Bramhall Manor Care Home

At our last inspection, the provider was in breach of 2 legal regulations relating to the management of medicines and the systems for governance, and enforcement action was taken. At this inspection we found continuing breaches regarding the safe management of medicines and governance and oversight of the service. We have asked the provider for an action plan in response to the concerns found at this assessment

Medicines were not always administered safely, and there were repeated concerns relating to medicines requiring specific administration guidance, including the safe application of topical creams. Concerns were also identified regarding the management of time‑sensitive medicines.

Risk assessments and care plans were implemented in a timely manner. However, shortfalls were identified as they did not always fully reflect people’s individual levels of risk, and oversight of risk management was inconsistent, with some areas being more robust than others. We found falls management had improved, with an increased focus on falls prevention and supporting people to maintain and improve mobility.

An overall improvement was noted in response times to call bells; however, there were still occasions when people experienced delays in receiving support. Staffing levels remained a recurring theme raised through surveys and meetings.

Feedback from people and their relatives was positive, and people told us they felt safe. Staff were suitably recruited and received the training and support required for their roles. The provider had ongoing actions in place to ensure staff received appropriate training to support people with learning disabilities and autistic people.

The home was clean, tidy, and well maintained, with suitable processes in place for equipment checks and maintenance. However, further work was required to ensure the environment fully met the needs of people living with dementia, particularly in relation to accessibility and orientation.

Systems for management and governance were not always effective in identifying, escalating, and resolving risks relating to medicines management, fluid monitoring, and record‑keeping. While record‑keeping was improving, it was not consistently accurate or sufficiently detailed to evidence safe, effective, and person‑centred care.

Staff generally described a positive culture, with good teamwork and pride in their work. A range of engagement with families was in place through meetings, surveys, and regular communication, with feedback welcomed and responded to. There were positive community links, including intergenerational activities and opportunities for people to access the local community.