Archived: Bramble Lodge

Updated 1 May 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was completed by one inspector, inspection manager and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type: Bramble Lodge is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: This inspection was carried out on 13 February 2019. It was unannounced.

What we did: We used information we held about the home which included notifications that they sent us to plan this inspection. We also used the completed Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. However, the provider had completed this eight months previously and we therefore gave opportunities for them to update us throughout the inspection.

We used a range of different methods to help us understand people’s experiences. We spoke with eight people who lived at the home about the support they received. As some of the people found verbal communication more difficult, we also observed the interaction between people and the staff who supported them in communal areas throughout the inspection visit. We also spoke with five people’s relatives to gain their feedback on the quality of care received.

We spoke with the provider, the registered manager, the deputy manager, four senior care staff, three care staff and two home assistants. We also spoke with one visiting health professional. We received written feedback from the local authority contracts monitoring team prior to inspection. We reviewed care records for five people to check they were accurate and up to date. We also looked at medicines administration records and reviewed systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement. These included accidents and incidents analysis, meetings minutes and quality audits.

Updated 1 May 2019

About the service: Bramble Lodge is a residential care home that was providing accommodation and personal care to older people and people living with dementia. They were registered to provide care for 65 people and there were 61 living at the home when we visited. The accommodation is across several floors with a selection of communal areas on two of the floors. There are also large, accessible gardens.

People’s experience of using this service:

The service met the characteristics of requires improvement.

Medicines were not always managed effectively to reduce the risks associated with them. Infection control systems were not always embedded to protect people from harm. In addition, some incidents which should have been reported to safeguarding authorities and CQC had not been. Staff were not always effectively deployed to protect people from harm. There was a particular impact at mealtimes which resulted in people’s dignity not being upheld and people not always receiving sufficient support to eat. People’s privacy was also not always protected. The systems the provider had in place to monitor and manage this were not always effective.

There were risk assessments which gave staff the necessary guidance about the help people needed. Any concerns or accidents were reviewed to learn lessons from them. Staff worked well together and with external professionals to promote people’s health and physical wellbeing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The environment enabled people to maximise their independence.

The provider had invested in resources to ensure people had the opportunity for stimulating and meaningful activities. When people required end of life care, there were measures in place to ensure support was compassionate and personalised. People felt able to raise concerns about their care and be confident they would be dealt with promptly.

The registered manager was approachable and there were systems in place which encouraged people to give their feedback. There were relationships with other organisations to meet people’s needs.

More information is in the full report.

Rating at last inspection: The service was last inspected on 12 April 2016 and was rated good.

Why we inspected: This was a scheduled inspection based on the date the service was registered.

Enforcement: We found two breaches in regulatory standard and you can see what action we told the provider to take at the back of the full version of the report.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk