Brookholme Care Home

About the service

Brookholme Care home is a residential care home providing personal care and accommodate for up to 40 people. The service provides support to older people and people with physical needs or living with dementia. At the time of our inspection there were 36 people using the service.

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

The providers quality processes were not always in place or the required audits used to identify where changes may be needed. The home was not cleaned to a high standard and we saw some areas of the home required attention to detail to--in ensure it looked well cared for. Cleaning schedules and oversight of the home had not been completed to ensure the standards were being met.

Other audits had been used to reflect on people’s safety. For example, reviewing accidents and incidents. Measure were put in place to mitigate risks, or observe people post fall.

Medicines were managed safely by staff who had completed training and had their competencies completed.

There were sufficient staff to meet the needs of people, following a dependency tool being completed to access the levels of need. Staff were recruited safely and completed induction and training to support their roles.

Learning from incidents had promoted further training to ensure all staff had the required skills and knowledge when completing moving and handling techniques.

The provider worked with health and social care professionals. Referrals were completed and their advice detailed in the care plans and shared with staff.

People, relatives and staff views were considered and used to drive changes. All the relatives we spoke with complimented the staff on their kindness and attitude. They reflected on the range of activities available, communication and information around managing COVID 19.

Overall infection prevention and control was managed well. People’s safety was considered, and risk assessments were in place. Staff understood the importance of protecting people from harm, safeguards had been investigated and any learning shared.

All complaints were investigated, and duty of candour considered. Notifications to us were completed to enable us to monitor 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 Good (published 27 July 2018).

Why we inspected

The inspection was prompted in part due to concerns received about safety and risks to people. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements in relation to their auditing processes to drive improvements and maintain quality.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same, however we have rated the well led section as requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brookholme Care Home on our website at www.cqc.org.uk.

We found the following examples of good practice.

¿ Staff had received training in donning and doffing personal protective equipment (PPE), and we saw this was accessible throughout the home and staff used it in accordance with the most up to date guidance. Staff had received further training in COVID-19 and infection control.

¿ Additional PPE stations had been fastened onto walls around the home, this meant staff always had an accessible supply.

¿ We saw the infection control and COVID-19 policy were kept up to date in line with current guidance. We reviewed audits which reflected actions had been taken to maintain the standards within the home.

¿ There were no visitors allowed in the home at the time of our inspection. Only essential medical professionals had entered the home during the outbreak. Some people who were receiving care at the end of their life, received visitors, and the required checks were completed to reduce the risk of infection. The provider had installed a visitor’s lodge situated outside to enable visitors to return once the outbreak was over.

¿ Walkie talkies were being used as an additional tool for staff communication. This reduced unnecessary movement around the home.

¿ The home was clean throughout and additional cleaners had been utilised to ensure that the home was consistently clean and touch points regularly wiped. Clinical waste collection had been increased during the outbreak.

¿ Management meetings took place by teleconference. This enabled them to regularly review actions that had been taken to reduce risk and prevent the spread of the virus.

¿ The registered manager had planned actions based on the infection control gathering tool which formed how they managed the home, increasing cleaning and personal protective equipment to keep people safe during the outbreak.

¿ The home keep those people who had tested positive in a separate part of the home. This further prevented the spread of infection and a dedicated staff team ensured that possible cross contamination was kept at a minimum.

¿ A new standard operating system had been developed during the pandemic. This covered all aspects of managing the service and possible outbreak, including the wellbeing of people living at the service and staff.

This was Brookholme Care Home’s first inspection under a new registration.

There was a registered manager in post. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff received training and support to enable them to fulfil their role effectively and were encouraged to develop their skills. They received regular supervision and attended team meetings where they discussed improvements to the home.

People were kept safe by staff who understood their responsibilities to detect and report abuse. They had developed caring, respectful relationships with people and ensured that their dignity and privacy were upheld. There were enough staff to meet people’s needs promptly. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to maintain good health and had regular access to healthcare professionals. Mealtimes were not rushed and people were given a choice of meal. We saw that food and drink was regularly provided and records were maintained for people who were nutritionally at risk. Care plans were regularly reviewed to correspond with changing support needs and they were personalised and accessible.

People were encouraged to pursue interests and hobbies and regular activities were planned. Visitors were welcomed at any time. People knew the registered manager and felt confident that any concerns they raised would be resolved promptly. There were regular meetings with people and their relatives and their feedback was used to improve the home.

Risk was assessed and actions were put in place to reduce it and their effectiveness was monitored and regularly reviewed. Lessons were learnt when things went wrong to reduce the likelihood of it happening again. There were systems in the home to keep it clean and free from infection. Medicines were managed to reduce the risks associated with them and people received them when they needed them.

There were systems in place to drive quality improvement which included regular audits and feedback from people who use the service and staff. There were good relationships with other organisations and professionals; including specialist support to improve the home.