CQC report explained · a nursing home
What the CQC found at Bricklehampton Hall
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, June 2022
Rated Good; inspectors found improvements since 2019, with kind care and safe systems, but two medicines checks were out of date.
Inspectors visited on 11 and 12 May 2022. The first day was unannounced and the second was announced. They spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, personalised care plans, kind and respectful care, activities, safe visiting arrangements and improved quality checks.
This was an improvement from Requires Improvement at the previous inspection in 2019. The provider had addressed the earlier breaches and was no longer in breach of regulations. Inspectors still found two out-of-date medicines competency assessments and a gap in recording the use of one pain relief patch, both of which were acted on during the inspection.
Kind and respectful care
Inspectors saw staff treating people kindly and respectfully. People and relatives were positive about the care and support.
“People were provided support from staff who treated them in a respectful, kind and caring way.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. People said staff responded quickly when they used their call bells.
“There are enough staff if I press my buzzer day or night, they [staff] always come quickly and ask if anything is wrong?.” from the report
Personalised care
Care plans reflected people's needs and preferences. Inspectors found improved recording of wound care and other individual care needs.
“People's care plans were personalised and reflected needs and preferences.” from the report
Improved oversight
The provider had strengthened its quality checks and used them to support further improvements.
“Since our last inspection the provider had made improvements in their quality monitoring and oversight.” from the report
Activities and social contact
The home had two activities coordinators and an entertainment programme spread across the week. People could choose whether to take part.
“The provider had two activities coordinators who led sessions over a 7-day period.” from the report
Some medicines checks were out of date
needs fixingTwo staff competency assessments for medicines were out of date. The management team arranged for these staff to be assessed, and evidence was later provided.
“However, two competency assessments for staff showed that these where out of date.” from the report
Patch records needed improvement
needs fixingThe system did not record where a pain relief patch was applied or confirm that the previous patch had been removed. A new system was put in place during the inspection, and no harm was found.
“The system did not record the site of application and confirm removal of the previous patch.” from the report
- 01Are all staff's medicines competency assessments now in date, and how are they checked regularly?
- 02How do you now record where transdermal patches are applied and confirm that old patches are removed?
- 03What refurbishment work is still planned, and when is it expected to be completed?
- 04How do you keep care plans and wound care records up to date when people's needs change?
- 05How is the home's 91% training compliance being improved, particularly for face-to-face fire safety and first aid training?
This inspection checked all five key questions and infection prevention and control, and followed up the action plan from the September 2019 inspection. This explanation was written from the published report of 9 June 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, November 2019
Rated Requires Improvement; inspectors found risks with medicines, staffing, call bells, records and management systems.
This was an unannounced inspection over three days. The inspector spoke with people living in the home, relatives, staff and a healthcare professional. They reviewed care records, medicine records, staff recruitment files and management records.
The home was not always safe. Inspectors found medicines were sometimes given late and records were incomplete. Fire extinguishers were blocked, some sluice-room keys were not secure, and a call bell sounded for 14 minutes before it was silenced. People also reported waits of up to 30 or 45 minutes.
Care records did not always show the treatment needed for wounds. Mental capacity assessments and best-interest decisions were not consistently recorded. Inspectors also found gaps in staff training, recruitment checks, privacy and dignity, and the systems used to monitor quality. The home was rated Requires Improvement in all five areas, down from Good at the previous inspection in April 2017.
Kind staff
Most people and relatives were positive about the care and said staff were kind. Staff were seen responding kindly when someone felt unwell.
“Another person described the staff as, "Kind and caring.” from the report
Healthcare access
People could see healthcare professionals when needed. A healthcare professional said staff requested support appropriately and acted on advice.
“They told us they were asked to see people appropriately and in a timely manner.” from the report
Activities and relationships
People had a range of activities and events, and visitors could see their relatives whenever they wanted. This helped people maintain interests and relationships.
“There is a programme every day for people in the lounge. Bowls, music and movement, flower arrangement and cookery.” from the report
Immediate action
The manager took action during the inspection where possible. An external consultancy was also brought in to help make and maintain improvements.
“Improvements were made immediately where possible.” from the report
Medicines and wound care
seriousSome medicines were administered late and records did not always show what had been given. Wound treatment was not always completed or recorded clearly, creating a risk that people would not receive the treatment they needed.
“This meant people were not always receiving their medicines at their prescribed times to meet their specific healthcare needs and conditions.” from the report
Environmental safety
seriousFire extinguishers were blocked on more than one inspection day. Sluice-room keys were left in locks, and flooring and equipment created possible trip hazards.
“Having firefighting equipment blocked could delay access to these items in an emergency.” from the report
Call bell response
seriousPeople described waits of up to 30 or 45 minutes. Inspectors saw a call bell sounding for 14 minutes, and the emergency function did not work consistently.
“On the final day of the inspection we witnessed a call bell sounding for 14 minutes before it was silenced.” from the report
Consent records
seriousCapacity assessments and best-interest decisions were not consistently recorded, including decisions about alarm mats. This meant the home could not show that restrictive practices had the right legal basis.
“Best interest decisions were not consistently recorded to show who was involved in decisions about people’s care and support” from the report
Privacy and dignity
needs fixingStaff did not always knock and wait before entering bedrooms. Personal care information was also discussed in a communal area, and bath records displayed people’s names.
“We saw staff entering bedrooms without knocking first.” from the report
Management oversight
seriousQuality checks did not identify several important problems. The provider also failed to send some required notifications to CQC.
“Systems were not sufficiently robust to ensure the quality of the service was suitably well led.” from the report
- 01What changes have been made to ensure medicines are given at the prescribed times and recorded accurately?
- 02How are wound dressings now recorded, checked and followed up?
- 03What are the current staffing levels, and how quickly are call bells answered, including in bedrooms?
- 04How do you ensure capacity assessments and best-interest decisions are completed before restrictive equipment or practices are used?
- 05What checks now identify problems with fire safety, recruitment, training, privacy and care records?
This was a planned, unannounced inspection covering all five CQC questions and both the premises and care provided; the previous Good ratings from 2017 were reassessed and each fell to Requires Improvement. This explanation was written from the published report of 15 November 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.
Every inspection of Bricklehampton Hall
4 rated inspections over 7 years: the service has held its Good rating throughout.
- June 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 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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At least 100 live-in carers within about an hour of Worcestershire
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