Bramble Down

Updated 26 June 2021

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

This inspection was carried out by one inspector.

Service and service type

Bramble Down is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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

We gave short notice of this inspection due to the COVID-19 pandemic.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this 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 used all of this information to plan our inspection.

During the inspection-

We spoke with five people who used the service and received feedback from three relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, quality assurance manager, senior care workers, care workers and the chef.

We reviewed a range of records. This included three people’s care records and multiple 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also received feedback from a further three staff.

Updated 26 June 2021

About the service

Bramble Down is a care home providing personal care for up to 31 older people. At the time of the

inspection there were 30 people living at the home.

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

Bramble Down House had a visible person-centred culture which ensured that staff in all roles were highly motivated and offered care and support that was compassionate and kind.

There was a good ethos within the service of treating people with dignity and respect. People were at the forefront of the service delivery and the provider was committed to and passionate about providing a good quality service. We received positive feedback from the majority of people and relatives. Any issues were already known by the service and were being addressed. The feedback reflected staff were kind, caring and committed. People complimented the continuity of care provided by regular staff, especially during the pandemic, which contributed to the building of meaningful relationships. Staff, supported by the activity team, recognised what was important to people and ensured an individually tailored approach that met people's personal needs, wishes and preferences were delivered.

Care and support plans were reviewed and changed as people's needs changed. The service worked closely with healthcare professionals. People were supported to maintain good health and to meet their nutritional needs.

Staff told us they were supported by the management team with empathy and understanding.

The registered manager, provider and management team provided supportive leadership and had developed a dedicated staff team who were committed to the vision and values of the service.

The provider had effective quality assurance systems, led by a quality assurance manager, in place which were used to drive improvement.

People living at Bramble Down told us they received safe care from skilled and knowledgeable staff. Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place. Risks to people's safety and well-being were managed through a risk management process.

There were sufficient staff deployed to meet people's needs, including over-recruitment during the pandemic.

Medicines were managed safely, and people received their medicines as prescribed.

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.

Rating at last inspection

The last rating for this service was requires improvement (published 4 December 2019). 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 Regulation 12 Safe care and treatment and Regulation 17 Good governance.

Why we inspected

We looked at infection prevention and control measures under the Safe key question at the previous inspection. At that inspection we were assured that the service can respond to COVID-19 and other infection outbreaks effectively.

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the key questions of Safe, Caring and Well Led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions 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 and Infection Control and Prevention inspection, by selecting the ‘all reports’ link for Bramble Down 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 re-inspection programme. If we receive any concerning information we may inspect sooner.