CQC report explained · a nursing home
What the CQC found at Brendoncare Alton
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were safeguarded from abuse, risks were assessed and managed, medicines were administered safely, and staffing levels were considered sufficient. Two unnecessary bed rails were found on one household and were removed immediately.
- Effective?
- Good
- Staff were trained and supported, people's healthcare needs were met, and the home followed best practice guidance. Inspectors found delays with the lunch trolley on one household and staff did not always support people while seated beside them.
- Caring?
- Good
- Staff treated people with kindness, compassion, privacy and respect. People were involved in day-to-day decisions, although some staff were considered overly cautious about falls, which could reduce independence.
- Responsive?
- Good
- Care plans reflected people's needs, history and preferences. The home offered activities, supported relationships and religious needs, responded to complaints and involved people in end of life decisions.
- Well-led?
- Good
- Inspectors found an open culture, visible management and clear systems for monitoring quality and safety. The manager was aware that people's experience was not equally consistent across all households and was taking action.
What inspectors found, October 2019
Rated Good; inspectors found kind, safe and personalised care, with some issues on one household about meals, bed rails and independence.
Inspectors visited on 1 and 2 October 2019. They spoke with 11 people, a relative, staff and a visiting healthcare professional. They observed care, checked seven care records, medicines records, staff files and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse, received their medicines safely, and had enough staff to meet their needs.
Staff were described as kind and respectful. Care was planned around people's needs and preferences, with activities, healthcare support and end of life planning in place. Inspectors also found some issues on one household, including delayed lunch, unused bed rails and staff being overly cautious about falls.
Keeping people safe
The home had safeguarding systems, risk assessments, incident reviews and suitable staffing arrangements. Inspectors found that medicines and equipment were managed safely.
“People were safeguarded from the risk of abuse and processes were in place to share any relevant learning from incidents, to reduce the risk of re-occurrence.” from the report
Kind and respectful care
Staff were observed treating people with kindness and compassion. People were supported to make everyday choices and their privacy and dignity were respected.
“Staff treated people with kindness, respect and compassion as they provided their care.” from the report
Personalised support
Care plans included people's needs, interests, history and aspirations. Staff supported activities and relationships that mattered to each person.
“People received individualised care, planned around their needs and preferences.” from the report
Supportive environment
The refurbished areas were clean, homely and designed with dementia needs in mind. People had space to move around, relax and take part in activities.
“The environment was homely and well-furnished. The household for those living with advanced dementia, had been decorated using blues and greens which evidence shows are calming.” from the report
Open management
Inspectors found clear oversight, regular audits and a positive culture. The home sought views from people, relatives and staff and used them to make changes.
“There was a positive, open culture focused on achieving good outcomes for people.” from the report
Unused bed rails
seriousTwo people on one household still had bed rails that were not needed or authorised. The rails were removed as soon as inspectors raised the issue.
“People can be at risk from entrapment or falls from their use and they should only be used with a risk assessment and authorisation.” from the report
Lunch arrangements
needs fixingOn one household, the lunch trolley was delayed on both inspection days. Staff were also more stretched and did not always support people while seated next to them.
“On one household lunch was not totally consistent with the other households.” from the report
Supporting independence
minorTwo people said some staff were too cautious when managing falls risks. Inspectors said this could limit their independence, and raised it with the manager.
“Two people on one household told us they found certain staff were overly cautious in relation to managing the risk of them falling, which potentially could reduce their independence.” from the report
Involvement in care plans
minorNot everyone inspectors spoke with could remember being involved in their care plans. The records did show involvement from people and relatives in assessments and reviews.
“People we spoke with could not all recall having been involved in their care plans.” from the report
- 01What action was taken after the two unnecessary bed rails were found, and how do you now check that bed rails are risk assessed and authorised?
- 02What changes were made to lunch arrangements on the household where the trolley was delayed?
- 03How do you make sure staff support independence while still managing the risk of falls?
- 04How are residents and relatives involved in writing and reviewing care plans, and how do you check that people understand their plans?
- 05Has the major refurbishment programme now been completed, and are all households operating consistently?
This was a planned comprehensive inspection of the care home, covering the premises and care provided and all five CQC questions. This explanation was written from the published report of 24 October 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.
What inspectors found, June 2017
Rated Good; inspectors found safe, effective, kind and personalised care, with fluid intake records needing improvement.
This was an unannounced comprehensive inspection on 22 and 23 May 2017. Inspectors visited all five units, spoke with people, relatives, staff and health professionals, and reviewed care plans, staff records and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found suitable staffing, safe medicines systems, trained staff, respectful care, personalised care plans and activities for people, including those living with dementia.
There was one recorded shortfall. Fluid charts for people at risk of dehydration did not include an individual target, making it harder for staff to see whether enough had been drunk. The manager said this was already known and would be addressed. A new manager was also in the process of registering with the CQC, following earlier changes in managers.
Safe care systems
The home had safeguarding procedures, regular risk reviews and systems for learning from incidents. Staff had completed safeguarding training.
“People were kept safe from the risk of abuse as relevant processes and procedures were in place.” from the report
Kind and respectful staff
People described staff positively. Inspectors saw staff show interest in people, explain care, protect privacy and involve people in everyday choices.
“People were observed to be happy and relaxed in the company of the staff who demonstrated an interest in them as individuals and concern for their welfare.” from the report
Personalised care
Care plans included people's preferences, life histories, goals and what mattered to them. Staff used this information to tailor care.
“People's care plans were reviewed regularly and showed people or their relatives were consulted to ensure their care remained relevant to them.” from the report
Support for people living with dementia
Staff had dementia training and used personalised activities, memory boxes, coloured cups and a sensory room to support people.
“Staff were responsive to the needs of people living with dementia.” from the report
Management oversight
The provider received regular reports, visited the home and reviewed audits and action plans. The new manager was working to involve staff more in quality improvement.
“The provider was regularly supplied with information about the quality of the service provided.” from the report
Fluid intake records
needs fixingFor people at risk of dehydration, fluid charts did not state an individual daily target. This could make it harder for staff to identify whether a person's needs had been met.
“However, people's fluid charts did not document an individual objective for their fluid intake, to enable staff to easily identify if their needs had been met.” from the report
Changes in management
minorThere had been changes in managers, and the new manager was still applying to become registered. The report says a stable management team was in place at the time of inspection.
“The service had a registered manager; however, they were in the process of de-registering and the new manager was in the process of registering.” from the report
- 01How do you now set and record an individual fluid intake target for each person at risk of dehydration?
- 02Has the current manager completed CQC registration, and who is responsible for the home if this is still in progress?
- 03How do you make sure staffing levels remain sufficient when staff are busy or vacancies need agency cover?
- 04How are relatives involved when care plans are reviewed or changes are needed?
- 05How do you check that activities are suitable for people living with dementia and for people who prefer one-to-one support?
This was an unannounced comprehensive inspection covering all five rating areas and all five units; the previous inspection was in February 2016 and found no concerns. This explanation was written from the published report of 30 June 2017 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 Brendoncare Alton
4 rated inspections over 5 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016GoodSafe: Requires improvement
- November 2015Inspected but not ratedSafe: Requires improvement
- April 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
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