CQC report explained · a residential care home
What the CQC found at Bramblings Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- Inspectors found safe care, enough staff, safe medicines management, suitable risk assessments and appropriate safeguarding arrangements. They were not always assured that PPE was being used effectively and safely.
- Effective?
- Good
- Staff had the training and supervision needed for their roles. People’s dietary, healthcare and communication needs were supported, and the home was found to be working within the principles of the Mental Capacity Act.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward.
- Responsive?
- Requires improvement
- This question was not inspected during this focused visit. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- The home had management systems, audits and an improvement plan, but oversight was not consistent. One incident was not notified to the CQC and another was not recorded in the home’s internal system.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found safe, effective care, but the home’s oversight and reporting needed improvement.
This was an unannounced focused inspection on 23 May 2022. Two inspectors spoke with people, relatives and staff, and reviewed care records, medicines records, staff files and management audits. They looked only at Safe, Effective and Well-led.
People were described as safe and happy. Inspectors found suitable staffing, safe medicines management, up-to-date risk assessments, trained staff and support with food, drinks and healthcare. Safe and Effective were both rated Good.
The overall rating was Requires Improvement because Well-led remained Requires Improvement. Most systems were in place, but one incident had not been reported to the CQC and another incident involving delayed medicines had not been recorded in the home’s own system.
Risk management
Risk assessments were clear and current. Staff updated care plans after incidents and shared changes in people’s needs during handovers.
“Risk assessments contained enough information for care staff to provide safe care and manage any risks, such as falls, skin damage or choking.” from the report
Staff training
Inspectors found that staff had the knowledge and skills needed to provide care, with training and supervision records kept up to date.
“Staff had received training and had the knowledge and skills they needed to safely provide care.” from the report
Food and healthcare
People’s dietary needs and preferences were met, including modified food and fluids where recommended. Staff worked with healthcare professionals and helped people access treatment.
“People were supported to eat and drink safely in line with recommendations received from Speech and Language Therapists (SaLT) and dieticians.” from the report
PPE use
minorInspectors were not fully assured that personal protective equipment was always being used effectively and safely. The provider was signposted to resources to improve its approach.
“We were not always assured the provider was using PPE effectively and safely.” from the report
Missed CQC notification
needs fixingOne recent incident had not been reported to the CQC as required. This was discussed during the inspection and action was taken to correct it.
“We saw CQC notifications had been made, but one recent incident had not been notified to the CQC.” from the report
Incident recording
needs fixingA delay with medicines caused by a pharmacy issue had not been recorded in the home’s own incident system. Inspectors identified this as an area needing improvement.
“A recent incident where a person had a delay with medicines due to a pharmacy issue had not been recorded using the providers internal systems.” from the report
- 01What changes have been made to ensure every reportable incident is notified to the CQC on time?
- 02How do you now record and review medicine delays, including those caused by pharmacies?
- 03What checks are in place to make sure staff use PPE effectively and safely?
- 04What is the current improvement plan for the Requires Improvement rating for Well-led?
- 05What were the previous ratings for Caring and Responsive, and when will these areas next be fully assessed?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 5 July 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, July 2019
Rated Requires Improvement; improvements meant it left special measures, but safety, training and records still needed work.
This was an unannounced follow-up inspection on 6 and 7 June 2019. Two inspectors spoke with people, relatives, staff, the provider and a healthcare professional. They also checked care records, medicine records, staff files, training information, maintenance records and quality checks.
The home had improved since its previous inadequate rating. People received kinder, more person-centred care. Staffing levels had increased, medicines were generally given by trained staff, healthcare advice was followed, and complaints were handled more openly.
Important problems remained. Some hazardous areas were unlocked, risks were not always identified, medicine records and disposal were not always safe, and some staff training was incomplete. The building needed repairs and updating, activities were limited, and care and safety records were not consistently accurate.
The overall rating and all five question ratings were no longer inadequate. However, all except Caring were rated Requires Improvement. The home was no longer in special measures, but the provider remained in breach of three regulations and had to submit an action plan.
Kind and respectful care
Inspectors saw caring interactions throughout the day. Staff supported people's dignity, comfort, choices and independence.
“There were many caring interactions between staff and the people living at Bramblings throughout the day.” from the report
More staff available
Staffing levels had increased. People said they usually received help promptly, and staff said they had more time with people.
“People told us they did not have to wait for staff to come to their assistance when they needed it.” from the report
More personal care plans
Care plans included people's histories, relationships, routines and preferences. Staff used this information to provide more individual support.
“People's care plans had improved and provided more information for staff to follow to make sure people's needs and preferences were met.” from the report
Better handling of complaints
Complaints and informal concerns were recorded, investigated and followed up with people and relatives.
“This meant people were listened to and their complaints taken seriously, with action taken by the manager.” from the report
Improved healthcare support
Records showed better follow-up of healthcare appointments, advice and treatment. Referrals were made when people needed specialist help.
“Staff now recorded the advice and treatment given and any further treatment staff needed to support people with.” from the report
Unlocked hazardous areas
seriousInspectors found unlocked cupboards and rooms containing medical equipment, used sharps, cleaning products and other harmful substances. Some risks were only addressed after inspectors pointed them out.
“People were placed at risk of harm from easy access to harmful equipment and substances.” from the report
Medicine safety gaps
seriousUnused tablets were found on top of rubbish, cream records were incomplete, and there were no body maps for some pain patches. Staff also lacked information about the fire risk from some creams.
“The failure to ensure peoples prescribed medicines were managed in a safe way is a breach of Regulation 12” from the report
Incomplete staff training
seriousSome new staff had not completed essential training promptly. Domestic staff also had very limited training in areas including manual handling and infection control.
“This meant the provider could not be assured of their ability to make sure people were provided with safe care” from the report
Building and garden needed work
needs fixingWorn carpets, furniture, uneven surfaces and limited signs created risks or made the home less suitable for people living with dementia. The overgrown garden was not suitable for use.
“The garden was overgrown and not suitable for people to sit out in.” from the report
Limited activities
needs fixingActivities offered limited choice and variety. Inspectors found that not everyone was offered alternatives when the usual activities did not interest them.
“Activity opportunities to join in were limited and new ideas had not been tried.” from the report
- 01What has been done to keep cupboards and rooms containing medicines, sharps and cleaning products locked?
- 02How are topical creams, pain patches and unused medicines now recorded, stored and disposed of safely?
- 03Have all staff, including new and domestic staff, completed the essential training identified in the report?
- 04What changes have been made to the care plan audits, pressure mattress checks and nutritional records?
- 05What new activities, garden improvements and end of life care planning are now available?
This was an unannounced follow-up inspection covering all five key questions, including the premises and care provided; it checked progress after the previous inadequate inspection. This explanation was written from the published report of 19 July 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Bramblings Residential Home
5 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- July 2022Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
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 3 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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