CQC report explained · a residential care home
What the CQC found at Brailsford House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2021
Brailsford House was inspected but not rated; inspectors were assured about most infection controls, but only somewhat assured that PPE was used effectively and safely.
This was an announced, targeted inspection on 18 December 2020. It looked only at infection prevention and control during the coronavirus pandemic.
Inspectors found visiting procedures, regular COVID-19 testing, safe PPE disposal, enhanced cleaning and a stable staff team. Staff also helped people keep in touch with relatives.
Inspectors were assured about most infection control arrangements. They were only somewhat assured that PPE was being used effectively and safely, and signposted the provider to resources to improve its approach.
The home was inspected but not rated. This was not a full inspection of the quality of care, and the report does not give an overall rating.
Regular testing
There was a regular testing programme for people living in the home and staff, allowing positive results to be acted on quickly.
“There was a clear regular programme for staff and people living in the home to be tested for COVID-19.” from the report
Cleaning and hygiene
Cleaning had been increased, including cleaning frequently touched surfaces, to reduce the risk of infection spreading.
“Enhanced cleaning schedules were in place including high touch areas such as door handles and hand rails.” from the report
Stable staff team
Staff did not work in other care settings and no agency staff were used, which inspectors said reduced the risk of cross infection.
“There was a stable staff team who did not work in any other care settings.” from the report
Family contact
Staff supported people to keep in touch with relatives by telephone during restrictions on visiting.
“People we spoke with confirmed staff had supported them to stay in contact with their family during the pandemic.” from the report
PPE practice
minorInspectors were only somewhat assured that PPE was being used effectively and safely. They signposted the provider to resources to develop its approach.
“We were somewhat assured that the provider was using PPE effectively and safely.” from the report
- 01What has the home changed since the inspection to improve the way PPE is used and disposed of?
- 02How are staff checked to make sure PPE is being used effectively and safely?
- 03What are the current visiting arrangements, including garden visits and visits after any quarantine period?
- 04How often are people living in the home and staff tested, and what happens after a positive result?
- 05How will the home help my relative keep in contact with family if visiting is restricted?
This was a targeted inspection of infection prevention and control only; it did not rate the other areas of care or give an overall rating. This explanation was written from the published report of 13 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.
What inspectors found, May 2019
Rated Requires Improvement; inspectors found unsafe medicines systems, fire safety gaps and weak oversight, despite kind care and good staff training.
This was an unannounced inspection on 19 February 2019. Inspectors reviewed care files, staff records, medicines, accidents, complaints and quality checks. They spoke with all 18 people living at the home, seven visitors and staff.
People generally said they felt safe and received good care. Staff were trained and supervised, care plans were reviewed, people were supported with food and healthcare, and staff treated people kindly and respectfully.
However, medicines were not managed safely. Five of six people's medicine counts had discrepancies. Fire drills and evacuation practices had not taken place. There were also no recorded checks on bed rails or window restrictors, and one upstairs window had no restrictor at the time of inspection.
The overall rating fell from Good at the previous inspection, published on 18 March 2016, to Requires Improvement. The home was in breach of Regulation 12 on safe care and treatment and Regulation 17 on good governance.
Kind and respectful staff
People and relatives were positive about the care. Staff supported independence, privacy and dignity.
“They [staff] are kind, caring and definitely approachable, they are very nice” from the report
Good staff training
Inspectors found staff training was up to date and that staff received regular supervision and yearly appraisals.
“We saw that staff training was up to date.” from the report
Personalised care
Care plans included people's life histories, preferences and social or cultural needs. They were reviewed monthly or when needs changed.
“Care plans were developed to reflect what was important to the person and to meet any social or cultural needs.” from the report
Food and healthcare
People enjoyed the food and were supported to access healthcare professionals, including GPs and speech and language therapists.
“The meals are fantastic and home cooked.” from the report
Medicines were not safely managed
seriousInspectors found discrepancies in five of six people's medicine counts. The last recorded medicine competency check was in March 2017, although checks were said to be annual.
“We looked at six people's medicines and found there was a discrepancy with counts on five of these.” from the report
Fire and premises safety gaps
seriousStaff had not practised a fire drill or evacuation. Checks on bed rails and window restrictors were not recorded, and one upstairs window had no restrictor during the inspection.
“We found a window upstairs with no restrictor in place.” from the report
Communication and choice
needs fixingThe home could not show that people unable to communicate verbally were supported to make choices in practice. The manager said picture cards were being developed.
“Further work was needed to support people who could not communicate verbally.” from the report
Activities and social contact
needs fixingSome activities were not suited to people's age or abilities, and one person was cared for in bed all day with their door closed. Inspectors asked the home to review the risk of social isolation.
“We asked the registered manager to review this, as the person could become socially isolated.” from the report
Quality checks missed problems
seriousThe home's audits did not identify the medicine concerns. Policies also needed updating and management systems did not identify all the issues found by inspectors.
“However, the audits did not highlight the concerns we found with medicines.” from the report
- 01What changes have been made to medicine counting, medicine records and staff competency checks since this inspection?
- 02When was the last fire drill and practice evacuation, and how are these now recorded?
- 03Are window restrictors and bed rails checked regularly, and can we see the records?
- 04How do you support people who cannot communicate verbally to make choices about their care?
- 05What activities are now available for different abilities, and how do you prevent people from becoming socially isolated?
This was an unannounced scheduled inspection that looked at the overall quality of the care home and rated all five CQC questions. This explanation was written from the published report of 10 May 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 Brailsford House
2 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- January 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- May 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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.
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