CQC report explained · a residential care home
What the CQC found at Brackendale House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, with risk plans, safeguarding systems and regular safety checks in place. Inspectors did identify risks involving lone night working, hot pipes, radiators, smoking with paraffin-based creams and distractions during medicine rounds.
- Effective?
- Good
- Care plans reflected people's preferences and needs. Staff were trained, understood mental capacity requirements and worked well with the GP and mental health professionals, although access to crisis support outside normal hours could be difficult.
- Caring?
- Good
- Staff were observed treating people with kindness, dignity and respect. People were encouraged to make choices, maintain independence and raise concerns.
- Responsive?
- Good
- Care was personalised and included activities, community access and support for people's interests. End of life care plans and training had been introduced since the previous inspection.
- Well-led?
- Good
- The home had regular audits, staff meetings and management checks. The manager responded to issues found during the inspection, including gaps in recording one-to-one hours and the lone working arrangements.
What inspectors found, May 2019
Brackendale House was rated Good; inspectors found kind, safe and well-organised care, with several issues addressed after the visit.
This was an unannounced, comprehensive inspection on 10 April 2019. Inspectors spoke with six people, observed care, reviewed seven care records and four medicine records, and checked staff and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were supported by enough suitably trained staff, received personalised care and were encouraged to take part in activities and the local community.
Inspectors found some risks and shortfalls during the visit. These included exposed hot pipes, uncovered radiators, risks around lone working at night, medicine-round distractions and variable cleanliness in some bathrooms. The home took action on several of these points after the inspection.
The home had previously been rated Requires Improvement, with breaches of Regulations 9 and 17. This inspection found that the overall rating had improved to Good and that legal requirements were met.
Kind and respectful staff
Staff showed compassion, protected people's dignity and offered reassurance when people became upset.
“We observed staff treating people with compassion and affection, and taking the time to have meaningful conversations.” from the report
Personalised support
Care records included people's preferences, interests, communication needs and the tasks they could do independently.
“People's care and support plans contained information about personal preferences and choices, including areas of strength, hobbies and interests.” from the report
Community involvement
People were supported to take part in activities, voluntary work and visits to local places.
“There was an activity programme in place, providing group and one to one sessions on site and encouraging people to access the community.” from the report
Staffing and training
Inspectors found enough staff on shift and evidence of recruitment checks, training, supervision and competency checks.
“People had their care and support needs met by sufficient numbers of suitably trained staff.” from the report
Improved leadership
Management used audits, meetings and feedback to monitor care and make changes. The rating improved from Requires Improvement to Good.
“The service had good governance arrangements in place and completed internal quality checks and audits.” from the report
Night-time lone working
needs fixingThere was initially no way for the single night worker to get help quickly in an emergency. The provider installed communication equipment after the inspection.
“Night shifts consisted of one staff member. Due to the layout of the service and potential need for support to respond to an emergency, we identified there were no measures in place to enable the night staff member to access assistance.” from the report
Environmental safety
needs fixingInspectors found exposed hot pipes and uncovered radiators. Measures were put in place after the visit to reduce these risks.
“We identified some exposed hot pipes and uncovered radiators during the inspection.” from the report
Medicine-round distractions
needs fixingPeople regularly entered the office while medicines were being given to others. The home was asked to improve controls around the medicine trolley and office access.
“We identified that people regularly came into the office when medicines were being given to other people.” from the report
Variable cleanliness
minorSome bathrooms and toilets smelled unpleasant in the morning, although the issue had been addressed when inspectors checked again after cleaning.
“The standards of cleanliness were variable, with malodour found in some bathrooms and toilets during the morning.” from the report
Tired decoration
minorSome decoration was worn. The home had a rolling refurbishment plan, but families may want to ask what work has since been completed.
“Some decoration was tired, but the service had a rolling refurbishment plan in place.” from the report
- 01What communication equipment is now available to staff working alone at night, and how is it tested?
- 02What changes were made to stop people entering the office during medicine rounds?
- 03Have all the exposed hot pipes and uncovered radiators been dealt with, and how are these risks checked now?
- 04What refurbishment work has been completed since the inspection, particularly in areas where decoration was tired?
- 05How does the home support people if they need urgent mental health help outside normal working hours?
This was an unannounced, scheduled comprehensive inspection covering all five key questions and checking progress after the previous Requires Improvement rating. This explanation was written from the published report of 9 May 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.
What inspectors found, June 2018
Rated Requires Improvement; inspectors found safe, kind care but care planning, decision records and quality checks were not good enough.
Inspectors visited the home on 11 April 2018. They spoke with two people, two staff members and managers, and reviewed care files, staff records, medicines, training, rotas, complaints and quality checks.
The home was rated Good for Safe and Caring. People were protected from abuse and avoidable harm, medicines were generally given safely, staffing was sufficient, and people described staff as kind. The building had also been cleaned and improved since the previous inspection.
The home Requires Improvement overall. Inspectors found care plans that were not always current or detailed enough, and people were not consistently involved in planning their care. Records about mental capacity and best-interest decisions were sometimes unclear.
The home was also rated Requires Improvement for Effective, Responsive and Well-led. The provider knew about some problems but did not always give staff enough time or resources to fix them promptly.
Safe care
Inspectors found that risks were identified and managed, staffing was sufficient, and medicines were generally administered safely.
“People were protected from abuse and avoidable harm.” from the report
Kind relationships
People described good relationships with staff. Inspectors saw staff listening to people, using preferred names and treating them kindly.
“People told us staff were caring and kind and their needs were met.” from the report
Independence
People were supported to use the community, prepare food and drinks, and do tasks for themselves where they could.
“People were supported to be as independent as possible.” from the report
Environmental improvements
Since the previous inspection, parts of the building had been refurbished and cleaning arrangements had improved.
“When we walked around the building we found it to be clean and tidy.” from the report
Care plans
seriousCare plans were sometimes inconsistent, out of date or missing important information. This could mean staff did not have clear guidance about a person's current needs.
“Care plans were not always up to date and did not sufficiently guide staff on people's current care and support needs.” from the report
Involvement in care decisions
seriousPeople were not consistently shown to have been involved in reviewing their care plans. Some mental capacity and best-interest records were contradictory or incomplete.
“People were not given the opportunity to be involved in the development and review of their care plan.” from the report
Quality checks
seriousThe provider knew about some care planning problems but did not provide enough time or resources to deal with them promptly. The quality checks also failed to identify all the concerns.
“Where areas for improvement had been identified action not taken in a timely manner with identified timescales and allocated resources.” from the report
Drug and alcohol guidance
needs fixingThe home had no policy covering drug and alcohol misuse, even though this was relevant to some people living there. Staff were not clear about the procedure.
“The lack of a policy meant that boundaries within the service relating to drug and alcohol were not clearly defined and may not be fully understood by people and staff.” from the report
End of life planning
needs fixingNot all care plans recorded people's preferences and choices for end of life care. Inspectors recommended seeking appropriate advice.
“Not all care plans contained information about people's preference and choices for their end of life care.” from the report
- 01How have you made sure every care plan is current, detailed and consistent across all records?
- 02How are people involved in creating and reviewing their care plans, and how is this involvement recorded?
- 03How do you record mental capacity assessments and best-interest decisions for choices such as medicines or tobacco?
- 04What is the current policy for drug and alcohol misuse, and how are staff trained to follow it?
- 05What has changed in end of life care planning since this inspection?
This was a planned inspection of all five key questions; the report also compares the findings with the previous inspection in October 2016. This explanation was written from the published report of 8 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.
Every inspection of Brackendale House
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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13 live-in carers within about an hour of Norfolk
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Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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