CQC report explained · a residential care home
What the CQC found at Brackenley
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Staff understood risks, medicines were managed safely and there were enough staff to meet people's needs, although the recording of accidents and incidents was being reviewed.
- Effective?
- Good
- Care was regularly assessed and reviewed. Staff worked with families and healthcare professionals, supported people's health and respected their choices and legal rights.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were supported to express their views, make choices and maintain their independence.
- Responsive?
- Good
- Care was personalised and based on what mattered to each person. People could take part in many activities, pursue hobbies and raise concerns with staff.
- Well-led?
- Outstanding
- Inspectors found exceptional leadership, a strong person-centred culture and a clear focus on learning and improvement. Management actively sought feedback and worked with other organisations to improve opportunities for people.
What inspectors found, June 2019
Brackenley was rated Good overall, with Outstanding leadership and kind, effective care.
Inspectors visited on 10 and 17 April 2019. The first visit was unannounced and the second was announced. They spoke with people, relatives, staff and healthcare professionals, and checked care, medicines, staff records and management records.
People were found to be safe, treated with kindness and supported to make choices. Staff understood people's needs, worked with healthcare professionals and supported a wide range of activities, hobbies and community opportunities.
All five areas were rated Good except well-led, which was rated Outstanding. The home was also rated Good at its previous inspection, published in October 2016.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff supported privacy, independence and personal choices.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Staff understood people's individual needs, histories and preferences. People were involved in setting goals and reviewing their care.
“People received very person-centred care; staff had a detailed understanding of people's needs and what was important to them.” from the report
Activities and independence
People had access to varied activities, education, training and opportunities linked to community life and employment.
“People were supported to access a very wide range of meaningful activities and to pursue their hobbies and interests.” from the report
Strong leadership
Management created an open culture focused on people, staff development and continual improvement. Feedback from people, relatives and professionals was used to improve the service.
“The provider and registered manager were exceptionally committed to continually improving and developing the service to meet people's individual needs and improve their quality of life.” from the report
Incident records were under review
minorThe provider was reviewing how accidents and incidents were recorded so that management could monitor how they were handled more effectively.
“The provider was in the process of reviewing how accidents and incidents were recorded to help them better monitor how they were handled.” from the report
Home size was larger than current guidance
minorThe home supported 13 people, which inspectors said was larger than current best practice guidance for a service supporting people with a learning disability. Inspectors said the building and management reduced the negative impact.
“This is larger than current best practice guidance for a service supporting people with a learning disability.” from the report
- 01What changes were made to the way accidents and incidents are recorded and monitored?
- 02How will you make sure the size of the home does not affect people's support, privacy or independence?
- 03How are people involved in reviewing their care plans and setting personal goals?
- 04What activities, education or community opportunities would be available for my relative?
- 05How do staff support people to make choices and communicate their wishes?
This was a planned inspection covering all five CQC questions, including both the premises and the care provided. This explanation was written from the published report of 29 June 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, October 2016
Rated Good overall, but inspectors found that safety records, care plans and some maintenance checks needed improvement.
Inspectors visited the home without warning on 5 July 2016. They spoke with six residents, a relative, staff and other people involved in running the home. They observed care, checked four care records, staff records, medicines information and maintenance records.
People said they felt safe and were treated with dignity and respect. Staff were trained, there were enough staff, and people were supported with food, healthcare, activities, community trips and holidays. The home was rated Good for Effective, Caring, Responsive and Well-led.
Safety was rated Requires Improvement. Inspectors found missing or incomplete records for some medicines, fire checks, maintenance and an injury linked to poor bathroom lighting. Care plans and records did not always reflect people's current needs. The provider knew about these issues and had started work to improve record keeping and quality checks.
The overall rating improved from Requires Improvement at the previous inspection in March 2015 to Good. The report says improvements had been made in giving people more choice, control, dignity and respect.
Enough trained staff
Inspectors found sufficient staff with suitable experience. Staff had relevant training, supervision and support.
“There were sufficient numbers of suitably experienced staff.” from the report
Kind and respectful care
People and relatives spoke positively about how staff treated them. Inspectors saw a friendly and homely atmosphere, with attention to privacy and dignity.
“People who used the service told us they were happy with the way staff treated them and how their care was provided at Brackenley.” from the report
Activities and community life
People could take part in activities, learning, work placements, exercise and trips into the local community. The report also records that people had been supported to go on holiday.
“People had access to the local community and were supported to take part in activities that interested them. People had been on holidays.” from the report
As-needed medicine guidance
seriousWritten instructions were not always detailed enough to guide staff on when and how to give medicines prescribed for use only when needed. This was a safety shortfall.
“However, we found that detailed written protocols to help guide staff on how these medicines should be managed and administered safely for the individuals concerned were not in place.” from the report
Care plans not up to date
needs fixingSome care plans did not reflect recent changes in people's health or support needs, even though staff knew what care was needed.
“Two of the three care plans and records we viewed had not been updated to reflect recent changes in people's circumstances and needs.” from the report
Fire and maintenance records
seriousSome fire checks and maintenance records were missing, out of date or difficult to locate. The report also noted that some evacuation plans had not been reviewed for over a year.
“Weekly fire alarm tests were recorded until 5 May 2016, but with no record of checks taking place after this date.” from the report
Poor bathroom lighting
seriousInspectors found dim lighting in two en-suite bathrooms. One person had hurt their toe, but the incident had not been fully recorded or investigated and the lighting risk had not been reduced.
“We also observed poor lighting in another en-suite bathroom.” from the report
Quality checks missed problems
needs fixingThe provider's existing quality checks had not identified or corrected all the record-keeping and maintenance issues. New systems were only at an early stage.
“The provider's existing quality assurance systems had not been effective in recognising and rectifying the issues we have described above.” from the report
- 01What written guidance is now in place for each resident's as-needed medicines, and how is it checked?
- 02How do you make sure care plans are updated promptly when a resident's needs or health change?
- 03What action was taken about the dim bathroom lighting and how were similar risks checked elsewhere in the home?
- 04Are fire alarm tests, fire drills, evacuation plans and maintenance certificates now complete and easy for the manager to access?
- 05How do your current quality checks identify missing records, accidents and changes in residents' needs?
This was an unannounced overall inspection covering all five CQC questions, with the inspectors speaking to residents, a relative and staff and reviewing care, medicines, staff and management records. This explanation was written from the published report of 22 October 2016 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 Brackenley
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- October 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- September 2014
Registered with the Care Quality Commission on 24 September 2014.
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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Most charge £1,010 to £1,290 a week. 27 can care for a couple. 12 years' experience on average.
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