Bramwell

Updated 3 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service on 6 and 7 December 2017 and the inspection was unannounced. The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to our inspection we reviewed information we held about the service. This included information received and statutory notifications. A notification is information about important events which the provider is required to send us by law. We sought feedback from health and social care professionals who have been involved with the service and commissioners who fund the care for some people who use the service and due to the concerns raised by commissioners we brought forward our inspection.

During the visit we spoke with seven people who used the service, six relatives, three care team managers, five care staff, one housekeeper, one cook and the registered manager. We also used the Short Observational Framework for inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at all or part of the care records of five people who used the service, medicines records, staff recruitment and training records, as well as a range of records relating to the running of the service including maintenance records and quality audits carried out by staff at the service.

Updated 3 February 2018

We inspected the service on 6 and 7 December 2017. The inspection was unannounced. Bramwell Care Home is a care home providing accommodation and personal care for people who live at the service. 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. Bramwell Care Home accommodates up to 93 people across six units over two floors. On the day of our inspection 73 people were using the service.

At our previous inspection 15 and 16 November 2016 the provider was in breach of a number of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The concerns were around the lack of assessment of the risks to people’s safety, the lack of sufficiently skilled and experienced staff and the lack of systems in place to assess, monitor and improve the quality and safety of the service. During this inspection we found the provider had made significant improvements to the service and were no longer in breach of any regulations of the health and social care act.

A registered manager was in post and they were available during the inspection. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People at the service were protected from possible abuse as staff at the service had the knowledge and understanding of the types of abuse people could be exposed to and how they should report issues of concern. Staff felt confident the management team would address any issues of concern and the registered manager fulfilled their responsibilities in dealing with safeguarding issues by reporting, investigating and acting on concerns raised ensuring that lessons were learnt from incidents.

The risks to people’s safety were regularly assessed to ensure they received safe care appropriate to their needs. Staffing levels met the needs of people and they received their medicines safely from staff who received appropriate training in medicines management. The cleanliness of the service was maintained and monitored and staff were knowledgeable on how to protect people from the risks of infection.

Nationally recognised and established assessment tools were used to assess people’s needs and staff received appropriate training for their roles. People were supported to make decisions and staff knew how to act if people did not have the capacity to make decisions to ensure their rights were respected.

People lived in a service which met their needs in relation to the premises and adaptions were made where needed. People had access to information in a format which met their needs.

People’s health and nutritional needs were well managed and staff acted on advice given to them by health professionals to manage people’s health and nutritional needs.

People were cared for by staff who knew their needs and preferences and were caring and kind towards them and their relatives. They were supported with respect by staff who maintained their privacy and dignity whilst encouraging and supporting their independency.

People received individualised care from staff who had the information they required to provide that care. People were supported to take part in a range of social activities and maintain relationships that were important to them. People were comfortable when raising concerns or complaints and felt issues raised were addressed to their satisfaction. People’s wishes in relation to their end of life care were supported with care and empathy.

The service undertook a robust auditing process to maintain the quality of the service. The registered manager worked with people, relatives, staff and external professionals to provide an open and transparent service for the people who lived there.