During an assessment under our new approach
About the service
Brambles Care Home is a residential service providing personal care without nursing for up to 33 people. At the time of inspection 29 people were using the service. The service is set over four floors in the local community with access to a large garden and patio areas.
Who the service is for
The service supports older people and people living with dementia.
Key findings
We carried out this assessment from the 22 July until the 29 July 2026. This service was previously rated as good at the last inspection on the 26 November 2019. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.
People consistently told us they enjoyed living at the service and felt it was a safe place to live. There were enough staff to support people how they wished to be supported. Staff were recruited safely and underwent a thorough induction process. Staff received training appropriate to their role and were actively encouraged to develop themselves and further their careers. Staff told us they were supported to achieve nationally recognised qualifications. Risk assessments were in place to help staff mitigate risks of harm to people whilst maintaining their independence. People received their medicines as prescribed and where needed medicines were regularly reviewed by the GP practice and local pharmacy.
People were safeguarded from the risk of abuse by staff who understood their responsibilities to report concerns. One member of staff told us, “We look after vulnerable people and ensure they are always safe and not at risk of abuse. If they were I would raise this and escalate it to the appropriate authorities.” Records we saw showed the registered manager reported safeguarding concerns to the local authority safeguarding team and worked with them to ensure people were safe.
People and staff told us there was enough staff to support people safely. One person said, “The staff are very nice and present, there is always someone around if you need something, which is great.” A member of staff said, “We have enough time to look after everyone without feeling rushed.”
Staff told us they had regular meetings to discuss people’s care needs and the running of the service with the registered manager. Staff had the opportunity to discuss any issues or their development needs during supervision sessions. Staff told us they worked well together as a team and had a supportive manager.
The environment was clean and well maintained. People were very complimentary of the cleaning, laundry and maintenance staff. One person told us, “The cleaner is very thorough and keeps everything nice and clean.” We saw feedback on the laundry staff saying, ‘The laundry is always brought back so quickly,’ and the laundry service is, ‘fantastic, efficient.’
The provider employed a maintenance person to manage the day-to-day repairs and safety monitoring of the building and equipment used. Where needed, external contractors were employed, for example, the service had undergone development and refurbishment of certain areas. Following a recent fire risk assessment, we saw works recommended had been addressed or were in the process of being addressed. Staff underwent fire evacuation training and held regular fire checks and drills.
Care was person-centred and assessments of people’s needs were completed before they started using the service. Each person had a named key worker who worked closely with them to ensure their needs could be met as they wished. Before people came to the service an assessment of their needs was completed, and they or their family had an opportunity to look around the service. One person told us, “My family came and saw the home before I moved in. Straight away they said they felt the home was caring and you could feel warmth here.”
The registered manager employed 2 cooks and kitchen staff who provided freshly cooked meals each day for people and home-made desserts and cakes. The cooks liaised with staff and were kept informed of people’s special dietary requirements so they could tailor meals to people’s needs. We saw menus and meals were discussed with people to get their feedback during regular resident meetings. Where needed people’s weights were monitored and if there were any concerns staff liaised with the GP practice. If specialist advice was needed people were referred to speech and language therapists. People were generally complimentary of the food, although some people felt portion sizes were too big. One person said, “The food is nice we have a choice and if we don’t like what is on the menu we can have something else.”
Staff had systems in place to monitor people’s health needs. The service had regular reviews from their GP practice and frailty nurse. When needed, the district nurse visited the service to provide support, advice and treatment. People told us when required staff arranged appointments for them and if specialist reviews were needed at hospitals staff arranged this for them. One person told us, “The nurse has been in today and checked my blood pressure.” Another person said, “I have a hospital appointment this afternoon, the staff will come with me.” A healthcare professional told us, “Staff are good at communication, keeping us informed and following instructions. Staff are very good at notifying us of any deterioration in people’s conditions so we can do a prompt review.”
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives. Where conditions of DoLS were in place the registered manager ensured these conditions were met.
The provider and registered manager promoted equality in experience and outcome for people. The registered manager had systems in place to measure and monitor outcomes for people, including holding regular meetings with people and relatives, and undertaking regular surveys. We saw from minutes of meetings that any issues were discussed and responded to with feedback given to people at their next meeting. We saw meetings were an opportunity for people to give feedback on all aspects of the service they received including raising complaints and giving compliments. We saw feedback from a recent relative survey saying, ‘My relative is treated with so much dignity.’
The registered manager had systems in place to keep oversight of the service. There were audits in place which demonstrated learning and actions taken to monitor and improve outcomes for people. The registered manager was training senior staff to take more responsibility in completing audits and following up on actions from these. Staff were supported with regular meetings and supervision, in addition the registered manager completed observations periodically of staff practice and provided feedback to them. This was an opportunity to identify if staff skills needed development or further training. There were named champions at the service, this gave staff additional responsibility to champion certain activities such as promoting wellbeing, oral health, nutrition and safe medication practices.
Staff shared the registered managers and providers vision to provide positive outcomes for people. Staff told us they enjoyed working at the service and felt they worked well together as a team. One member of staff said, “I love my job, the manager is very supportive, we can talk to them, and they listen to any concerns.” Another member of staff said, “I look at the residents like they were my family, it’s their home and I try to make it as homely as they can for them.”