CQC report explained · a residential care home
What the CQC found at Bradstowe Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found safe, kind care, but care records and quality checks were not always good enough.
This was an unannounced focused inspection on 28 February 2023. The inspector spoke with six people and 10 staff, and reviewed care records, medicines records, recruitment files, audits and other management records.
Safe and Effective were rated Good. Inspectors found that risks and medicines were managed better, staff were trained, people received enough food and drink, and health needs were acted on promptly. People said staff were kind and they felt safe.
Responsive and Well-led were rated Requires Improvement. Care plans did not contain enough detail about people's preferences, support needs or end-of-life wishes. Quality checks had improved, but action was not always taken when problems were found. The overall rating stayed Requires Improvement, and this was the third consecutive inspection with that rating.
People felt safe
People told inspectors they felt safe and staff responded quickly when help was requested. Safeguarding arrangements and recruitment checks were in place.
“People told us they felt safe living at the service. They were confident to raise any concerns they had with staff.” from the report
Safer medicines
Medicines management had improved since the previous inspection. Records were complete and accurate, and people received medicines as prescribed.
“Medicines records were complete and accurate. Handwritten entries had been countersigned by 2 staff to confirm they were accurate.” from the report
Good staff support
Staff had induction, training and supervision. Training included dementia, diabetes, catheter care and moving people safely.
“Staff had the skills, training and support they needed to keep people as safe and well as possible.” from the report
People's views acted on
People were involved in decisions about the home. Their feedback led to changes such as a later lunch time, more activities and easier-to-use call bells.
“People attended monthly meetings and their suggestions were acted on.” from the report
Care records lacked detail
seriousCare plans did not consistently explain people's choices, preferences or the equipment and techniques staff should use. This created a risk of inconsistent or unsafe care.
“People's care plans continued to contain limited information about their choices and preferences.” from the report
End-of-life wishes were not recorded
seriousEnd-of-life plans contained little or no information about important wishes, including spiritual needs, preferred company and preferred place of care.
“People's end of life plans continued to contain little or no information about their end of life preferences, including their spiritual needs, who they wanted to be with them and where they wished to be at the end of their life.” from the report
Checks did not always lead to action
seriousAudits and quality checks had improved, but the provider had not always acted on problems found, including weaknesses in the electronic care records system.
“Improved quality assurance systems had been put into operation since our last inspection. However, action had not always been taken to address shortfalls found.” from the report
No registered manager
needs fixingThere was no registered manager in post at the time of the inspection. A manager had been appointed and intended to apply for registration.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01How have you updated each person's care plan to record their preferences and the exact support techniques staff should use?
- 02What information is now recorded about each person's end-of-life wishes, including spiritual needs, who they want with them and where they want to be cared for?
- 03What training have staff received on using the electronic records system, and how do you check that records are complete?
- 04What action is taken when audits find a shortfall, and how is completion checked?
- 05Has the manager applied to become registered with the CQC, and what is the current position?
This was an unannounced focused inspection covering Safe, Effective, Responsive and Well-led; Caring was not inspected and its previous rating was carried forward. This explanation was written from the published report of 24 March 2023 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 2022
Bradstowe Lodge was rated Requires Improvement, with well-led rated Inadequate; inspectors found continuing safety, medicines, care planning and management problems.
This was an unannounced focused inspection. One inspector visited on 19 May 2022 and reviewed records and audits until 24 May 2022. They spoke with people, relatives, staff and a health professional.
Inspectors found some positive points. There were enough staff, recruitment checks had improved, infection control arrangements were satisfactory, and people were supported with food, healthcare and personal choices.
However, important problems remained. Risk assessments and medicines records were not always safe or complete. Care plans did not consistently explain people's preferences or end of life wishes. People’s requests, including changing the lunchtime, were not always acted on.
The overall rating remained Requires Improvement, as it had at the previous inspection. Safe, Effective and Responsive were rated Requires Improvement. Well-led fell from Requires Improvement to Inadequate because the provider's checks had not found or fixed repeated problems.
Enough staff
Inspectors found enough staff to meet people's needs. Call bells were answered quickly and recruitment checks had improved.
“There were enough staff to meet people's needs.” from the report
Infection control
Inspectors were assured that the home had arrangements for preventing and managing infections, including use of protective equipment and testing.
“We were assured that the provider was using PPE effectively and safely.” from the report
Food and healthcare
People were offered a balanced diet and special diets were provided. Staff referred people to health professionals when needed.
“People were supported to eat a balanced diet.” from the report
Choice and support
Staff supported people to make decisions and respected their choices. People and relatives said staff knew them well and were supportive.
“People were supported to make their own decisions.” from the report
Risk assessments
seriousRisk assessments did not always give staff clear instructions. Inspectors found missing guidance for diabetes, catheters, bleeding risks and falls, including limited analysis of 35 falls.
“The failure to manage risks to people's health and welfare was a continued breach of Regulation 12 (2) of the Health and Social Care Act 2008” from the report
Medicines
seriousSome medicines guidance was inaccurate or incomplete. Records did not always show the correct checks and some medicines requiring two staff had only one signature.
“The failure to ensure the safe management of medicines is a continued breach of Regulation 12 (2) of the Health and Social Care Act 2008” from the report
Care plans and records
needs fixingCare plans did not consistently explain people's preferences, daily support needs or end of life wishes. Assessments using recognised tools were also incomplete.
“Care plans contained limited information about people's choices and preferences.” from the report
Weak management checks
seriousThe provider's audits did not cover all important areas and failed to find problems that had continued since the previous inspection.
“The failure to effectively monitor and improve the service was a continued breach of regulation 17 (2) of the Health and Social Care Act 2008” from the report
Feedback not always acted on
needs fixingPeople had asked for lunch to be moved from noon because it was too early, but this had not happened by the inspection.
“The failure to act on feedback from people to improve the service was a breach of regulation 17 (2) of the Health and Social Care Act 2008” from the report
- 01What has changed to make risk assessments complete and clear for people with diabetes, catheters, falls risks or blood-thinning medicines?
- 02How are medicines now checked, including 'when required' medicines and medicines that need two staff signatures?
- 03How do you make sure care plans record each person's daily preferences and end of life wishes?
- 04What action has been taken to meet the positive conditions placed on the provider's registration?
- 05Why is lunch still served at noon, and how are people's requests about meal times now considered?
This was a focused inspection covering Safe, Effective, Responsive and Well-led; Caring was not inspected and its rating was carried forward from the previous inspection. 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.
Every inspection of Bradstowe Lodge
4 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 December 2010.
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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