CQC report explained · a residential care home
What the CQC found at Braemar Lodge Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Braemar Lodge Residential Care Home: Rated Requires Improvement; inspectors found progress, but dignity and quality checks were still not reliable.
This was an unannounced focused inspection. Inspectors looked mainly at Safe and Well-led, including infection prevention and control. They spoke with people, relatives and staff, observed care and checked care, medicine, recruitment and management records.
Some earlier problems had improved. Safeguarding training, risk assessments, medicine records, staff training and recruitment checks were better. Staff were described as kind, patient and calm when giving medicines. However, one person's prescribed as-needed medicine was not offered when the person's protocol said it should be.
The inspectors found breaches about dignity and respect and about management oversight. The overall rating remains Requires Improvement, and this is the home's second consecutive rating of Requires Improvement. Ratings for Caring, Effective and Responsive were carried over from the previous inspection because they were not examined during this visit.
Safeguarding improved
All staff, including administrative and housekeeping staff, had safeguarding training and could explain how to report concerns.
“The staff team, including admin and housekeeping staff, had received training on how to recognise and report abuse.” from the report
Clearer risk records
Care plans and risk assessments had been reviewed and moved to a digital system, giving staff access to current information.
“At this inspection we found risks to people's safety had been assessed and recorded clearly.” from the report
Calm medicine administration
Medicine rounds were spaced through the day, and staff had training and competency checks. The report also identified a specific failure with one as-needed medicine.
“Staff administered people's medicines calmly and made sure people were not rushed.” from the report
Supportive management
People, relatives and staff said the management team was approachable. Staff meetings, surveys and ongoing communication were used to gather views.
“They promoted an open culture where everyone's views and opinions were valued.” from the report
Privacy and dignity
seriousThe report found poor practice affecting privacy and dignity. This included displaying people's names and room numbers, not discreetly covering a catheter bag and unclear arrangements for shared rooms.
“The provider did not always ensure people received their care and support in a way that promoted their dignity.” from the report
Weak quality checks
seriousThe provider's checks did not reliably find problems with recruitment, as-needed medicines, safety arrangements or dignity. This was a continued breach.
“The provider did not have robust processes to monitor the quality and safety of the service.” from the report
Damaged facilities
needs fixingA bath hoist and commode chair were damaged and could not be properly wiped clean, creating a potential infection control risk. Action was taken only after the inspection.
“Some items such as a communal bath hoist and a person's commode chair were damaged and therefore not 'wipe clean surfaces' which posed a potential infection control risk.” from the report
As-needed medicine not offered
needs fixingOne person became anxious during the inspection but was not offered their as-needed medicine as required by the person's protocol.
“The person had experienced anxiety on the day of the inspection but had not been offered the PRN medication as stated in the protocol.” from the report
- 01How will you make sure people's privacy and dignity are protected in communal areas and shared rooms?
- 02What has been done to replace or repair the damaged bath hoist, commode chair and other facilities?
- 03How will you check that as-needed medicines are offered exactly as set out in each person's protocol?
- 04What changes are in the action plan to improve quality monitoring, and when will you review whether they have worked?
- 05How will you keep people safe without locking the front door in a way that could conflict with fire safety arrangements?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 24 August 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, June 2022
Braemar Lodge Residential Care Home is rated Requires Improvement; inspectors found caring staff but weaknesses in safety, training and oversight.
This was an unannounced focused inspection on 11 May and 23 May 2022. Two inspectors spoke with one person using the service, two relatives and nine staff. They also spoke with managers and checked care records, medicines records, staff files and management records.
The home was not always safe. Care plans and risk assessments lacked important detail. Medicine records had gaps, fluid charts were completed retrospectively, and not all staff had suitable training or supervision. Staffing numbers and staff competence were not always sufficient.
The home was also not always well-led. Training records and quality checks did not reliably identify problems. Staff and relatives gave mixed feedback about management support and openness. Staff were caring and knew people well, and inspectors found the home was working within the principles of the Mental Capacity Act.
The overall rating changed from Good at the last inspection in 2019 to Requires Improvement. This inspection only reassessed Safe and Well-led. The other three ratings were carried forward from the previous comprehensive inspection.
Kind and familiar care
Inspectors found that staff were caring and knew people well. People and relatives gave positive feedback about the care and support.
“People and their relatives were positive about the care and support provided.” from the report
Support with choices
The records reviewed showed that the home was following the principles of the Mental Capacity Act and using least restrictive approaches.
“In the files we reviewed, we saw DOLS had been applied for appropriately.” from the report
Infection control measures
Inspectors were assured about several infection control arrangements, including visitors, distancing, admissions, protective equipment and hygiene.
“We were assured that the provider was using PPE effectively and safely.” from the report
Some safety checks
Inspectors found that staff managed the living environment and equipment well in several areas, including equipment checks and assessments for pets entering the home.
“Staff managed the safety of the living environment and equipment well to minimise risk.” from the report
Incomplete risk assessments
seriousSome care plans contained conflicting or limited information. Respite residents did not always have detailed care plans and risk assessments.
“Not all risks to the health and safety of people receiving care had been assessed.” from the report
Medicine records
seriousStaff did not always sign medicine administration records. Some as-needed medicines lacked clear instructions, and one person did not have a care plan for medicines given covertly.
“Staff did not always sign Medication Administration Records (MAR) when they had given people their medication.” from the report
Training and staffing
seriousSome staff had not completed required training, and practical moving and handling training was not provided to new staff. Planned staffing numbers were not always met and some staff raised concerns about night staffing.
“Care was not always provided by staff who were trained and competent to do so safely.” from the report
Weak quality checks
seriousTraining records, medicine audits, care records and cleaning schedules were not reliably checked. The systems did not identify all the problems inspectors found.
“Systems to monitor and improve the quality and safety of the service were not reliable and effective.” from the report
Safeguarding arrangements
seriousNot all staff had safeguarding training. Notifications were not always sent to the CQC when concerns had not yet been confirmed by the local authority.
“Safeguarding training was not provided to all staff and notifications were not always made to CQC.” from the report
Openness among staff
needs fixingSome staff did not feel valued or supported and were concerned that close relationships between staff and managers could affect whether concerns were addressed. Inspectors were not assured that staff could raise concerns without fear of repercussions.
“We were not assured that the culture was fully open so that staff felt able to challenge unsafe or unacceptable practice without fear of recriminations.” from the report
- 01What has been done to make sure every person has a current, detailed care plan and risk assessment, including people staying for respite care?
- 02How are medicine administration records checked each day, and how are instructions for as-needed and covert medicines kept up to date?
- 03Which staff have now completed practical moving and handling training, and how is their competence checked before they work independently?
- 04How are staffing numbers calculated for each shift, particularly at night?
- 05What changes have been made to audits and training records so that problems are identified promptly?
This was an unannounced focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 30 June 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 Braemar Lodge Residential Care Home
6 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- August 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Braemar Lodge Residential Care Home →
- June 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Braemar Lodge Residential Care Home →
- July 2019Goodstayed GoodSafe: Requires improvementWell-led: Good
- September 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 14 February 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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