CQC report explained · a residential care home
What the CQC found at Dimensions Somerset The Brambles
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risk assessments, medicines systems and infection control arrangements were in place, although staffing shortages could affect activities.
- Effective?
- Good
- People received personalised care, support with food and drink, healthcare and help to make choices. Some agency staff had not read care plans and risk assessments, and the manager acted to improve this.
- Caring?
- Good
- This area was not inspected during this focused visit. A rating from an earlier comprehensive inspection was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. A rating from an earlier comprehensive inspection was used in calculating the overall rating.
- Well-led?
- Good
- The home was organised and had clear responsibilities, improvement plans and quality checks. This rating improved from Requires Improvement at the previous inspection.
What inspectors found, February 2022
Dimensions Somerset The Brambles was rated Good; inspectors found people were safe and treated kindly, but staffing shortages could affect activities and choice.
This was a focused inspection on 14 and 17 December 2021. It followed a serious safeguarding incident. Inspectors checked Safe, Effective and Well-led. They spoke with people, relatives and staff, observed care and reviewed care plans, medicines records, rotas and safety checks.
Inspectors found people were safe, comfortable and relaxed. Staff knew how to report abuse. Medicines were generally given safely and at the right time. People received personalised care, help with food and drink, and support from health professionals.
There were staff vacancies and a reliance on temporary staff. Inspectors said people remained safe, but care, activities and choices could be affected when staffing was at minimum levels. Some agency staff had not read care plans and risk assessments, although the manager took immediate action.
The home was rated Good overall. Safe and Effective remained Good. Well-led improved from Requires Improvement to Good. The other two areas, Caring and Responsive, were not inspected during this focused visit, so earlier ratings were used in the overall judgement.
People were safe
Inspectors found people were safe and relaxed with staff. Relatives also viewed the home as a safe place.
“People were comfortable and relaxed with the staff who supported them.” from the report
Kind support
Staff were observed treating people with kindness, dignity and respect. They supported people patiently during meals and everyday care.
“We saw staff were positive, energetic and engaged with people, treating them with kindness, dignity and respect.” from the report
Good management
The home had clear responsibilities, regular checks and an up-to-date plan for improvements. Management was open about problems and actions being taken.
“There was a clear, up to date improvement plan for the service.” from the report
Safe medicines
Records showed medicines were given as prescribed and at the right time. Staff had medicines training and their practice was checked.
“People's medicines were looked after and managed safely.” from the report
Staff shortages
needs fixingThere were three day staff vacancies and two night staff vacancies. When staffing was at minimum levels, activities and the consistency of care could be affected.
“Therefore, when staffing levels fell to minimum levels, people were safe but their overall care or activities could be affected.” from the report
Temporary staff did not always know people's plans
needs fixingSome agency staff had not read care plans and risk assessments. The manager took immediate action, but this is important because people had complex individual needs.
“Agency staff spoken with told us they had not always read people's care plans and risk assessments.” from the report
Some medicine records were incomplete
needs fixingWhere medicines were given hidden in food or yoghurt, the checks with the pharmacy were not always recorded in people's records.
“We were told that this was checked with the pharmacy to make sure these medicines could be given in this way, but this was not always documented in people's records.” from the report
- 01How many permanent day and night staff vacancies are there now?
- 02How do you make sure agency staff read each person's care plan and risk assessments before providing care?
- 03What activities or outings have been missed because of staffing levels, and how are you addressing this?
- 04What learning has been completed from the serious safeguarding incident, and what changes have been made?
- 05What work has been completed on the communal areas and garden since this inspection?
This was a focused inspection of Safe, Effective and Well-led following a serious safeguarding incident; Caring and Responsive were not inspected and earlier ratings were carried forward. This explanation was written from the published report of 5 February 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, August 2018
Rated Good overall; inspectors found kind, effective care, but risk records, cleanliness and management systems needed improvement.
This was an unannounced, comprehensive inspection on 19 June 2018. Inspectors met the seven people living at the home, spoke with staff, relatives and a visiting professional, and checked care plans, medicines, recruitment, training, complaints and monitoring records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors saw kind staff who respected people's choices and dignity. People had suitable training, healthcare support, food and activities. Medicines were generally managed safely and safeguarding procedures were understood.
The home was rated Requires Improvement for Well-led. Risk assessments were missing for some known risks. Cleaning was not consistently thorough, some care records were not stored securely, and checks to find and correct problems were not effective enough. The manager began updating risk assessments and said improvements to cleaning, record storage and monitoring would be made.
Kind and respectful staff
Inspectors saw staff treating people with kindness, respecting their choices and protecting their dignity.
“People were cared for by staff that were kind and compassionate.” from the report
Communication support
Staff understood people's individual ways of communicating, including signs used by people who could not communicate verbally.
“Staff sought ways to communicate with people.” from the report
Medicines management
Medicines were stored at suitable temperatures, personalised guidance was available, and staff worked with doctors to review sedative medicines.
“People's medicines were managed in accordance with current national guidance.” from the report
Personal activities
People had individual activity programmes and were supported to continue hobbies and take part in community activities.
“The provider carried out person-centred activities and encouraged people to maintain their hobbies and interests.” from the report
Missing risk assessments
seriousStaff had identified some risks but had not always written the assessment and instructions needed to manage them safely. The manager began updating these during the inspection.
“Risk assessments were not always completed to enable people to receive care and support with minimum risk to themselves and others.” from the report
Cleaning and infection control
needs fixingInspectors found cobwebs and dust in communal areas and bedrooms. Some communal toilets had no hand-washing signs, and the manager said a deep clean and regular checks would be arranged.
“We found considerable amounts of cobwebs, and dust both in communal areas and peoples bedrooms.” from the report
Weak management checks
needs fixingThe provider and manager had not used effective action plans and audits to make sure known problems were fixed and improvements were sustained.
“Current governance arrangements had not consistently identified shortfalls within the service.” from the report
Care records and care planning
needs fixingSome records were accessible to visitors, and care plans were not always reviewed regularly. Inspectors also found limited evidence that people and relatives had been involved in some care planning decisions.
“Care records were kept in places where visitors had access to them.” from the report
Changes affecting people and staff
needs fixingStaff changes had unsettled some people, who could become anxious around unfamiliar staff. Staff also said they were not properly informed about proposed changes, redundancies and salary reductions.
“Staff told us the staff changes had had an impact on people living at Brambles because people got anxious when new staff came to work at Brambles.” from the report
Access to complaints information
minorPeople could not make verbal complaints, but the home did not display a complaints procedure or provide accessible information explaining how to complain.
“People using the service might not understand how they can complain or who they should speak to.” from the report
- 01Have all known risks now got a completed assessment and clear instructions for staff?
- 02What checks now make sure cleaning and infection control standards are maintained?
- 03Where are care records stored, and how do you prevent visitors seeing confidential information?
- 04How often are care plans reviewed, and how are people and relatives involved in decisions?
- 05What staffing changes have happened since the inspection, and how are you limiting anxiety caused by unfamiliar staff?
This was the first comprehensive inspection since the service transferred from the local authority to Dimensions in April 2017, and it covered all five CQC questions. This explanation was written from the published report of 2 August 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 Dimensions Somerset The Brambles
2 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Dimensions Somerset The Brambles →
- August 2018GoodSafe: GoodEffective: GoodWell-led: Requires improvement
Read what inspectors found at Dimensions Somerset The Brambles →
- April 2017
Registered with the Care Quality Commission on 3 April 2017.
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 £1,370 a week. 62 can care for a couple. 12 years' experience on average.
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