We carried out a review of the data available to us about Little Bramingham Farm Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Little Bramingham Farm Residential Care Home, you can give feedback on this service.
We found the following examples of good practice.
The registered manager had implemented systems for ensuring checks on visitors were conducted and outcomes recorded to minimise the risks of people contracting COVID-19. This included screening questions, lateral flow testing and confirmation of vaccination status (for visiting professionals) as well as full use of Personal Protective Equipment (PPE).
Each person had a named essential care giver. The essential care givers took part in weekly testing regimes and had been able to offer support to people throughout COVID-19 outbreaks in the service. Relatives told us this was really helpful and they were happy with all visiting arrangements. The staff supported people to use social media platforms and telephones outside of face to face visits to stay in touch. People and visitors had a choice of visiting in people’s bedrooms or in a designated visitors log cabin. People also had overnight visits to their relative’s homes.
People, relatives and staff all took part in testing using PCR tests as well as lateral flow tests. They wore all required PPE correctly and had stations outside bedrooms, at the front entrance and other communal areas for safe disposal of PPE. The staff had tried using clear masks for communicating with people who needed to see facial expressions.
Each person had individual risk assessments about COVID-19. People who were unable to consent to testing, vaccinations or any visiting restrictions had completed a mental capacity assessment and been supported in their decision making.
We found the following examples of good practice.
The home was clean and there were safe processes to manage the entry of staff, visiting professionals and relatives when they came to the home.
Swift action was taken when people presented as unwell.
Staff wore personal protective equipment (PPE) and recorded their temperatures on entry into the home.
Further information is in the detailed findings below.
Little Bramingham Farm Residential Care Home provides care and support for up to 25 people living with various care needs. Some of the people were living with dementia. The service consists of two floors, providing single bedrooms and communal areas. There were 22 people living at the service at the time of the inspection.
People's experience of using this service and what we found
People and relatives' feedback was extremely positive and complimentary about the care people received. They all said staff provided very good care to meet people’s needs. Everyone said staff were exceptionally caring, kind and friendly. They provided person-centred and responsive care to people. People experienced very good care outcomes and relative’s comments about the service supported this. It was clear that the provider and the registered manager had further developed the service to enhance people's experiences of care. One relative said, “You can use this as an example of how a home should be run. We would recommend this to anyone.”
Everyone said the staff were very passionate about creating a homely, inclusive and happy atmosphere for people. Relatives said the service was exceptional at promoting a caring environment for everyone, including staff. One relative said, “It’s genuinely a lovely place.” It was evident staff were highly motivated to create an atmosphere that promoted mutual compassion and care. Staff had developed caring and respectful relationships with people and relatives. Staff always promoted people's dignity and privacy, and they supported them to remain as independent as possible.
There were robust systems to ensure people were safe. People were protected from harm by staff who were trained to identify and report concerns. People were safe because potential risks to their health and wellbeing had been managed well. There were enough staff to support people safely. Some staff had worked at the service for many years and they had got to know people and their relatives quite well. People were supported well to take their medicines. Lessons were learnt from incidents to prevent recurrence. Staff followed effective processes to prevent the spread of infections.
Staff worked hard to ensure people received effective care to meet their needs. People were supported by very skilled and knowledgeable staff. The provider ensured staff practice was supported by good practice guidance so that people achieved good care outcomes.
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 received exceptionally personalised care and support which met their needs, reflected their preferences and promoted their wellbeing. People felt they mattered, and staff valued relatives’ contributions to discussions about people’s care. Staff had worked extremely hard to make sure people took part in a variety of activities they enjoyed. Community involvement was something the service did exceptionally well, with a range of events planned which relatives and members of the public attended. The provider listened to suggestions, concerns and complaints. They used this information to continually improve the service. There were records about how people wanted to be supported at the end of their lives.
There was strong leadership at the service. The registered manager promoted a positive, open and inclusive culture, and they were driven to continually improve people’s experiences. They said, “Since the last inspection, we have grown and grown. I am passionate about Little Bramingham Farm Residential Care Home, and community involvement is one of the things we do quite well.” Staff roles and responsibilities were clear, and staff were supported and encouraged to use creative ways to support people to achieve their personal goals. The provider’s values were reflected in the way staff interacted with everyone and how they supported people. The provider’s quality monitoring processes were robust, and they evidenced what they did to continually improve the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good (published 24 August 2017).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
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.
At the last inspection the service was rated good. At this inspection we found the service remained good.
People told us they felt safe living at the service. A visiting relative also said they felt their relative was kept safe. Individual risks to people were appropriately assessed, identified and managed.
There were enough competent staff to provide people with support when they needed it. Staff had been recruited through a robust recruitment process and had received appropriate training and support to help enable them to carry out their roles effectively.
People received appropriate support to eat and drink sufficient amounts to maintain their health and well-being in relation to nutrition and hydration. Specialist diets were provided and professional input was obtained as required.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People were supported to have maximum choice in relation to all aspects of their lives.
People, relatives and staff told us, and we observed that people were treated with kindness by staff who respected their privacy and maintained their dignity.
People and their relatives were given the opportunity to feed back on the service and their views were listened to and acted upon.
People received personalised care that met their individual needs. People were given appropriate support and encouragement to access and participate in meaningful activities and to pursue hobbies and individual interests both within the home and in the community.
People were supported to share their views by giving feedback through residents’ meetings or by recording their dissatisfaction in a comments and complaints book located in reception. People knew how to complain if they were unhappy with any aspect of the service and were confident they would be listened to.
There was an open, transparent and inclusive atmosphere within the service. People and staff had regular meetings to discuss the service and think about future developments and improvements they could make.
There were systems and processes in place to monitor the overall quality and safety of the service and shortfalls identified were promptly acted on to improve the quality of the service. People gave positive feedback on the management of the service.
Further information is in the detailed findings below
This inspection was carried out over two days, on 5 and 8 January 2015. It was an unannounced inspection and was undertaken by one inspector.
Little Bramingham Farm Residential Care Home is a registered care home for a maximum number of 25 elderly and frail people. It does not provide nursing care. The home offers accommodation over two floors. There were 22 people living at the home when we inspected it.
At the time of our inspection, there was a registered manager in place. 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 and associated Regulations about how the service is run.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that people’s rights were being protected, as DoLS applications were in progress and were being submitted to the authorising agencies.
People were assisted by staff in a way that supported their safety and they were treated with respect. People had care plans in place which took account of their needs and individual choices.
People’s medication was administered by staff who had received training to ensure that the medication was administered safely and in a timely manner.
Staff cared for people in a warm and caring manner. They used appropriate techniques to calm people when they were anxious or angry.
Staff were trained to provide effective and safe care which met people’s individual needs and wishes and were supported by the manager to maintain and develop their skills and knowledge by way of regular supervision, appraisals and training.
People were able to raise any suggestions or concerns they might have with the manager and were listened to as communication with the manager was good.
Arrangements were in place to ensure the quality of the service provided to people was regularly monitored.
We considered our inspection findings to answer questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found.
Is the service safe?
Staff had received training on the safeguarding of vulnerable adults and were able to demonstrate their understanding of the different types of abuse. We saw that the provider acted on any concerns that were raised by people who used the service or staff. People we spoke with told us that they were "looked after well". People's needs had been assessed and monitored; care documents reflected people's needs and provided care staff with clear information on how to safely care for people. Risk assessments had been put in place for people and staff were aware of the risks and how to manage them.
Is the service effective?
We saw that people living in the home were free to move around and were happy in their surroundings. People told us that staff were quick to respond to them and 'do the best they can' to assist them quickly. They told us that the care they received was "very good". We observed staff were caring towards people and people we spoke with also told us that the staff were very good. We saw that the care plans were regularly reviewed and contained detailed information about the person and their needs. This meant that staff were aware of people's needs and were able to provide the correct care and support.
Is the service caring?
People told us that staff were "caring" but at night staff were sometimes 'overworked' and made people feel 'uncomfortable' about asking for support at night. People told us that they were happy with the care being provided by most staff, but that at night it was not always the same because staff were overstretched. We observed that the day staff were attentive towards people and people spoke fondly of the day staff. People said that there were no restrictions on what they did and they especially enjoyed going into the garden area of the home, which was always accessible to them.
Is the service responsive?
Care plans and risk assessments were reviewed and any changes required were made. The provider was quick at responding to any concerns within the home, and we saw that where people had raised safeguarding concerns these had been investigated thoroughly by the provider and families and the local authority were also informed.
Is the service well-led?
The provider had a registered manager in post. People we spoke with told us that the home manager was 'hands on' and worked well with people to ensure the home was running smoothly. We saw that the manager was aware of any issues within the home and was also quick at responding to any concerns.
We observed good interactions between people and staff. People looked relaxed and comfortable in the company of staff. We saw staff demonstrating genuine affection, care and concern for people.
We found that people were provided with a choice of suitable and nutritious food and drink in sufficient quantities to meet their needs.
The home had systems in place to reduce the risk and spread of infection. A person who used the service said, 'My room is cleaned daily and the sheets get changed as and when needed. It's like a posh hotel.'
We found that the premises were safe and adequately maintained. The equipment used was also safe and fit for its purpose. This meant that people were not at risk of unsafe premises or equipment.
Suitable arrangements were in place to ensure that the staff were appropriately supported to deliver care safely and effectively. A relative of a person who used the service said, 'The staff are good at their job. They are caring which is in their culture.'
We observed people were offered support at a level which encouraged independence and assured their individual needs were met. The staff were friendly and courteous in their approach to people and interacted confidently with them. We noted that people were encouraged to express their views about the quality of care in the home. They were also involved in planning their care, making decisions about their support and treatment, and how they spent their time. One person talked about the range of activities available to them and said 'I love our days out.' Another person told us 'They are very on the ball here.' Within the care files we saw people had been involved with, and agreed with the particular care needs that had been identified for them.
One person said to us that although overall the staff answer the call bells in a timely way, 'we sometimes have to wait a while if they are busy'.
People told us they very much enjoy the days out and especially the kite flying on Dunstable Downs.
People were able to take an active part in resident meeting and were able to have their say and felt they were listened to and action taken if necessary.