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Bradbury Grange Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 December 2018

This inspection took place on 14 and 15 November 2018 and was unannounced.

Bradbury Grange is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Bradbury Grange can accommodate 50 people. At the time of our inspection there were 50 people living at the service.

Accommodation is spread over two floors in a large detached property. On each floor there was a large communal lounge and dining room where people could choose to spend their time.

There was no registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had been appointed in September 2018, they told us they planned to submit an application to register with CQC.

We last inspected the service in March 2017 and the service was rated Good overall. During this inspection we found two breaches of Regulation and the service is no longer rated Good.

Recruitment processes were not sufficiently robust to ensure that people were supported by staff that were recruited safely. The area manager and manager had identified this prior to our inspection and were taking steps to make sure that recruitment processes were robust before any further recruitment took place.

Potential risks to people’s health and welfare had been assessed, however there was not consistent, clear guidance for staff to follow to mitigate the risk and keep people safe. The manager had identified this and was undertaking a review of each person’s care files.

Accidents and incidents had been recorded and analysed to identify patterns and trends, action had been taken to reduce the risk of them happening again. Checks had been completed on the environment and equipment to make sure it was safe.

People’s medicines were managed safely. Systems were in place to make sure people received their medicines and these were effective. Medicine records were accurate.

Care plans contained guidance about people’s choices and preferences. Care plans were reviewed regularly and with people where they were able or their representative. People were supported to remain comfortable at the end of their lives.

Staff met with people before they moved to the service to make sure that staff could meet their needs. Staff monitored people’s health and referred them to healthcare professionals when their needs changed. Staff followed the guidance given by health professionals to keep people as healthy as possible. People had access to professionals such as a dentist and optician. People were encouraged to lead as healthy lifestyle as possible, for example moving in their chair or bed. People had a choice of meals and were supported to eat a balanced diet.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible, the policies and systems in place supported this practice.

People were supported to be as independent as possible and where possible were involved in developing their care and support. People had access to activities they enjoyed and these reflected their interests. People were treated with kindness, staff respected people’s dignity and privacy. People were relaxed in the company of staff and staff understood how to support people when they were anxious.

People were protected from harm and abuse. Staff knew how to recognise signs of abuse and how to report any concerns. Staff were confident that the manager would deal with their concerns appropriately. The manager would deal with concerns to the local saf

Inspection areas

Safe

Requires improvement

Updated 21 December 2018

The service was not consistently safe.

Recruitment processes were not entirely robust.

Potential risks to people’s health, safety and welfare had been assessed. However, there was not consistent, detailed guidance for staff to follow to mitigate the risk.

There were sufficient staff on duty to meet people’s needs, supported by a team of volunteers.

People were protected from abuse, staff understood their responsibility to report any concerns.

Medicines were managed safely and people received their medicines as prescribed.

The building was clean and odour free. Staff used gloves and aprons when required, to reduce the risk of infection.

Accidents and incidents were recorded and analysed. Action was taken to reduce the risk of them happening again.

Effective

Good

Updated 21 December 2018

The service was effective.

People’s needs were assessed to make sure that staff could meet their needs. Care was developed in line with current guidance.

Staff received training appropriate to their role. Staff received supervision and appraisal to develop their skills.

People were supported to eat a balanced diet and maintain as healthy lifestyle as possible.

People were referred to specialist healthcare professionals and staff followed their guidance to keep people as healthy as possible.

The building had been adapted to meet people’s needs.

Staff were working within the principles of the Mental Capacity Act 2005.

Caring

Good

Updated 21 December 2018

The service was caring.

People were treated with kindness, respect and were given support when they were anxious.

People were supported to express their views about their care.

People’s dignity and privacy were respected. People were supported to be as independent as possible.

Responsive

Good

Updated 21 December 2018

The service was responsive.

Care plans contained details about people’s choices and preferences and were reviewed regularly.

People were supported to take part in a range of activities they enjoyed.

People were supported at the end of their lives.

Complaints were recorded and investigated following the provider’s policy.

Well-led

Requires improvement

Updated 21 December 2018

The service was not consistently well led.

A new manager had been appointed in September 2018, they had not yet applied to register with the CQC. This is a condition of the provider’s registration. The manager understood their regulatory responsibility and had submitted statutory notifications as needed.

People, their relatives and staff were positive about the leadership at the service. Staff felt supported by the management.

There was an open culture in the service, focused on improving the service for people.

Checks and audits had been completed. When shortfalls had been identified, action had been taken to rectify the shortfall and drive improvement.

People, relatives and staff were given the opportunity to express their views about the service.

The service worked with other agencies to improve people’s experience.