Bramble House

Updated 24 March 2020

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 team consisted of two inspectors.

Service and service type

Bramble 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.

There was a registered manager at Bramble House. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider had not been asked to complete a provider information return prior to our inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received from the provider about the action they had taken since our last inspection and any notifiable events which had involved people who used the service. We also sought feedback from a local authority commissioner.

During the inspection

We spoke with one person who used the service. We spoke with three members of care staff, the provider, the registered manger, the head of care and a housekeeper. We reviewed a range of records; this included four people’s care records and multiple medicine administration records. We spoke with the relatives of three people living at Bramble House and received feedback from two healthcare professionals.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 24 March 2020

About the service

Bramble House is a care home without nursing that provides a service to up to 29 older people, some of whom may be living with dementia or a physical disability. At the time of our inspection, there were 27 people living at the service.

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

Improvements had been made in all areas since the last inspection. Systems were now in place to allow the registered manager and provider to continuously monitor the quality and safety of the service provided.

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's needs were assessed, and care plans were regularly reviewed to ensure information remained up to date and person-centred. Risks to people's health and safety were managed well. When accidents or incidents occurred, learning was identified to reduce the risk of them happening again.

Feedback we received from people’s relatives and from two healthcare professionals confirmed that the registered manager and provider were vigilant and responded quickly and appropriately when people’s health needs changed.

The environment was clean, well-decorated and maintained to a good standard with personalised bedrooms. There were enough staff to support people and staff were always visible. People's relatives told us that staff at Bramble House were very caring and knew the people that lived there well.

People living at Bramble House, their relatives and staff all considered the service was well-led. The service operated in a way that demonstrated there was an open and transparent culture, led by the provider and the registered manager. Staff told us they received the leadership and direction they required and felt part of a team.

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 and update

The last rating for this service was requires improvement (published 13 November 2019) and there were two breaches of regulation. The provider completed a monthly action plan after the last inspection to show what they would do and by when to improve the service. At this inspection, we found improvements had been made and sustained and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bramble House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information, we may inspect sooner.