CQC report explained · a residential care home
What the CQC found at Bradbury Grange
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People did not always receive care when they needed it because staffing levels were not consistently sufficient. Medicines could be delayed, and there was not always guidance for staff about when to give medicines prescribed as needed.
- Effective?
- Requires improvement
- Some staff had not received practical moving and handling training or specialist training for conditions such as diabetes, catheter care and stoma care. People did receive healthcare support, food and drink suited to their needs, and support with consent and choice.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- There was no registered manager, and quality checks had not led to clear action plans or reliable improvements. Staff said they felt unsupported and not listened to.
What inspectors found, October 2022
Requires Improvement; inspectors found staffing, training and management problems that could affect people's safety and care.
This was an unannounced focused inspection on 24 August 2022. Inspectors spoke with people, relatives, staff and a visiting professional. They reviewed care, medicines, staff and management records, and observed care.
The home was rated Requires Improvement overall, and for Safe, Effective and Well-led. There were not always enough staff, some staff lacked practical and specialist training, and management checks had not identified or fixed important problems. A registered manager was not in post.
There were also positive findings. Staff were recruited safely, people were protected from abuse, care needs were assessed, healthcare professionals were involved, and people were supported with food, drink, choice and consent. The home had improved in some areas since the previous inspection, but it remained in breach of regulations.
The inspection only assessed Safe, Effective and Well-led. The ratings for Caring and Responsive were carried over from the previous inspection, so this report does not give new findings about those areas.
Safe recruitment
The home completed employment history checks, references, identity checks and DBS checks before staff started work.
“Full employment histories had been obtained. Gaps in employment history were explored and two references were obtained before staff started work at the service.” from the report
Protection from abuse
Inspectors found that safeguarding procedures were followed and staff understood how to recognise and report concerns.
“People were protected from the risk of avoidable harm.” from the report
Healthcare support
The home worked with GPs and other professionals, and people were referred for specialist help when needed.
“People had access to healthcare agencies and support in a timely way.” from the report
Food and drink
People had meal choices, special diets were catered for, and food and fluid intake was monitored where needed.
“People received a healthy, balanced and nutritious diet that supported their health and wellbeing.” from the report
Choice and consent
People were supported to make everyday choices, and staff asked for consent before providing care.
“People told us that staff always asked them for consent before they provided care and support.” from the report
Not enough staff
seriousPeople sometimes waited a long time for help, meals and getting dressed. Agency staff were used to cover shortages, but they did not always know people's preferences and needs.
“The provider had failed to deploy enough staff to ensure people received the care and support that they needed when they needed it.” from the report
Training gaps
seriousSome staff had no practical moving and handling training or competency checks. Staff also lacked training for some people's specialist health needs.
“The provider had failed to ensure that staff had the necessary specialist training and support to undertake their roles effectively and safely, to ensure people received the care and support they needed.” from the report
Weak management checks
seriousAudits did not identify some problems, and action plans did not say who would fix issues or by when. There was no registered manager in post.
“The provider had failed to assess, monitor and mitigate risks to the quality and safety of the service and to individual people using the service” from the report
Limited activities
needs fixingPeople, relatives and staff said there was little to do and that this had not improved. The home was trying to recruit an activities worker but had not appointed anyone.
“People told us they were bored and there was not enough do.” from the report
Medicines guidance
needs fixingSome morning medicines were delayed, and there was no written guidance to help staff give medicines prescribed as needed consistently and safely.
“There was no guidance was in place for staff to refer to where people required 'as and when' medicines to ensure this was done consistently and safely.” from the report
Support for distressed behaviour
needs fixingCare records did not give step-by-step guidance for staff supporting people with dementia who became distressed or upset. This was more difficult when agency staff did not know people well.
“There was no step by step guidance for staff on what action they needed to take on how to manage these situations safely and consistently on an individual basis.” from the report
- 01How many permanent and agency staff are currently on each shift, and how does this compare with the home's current dependency assessment?
- 02Have all staff completed practical moving and handling training, and how are their skills checked?
- 03What specialist training is now in place for diabetes, catheter care and stoma care?
- 04How are medicines given as needed managed now, and how do you prevent medicine rounds being delayed?
- 05Who is currently responsible for management, and what evidence can you show that the CQC action plan has been completed?
This was a focused inspection of Safe, Effective and Well-led, prompted partly by concerns about care, support and staffing; Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 8 October 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, January 2021
Bradbury Grange was inspected but not rated; inspectors were assured about infection prevention and control.
This was an unannounced, targeted inspection on 8 December 2020. It looked only at infection prevention and control practices, as part of checks linked to coronavirus outbreaks.
Inspectors were assured that the home was managing visitors, social distancing, admissions, protective equipment, testing, hygiene and infection outbreaks safely. They also found that the infection prevention and control policy was up to date.
Staff were kept in one area of the home to reduce infection spread. They were offered free meals, changed into uniforms at work and could use a laundry service. Staff also reassured people who were confused about the changes.
The home was inspected but not rated. This report does not give an overall rating or ratings for the other four areas.
Staff arrangements
Staff were deployed to work in one area of the home, which reduced the risk of infection spreading between areas.
“The registered manager had deployed staff to work in one area of the service only, to minimise the risk of the spread of infection.” from the report
Support for people
Staff gave people reassurance when they were confused by changes and explained things in a way they could understand.
“Staff explained information in a way people understood and took the time to listen to their concerns.” from the report
Staff hygiene
The home offered staff meals so they did not need to leave during shifts. Staff also changed into uniforms at the home and had access to a laundry service.
“Staff changed clothing into their uniforms at the service and were offered a laundry service to ensure their uniforms were washed at the correct temperature.” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors prevented from catching or spreading infections now?
- 02How do you make sure staff use protective equipment safely and have access to testing?
- 03Are staff still kept to one area of the home to reduce infection spread?
- 04How are people supported if they become confused or worried about changes to routines?
- 05When were the other areas of care last inspected and rated?
This was a targeted inspection of infection prevention and control practices only; the service was inspected but not rated and the other key questions were not assessed. This explanation was written from the published report of 7 January 2021 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 Bradbury Grange
7 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- October 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Inspected but not rated
- February 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- May 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2014
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.
- July 2011
Registered with the Care Quality Commission on 29 July 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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39 live-in carers within about an hour of Kent
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 £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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.