CQC report explained · a residential care home
What the CQC found at Brackley Fields Country House Retirement Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found gaps in risk assessments, injury records and records of risk-reducing care. Medicine records did not always explain why as-required medicines were given or when they should be used.
- Effective?
- Good
- People received support to access healthcare and maintain their health, and staff received training and supervision. Oral care records were not always completed.
- Caring?
- Good
- People and relatives described staff as kind, respectful and compassionate. Inspectors saw positive interactions and support for privacy, dignity, independence and choice.
- Responsive?
- Requires improvement
- Records did not always show that personalised personal care was provided, and some communication information was incomplete. Activities, relationships and complaints were handled positively.
- Well-led?
- Requires improvement
- Management systems did not reliably identify missing records, medicine concerns, incomplete risk information or unrecorded physical interventions. The home was open to inspection and some audits, such as call-bell and cleanliness checks, were effective.
What inspectors found, August 2022
Rated Requires Improvement; inspectors found kind care and good health support, but safety, personalised care and management oversight needed improvement.
The unannounced inspection took place on 14 July 2022. One inspector visited the home, an expert by experience spoke with people and relatives by telephone, and inspectors spoke with staff and checked care, medicine and management records.
Inspectors found problems with risk assessments, injury records, medicine records and records showing whether personal care had been completed. People and staff also said there were times when staffing levels meant people waited for help or some tasks were not completed.
There were positive findings. Staff were described as kind and caring. People received support with healthcare, food, activities and decision-making. The home was clean and rooms were personalised, although some areas needed updating.
The overall rating changed from Good to Requires Improvement. Safe and Responsive changed to Requires Improvement, while Well-led remained Requires Improvement. Effective and Caring remained Good.
Kind and respectful staff
People and relatives said staff were kind, caring and respectful. Inspectors also observed positive interactions.
“People were supported by kind caring staff who had been safety recruited and received training to understand people's needs.” from the report
Good healthcare support
The home made referrals to healthcare professionals when needed and followed the advice received.
“Referrals to healthcare professionals were made as required.” from the report
Food and personal choice
People's dietary and fluid needs were assessed and monitored. People were offered choices and staff took account of individual likes and dislikes.
“People were supported to eat and drink in order to maintain a balanced diet.” from the report
Activities and relationships
People were offered meaningful activities and supported to stay in contact with important people.
“People were supported to engage in activities that were meaningful to them.” from the report
Medicine information
seriousRecords did not always show why as-required medicines had been given. Staff did not always have clear instructions about when these medicines should be used.
“Staff did not always have the information required to understand the reason PRN medicines were prescribed.” from the report
Risks and injuries
seriousSome risks were not fully assessed or managed. Injury records did not always include enough detail or follow-up information.
“When people suffered injuries, records were not always completed to identify the size, shape and colour of the injury or any follow up information regarding how the injury was healing.” from the report
Staffing levels
needs fixingPeople and staff reported waiting for help, including help to use the toilet. Inspectors recommended that staffing levels be reviewed.
“There are not enough staff and people sometimes wait for an hour to use the toilet.” from the report
Personal care records
needs fixingRecords did not always show that bathing, showering and hair-washing support was offered often enough. This meant the home could not always show that people's personal care needs had been met.
“Records did not always evidence person centred care was delivered.” from the report
Management checks
seriousAudits and other systems did not reliably identify missing care records, medicine problems, incomplete risk information or unrecorded physical interventions.
“Systems and processes were not effective in identifying when support tasks were not completed or recorded.” from the report
- 01What changes have you made to staffing levels, especially on night shifts, since the inspection?
- 02How do you now check that as-required medicines have clear instructions and that the reason for giving them is recorded?
- 03How do you make sure risk assessments, injury records and follow-up actions are complete?
- 04How do you check that bathing, showering, hair care and other personal care tasks are offered and recorded?
- 05What action has been taken to improve the management audits and the parts of the home that needed updating?
This was an unannounced inspection covering all five CQC questions, including infection prevention and control, with records, observations and feedback from people, relatives and staff reviewed. This explanation was written from the published report of 17 August 2022 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, September 2019
Brackley Fields Country House Retirement Home was rated Good overall; care was kind and safe, but leadership and record keeping still needed improvement.
Inspectors carried out an unannounced inspection on 23 July 2019. They spoke with people, relatives and staff, and reviewed care records, medicines records, recruitment files and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found safe medicines, suitable staff checks, kind care, good access to health professionals and activities for people. People were generally treated with dignity and respect.
Well-led was rated Requires Improvement. Records did not always show people's choices, routines, fluid intake or care reviews clearly. Complaints investigations were not always fully recorded, and the home did not use a staffing tool to check the number of staff needed.
The overall rating improved from Requires Improvement at the previous inspection. The provider was no longer in breach of Regulation 17, but inspectors made recommendations about staffing, person-centred care, care records and quality audits.
Kind and respectful care
People and relatives described positive relationships with staff. Inspectors saw staff speaking kindly and respecting privacy and dignity.
“We saw staff treating people well and talking with them kindly and with respect.” from the report
Safe medicines
Medicines were administered as prescribed, with accurate administration records and suitable storage and disposal.
“Medicines were managed safely, medicines were administered as prescribed.” from the report
Staff training
Staff completed induction, training and shadow shifts. They were confident in their roles and received supervision and appraisals.
“All staff completed an induction which included full training and shadow shifts” from the report
Links with health professionals
The home made referrals and worked with health professionals to meet people's needs.
“Staff worked with external professionals to ensure people were supported to access health services” from the report
Activities and relationships
People were offered activities, including individual activities for those who preferred to stay in their rooms. Relatives were welcomed and people were supported to maintain relationships.
“An activities coordinator engaged people to participate in activities.” from the report
Staffing pressure
needs fixingThe home did not use a staffing dependency tool. Although there were enough staff to keep people safe on the inspection day, some staff and people reported pressure or delays in responding to call bells.
“Everybody goes home stressed. We can't keep up with everything.” from the report
Choices and routines not always recorded
needs fixingCare plans did not always record people's likes, dislikes, routines or preferences about personal care. This could make it harder to provide consistently personalised care.
“Systems and processes were not in place to ensure person centred care was always offered” from the report
Care records not reliably updated
needs fixingAudits did not always identify when records needed review. Some risk assessments and daily fluid charts were incomplete or out of date.
“Audits on people's care files failed to identify when records required reviewing and updating.” from the report
Complaints records
minorThe home kept a complaints log, but investigations were not always documented fully. The manager agreed to record future investigations in full.
“investigations relating to complaints were not documented” from the report
Limited end of life preferences
minorNot all care plans recorded people's wishes about care at the end of life, such as religious support or preferred objects and sounds.
“Not all care plans recorded the wishes of a person regarding any care leading up to their death” from the report
- 01How do you now check that staffing levels are enough for people's care needs and choices?
- 02How do you record and review each person's routines, likes, dislikes and preferred gender of care staff?
- 03How do you make sure risk assessments and daily fluid charts are reviewed and completed when needed?
- 04How are complaints investigated and recorded from start to finish?
- 05How do you record people's end of life wishes, including religious support and personal preferences?
This was an unannounced inspection covering all five CQC questions and both the premises and care provided; all five ratings were reviewed. This explanation was written from the published report of 4 September 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 Brackley Fields Country House Retirement Home
6 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- August 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Brackley Fields Country House Retirement Home →
- September 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Brackley Fields Country House Retirement Home →
- July 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 6 September 2012.
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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