CQC report explained · a residential care home
What the CQC found at Bramhall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, clear risk plans, safe medicines management and good infection control.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward to calculate the overall rating.
- Well-led?
- Good
- The home had an open culture and systems for checking the quality and safety of care. People and staff were able to share their views, and lessons from incidents and complaints were shared with staff.
What inspectors found, December 2023
Bramhall was rated Good; inspectors found safe care and strong management, but this visit did not reassess all areas of care.
This was an unannounced, focused inspection on 22 November 2023. Inspectors spoke with people living at the home, relatives, visitors and staff. They observed care and checked care, medicine, staff and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, suitable risk plans, safe medicines, good cleanliness and appropriate infection control. They also found that incidents were reviewed and that the manager used checks and people's views to improve care.
The overall rating stayed Good, the same as at the previous inspection on 15 March 2018. This visit looked only at Safe and Well-led. The ratings for Effective, Caring and Responsive were carried forward from the earlier inspection.
Enough staff
Inspectors found enough staff to meet people's needs promptly. People said call bells were answered within a minute and staff were available at night.
“People told us there were enough staff to meet their needs and call bells were answered within a minute.” from the report
Safe medicines
Medicines were ordered in good time, stored safely and given as prescribed. Staff had received medicine administration training.
“Systems were in place to ensure medicines were ordered in a timely fashion and stored safely so they were available when people needed.” from the report
Good safety checks
Risks were identified in care plans, with detailed instructions for staff. Incidents such as falls and pressure areas were reviewed for patterns and improvements.
“Incidents were then reviewed monthly to see if there were any trends which indicated areas for improvement.” from the report
Open management
People could raise concerns with the manager, and surveys were used to identify possible improvements. The manager was open with people and relatives when incidents happened.
“People were happy they could voice their thoughts on the care they received and were listened to.” from the report
Inspectors raised no specific concerns in this report.
- 01What were the previous ratings for Effective, Caring and Responsive, and when will these areas next be inspected?
- 02How will you assess and update my relative's risks, including their equipment and emergency evacuation needs?
- 03How do you check that medicines are ordered on time, stored safely and given in line with prescriptions?
- 04What action has been taken after recent falls, pressure areas or other incidents involving residents?
- 05How will my relative and our family be able to raise concerns and see what action has been taken?
This was an unannounced focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 20 December 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, March 2018
Rated Good; inspectors found kind, safe care, but identified gaps in medicines protocols, care records and legal safeguards.
This was an unannounced inspection on 12 December 2017. Inspectors spoke with people living at the home, a relative and staff. They observed care and checked care files, medicines records, staff recruitment records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were treated kindly, involved in decisions and supported to access healthcare, activities and end-of-life care.
There were some areas to improve. Some as-required medicines protocols were missing. Care plans did not always contain enough personal detail. The home also needed to make sure all required legal applications and communication information were in place.
This was the second inspection in a row where the home was rated Good. The rating means the inspectors found the service met the required standards at the time of this inspection, but it does not mean there were no shortcomings.
Kind and respectful care
Inspectors saw staff treating people with compassion. People’s dignity, privacy, independence and choices were respected.
“Staff demonstrated they knew people they supported very well; they spoke in a caring and sensitive manner showing compassion and kindness.” from the report
Safety measures
Risks were assessed and managed, including falls, pressure ulcers, distress and emergencies. The home was clean and staff understood safeguarding and infection control.
“We found that risks to people's safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected.” from the report
Support for health and nutrition
People received suitable food and drinks, with extra support where needed. Staff helped people access doctors, nurses, dentists and opticians.
“People were supported to live healthier lives by receiving on-going healthcare support.” from the report
Activities and end-of-life support
People were offered activities linked to their interests. Their end-of-life wishes were recorded and support from specialist professionals was available.
“Suitable provision had been made so that people could be supported at the end of their life to have a comfortable, dignified and pain-free death.” from the report
Learning and oversight
The home investigated complaints and incidents, used audits and involved people and relatives in improvements.
“The home was well managed and there were systems in place to monitor the quality of care provided.” from the report
Missing medicines protocols
needs fixingSome instructions for staff giving as-required medicines were missing. The home had already been told about this through a pharmacist audit and said action was being taken.
“However, there were some protocols missing and we raised this with the registered manager.” from the report
No formal staffing tool
needs fixingThere was no formal system to calculate how many staff were needed. The manager said staffing was monitored and numbers would be increased if people’s needs required it.
“There was no formal system in place to identify the numbers of staff needed to provide care for people.” from the report
Care plans lacked personal detail
needs fixingCare plans contained key safety information but did not always explain what people could do for themselves or whether moving them could cause pain.
“However, they did not support care to be tailored to people's individual needs.” from the report
Legal safeguards
seriousThe home had not initially recognised that some people needed applications for Deprivation of Liberty Safeguards assessments. The manager said applications were submitted after the inspection.
“The provider had not been aware that people who were not exit seeking but were unable to choose to live at the home needed a DoLS application.” from the report
Communication information
minorCommunication needs were not included in the assessment process, and the report says accessible information was not covered. The manager knew this needed more work.
“People's communication needs were not currently recorded in the assessment process” from the report
Older part of the building
minorSome signs in the original part of the home were too small or did not clearly identify toilets. The provider planned refurbishment.
“In the original home there was some signage in place to support people living with dementia but it did not fully support people's independence” from the report
- 01Have all the missing protocols for as-required medicines now been completed and checked?
- 02How do you decide how many staff are needed on each shift, and what happens when people have to wait?
- 03Have all people who need Deprivation of Liberty Safeguards assessments had their applications completed and followed up?
- 04How have care plans been improved so they describe each person’s abilities, pain risks and preferred way of receiving care?
- 05How are communication needs and accessible information recorded for each person?
This was an unannounced inspection covering all five CQC questions, with the overall rating and each question rating assessed during the visit. This explanation was written from the published report of 15 March 2018 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 Bramhall
3 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Goodstayed GoodSafe: GoodWell-led: Good
- October 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Registered with the Care Quality Commission on 26 September 2014.
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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9 live-in carers within about an hour of Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.