found no evidence of harm but identified safety, staffing and leadership problems.

This was an unannounced, focused inspection on 15 December 2020. One inspector spoke with people and staff, reviewed care, medicine, recruitment and management records, and checked infection control. The inspection followed concerns about management and possible risks of harm.

The home was rated Requires Improvement overall. Safe and well-led were both rated Requires Improvement. Inspectors found no evidence that people were at risk of harm during this inspection, but fire safety records, staff risk assessments, medicine recording and staff support needed improvement.

Inspectors found some positive practice. People appeared settled, staff had safeguarding and medicine training, and recruitment checks were carried out. However, staff shortages, reduced supervision and a developing closed culture raised concerns about how reliably the home was managed.

The previous overall rating was Good, published on 1 August 2019. Because this inspection only examined Safe and well-led, the ratings for the other key questions were carried forward from the previous comprehensive inspection.

What inspectors praised
  • Safeguarding training

    Staff had been trained to recognise and report abuse and knew how to find the relevant policies.

    “All staff had received training in recognising and reporting abuse and knew how to access the required policies.” from the report
  • Recruitment checks

    The home used checks on background, character and qualifications before appointing staff.

    “People were supported by staff who had been recruited following safe recruitment procedures.” from the report
  • Medicine training

    Staff administering medicines had been trained and assessed as competent. Medicines were stored securely and there were no missed signatures on administration records.

    “People received their medicine from staff who had received training in the safe administration of medicine and had been assessed as competent.” from the report
  • Positive interactions

    People appeared settled, and inspectors observed positive interactions between people and staff.

    “People appeared settled in the home and the interactions we observed between people and the staff team were positive.” from the report
What inspectors were concerned about
  • Fire safety records

    serious

    The main fire evacuation plan did not match the people living in the home, and inspectors found no evidence that the property fire risk assessment had been reviewed as required. The evacuation plan was updated during the visit.

    “People all had personal emergency evacuation plans, but the main fire evacuation plan did not represent the current people living in the home.” from the report
  • Missing staff risk assessments

    needs fixing

    Staff from a Black, Asian and minority ethnic background had not had individual Covid-19 risk assessments. The provider said these would be completed.

    “At the time of inspection staff who were of a Black, Asian and minority ethnicity (BAME) had not completed an individual risk assessment in relation to Covid–19.” from the report
  • Staffing pressure

    needs fixing

    Although inspectors found enough staff to support people, some staff said they regularly worked beyond their contracted hours to cover gaps and felt tired.

    “The team is tired, we all have to pick up extra shifts whether we want to or not. We need to have more staff recruited.” from the report
  • Staff support and culture

    needs fixing

    Regular supervision had stopped, and inspectors found a developing closed culture in which staff did not always feel listened to when raising concerns.

    “We were concerned there had been a closed culture developing whereby staff were not always listened to when concerns were raised.” from the report
  • Medicine recording

    needs fixing

    There was confusion about recording as-required medicines, making it difficult to tell whether medicines had been offered and why. This was corrected during the inspection.

    “There was some confusion found regarding the correct recording for 'as required' medicine which made it difficult to establish whether people had actually been offered their medicine and if so why.” from the report
Questions to ask them, based on this report
  1. 01Has the main fire evacuation plan been kept up to date, and when was the property fire risk assessment last reviewed?
  2. 02Have individual Covid-19 risk assessments been completed for all staff who need them?
  3. 03What action has been taken to recruit more staff and reduce the need for staff to work extra shifts?
  4. 04Have regular staff supervisions restarted, and how are staff supported to raise concerns?
  5. 05How are as-required medicines now recorded so it is clear whether they were offered and why?

This was a focused inspection of Safe and well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 10 February 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.

An earlier report, explained

What inspectors found, August 2019

The Bungalow was rated Good in all areas; inspectors found safe, kind and personalised care, with some limits to the complaints process.

This was an unannounced inspection on 24 June 2019. One inspector met three of the four people living there, spoke with people, staff and a relative, and checked care, medicines, recruitment and management records.

The inspectors found that people were safe and well supported by staff who knew them well. Care was personalised, and people were supported to make choices, stay independent, take part in activities and keep in touch with family and friends.

The home had enough trained staff, worked with health and social care professionals, and had checks in place to monitor quality. All five CQC questions were rated Good. This was the same overall rating as the previous inspection in October 2016.

What inspectors praised
  • Safe and consistent support

    Staff knew people well and provided flexible one-to-one support. Risks, medicines and safeguarding arrangements were managed safely.

    “People were safe and well supported by a staff team who knew them well.” from the report
  • Choice and independence

    People were supported to make decisions and do things for themselves where possible. Staff used the least restrictive approach and involved relatives or advocates when needed.

    “People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests.” from the report
  • Personalised activities

    People received support to take part in activities, education and community life that matched their interests and choices.

    “People had opportunities to attend educational and social activities of their choice.” from the report
  • Good staff support and oversight

    Staff received relevant training and felt supported. Audits, incident reviews and action plans were used to monitor and improve the service.

    “The provider had audit and quality monitoring systems in place that identified any concerns relating to the safety and quality of the service.” from the report
What inspectors were concerned about
  • Formal complaints may not be accessible

    minor

    The complaints procedure was available, but inspectors said people using the home could not follow the formal process. Staff therefore relied on noticing changes in behaviour or body language to identify dissatisfaction.

    “People who used the service would not be able to follow this formal process however they were able to express dissatisfaction in other ways” from the report
  • End of life planning was still developing

    minor

    No one currently needed end of life support, but an end of life plan for one person was still being developed with support from an advocate.

    “The registered manager was currently developing an end of life plan for one person with the support of the person's advocate.” from the report
Questions to ask them, based on this report
  1. 01How do you help someone make a complaint if they cannot use the formal complaints procedure?
  2. 02How do you record and respond to changes in a person's body language or behaviour that may show they are unhappy?
  3. 03What is the current position on end of life plans for people who may need them?
  4. 04How do you make sure staffing remains flexible when a person's needs change?
  5. 05How are relatives and advocates involved in decisions when someone cannot communicate their views verbally?

This was an unannounced comprehensive inspection covering all five CQC questions, including the care provided and the home environment. This explanation was written from the published report of 2 August 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.

The story over the years

Every inspection of The Bungalow

3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.

  1. February 2021Requires improvementcurrent ratingdown from Good
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at The Bungalow →

  2. August 2019Goodstayed Good
    Safe: GoodWell-led: Good

    Read what inspectors found at The Bungalow →

  3. November 2016Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read this report on cqc.org.uk

  4. June 2014

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  5. August 2013

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  6. June 2012

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  7. November 2010

    Registered with the Care Quality Commission on 25 November 2010.

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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