CQC report explained · a residential care home
What the CQC found at The Brambles Rest Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe medicines management, suitable staffing, risk assessments, infection controls and action after accidents. People said they felt safe.
- Effective?
- Good
- This key question was not inspected during this focused visit. The report says ratings for questions not inspected were carried forward from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report did record that people and relatives were involved in decisions about care.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report noted that person-centred information was available and that people could share their views.
- Well-led?
- Good
- Inspectors found regular audits, provider oversight, meetings with people and relatives, and an open approach to concerns and improvement.
What inspectors found, April 2022
Rated Good; inspectors found safe care and stronger management, following improvements since the previous inspection.
This was a focused inspection over 30 March and 1 April 2022. One inspector spoke with people, relatives, staff and managers, observed care, checked the environment and reviewed care, medicine, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found medicines were managed safely, staffing was sufficient, infection controls were in place, risks were assessed and accidents were reviewed. People and relatives said they felt safe and could raise concerns.
The overall rating improved from Requires Improvement, published in July 2021. The report says the home had improved its medicines management and person-centred record keeping. Because this was a focused inspection, the other key questions were not inspected and their previous ratings were used for the overall rating.
Medicines were safer
Medicines were stored securely. Staff were trained and checked as competent, and people were involved in taking their medicines.
“Staff had received training and their competency had been checked to ensure they were competent to manage medicines safely.” from the report
Enough staff
Inspectors found staffing was sufficient, call bells were answered quickly and people received help when they needed it.
“The provider deployed sufficient staff to enable people's needs to be met promptly.” from the report
Good risk information
Care records included information about people's health, mobility, nutrition and skin health. Staff could explain people's individual needs.
“Risk assessments of nutrition, skin health and mobility were carried out and care records contained information on the help people needed to maintain their safety.” from the report
Infection controls
Inspectors were assured that the home had arrangements for preventing and managing infections, including safe visiting arrangements.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Management checks
The provider and manager used audits, meetings and action plans to monitor the home and share learning.
“Checks and audits were completed to drive improvement.” from the report
No registered manager in post
minorThere was a manager, but they had not yet become the registered manager. The report says an application process had started.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has the manager's application to become the registered manager now been completed?
- 02How often are medicines audits carried out, and what happens if an error or missing record is found?
- 03How are changes in a person's mobility, nutrition, skin health or other risks recorded and passed to staff?
- 04How are staffing levels decided at busy times, and how quickly are call bells usually answered?
- 05What visiting arrangements are currently available, and how would these change during an infection outbreak?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 14 April 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, July 2021
Rated Requires Improvement; inspectors found kind, person-centred care, but medicines, equipment checks and management systems still needed improvement, and the home is no longer in Special Measures.
Inspectors visited on 1 June 2021. They spoke with five people, 11 staff and relatives, observed care, checked the home and reviewed care, medicines, staffing and management records. They also checked infection prevention and control arrangements.
People were generally treated with kindness and respect. Staff supported people's choices, meals, activities, healthcare and end of life wishes. Inspectors rated Effective, Caring and Responsive as Good.
There were important shortfalls in Safe and Well-led. One person's medicines were not fully accounted for, some equipment was set wrongly for people's weights, and records did not always explain people's individual symptoms and support needs clearly. Audits had not identified all these problems.
The overall rating improved from Inadequate to Requires Improvement. The home had been in Special Measures since December 2019, but it is no longer in Special Measures and was no longer in breach of regulations at this inspection. CQC said it would monitor progress and return under its re-inspection programme.
Kind and respectful care
People told inspectors they felt cared for. Staff protected privacy and dignity and supported people to maintain independence and make everyday choices.
“People were cared for in a safe, clean and homely environment by staff who were caring, competent and knowledgeable about people's needs.” from the report
Personalised support
Care records included people's preferences and wishes. Staff supported communication needs, activities, relationships and access to healthcare.
“People's individual needs were assessed, and care records reflected people's preferences and wishes.” from the report
Good food and activities
People could choose their food and ask for alternatives. Inspectors saw regular drinks and snacks being offered, and people said they enjoyed the activities.
“People said they were happy with the food and could ask for an alternative if they wanted.” from the report
Medicines records
seriousTwenty-four tablets for one person were not accounted for, and staff had not found this through their checks. The provider investigated immediately and added safeguards, but CQC recommended following best practice for medicines management.
“People could not be assured medicines were always managed safely as improvements were required.” from the report
Equipment settings
seriousEquipment used to help protect two people's skin was set significantly higher than their documented weights. Extra checks were introduced after the inspection.
“The provider did not always ensure risk was managed to prevent avoidable harm occurring.” from the report
Incomplete individual records
needs fixingSome records did not fully describe people's symptoms and the support they would need if their health changed. The provider sent amended records after the visit, but one still needed more person-centred information.
“Records did not always reflect the individual symptoms and help and support people needed if their health condition changed.” from the report
Management checks
needs fixingAudits and quality checks had not identified the missing medicines or incorrect equipment settings. The service was also recruiting a manager and had no manager registered with CQC at the time.
“However, audits and checks did not always identify the shortfalls we found on the inspection.” from the report
- 01How are medicines now checked so that missing tablets or recording errors are found promptly?
- 02How do you check that pressure-relieving and other safety equipment is set correctly for each person's current weight?
- 03How are changes in a person's symptoms and support needs recorded and shared with staff?
- 04Has a manager now been appointed and registered with CQC, and who is responsible for the home until then?
- 05What extra audits or checks were introduced after this inspection, and what have they found?
This was a planned inspection covering all five key questions, with additional checks of infection prevention and control under Safe because of the COVID-19 risk. This explanation was written from the published report of 16 July 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 The Brambles Rest Home
6 rated inspections over 6 years: the service has held its Good rating throughout.
- April 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- January 2021Inadequatestayed InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Inadequate
- December 2019Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- September 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015
Registered with the Care Quality Commission on 23 November 2015.
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
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