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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 19 November 2019

About the service

The Brambles is a residential care home providing personal care for up to five people living with a learning disability, autism spectrum disorder or Down’s Syndrome. At the time of the inspection there were five people living in the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a small home which fit with the local domestic style properties. It was registered for the support of up to five people, in line with best practice guidance. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Risks to people’s safety and wellbeing were not always managed effectively, which put people at risk of harm. Infection control and fire risks were not managed safely and people did not always receive their medicines as prescribed.

Though some support interventions were effective and achieved positive outcomes, not all support plans reflected best practice and professional advice. Risks relating to eating and drinking were not effectively managed.

The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the as they had limited choice and control and were subject to unjustified restrictions of their liberty.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service did not have effective measures in place to ensure that quality and safety issues were identified and addressed in a timely way. Records were not always up to date, accurate, complete and available. The home was going through a period of change and staff reflected there was an improving picture. Some areas highlighted on this inspection had been identified by the management team as areas for improvement, and some improvements had been made.

People’s interests and preferences were taken into account and they had access to activities which reflected this. People were supported to avoid social isolation. Some staff had a very kind and patient approach, where others were directive and did not treat people with respect.

The service did not consider people’s wishes ahead of reaching the end of their life. We recommended the service apply guidance on advanced care planning, so that people and those important to them can have their wishes and preferences considered ahead of making urgent care decisions when they become unwell.

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

Rating at last inspection

The last rating for this service was good (published 16 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches of regulations in relation to managing risks of people’s health and wellb

Inspection areas

Safe

Requires improvement

Updated 19 November 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 19 November 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 19 November 2019

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 19 November 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 19 November 2019

The service was not always well-led.

Details are in our well-led findings below.