CQC report explained · a residential care home
What the CQC found at The Cyder Barn
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2020
Inspected but not rated; the home gave medicines safely, but some medicine records and instructions needed improvement.
This was an unannounced, targeted inspection on 18 February 2020. It followed a concern about how medicines were managed. Inspectors reviewed medicine storage and management, watched a medicines round and checked records and policies.
Inspectors found that medicines were given safely and with care. Records showed prescribed medicines had been given, medicine stocks were checked daily and medicines were stored securely. People could manage their own medicines if they wished, following a safety assessment.
There were some gaps. Instructions for some as-required medicines were missing or not detailed enough. Records for creams were incomplete, some medicine lists were not updated and not all trained night staff had completed competency checks. Inspectors found no evidence that people had been harmed because of the concern.
The home was inspected but not rated at this visit. Its previous overall rating was Good and remained Good. This inspection did not assess the whole Safe question or the other four questions.
Safe administration
Inspectors watched medicines being given and found this was done safely and with care. Senior staff had training and competency checks.
“the morning medicines round was observed, and medicines were given in a safe and caring way.” from the report
Accurate stock checks
Medicine stocks were counted each day and were accurate. Inspectors also found no gaps in the 13 medicine administration records they reviewed.
“Stock counts of medicines were completed daily and found to be accurate.” from the report
Secure storage
Medicines were stored in a locked room and secure trolleys. Temperatures were checked daily and were suitable.
“Medicines were stored in a locked treatment room and the medicines trolleys were stored securely” from the report
People managing their own medicines
People could manage their own medicines if they wanted to. The home completed risk assessments to check this was safe.
“People could look after their own medicines at the home and risk assessments were completed to ensure it was safe for them to do so.” from the report
As-required medicine instructions
needs fixingSome instructions for medicines given when needed were missing or lacked enough detail. Inspectors said this could mean doses were not given as the prescriber intended.
“some of these protocols were missing, and others lacked detail on when the medicine should be administered and were not person-centred.” from the report
Incomplete medicine records
needs fixingSome medicine lists had not been updated after changes. Records for medicated creams had gaps, so it was unclear whether creams had been applied.
“Carers used separate charts to record the administration of topical preparations, including medicated creams. There were gaps in the recording, so it was unclear if these were being applied.” from the report
Staff competency checks
needs fixingSome trained night staff had not completed competency assessments for giving medicines. Agency staff were not allowed to administer medicines.
“However, night staff who were trained to administer medicines did not have competency assessments completed.” from the report
- 01Have all missing and incomplete instructions for as-required medicines now been completed and made person-centred?
- 02How do you check that medicine lists are updated promptly when prescriptions change?
- 03Have all staff who administer medicines, including night staff, completed competency assessments?
- 04How are the application of medicated creams and their storage recorded and checked?
- 05What action was taken after the inspection to prevent medicine-record problems happening again?
This was a targeted inspection of a specific concern about safe medicine management; it did not assess the whole Safe question or the other four key questions, so the previous ratings carried over. This explanation was written from the published report of 26 March 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, January 2020
The Cyder Barn was rated Good; inspectors found safe, kind and personalised care, with some record-keeping improvements made during the visit.
This was an unannounced planned inspection over 16 and 18 December 2019. The inspector spoke with people living in the home, a relative, an advocate and staff. They observed care and checked care plans, medicines records, recruitment files and management records.
All five areas were rated Good: safe, effective, caring, responsive and well-led. People said they felt safe and were happy. Inspectors found trained staff, safe medicines systems, kind support, personalised care, good food and a varied activity programme.
Some records were not well organised. One care plan did not give enough detail about how to prevent or calm challenging behaviour, and guidance was not yet clear about trying other approaches before using some medicines. The home had identified these issues and made changes during the inspection.
The previous overall rating was Good, but Safe had previously been Requires Improvement. Inspectors found that safety had improved and rated Safe Good at this inspection.
Safe staffing and recruitment
Staffing levels were based on people's needs. Inspectors found that staff were not rushed, call bells were answered promptly and recruitment checks were completed.
“During the inspection staff did not appear rushed and bells were answered in a timely manner.” from the report
Kind and respectful care
People were treated warmly and their privacy, dignity, culture and choices were respected.
“We observed people were treated with kindness and care by staff.” from the report
Personalised support
Care plans gave staff guidance about people's needs, preferences and communication. Staff showed good knowledge of the people they supported.
“All staff demonstrated a good knowledge of people's individual needs.” from the report
Open management
The management team listened to people and staff, monitored quality and acted on problems. Staff said they felt supported.
“The registered manager demonstrated an open and positive approach to learning and development.” from the report
Medicine guidance
needs fixingFor some medicines used when needed, there was not yet clear guidance on trying to calm or manage behaviour before using medication. New guidance was being written during the inspection.
“However, there was not a clear protocol to identify ways of managing challenging behaviours before resorting to using medication.” from the report
Care records
minorSome records were stored in different places. One care plan lacked enough detail about triggers and ways to calm challenging behaviour, although it was rewritten during the inspection.
“Some records were disorganised, and sections stored in different places.” from the report
- 01Can you show how the updated protocols explain what staff should try before using medicines for challenging behaviour?
- 02How do you make sure care plans include people's triggers and the approaches that help calm them?
- 03How are care records now kept together and checked for missing or conflicting information?
- 04How do you assess staffing levels when people's needs change?
- 05How can a resident or relative raise a complaint, and how will we be told what action was taken?
This was an unannounced planned inspection covering all five CQC questions; Safe had improved from Requires Improvement at the previous inspection, while the other four ratings remained Good. This explanation was written from the published report of 18 January 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.
Every inspection of The Cyder Barn
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- January 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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