• Care Home
  • Care home

Archived: Broadlands Nursing Home Ltd

Overall: Requires improvement read more about inspection ratings

51 Burdon Lane, Cheam, Sutton, Surrey, SM2 7PP (020) 8661 1120

Provided and run by:
Broadlands Nursing Home Limited

Important: The provider of this service changed - see old profile

Latest inspection summary

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Background to this inspection

Updated 26 November 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

This inspection was undertaken by two inspectors.

Service and service type

Broadlands nursing home 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 did not have a manager registered with the Care Quality Commission. A new manager had been appointed but they had not yet applied to register with the CQC. Registered managers 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

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also viewed information we held about the service including statutory notifications received. We used all of this information to plan our inspection.

During the inspection

We spoke with three people using the service. We spoke with four staff, including the manager, a nurse, a care worker and the maintenance person, who also undertook domestic duties. We reviewed three people’s care records and records relating to staffing and the management of the service. We undertook general observations and used the Short Observational Framework for Inspection (SOFI) to observe lunchtime interactions and medicines administration. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Overall inspection

Requires improvement

Updated 26 November 2021

About the service

Broadlands nursing home is a residential care home providing personal and nursing care to 13 people aged 65 and over at the time of the inspection. The service is registered to support up to 25 people. However, currently their maximum occupancy is 18 people as they are only offering rooms for single occupancy in response to the COVID-19 pandemic.

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

There were not sufficient staff to meet people’s needs. Copies of rotas and feedback from staff confirmed that at times the service was not staffed at the provider’s assessed level to support people’s needs, particularly at night. People fed back that they felt there were not enough staff to provide them with timely support.

Staff were not up to date with their mandatory training and the staff did not feel adequately supported. The staffing pressures at the service impacted on the ability of staff to undertake their required duties.

Risks to people’s safety were not adequately assessed and mitigated. This included environmental risks such as the risk of falling from height from an unrestricted window, the risk of burns from freestanding heaters and the risk of poisoning from access to harmful chemicals. People’s care records did not provide clear and accurate information about how to support people to manage individual risks, and we saw that one person was not supported to reposition as frequently as their care plan stipulated to reduce the risk of pressure ulcers developing.

There were systems in place to review the quality of service delivery. These systems had identified some of the concerns we found during inspection. This included some of the environmental risks and lack of compliance with the provider’s mandatory training. However, action had not been taken in a timely manner to address these concerns. In addition, the checks had not identified all of the concerns we found during inspection. Therefore, we could not be assured that the systems in place were adequate to review the quality of all areas of the service and ensure people’s safety.

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. Staff involved people in their care. They were aware of what decisions people had the capacity to make and supported them in line with their preferences. We observed staff providing support in a caring and compassionate manner. Staff supported people to access healthcare services and to ensure their nutrition and hydration needs were met. Safe medicines management practices were in place and people received their medicines as prescribed.

Staff were knowledgeable of safeguarding adults procedures and reporting processes should any incidents or accidents occur. Staff adhered to government guidance about how to protect people from the risk of infection in relation to the COVID-19 virus. There was a commitment within the staff team to improve practices and provide high quality care, but some of the systems in place at the time of inspection were creating barriers to this.

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 good (published 8 November 2017).

Why we inspected

We received concerns in relation to staffing levels, staff training and management arrangements. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. 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 good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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 safe care and treatment, staffing levels, staff training and governance at this inspection. Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. If we receive any concerning information we may inspect sooner.