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Bramble Down Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 15 January 2020

About the service

Bramble Down is a residential care home providing nursing care. 27 people lived in the service at the time of the inspection. The service can support up to 40 people.

The service is on two floors, with access to the upper floor via stairs and lift. Bedrooms have en-suite facilities. There is a garden and courtyard outside.

People’s experience of using this service and what we found

People’s records identified their risk but there were not always clear plans in place to identify how these risks would be managed, reduced or mitigated. The service smelt fresh throughout. Some areas of the environment were clean. However, systems in place did not prevent or control the spread of infection. Medicines were not always managed safely.

People told us they felt safe and appeared comfortable when staff were with them. People told us staff were usually available when they needed them. Most people told us staff were kind and caring. People told us "We have a joke and a laugh” and “They’re very kind”. However, we observed several interactions between people and staff that did not show respect for the person.

Staff told us they had the skills and knowledge to meet people's needs effectively. All staff told us the training was good and they felt well supported. People told us they enjoyed the food at the service and described the food as, “Very nice” and “Amazing.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service had introduced electronic care plans. Some of the care plans were very informative, others lacked person-centred information and appeared generic. The management team told us they were in the process of further developing the electronic care plans to be more person centred. Staff knew people well and were able to tell us about their preferences. People told us they were happy with the social activities, events and outings at the service.

There were some audit systems in place, however these had not always been effective in identifying where improvements were needed. The management team spoke openly and honestly throughout the inspection process. They told us they would start work immediately to make the required improvements that were needed within the service.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 8 June 2017).


We have identified breaches in regulation relating to safe care and treatment, and governance at this inspection. We also made a recommendation in relation to evidencing people’s involvement in their care plans.

Please see the action we have told the provider to take at the end of this report.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Inspection areas


Requires improvement

Updated 15 January 2020

The service was not always safe.

Details are in our safe findings below.



Updated 15 January 2020

The service was effective.

Details are in our effective findings below.


Requires improvement

Updated 15 January 2020

The service was not always caring.

Details are in our caring findings below.



Updated 15 January 2020

The service was responsive.

Details are in our responsive findings below.


Requires improvement

Updated 15 January 2020

The service was not always well-led.

Details are in our well-led findings below.