Bradwell Hall Nursing Home

Updated 21 April 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, one assistant inspector and one 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.

Bradwell Hall 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

This inspection was unannounced.

What we did before the inspection

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 sought feedback from the local authority and professionals who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and 13 relatives about their experience of the care provided. We spoke with 21 members of staff including the providers, the clinical operations director, registered manager, unit managers, senior care workers, care workers and the domestic staff.

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

Updated 21 April 2021

About the service

Bradwell Hall is a care home providing personal and nursing care for up to 127 people aged 65 and over some of whom are living with dementia, mental health conditions, sensory impairments and physical disabilities. Bradwell Hall accommodates people across five different units, each which have their own adapted facilities. At the time of the inspection 64 people were living at the service.

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

People told us the care they received had significantly improved. The home had reduced in size which meant management had a greater oversight about the needs of people living at the service. The policies and practices in place had been redeveloped to support the new mission statement of the service.

People were supported by a well-trained staff team who understood people’s needs and knew how to keep people safe. Staff were recruited safely and there was a positive culture shift amongst the staff across the home. People received their medicine in a safe way and practices which had previously deemed to be unsafe were no longer supported. Staff understood the importance of choice and cared for people in a dignified way.

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.

Care plan documentation had improved. Records were detailed and gave staff the information they needed about people they were supporting. The governance systems had been redeveloped which evidenced care and support people received was monitored and reviewed to continue to drive improvement.

There was a new registered manager in place. The clinical operations director had continued to work with the providers, staff and people at the home to continue to improve practices, embed and sustain improvements and continue to enhance the quality of 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 (and update)

The last rating for this service was inadequate (published 10 February 2021).

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 regulations.

This service has been in Special Measures since September 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced inspection of this service on 29 and 30 September 2020. Breaches of legal requirements were found in regulation 12 (Safe Care and Treatment), regulation 13 (Safeguarding Service Users from Abuse and Improper Treatment) and regulation 17 (Governance). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

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, Caring, Responsive 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 inadequate to good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.

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.