CQC report explained · a residential care home
What the CQC found at Bramble Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, staffing was sufficient and infection-control measures were in place. They found minor errors in covert medicines and recommended that medicine management guidance be reviewed.
- Effective?
- Good
- Care plans were person-centred and up to date. People received prompt health care, staff worked with health professionals and the home supported people to make choices in line with the Mental Capacity Act.
- Caring?
- Good
- Staff were kind, compassionate and respectful. Inspectors saw staff supporting people's privacy, dignity, independence and everyday choices.
- Responsive?
- Good
- Care was personalised around people's preferences, communication needs and interests. People were supported to keep in touch with relatives, join activities and raise complaints.
- Well-led?
- Good
- The home had a positive culture and regular audits and meetings to monitor quality and risks. Inspectors found that feedback and audits were used to make improvements.
What inspectors found, January 2022
Rated Good; inspectors found safe, kind and personalised care, with minor medicines issues needing attention.
This was the home's first comprehensive inspection since it registered. It was unannounced and took place on 21 December 2021. Inspectors spoke with people, relatives, staff and health professionals, and reviewed care, medicines, staffing and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, regular risk reviews, good infection control and prompt health care support. Staff were kind, knew people well and respected their privacy, choices and independence.
There were some minor errors in managing covert medicines, and guidance for some as-required medicines needed more detail. The home corrected these points after the inspection, but CQC recommended reviewing medicine management. The home also had plans to improve staff training access, signage and end of life care plans.
Risk and safety checks
Risks such as falls and long-term health conditions were assessed and reviewed. The home used equipment, referrals and audits to reduce risks.
“Risks to people were managed effectively in order to keep people safe.” from the report
Kind and respectful staff
Staff knew people well and supported their dignity, privacy and independence. Inspectors saw staff giving people time to make choices.
“We observed staff asking people questions about what they wanted to do, or where they wanted to go.” from the report
Personalised activities and relationships
People had access to activities based on their interests and were supported to stay in contact with friends and family.
“There was a dedicated activity room and activity staff members.” from the report
Health care support
The home worked with health professionals and acted promptly when people became unwell. Advice was shared with staff during handovers.
“People received prompt health care support.” from the report
Quality oversight
The provider and manager used audits, meetings and feedback to identify risks and plan improvements.
“Audits had been used to drive improvements.” from the report
Medicines guidance
needs fixingInspectors found minor errors involving covert medicines. Guidance for some as-required medicines lacked detail, although the home updated it after the inspection.
“We found some minor errors in relation to covert medicines.” from the report
Online staff training
needs fixingSome staff found the new online training difficult to access. The home was arranging a training space and extra support.
“There were mixed feelings about the new training being online and its accessibility for all staff.” from the report
Communication signage
minorThe home had identified a need for extra signage to help people navigate around the building. This was planned as part of refurbishment.
“The provider had recognised areas for improvement in relation to AIS and has planned to implement additional signage to support people navigating around the home in the planned refurbishment.” from the report
End of life plans
needs fixingEnd of life care plans were still being developed so that people's wishes would be explored more fully.
“End of life care plans were being developed to be more personalised and ensure people's end of life wishes were fully explored.” from the report
- 01What checks are now in place for covert medicines and for as-required medicines when a person lacks capacity?
- 02How can staff who struggle with online learning access face-to-face training or extra support?
- 03What additional signs are planned, and when will they be installed?
- 04How will you make sure each person's end of life wishes are fully discussed and recorded?
- 05The report says staffing was due to increase. Has that increase happened, and how much individual time do people now receive?
This was the first comprehensive inspection since registration and covered all five key questions, with infection prevention and control also checked under Safe. This explanation was written from the published report of 20 January 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, September 2021
Bramble Lodge: inspected but not rated; infection control had improved after a previous breach and warning notice.
This was an unannounced, targeted inspection on 24 August 2021. It looked only at infection prevention and control after a COVID-19 outbreak.
Inspectors found improvements. They were assured that the home was using PPE safely, supporting testing, managing visiting, cleaning effectively and following social distancing measures.
The home was no longer breaching regulations at this inspection. The overall service and the safe question were marked inspected but not rated, so this report does not give a Good or Outstanding rating.
Safe use of PPE
Staff were observed using PPE correctly and following the required procedures for putting it on and taking it off.
“Staff wore PPE correctly, following current government guidelines.” from the report
Infection control checks
Monthly infection control audits were being completed. Problems found through the audits were acted on, including replacing damaged flooring to improve cleaning.
“IPC audits were completed monthly. Issues were identified and actioned.” from the report
Testing and visiting arrangements
The home supported whole-home testing and managed visits, social distancing and family contact through video calls.
“There was full engagement by people and staff with whole home testing.” from the report
Learning from the outbreak
The management team worked with the NHS infection prevention and control team and used learning from the outbreak to make changes.
“The management team worked with the NHS infection prevention and control (IPC) team to develop safe practices and reduce risks to people and the transmission of infection.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you continuing the PPE, testing and cleaning arrangements described in this inspection?
- 02How are current visiting arrangements being managed, and how will family contact be supported if there is another outbreak?
- 03How often are infection prevention and control audits completed now, and can you give examples of issues recently found and fixed?
- 04What changes were made after the previous warning notice, and how do you check that these changes remain effective?
- 05How are room moves, cohorting and personal emergency evacuation plans managed if people move rooms?
This was an unannounced targeted inspection of infection prevention and control only; the service was inspected but not rated and the other areas of care were not reviewed. This explanation was written from the published report of 4 September 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 Bramble Lodge
3 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2021Inspected but not ratedSafe: Inspected but not rated
- April 2021Inspected but not ratedSafe: Inspected but not rated
- May 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019
Registered with the Care Quality Commission on 4 November 2019.
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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