About the service Bradwell Hall Nursing Home is a residential care home providing nursing care to 116 people aged 65 and over at the time of the inspection. The service can support up to 187 people.
Bradwell Home Nursing Home has seven units, each with their own communal areas. During this inspection, we visited three of the units. People living in the home are living with dementia, mental health conditions, physical disabilities and sensory impairment.
People’s experience of using this service and what we found
People were not always protected against the risk of abuse. Before and during our inspection we had safeguarding concerns and three safeguarding referrals were made during and after this inspection.
People’s care and treatment was not always provided in a safe way. Staff did not always follow people's care plans, which increased the risk to their health and safety.
People’s medicines were not always safely managed. Staff did not always follow the provider's infection prevention and control systems and this placed people at risk of cross infection.
The registered persons had not ensured all staff supported people safely with their care. Staff did not always report concerns about people’s health needs.
We found widespread shortfalls in the way the service was managed and there was a risk of people receiving inappropriate care.
The provider had quality systems, including clear plans for improvement, in place. However, these were not always used effectively to help identify concerns to people’s health, safety and wellbeing.
The provider ensured people lived in a safe building. Safety checks and on-going monitoring helped to ensure the environment and equipment were in a good state of repair.
At the time of our inspection, no one at the home had a positive test result for COVID-19. The provider ensured people and staff were tested in line with government guidance.
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 requires improvement (published 20 March 2020) and there were breaches of regulation.
Why we inspected
Since our previous inspection, the provider had improved on their reporting processes for safeguarding concerns. However, there had been a significant increase in safeguarding concerns of a specific nature to warrant further inspection. These concerns included allegations of abuse, altercations between people and how these were managed. This had resulted in the local safeguarding authority monitoring the home more closely. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. We did not inspect the key questions of effective, caring and responsive which are rated requires improvement. 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 inadequate. 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 Bradwell Hall Nursing Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safeguarding people, the safe care and treatment of people and the management systems in place for the home at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.