CQC report explained · a residential care home
What the CQC found at Bradbury Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe medicines systems, current risk assessments, enough staff and effective incident follow-up.
- Effective?
- Good
- People's needs and choices were assessed and reviewed each time they stayed. Staff had relevant training, and people were supported with food, drinks and health appointments.
- Caring?
- Good
- People and relatives spoke positively about staff. Inspectors saw respectful support that protected privacy, dignity and independence.
- Responsive?
- Good
- Care plans were specific to each person and updated when needs changed. Communication methods were adapted, and people were supported to take part in activities and maintain relationships.
- Well-led?
- Good
- The provider had quality checks covering care, medicines, support plans and staff records. Inspectors found that these checks were used to plan and monitor improvements.
What inspectors found, December 2019
Bradbury Manor was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection carried out over two visits. The inspector spoke with people using the home, relatives and staff, and checked care records, medicines records, staff files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People said they were happy with their support and felt safe. Inspectors found that staff understood people's needs, supported their independence and helped them stay connected with activities, health services, family and friends.
The previous inspection had rated the home Requires Improvement and found breaches about medicines, incident management, quality checks and notifications. At this inspection, inspectors found improvements and said the home was no longer in breach of those regulations.
Safe medicines support
Medicines were securely stored, records were complete and staff were trained and assessed before administering medicines.
“Medicines administration records had been fully completed.” from the report
Personalised care
Care plans described people's individual needs, preferences and communication methods. They were reviewed each time someone stayed.
“People had clear care plans, which set out how their individual needs should be met.” from the report
Kind and respectful staff
People and relatives spoke positively about staff, and inspectors saw friendly and respectful interactions.
“We observed staff interacting with people in a friendly and respectful way.” from the report
Support for independence
Staff encouraged people to do things for themselves and supported them to develop skills and take part in community activities.
“The service supported people to develop their skills and be as independent at possible.” from the report
Improved management
The provider had strengthened its quality checks and used them to identify and monitor improvements.
“The provider had effective quality assurance systems in place.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you make sure medicines records remain complete and medicines are stored safely during every short break?
- 02How will you review my relative's care plan and risks each time they stay?
- 03Which staff have completed the training needed for my relative's specific health or communication needs?
- 04How will you record and act on any incidents or changes in my relative's support needs?
- 05How will you support my relative to keep attending their usual activities and maintain contact with family and friends?
This was an unannounced inspection covering all five CQC questions, following a previous Requires Improvement rating and breaches of regulations. This explanation was written from the published report of 6 December 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, November 2018
Bradbury Manor was rated Requires Improvement; inspectors found kind and effective care, but repeated safety, reporting and management failures left people at risk.
Inspectors visited without notice on 19 and 20 September 2018. They spoke with one person, observed three others, contacted relatives and health and social care professionals, and spoke with staff and managers. They also checked care records, medicines records, staff files, rotas and quality checks.
The home was rated Good for Effective and Caring. People were treated kindly, offered choices and supported to see health professionals. Mental capacity assessments had improved, and people were supported with meals, activities and friendships.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Incident investigations and actions were not always recorded, medicines temperature checks were incomplete, and staff raised concerns about shortages and agency staffing. Care plans did not always give staff enough information, complaints were not followed up clearly, and safeguarding incidents were not always reported to CQC.
This was the third consecutive Requires Improvement rating. The home was in breach of three regulations, including Regulation 12 for a third consecutive inspection. CQC said it was considering further action.
Kind and respectful care
People were treated warmly. Staff offered comfort, choices and respect for people's decisions.
“We saw staff responded to people in positive ways offering choice and respecting their decisions.” from the report
Improved decision-making support
Mental capacity assessments had improved. People and those who knew them were involved in reaching decisions.
“The assessments showed that people had been appropriately involved in the process and supported to try and understand the decision needing to be made.” from the report
Links with health professionals
People could see health professionals when needed, and care plans described support for their health needs.
“People were able to see health professionals where necessary, such as their GP, specialist nurse or to attend hospital appointments.” from the report
Activities and engagement
Activities were adapted to people's needs and preferences. Inspectors saw staff helping people take part.
“We observed staff spending time with people and encouraging engagement in activities.” from the report
Clean surroundings
Inspectors found the home clean and homely, although cleaning checklists were still missing.
“We found the service to be very clean and homely.” from the report
Incident follow-up
seriousRecords did not always explain how people were supported, whether medical help was obtained or how future risks would be reduced. One person with a possible head injury had no recorded consideration of medical assistance.
“There was no information on how people were supported, if medical help had been accessed or if actions to minimise the risk of a reoccurrence had been implemented.” from the report
Medicines storage and records
seriousThe home did not record minimum and maximum medicines-room temperatures. A medicines fridge had been outside the safe range several times, and other medicines records did not always match the prescriber's instructions.
“There were no records of the room temperature to show that medicines were being stored at appropriate temperatures.” from the report
Staffing pressure
needs fixingThe home relied on relief and agency staff and was short of 158 staff hours during the inspection week. Staff said sickness and shortages were making staffing difficult.
“The staffing is not good, we have agency on every shift.” from the report
Safeguarding notifications
seriousSeveral allegations and incidents had not been reported to CQC as required. In some cases, there was also no recorded evidence of investigation or action to reduce ongoing risk.
“The provider had further failed to notify us of two allegations of psychological abuse occurring in April and May 2018.” from the report
Weak quality checks
seriousThe home's audits had not identified or addressed concerns about medicines, incidents and care plans. Agreed monthly medicines audits had not been carried out.
“The provider's quality assurance systems in place had failed to identify concerns in the service for timely action to be taken, to keep people safe.” from the report
- 01How do you now record every incident, including medical advice, the support given and actions to prevent it happening again?
- 02How are minimum and maximum medicines-room and fridge temperatures checked, recorded and acted on when they are outside the safe range?
- 03What has changed to reduce reliance on agency and relief staff, and how do you make sure temporary staff understand each person's needs?
- 04How have care plans been updated to give clear instructions about communication, personal care, nutritional risks and wishes if someone becomes seriously unwell?
- 05How do you now make sure safeguarding incidents are reported to CQC on time and that quality audits identify and complete required actions?
This was an unannounced inspection of all five key questions; the report says the home provides planned and emergency short-term respite care for up to 10 people. This explanation was written from the published report of 2 November 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 Bradbury Manor
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about two hours of Wiltshire
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 £1,020 to £1,340 a week. 82 can care for a couple. 12 years' experience on average.
“Linet became her carer and all changed, my daughter started eating, taking her medications and more important her happiness came back.”
“I cannot recommend Prisca highly enough, she is one in a million.”
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.