CQC report explained · a residential care home
What the CQC found at Brandreth Lodge Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments and care plans were not always up to date. Inspectors also found medicines that had expired, insecure storage and overdue medicines training.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- Quality and risk management systems were not effective enough. Training, supervision, fire drills, policy reviews and actions from audits were behind schedule.
What inspectors found, September 2023
Brandreth Lodge Nursing Home rated Requires Improvement; inspectors found risks, medicines and management systems were not consistently safe.
This was an unannounced focused inspection on 26 and 27 July 2023. One inspector spoke with people, relatives and staff, and checked care records, medicines, recruitment files, training records, rotas, audits and safety certificates.
The home had enough staff, kept clean premises and protected people from abuse and infection. Inspectors also saw kind interactions and found a homely atmosphere. However, risk assessments and care plans were not always up to date, some environmental repairs and safety checks were overdue, and medicines were not always managed safely.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The home remained in breach of regulations about safe care and treatment and good governance. The other three question ratings were carried forward from the previous inspection because this visit did not cover them.
Enough staff
Inspectors found enough staff to meet people's needs, and recruitment checks had been completed.
“People were supported by enough staff and staff were recruited safely.” from the report
Protection from abuse
People were protected from abuse, and staff knew what to do if they had concerns.
“People were protected from the risk of abuse.” from the report
Infection control
Inspectors were assured that the home used protective equipment safely, supported safe admissions and responded to infection risks.
“People were protected from the risk of the spread of infection.” from the report
Positive atmosphere
Inspectors observed positive interactions. Staff said they enjoyed their work and felt supported by managers.
“We found a positive culture and the service had a 'homely' atmosphere.” from the report
Risk assessments and repairs
seriousSome care plans and risk assessments were out of date. Inspectors also found overdue electrical testing, broken window safety equipment and an unresolved loose carpet.
“Risks to people's health and safety were not always assessed, monitored, and managed effectively.” from the report
Medicines management
seriousSome medicines had expired. A cupboard containing drink thickener was not secure, creams were not stored securely and medicines training and competency checks were overdue or missing.
“Some medicines had expired meaning we could not be sure medicine would be effective.” from the report
Management oversight
seriousThe home did not have effective systems to identify and resolve repeated problems. Several training requirements, staff supervisions and fire drills were overdue.
“Systems had not been established to assess, monitor and improve the quality and safety of services, or to assess, monitor and mitigate risks relating to the health, safety and welfare of people who used the service.” from the report
Limited feedback opportunities
needs fixingStaff meetings and supervision were behind schedule. People said they would not know how to raise concerns and had not recently completed surveys or attended residents' meetings.
“People told us they would not know how to raise concerns however said they had not completed surveys or attended residents' meetings recently.” from the report
- 01Have all people's risk assessments and care plans been reviewed, especially where diets or bed-rail needs have changed?
- 02Have expired medicines been removed, medicines storage secured and 'as and when required' guidance completed?
- 03Has electrical testing been completed and have the broken window restrictor, windowpane and loose carpet been repaired?
- 04Are all staff now up to date with medicines training and regular supervision, and are competency checks recorded?
- 05How are audits, fire safety actions and complaints or feedback now tracked so that repeated problems are resolved?
This was a focused inspection of Safe and Well-led only; the other three ratings carried over from the previous inspection. This explanation was written from the published report of 14 September 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, September 2021
Brandreth Lodge Nursing Home was rated Requires Improvement; inspectors found caring staff but gaps in safety checks, medicines management and oversight.
This was an unannounced focused inspection on 10 August 2021. Inspectors looked at Safe and Well-led because the local council food safety officer had identified concerns. They spoke with five people, three staff, the cook and the registered manager, observed care, toured the home and checked records.
People said they felt comfortable and happy. Inspectors found enough staff, suitable infection control measures and good records for most medicines. However, some environmental risks had not been assessed, the kitchen was not clean, a first-floor sluice was not working properly and the controlled drugs records contained errors.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. The other three areas were not inspected during this visit, so their previous ratings were used in the overall rating. The previous overall rating was Good.
Enough staff
Inspectors saw enough staff on duty and found that extra staff could be deployed when people's needs changed.
“We observed there were sufficient staff on duty on the day of the visit.” from the report
Safeguarding awareness
Staff understood how to report concerns about abuse and knew they could contact outside authorities.
“Staff knew they could report any concerns about people's welfare to other authorities including the police, social services and CQC.” from the report
Positive relationships
People and staff spoke positively about the management. Inspectors observed a welcoming culture in the home.
“We observed a positive and welcoming culture within the service.” from the report
Unassessed environmental risks
seriousRisks linked to the uneven driveway, kitchen conditions, and equipment stored in the dining room had not been assessed. The first-floor sluice had also not worked properly for about 12 months.
“Environmental risks to people's health and safety had not always been assessed and monitored.” from the report
Medicines records
seriousThe controlled drugs register did not match the medicines held. Inspectors also found a controlled medicine that had expired and a medicine that had not been followed up as required.
“Medicines were not always managed safely.” from the report
Kitchen cleanliness
seriousThe kitchen had noticeable grease, dirt and cobwebs. A local food safety inspection had led to the home's food hygiene rating being reduced to 1.
“The environment had a satisfactory standard of cleanliness, apart from the kitchen, which had noticeable grease and dirt at the side of the aga and cobwebs on the ceiling.” from the report
Limited resident involvement
needs fixingInspectors found no evidence that residents' meetings had been offered, and the last satisfaction survey had been completed in 2019.
“However, we saw no evidence to demonstrate people had been given the opportunity to attend residents' meetings and the last customer satisfaction survey had been carried out in 2019.” from the report
- 01Have the potholes and uneven areas on the driveway been repaired, and what risk assessment now covers them?
- 02Has the first-floor sluice been replaced and is it working reliably?
- 03How have the controlled medicines records been checked, and how will you prevent expired or unaccounted-for medicines?
- 04Has the kitchen refurbishment and cleaning work been completed, and what is the current food hygiene rating?
- 05What action has been taken in response to the Regulation 17 breach and the CQC action plan?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 14 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 Brandreth Lodge Nursing Home
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Brandreth Lodge Nursing Home →
- September 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Brandreth Lodge Nursing Home →
- February 2021Inspected but not ratedSafe: Inspected but not rated
- March 2018GoodSafe: GoodWell-led: Good
- October 2016
Registered with the Care Quality Commission on 3 October 2016.
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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