Bracken House

Updated 14 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Bracken House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Bracken House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 17 October 2023 and ended on 25 October 2023. We visited the location’s service on 17 and 23 October 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the site visit, we spoke with 7 people who lived at the home and 6 relatives. We spoke with 3 staff in detail including a senior case assistant, the housekeeping manager, and the catering manager. We also spoke with the registered manager, the Operational Lead for Residential Services, and the Operations Director.

Following the site visit, we spoke to 2 additional relatives and 6 additional staff members by telephone.

We looked at 6 people’s care records and 5 people’s medicine administration records (MARs). We also viewed 3 staff files and documentation related to the governance of the service.

The provider sent us further documentation we requested following the site visit including accidents and incidents analysis and action plans.

Updated 14 December 2023

About the service

Bracken House is a residential care home providing personal care to up to 34 people. The service provides support to older people some of whom are living with dementia. The care home accommodates people in 1 adapted building across 2 floors. There are 3 communal lounges downstairs and a dining area. At the time of our inspection there were 31 people using the service, 2 of whom were on respite placements.

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

Cleaning schedules were in place and the home was generally clean. However, systems in place failed to ensure the carpet cleaner was replaced in a timely manner when it was broken which meant stained carpets were not always cleaned effectively. Systems in place were not always effective in ensuring decision specific mental capacity assessments were recorded when needed. Systems were in place to check the quality of the service. Audits were undertaken and actions identified were overseen by senior management. Whilst we saw evidence of a number of actions being addressed by the provider, sufficient action was not always taken to address environmental risks identified.

People told us they felt safe, and relatives felt people were safe. Staff had completed safeguarding training and knew how to keep people safe. People had risk assessments in place for moving and handling and clinical risks and staff followed them. People were supported by a sufficient number of competent staff. People told us staff were available to support them when needed and they made them feel safe. People were supported by staff who were recruited safely and were required to complete an induction when they commenced their employment. People’s medicines were administered safely, and protocols were in place to guide staff when to administer ‘when required’ medicines. Where medicines errors occurred, action was taken to reduce the risk of reoccurrence.

The provider analysed accidents and incidents data to identify themes with a view to reducing the risk of reoccurrence. Staff told us the morale at the home had improved and people liked living at the home. The provider sought feedback from people, relatives, and staff to try to improve the care provided. The management team were open and honest when things went wrong and were proactive in seeking learning opportunities.

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.

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 1 December 2022). 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 improvements had been made and the provider was no longer in breach of regulations. However, the service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to unwitnessed falls, the governance of the service and management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained as requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the well led section of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bracken House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.