Bramshott Grange

We assessed a total of 4 quality statements in the safe key question. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Our rating for this key question has remained the same. We found areas of concern around the providers effectiveness to assess and monitor their medicines processes and some practices did not always reflect best practice guidance. We were not assured that people’s medicines records always contained adequate detail and directions for staff to follow were not always clear. These shortfalls constituted a breach in regulation as the provider failed to demonstrate good governance of medicines. We received positive feedback from people and their relatives that they felt they received safe care. Leaders of the service understood what actions they should take to keep people safe when things went wrong, which included sharing information with the relevant safeguarding authorities. The service adopted a proactive approach to learning and improvement and the provider promoted a positive learning culture. Individual risks to people were well managed and staff knew people and how to meet their needs safely. This included people’s mobility needs, falls risk management and where people required support with to use equipment.

We assessed a total of 1 quality statement in the caring key question. The scores for this area have been combined with scores based on the rating from the last inspection, which was good. Our rating for this key question has remained the same. Overall, we observed staff supported people in a compassionate manner. We received positive feedback from people, relatives and professional visitors that staff provided kind and compassionate care to people.

We assessed a total of 5 quality statements in the well-led key question. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. At this assessment our rating for this key question has deteriorated to requires improvement. We identified the provider was in breach of 1 regulation and the provider had failed to ensure the always operated good governance. Examples of shortfalls included medicines processes and records, failure to provide all required notifiable information to CQC and shortfalls in staff training oversight. Staff told us there was a good culture across the staff team and they were able to seek support from leaders and peers. Staff understood how to speak up and raise any concerns and felt actions would be taken where required. Leaders of the service were visible and compassionate, and the provider engaged staff to promote their values and ethos.