CQC report explained · a residential care home
What the CQC found at Tigh Bruadair
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Some risk assessments were not consistently up to date or detailed. Incident analysis was not robust enough to identify possible triggers and behaviour patterns, and staff turnover and agency staffing created additional concerns.
- Effective?
- Good
- People's needs, dietary preferences and health needs were assessed and supported. Staff received training, and the home followed Mental Capacity Act and deprivation of liberty procedures.
- Caring?
- Good
- People were treated with dignity and respect, involved in decisions and supported to develop their independence.
- Responsive?
- Good
- Care was personalised to people's needs, communication preferences and routines. People were supported with activities, hobbies, trips out and relationships.
- Well-led?
- Good
- The home had quality checks, an improvement plan and clear management roles. However, inspectors asked managers to follow up concerns about staff deployment, long shifts and communication.
What inspectors found, October 2021
Tigh Bruadair was rated Good overall, but inspectors found safety shortfalls involving risk records, incident analysis and staffing.
Inspectors visited on 7 September 2021. Two inspectors visited the home, spoke with three people, reviewed care and medicine records, checked staff recruitment files and observed the home. Relatives and staff also gave feedback by telephone and questionnaire.
The home was caring, effective, responsive and well-led, all rated Good. People were treated with dignity, involved in decisions and supported to take part in activities and community life. Medicines were given safely, people had access to health services, and infection control measures were in place.
Safe was rated Requires Improvement. Some risk assessments were not up to date or detailed enough, incident reviews did not always identify patterns, and there had been high staff turnover. The overall rating fell from Outstanding at the previous inspection, published in July 2019, to Good.
Choice and independence
People were involved in their care and daily decisions. Staff supported people to have choice, control and independence.
“People were involved in their care and treatment as fully as possible and care and support maximised their choice, control, and independence.” from the report
Active lives
People took part in varied activities and were supported to use local facilities and spend time in the community.
“People were supported to lead active and fulfilling lives and were a part of their local community.” from the report
Safe medicines practice
Medicines were stored, given and disposed of using safe procedures. The report also describes positive outcomes from reducing some people's medicines.
“Medicines systems were safely organised, and people were receiving their medicines when they should.” from the report
Recruitment checks
The home completed key checks before staff started work, including criminal record checks, interviews, induction and shadowing.
“Safe staff recruitment checks were completed before staff commenced their role.” from the report
Risk information
seriousSome care and COVID-19 risk assessments were not specific, current or detailed enough. For one person, the assessment said two staff were needed in the community while another review said three.
“Risks associated with people's individual known care and support needs had been assessed. However, information was not consistently up to date or detailed.” from the report
Learning from incidents
seriousIncident reviews did not give enough information to identify triggers or patterns in behaviour. The provider had recognised this and was taking action.
“Incident analysis procedures were not sufficiently robust to identify possible triggers and patterns to behaviours.” from the report
Staff turnover and agency staff
needs fixingStaff turnover was high and agency and bank staff were used to cover shortages. Not all agency staff had physical restraint training, which affected permanent staff.
“There had been a high turn over of staff and staff recruitment was ongoing. Agency and bank staff were used to cover staff shortfalls.” from the report
Communication and staffing concerns
needs fixingSome staff raised concerns about deployment, long shifts and communication between teams. Inspectors asked managers to follow these issues up.
“Some staff raised concerns about communication within the service.” from the report
- 01What has changed in the risk assessments, especially where a person's support needs have been updated by outside professionals?
- 02How do you analyse incidents to identify triggers and patterns in behaviour, and what improvements have been made since this inspection?
- 03How many agency or bank staff are currently used, and how do you ensure they have the training needed for each person's care and physical restraint needs?
- 04How are staffing levels checked against each person's assessed needs, and how are concerns about long shifts dealt with?
- 05How do the two teams share important information about people's care and any concerns raised by relatives?
This was a comprehensive inspection covering all five key questions, including infection prevention and control under Safe; the previous overall rating was Outstanding, published on 10 July 2019. This explanation was written from the published report of 2 October 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.
What inspectors found, July 2019
Tigh Bruadair was rated Outstanding overall, with kind, person-centred care and exceptionally strong management.
Inspectors visited without warning on 3 October 2018. They spoke with people living at the home, relatives, staff and the registered manager. They also examined care records, staffing, training and quality checks.
The home was rated Good for Safe, Effective and Responsive. It was rated Outstanding for Caring and Well-led. Inspectors found people were safe, medicines were managed properly, staff were trained, and people received care based on their individual needs.
Inspectors described a warm and respectful home where people were supported to make choices, stay in touch with family, use local facilities and take part in activities. The management team had strong systems for checking quality and making improvements.
Kind and respectful care
People were treated warmly and respectfully. Staff supported people in a calm way and gave emotional support when they were distressed.
“People were treated with kindness and were given emotional support when needed.” from the report
Choice and independence
People were supported to make everyday choices and to live in ways that suited them. Staff used different communication methods when people could not communicate verbally.
“People's privacy, dignity and independence were respected and promoted.” from the report
Strong management and improvement
The management team used regular audits, development plans and feedback to monitor the home and make changes. People and staff were involved in improving the service.
“An effective system of audits was in place that ensured the service was regularly monitored to maintain and improve existing high standards.” from the report
Inspectors raised no specific concerns in this report.
- 01How are people's current medicines reviewed, and how do you decide whether medicines can be reduced safely?
- 02How are people involved in choosing new staff who will support them?
- 03What communication methods and tools are used for my relative's individual needs?
- 04How do you support people who become distressed, and how often are physical interventions reviewed?
- 05How would you support my relative with end of life care if their needs changed?
This was a comprehensive, unannounced inspection covering all five key questions; end of life care was not reported because nobody needed it at the time. This explanation was written from the published report of 11 July 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 Tigh Bruadair
3 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2021Goodcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Outstanding
- April 2016GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 27 April 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
9 live-in carers within about an hour of Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.