CQC report explained · a residential care home
What the CQC found at Buckingham Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Recruitment checks, safeguarding training, medicine records and fire arrangements were found to be suitable. Risk assessments were in place, although the home was updating some of them.
- Effective?
- Good
- Staff training, supervision and appraisals had improved. People were supported with healthcare, food and drink, and decisions were made under the Mental Capacity Act, although some best-interest records needed more detail.
- Caring?
- Good
- Staff knew people well, respected their dignity and supported independence and communication. People appeared relaxed and comfortable with staff.
- Responsive?
- Good
- Care was personalised and people were supported with activities, social groups, family relationships and community access. Information was being adapted, although the provider identified a need to improve accessible healthcare information.
- Well-led?
- Good
- The manager and staff were seen as approachable. Audits, meetings and feedback systems were used to monitor and improve the home, and required notifications had been sent to the CQC.
What inspectors found, June 2018
Rated Good; inspectors found safe, kind and personalised care, with some records and legal authorisations still needing attention.
Inspectors visited without notice on 4 and 5 June 2018. They spoke with people, relatives, staff and professionals, observed care, and checked recruitment files, care plans, medicine records and other documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were supported by staff who knew their needs and preferences. Inspectors saw kind interactions, support with activities, family contact and healthcare.
The home had improved since the previous inspection in May 2017, when it was rated Requires Improvement. Fire safety arrangements, staff support and reporting to the CQC had improved, and the earlier breaches were no longer continuing.
Inspectors still noted that some Deprivation of Liberty Safeguards authorisations had expired, some best-interest records needed to be clearer, and risk assessments were being updated.
Improved fire safety
Fire drills had taken place and included night staff. Environmental actions identified by the local authority fire officer had also been completed.
“Fire drills had taken place and had involved night staff.” from the report
Kind relationships
Staff knew people's complex needs and personal preferences. Inspectors saw people looking relaxed, smiling and laughing with staff.
“We observed staff were kind and caring in their approach to working with people.” from the report
Personalised support
People had individual care plans, choices about activities and regular opportunities to go out and attend social groups.
“People received a personalised service. Each person had care plans in place which reflected their individual needs.” from the report
Improved staff support
The home had introduced systems to record training, supervision and appraisals. Staff said they felt supported.
“The registered manager had a system in place to ensure staff received one to one meetings and an annual appraisal of their performance.” from the report
Expired legal authorisations
needs fixingSome Deprivation of Liberty Safeguards authorisations had expired. The manager had referred people for renewal and was waiting for the local authority to process the applications.
“DoLS were authorised and had been in place. However, these had expired.” from the report
Records still being developed
minorThe home had identified that some risk assessments needed more detail. Some records about best-interest decisions also needed to show more clearly who had been involved.
“The registered manager advised staff had been working on updating risk assessments.” from the report
Accessible healthcare information
minorThe provider had identified that information about healthcare appointments and treatment was not always being given in an accessible format. A pictorial booklet had been created for one person's regular treatment.
“The provider had identified they needed to ensure people received information about healthcare appointment and treatment in an accessible format.” from the report
- 01Have all expired Deprivation of Liberty Safeguards authorisations now been renewed or otherwise dealt with?
- 02What changes have been made to make best-interest records clear about everyone involved in the decision?
- 03Have all risk assessments been updated with the extra detail identified during the inspection?
- 04How will healthcare appointment and treatment information be provided in an accessible format?
- 05If another person moves into the home, how will night staffing levels be reviewed?
This was an unannounced inspection covering all five CQC questions and the overall rating, including checks on the improvements requested after the May 2017 inspection. This explanation was written from the published report of 26 June 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.
What inspectors found, June 2017
The Fremantle Trust - Buckingham Road was rated Requires Improvement; inspectors found kind, responsive care but important safety, staffing and management shortfalls.
This was an unannounced inspection on 24 and 26 May 2017. One inspector reviewed care plans, medicines records, staff files, training records, safety checks and other documents. The inspector also spoke with staff, the manager and relatives, and sought views from healthcare professionals and commissioners.
The home supported six people with learning disabilities, although it had places for seven. People were treated kindly, supported to make choices, helped with healthcare and nutrition, and encouraged to go out and take part in activities.
However, fire drills were not happening as often as expected and there were no records showing which staff had taken part. Some staff training, supervision and appraisals were overdue. Two serious injuries had not been reported to CQC. These issues led to breaches of regulations.
The overall rating was Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement. Improvements had been made since the previous inspection to remove mould, but other standards had not been maintained.
Kind and respectful care
Inspectors saw staff treating people with kindness and compassion. Staff protected privacy and dignity and knew people's histories, preferences and support needs.
“People were treated with kindness and compassion in their day to day care.” from the report
Good medicines management
Medicines were given as prescribed, with staff training and checks before staff administered them alone. Records showed when medicines had been given and storage temperatures were checked.
“People's medicines were managed safely to keep them healthy and well.” from the report
Person-centred support
Care plans recorded people's wishes and routines. Staff created detailed guidance to help one person attend regular hospital treatment in a consistent and less disruptive way.
“This showed staff had taken a person centred approach to ensuring the person was supported in a consistent manner.” from the report
Improved cleanliness
The mould found in the laundry and shower room at the previous inspection had been treated. Inspectors found no mould and said all areas of the home were clean.
“On this occasion, we found improvements had been made.” from the report
Fire safety practice
seriousFire drills were not held at the expected frequency, and records did not show which staff had attended. Inspectors said this created a risk that staff might not know how to respond safely in a fire.
“This meant the provider could not be certain which staff had taken part in practice drills and that all staff would know what to do in the event of a fire.” from the report
Staff training and supervision
seriousSome staff had missed required updates, including moving and handling, safeguarding and first aid training. Supervision and appraisals were also not happening as expected.
“Overall, we found staff had not consistently received the support and training they required for their professional development and to look after people safely.” from the report
Unreported serious injuries
seriousTwo accidents causing serious injuries had not been reported to CQC, even though they should have been. This meant CQC could not see what action had been taken.
“However, during the inspection we were informed about two accidents that had happened which resulted in serious injuries.” from the report
Missing criminal records check
seriousOne of five staff files did not show that a criminal records check had been completed. The report recommended protecting people from potential harm until this check was made.
“We recommend the service ensures people are fully protected from the potential risk of harm until a Disclosure and Barring Service check is made.” from the report
Night staffing
needs fixingA fire safety officer thought there might not be enough staff at night to supervise an evacuation and keep people safe. The provider was asked to review night staffing levels.
“We recommend staffing levels are reviewed to ensure there are sufficient staff at night.” from the report
- 01How often are fire drills now held, and do you keep a record of which staff attend?
- 02What night-time staffing level is in place during an emergency evacuation?
- 03Have all staff completed the required moving and handling, safeguarding and first aid updates?
- 04Are staff now receiving supervision and annual appraisals as expected?
- 05What action was taken after the two serious injuries, and are all reportable incidents now notified to CQC?
This was an unannounced inspection covering all five key questions and the overall rating, following the previous inspection in April and May 2016. This explanation was written from the published report of 23 June 2017 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 Buckingham Road
3 rated inspections over 3 years: the service has held its Good rating throughout.
- June 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 29 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.
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
89 live-in carers within about an hour of Buckinghamshire
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 £1,020 to £1,300 a week. 79 can care for a couple. 13 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.