Background to this inspection
Updated
24 August 2019
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Bramley House 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced on the first day.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, senior care workers and care workers.
We reviewed a range of records. This included four people’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We also looked at training data and quality assurance records.
After the inspection
We requested and received feedback from two professionals who regularly visited the service.
Updated
24 August 2019
About the service
Bramley House is a residential care home providing accommodation and personal care for up to 42 older people, some of whom may have dementia. At the time of the inspection, 32 people were living at Bramley House.
People’s experience of using this service and what we found
At the last inspection we found a breach of the regulations. The process of gaining consent for people who lacked capacity was not followed. At this inspection, we found the necessary changes had been made. 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.
People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Incidents and accidents were investigated and actions taken to prevent a reoccurrence.
At the last inspection we made a recommendation about the storage of some medicines. At this inspection, we found the necessary changes had been made. Medicines were administered, managed and stored safely.
At the last inspection we made a recommendation for the provider to seek guidance on care planning for people whose needs were changing. At this inspection, we found the staff and management were responsive to people’s changing needs and the necessary improvements had been made. Care plans were detailed and person centred with full life histories. This meant people were treated as individuals and staff had a good awareness of people’s likes and dislikes. Health and social care professionals were contacted appropriately, in a timely manner and the home worked in partnership with them well.
At the last inspection we found risk assessments had not been reviewed regularly. At this inspection the necessary improvements had been made. Various risk assessments were in place and had been reviewed. At the last inspection we found there were sometimes not enough staff. At this inspection, we found there were sufficient numbers of staff on duty at each shift to meet people’s needs.
At the last inspection we found staff required up to date training to equip them with skills to support people with particular needs. We also found staff required regular one to one supervision. At this inspection, we found staff training had improved and staff were receiving regular supervision.
People were cared for by staff who were compassionate and caring. One person told us they felt very well looked after and relatives said the staff were kind. The home was friendly, warm and homely and people appeared settled and calm. Infection control processes were effective.
The service had improved under the new registered manager. We received good feedback from staff about their support and the new management structure. There were systems in place to audit and check the quality of care and these were carried out at regular intervals.
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 (report published 23 July 2018) and there was one breach of regulation. 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.
Why we inspected
This was a planned inspection based on the previous rating. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.