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The Brambles Requires improvement

We are carrying out a review of quality at The Brambles. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 February 2021

About the service

The Brambles is a residential care home providing personal care to up to six people with a learning disability and/or autism spectrum disorder. At the time of the inspection there were four people living in the home.

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

People using the service were not always safe as the service had not fully assessed and put in place measures to reduce risks to their health, safety and wellbeing. This included management of their risks from Covid-19.

There had been improvements in the management of medicines. The service had responded to medicines errors and had sought an alternative administration method to reduce the risk of errors.

There had been some improvements in the reporting of incidents, however further improvements were required to ensure any learning could be identified. Staff had a good understanding of what needed to be reported internally as an incident and about types of abuse that needed reporting.

We identified records were not always up to date, complete or accurate and systems to review the quality of the service did not always identify issues for improvement.

The management team were aware of the culture in the home and were working to promote a more proactive approach within the staff team which promoted people’s independence. Staff told us they felt supported by the team and worked well together. Most staff felt confident to raise concerns, however one staff member told us they did not feel information was kept confidentially.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The environment was suitable for people to live a life like any other citizen. The service is small and located in a residential area with access to local facilities.

Staff understood how to promote independence. Records could be improved to ensure this was consistent. We could not be assured that risks were considered in line with best interest and least restrictive practices. Some aspects of care planning were not person-centred and it was not clear how people’s skills were being built upon to further improve their choice, control and independence.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 19 November 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found that some improvements had been made, however the provider had not made sufficient improvement and so was still in breach of regulations.

Why we inspected

This inspection was carried out to follow up on actions we told the provider to take at the last inspection.

We previously carried out an unannounced comprehensive inspection of this service on 29 August and 04 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action

Inspection areas

Safe

Requires improvement

Updated 13 February 2021

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 13 February 2021

Caring

Requires improvement

Updated 13 February 2021

Responsive

Requires improvement

Updated 13 February 2021

Well-led

Requires improvement

Updated 13 February 2021

The service was not always well-led.

Details are in our well-Led findings below.