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We are carrying out a review of quality at Broxbourne House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 10 January 2020

About the service

Broxbourne House is a residential care home providing personal and nursing care to 21 people aged 65 and over at the time of the inspection.

Broxbourne House accommodates people in one building. Communal areas are situated on the ground floor. Accommodation is provided on the ground and first floor. At the time of the inspection 21 people were using the service.

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

People were not safe. Risks to individuals were not assessed and appropriately managed. Medicines were not managed safely. There were insufficient staff with the appropriate skills and knowledge to meet people’s needs and keep them safe. Recruitment practices were not robust and did not ensure staff were suitable to work at Broxbourne House. Lessons were not learned when things went wrong.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. New staff did not receive appropriate training which meant they were not equipped with the relevant knowledge and skills. People's experience at meal times varied. People were generally complimentary about the food although some felt there was limited choice. Systems were in place to support people with their health needs. The design of the building meant people had limited space to use. The environment was not decorated to a good standard.

People were not treated with respect and their privacy and dignity was not maintained. Most people did not have their own toiletries and there were no towels, wipes or cloths in people’s rooms. People were often shaved and changed into their nightwear in the bathroom or shower room rather than their own bedroom. Towels, face cloths, duvet covers, pillowcases and sheets were all piled in a cupboard in a bathroom. These were worn, discoloured and some were torn although were replaced when we raised a concern with the registered manager. Some individual staff showed kindness and compassion. Feedback about staff and the care people received was mostly positive.

People did not receive person-centred care because daily routines were task orientated and determined by staff with little choice being offered to people. People were up early, went to bed early and their meals were served early. People's care needs were not identified, recorded, and highlighted in care plans. People sat for long periods with no stimulation and activities were not planned. People were supported to maintain relationships with family and friends; visitors told us they were welcomed. The provider had a system for dealing with complaints and concerns. A concerns record showed when issues were raised they were dealt with appropriately. Action was taken to investigate and resolve the concern.

The provider's quality management systems were not effective and did not identify areas where the service had to improve. The provider and registered manager did not demonstrate they understood their responsibilities and accountability. People who used the service, relatives and staff provided consistent positive feedback about the registered manager and provider. A health professional told us always had opportunity to speak with the registered manager.

The provider sent an action plan after the inspection which showed they were addressing concerns raised by CQC.

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 24 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to staffing and staff training, person-centred care, treating people with dignity and respect, assessing and managing risks to individuals, management of medicines, recruitm

Inspection areas

Safe

Inadequate

Updated 10 January 2020

The service was not safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 10 January 2020

The service was not effective.

Details are in our effective findings below.

Caring

Inadequate

Updated 10 January 2020

The service was not caring.

Details are in our caring findings below.

Responsive

Inadequate

Updated 10 January 2020

The service was not responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 10 January 2020

The service was not well-led.

Details are in our well-Led findings below.