CQC report explained · a residential care home
What the CQC found at Bruce Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had risk assessments and staff numbers had improved. However, thickener was found unsecured twice, some people did not have a call bell, and there were concerns about accidents, odours and hand-washing facilities.
- Effective?
- Good
- People received support with nutrition, healthcare and staff training. Inspectors found that drinks were not always available in bedrooms and oral care was not always being completed.
- Caring?
- Good
- People and relatives described staff as kind, respectful and caring. Inspectors found that people did not always receive choices or enough individual attention during some mealtimes.
- Responsive?
- Good
- Care plans recorded people's preferences and the home offered activities, including one-to-one sessions. One person's recorded preference for female carers was not followed.
- Well-led?
- Requires improvement
- The management structure, policies and audits were in place, but checks had not always identified and corrected problems. The home had started to reinstate meetings and other ways of gathering feedback.
What inspectors found, June 2023
Rated Good overall, but inspectors found the home was not always well-led and needed to improve checks on safety and personalised care.
Inspectors visited without notice on 22 May 2023. They spoke with people, relatives and staff, and reviewed care, medicine, recruitment and management records. They also checked infection prevention and control.
The home was rated Good for Safe, Effective, Caring and Responsive. People were generally safe, supported by kind staff, helped with their health and nutrition, and offered activities and personalised care. Inspectors found improvements since the previous inspection in staffing and medicines.
The home was rated Requires Improvement for Well-led. Audits and checks were in place but had not always found or fixed problems. Inspectors made recommendations about storing thickener safely, keeping water available, respecting gender preferences for care and strengthening quality monitoring.
Improved staffing
Inspectors found suitable staffing levels and the home had recruited new staff. It was no longer using agency staff at the time of the inspection.
“We reviewed staffing levels and rotas and found suitable numbers of staff were on duty to provide appropriate support.” from the report
Kind and respectful care
People and relatives gave positive feedback about staff. Inspectors observed people being treated with kindness, dignity and respect.
“Throughout the inspection we observed people were treated with kindness, dignity and respect.” from the report
Healthcare support
The home worked with GPs, nurses and other professionals when people's needs changed. The GP attended weekly to review people's healthcare needs.
“People at the home had access to a wide range of healthcare professionals.” from the report
Thickener was not always secure
seriousDrinks thickener was left unsecured in an unattended area twice. Inspectors said this created a risk of accidental swallowing and recommended safer storage.
“On the morning of the inspection we found drinks thickener had not been adequately secured away in an unattended area.” from the report
Water was not always available
needs fixingPeople staying in their rooms did not always have drinks available. The home was asked to ensure water was accessible at all times.
“On the morning of our site visit, we found people who were in their rooms did not have access to drinks.” from the report
Some care preferences were missed
needs fixingOne person's care plan requested female care staff, but records showed personal care had been provided by male staff. Inspectors recommended better arrangements and risk assessments when same-sex support is unavailable.
“One person's care plan had specified their care to be given by female care staff only and records showed us they had received personal care from male staff.” from the report
Checks did not always find problems
needs fixingThe home had audits and checks, but these had not always identified or corrected issues with thickener, drinks, oral care, mealtimes and preferred-gender care.
“A suite of audits, checks and walkarounds were in place and regularly carried out; however, they had not always identified and remedied the issues found at the time of this inspection.” from the report
Some care was inconsistent
needs fixingInspectors found oral care was not always completed. On two units, people did not always receive choices or the individual attention needed during meals.
“However, we found on two units that staff were very busy, and people did not always receive choices, nor the individual attention required when someone needed full assistance to eat their meal.” from the report
- 01What changes have been made to keep drinks thickener secured at all times?
- 02How do you make sure people in their rooms always have access to water and other drinks?
- 03How are people's preferences for the gender of care staff recorded, communicated and followed?
- 04How do managers now check that oral care is completed and that people receive enough help and choice at mealtimes?
- 05What evidence can you show that the new quality checks are finding and fixing problems promptly?
This was an unannounced inspection covering all five CQC questions, including infection prevention and control; the previous inspection was published on 21 December 2021. This explanation was written from the published report of 22 June 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, December 2021
Bruce Lodge rated Requires Improvement; inspectors found staffing, medicines records and care planning needed improvement, although people felt safe and the new management team was making changes.
This was an unannounced focused inspection on 3 and 10 November 2021. Inspectors looked at Safe and Well-led, partly because of concerns about falls. They spoke with people, relatives, staff and health professionals, observed care and checked records.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found that there were not always enough staff to respond quickly. Medicines records, risk assessments, care plans and accident records did not always contain enough detail or consistent information.
People said they felt safe and staff were kind. A new registered manager and operational management team were carrying out checks and improvement work, but inspectors said they needed more assurance that these changes were effective and lasting. The overall rating fell from Good at the previous inspection in June 2019.
People felt safe
People told inspectors they felt safe, and staff understood their safeguarding responsibilities.
“People felt safe at the service.” from the report
Kind staff
Inspectors observed kind and caring support. People and relatives also spoke positively about the staff and manager.
“We observed that people were supported by staff who were kind and caring.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including visits and outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Health professional support
The home sought help from health professionals when people's needs changed, including from GPs, district nurses and dementia specialists.
“The service worked closely with a variety of healthcare professionals.” from the report
New management engagement
The new manager was described as approachable and proactive. Families were invited to share views and take part in care plan reviews.
“Since the new manager arrived, we have felt more assured than ever before.” from the report
Staffing levels
seriousThere were not always enough staff to meet people's needs quickly. Some people waited for assistance and were left without staff support in communal areas.
“There were not always enough staff to meet the needs of people quickly.” from the report
Medicines records
seriousSome medicine counts could not be accounted for. Records also lacked enough information about medicines given when needed or hidden in food and drink.
“Medication administration records did not always contain enough detail about how and when to give people certain types of medicines.” from the report
Risk and falls records
seriousCare plans and risk assessments were inconsistent and did not always explain clearly how risks should be managed. Accident records also missed important information.
“However, accident reports did not always capture important information, and risk assessments and care plans did not always show what else was being done to reduce further risk.” from the report
Improvement systems not yet embedded
needs fixingThe management team had introduced new checks and systems, but inspectors needed evidence that they were effective and consistently used.
“Work was ongoing to ensure a consistent approach to recording, monitoring and responding to these.” from the report
- 01How many staff are planned for each shift, and what has changed since inspectors found that people sometimes waited for care?
- 02How do you check medicines given 'as and when', or hidden in food and drink, are recorded and administered safely?
- 03How are falls and other accidents now recorded, reviewed and used to reduce further risk?
- 04How do care plans make sure staff have consistent, person-centred instructions about each person's risks and needs?
- 05What evidence can you show that the new audits and improvement plans are now effective and consistently followed?
This was a focused inspection of Safe and Well-led, with infection control also reviewed; the other key questions were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 21 December 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 Bruce Lodge
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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