CQC report explained · a nursing home
What the CQC found at Bange Nursing Homes Limited t/a Bradley House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received their medicines as prescribed, equipment was checked and there were enough staff to meet people's needs. Inspectors recommended regular fire drills because these had not been held regularly.
- Effective?
- Good
- This area was not assessed during this focused inspection. Its rating was carried over from the previous inspection.
- Caring?
- Good
- This area was not assessed during this focused inspection. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This area was not assessed during this focused inspection. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- The home had quality checks, acted on identified issues and communicated well with relatives. Inspectors identified some gaps in audits, staff debriefs and regular supervision, and the management team said it would improve these.
What inspectors found, March 2023
Rated Good; inspectors found safe care and stronger management, but regular fire drills and staff support needed attention.
This was an unannounced follow-up inspection on 14 and 15 February 2023. One inspector and an Expert by Experience spoke with people, relatives, staff and visiting professionals. They reviewed care, medicine, incident and management records, and observed support and the home environment.
The home was rated Good overall, with Good ratings for Safe and Well-led. Inspectors found enough staff, safe recruitment, completed medicine records, a clean environment and systems for reporting and reviewing incidents. People and relatives said people were safe, and relatives were positive about communication and care.
The inspection only assessed Safe and Well-led. The ratings for Effective, Caring and Responsive were carried over from the previous inspection. The overall rating improved from Requires Improvement in 2019, and the two previous regulatory breaches had been resolved.
Medicines
Medicines were given as prescribed and medicine administration records were fully completed. Guidance was also available for medicines given when needed.
“People received their medicines as prescribed. Medicine administration records (MARs) were fully completed.” from the report
Staffing and equipment
Inspectors found enough staff to meet people's needs, with plans to increase staffing if more people moved in. Equipment was checked and serviced.
“Equipment was regularly checked and serviced in line with legal guidelines.” from the report
Communication
Relatives said communication was good and that they were kept informed about changes in their relative's health and wellbeing.
“Relatives said communication with the home was good and they were kept informed of any changes in their relative's wellbeing or health.” from the report
Cleanliness and infection control
The home was clean, and actions from an earlier local authority infection control visit had been completed. Inspectors were assured that infection risks were being managed.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed and the provider's infection prevention and control policy was up to date.” from the report
Fire drills
needs fixingFire drills had not been held regularly, despite an earlier fire risk assessment recommending them. The provider planned monthly drills, including at night.
“Fire drills had not been held regularly. A fire risk assessment from 2019 had recommended fire drills were completed, but this had only been arranged immediately prior to our inspection.” from the report
Risk assessment reviews
minorA small number of risk assessments had not been reviewed during the previous month. Extra support was being given to some nurses with care planning.
“A small number had not been reviewed in the last month.” from the report
Support after incidents
needs fixingSome staff did not feel fully supported after incidents involving behaviour that challenged the service. Management said it would introduce a debrief after incidents.
“some staff reported they did not feel fully supported by the management team following incidents of behaviour that challenged the service.” from the report
Staff supervision
minorStaff supervision meetings had not been held routinely. A plan was in place to make them more regular.
“Staff supervision meetings had not routinely been held. A plan was in place to make these more regular.” from the report
- 01How often are fire drills now carried out, including at night, and when was the most recent one?
- 02How do you make sure every risk assessment is reviewed on time?
- 03What debrief or support is offered to staff after an incident involving behaviour that challenges the service?
- 04How regularly are staff supervision meetings now held?
- 05What changes were made to the quality audits after the inspection?
This was a focused follow-up inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried over from the previous inspection. This explanation was written from the published report of 9 March 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, October 2019
Rated Requires Improvement; inspectors found kind, responsive care but continuing unsafe medicines management and weak oversight.
This was an unannounced inspection over three days. Inspectors spoke with people living in the home, relatives and staff. They observed care and reviewed care plans, medicines records, training, audits and other documents.
The home was rated Good for Effective, Caring and Responsive. Inspectors found caring staff, personalised support, suitable training, enough staff and activities for people to enjoy. The environment had improved and was clean and well maintained, although there was an unpleasant odour near the entrance.
Safe and Well-led were rated Requires Improvement. Inspectors found repeated problems with medicines, including missing stock, late or incorrect doses, incomplete guidance and ineffective checks. The home remained in breach of Regulations 12 and 17, although inspectors found improvements in recruitment, training, fire safety and the environment.
Kind relationships
Staff knew people well and were consistently caring and respectful. Inspectors saw staff take time to reassure and support people.
“We observed many caring and positive interactions between staff and people throughout the inspection.” from the report
Staffing and training
The home had enough trained staff and had improved its recruitment checks. New staff received an induction and existing staff received regular support and training.
“Staff were recruited safely; they received regular support and training.” from the report
Personalised support
Care was adjusted to people's preferences, routines and needs. People could choose where to sit, when to get up and where to eat.
“Care and support was flexible and tailored to people's needs.” from the report
Improved safety measures
The home addressed earlier concerns about high water temperatures and inconsistent fire drills. Risk assessments were available and up to date.
“At this inspection we found the service had addressed our previous concerns about the lack of fire drills.” from the report
Activities and social life
People had a planned programme of group and one-to-one activities. The home also provided a reminiscence room for people living with dementia.
“Activities available involved in a variety of one to one and group activities including singing and dancing, exercises, arts and crafts, games, themed parties and professional entertainers visiting.” from the report
Medicines were not consistently safe
seriousSome medicines were unavailable, given at the wrong time or continued at an old dose after the prescription changed. Records and guidance for some medicines were incomplete, putting people at risk of harm.
“People could not have some of their prescribed medicines because there was no stock available in the home for them.” from the report
Checks did not identify problems
seriousThe home's audits did not reliably find or correct medicines problems. This was a continued breach of the good governance regulation.
“Auditing systems for the safe management of medicines were not always effective.” from the report
Diet records were incomplete
needs fixingOne person's meal diary did not always show whether food had been prepared to the consistency advised by a speech and language therapist. The manager said the food was correct but accepted that staff records were not reliable.
“One person's meal diary did not always indicate if their meals had been made to the correct consistency as per the Speech and Language Therapist (SaLT) recommendations.” from the report
Unpleasant odour
minorThe home was clean and tidy, but an unpleasant odour remained around the main entrance. The provider was reviewing cleaning arrangements.
“However, we continued to find an unpleasant odour that seemed to be concentrated around the main entrance area of the home.” from the report
- 01What has been done to make sure prescribed medicines are always in stock and given at the correct time and dose?
- 02How do you check that 'when required' medicines are given with the right guidance and that their effect is recorded?
- 03How are medicines audits now reviewed, and who acts when an error or missing record is found?
- 04How do you check that meals for people on modified diets have the correct consistency and that this is recorded accurately?
- 05What progress has been made in removing the unpleasant odour near the main entrance?
This was an unannounced comprehensive inspection covering all five key questions, with the home and the care provided both looked at. This explanation was written from the published report of 19 October 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 Bange Nursing Homes Limited t/a Bradley House Nursing Home
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Bange Nursing Homes Limited t/a Bradley House Nursing Home →
- October 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Bange Nursing Homes Limited t/a Bradley House Nursing Home →
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- March 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 9 December 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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