Gatwick IRC Cluster

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We make sure there are enough qualified, skilled and experienced staff, who receive effective support, supervision and development and work together effectively to provide safe care that meets people’s individual needs.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe systems, pathways and transitions is based on the latest evidence we assessed for the Safe key question.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

At the last inspection we found the registered provider had not ensured that sufficient numbers of suitably qualified, competent, skilled and experienced staff were deployed. Staff did not receive the support necessary to enable them to carry out the duties they are employed to perform. In particular:

There had been minimal staff supervision in 2024 with staff saying that they did not feel supported, were regularly working under pressure and feeling stressed. Additionally, the lack of a primary care clinical lead meant the primary care team lacked guidance and support.

At this inspection we found the clinical supervision offer had improved in both primary care and mental health. Records provided showed that staff were able to access this important aspect of nursing development. Staff were able to choose who supported them with their clinical or reflective practice session and the use of group reflective practices had proven popular. There remained some hesitancy within the staffing group to commit to regular supervision, but we could see work continued to develop and impress the importance of these sessions.

Staff we spoke with were more optimistic and positive about the changes at Brook House. Morale was notably higher which staff put down to more stable leadership which gave structure and direction to the service. Staff were better supported with issues that arose and the opportunity for supervisions and reflective practice.

At our previous inspection, despite efforts to recruit new staff, a high level of vacancies persisted. There had been numerous occasions in 2024 where staffing levels had fallen below the planned levels for primary care nurses, health care assistants and mental health nurses.

During this inspection staffing numbers and skill set had increased. We had found both primary care and mental health had been able to recruit into key positions and staff retention had been more stable. However, the staffing model remained fragile and required ongoing commitment by leaders to ensure staff felt adequately supported to undertake their roles.

We found during our last inspection medicines’ reconciliation for new arrivals was not always carried out within the required 72 hours due to a lack of trained staff to do this. We now found medicines’ reconciliation had improved with the numbers of completed reconciliations within 72hrs ranging between 80-100%. Pharmacy reviewed its performance data and noted the dip in reconciliation efficiency was mostly down to the lack of weekend cover. Additional training to the nursing team on medicines’ reconciliation had been delivered and this will improve the continuity of weekend reconciliations.

Additionally, during the previous inspection, we found patients with unstable, poorly managed long-term medical conditions did not receive the required level of support due to a lack of staff capacity to manage this.

The management of long term medical conditions were much improved at this inspection. We found patients with long term conditions or complex health needs received joined up care. Patients had clear and comprehensive care plans which were personalised with use of vocal translation to ensure the patients understood. Given the fast pace of the centre the long-term conditions team understood the importance of ensuring patients required prompt screening and interventions to have their long-term conditions managed and any medicines prescribed before the patients’ potential removal or release.

Staff did not have the capacity to systematically manage and promote the program of vaccinations at our last inspection.

We found during this inspection a health promotion and vaccine programme had been delivered. Uptake for these vaccines had been mixed due to cultural skepticism, lack of understanding or peer pressure. However, staff took every opportunity to inform and support patients to make informed choices around the vaccinations available. The uptake varied with approximately 80 patients a month choosing to be vaccinated against for example, MMR or Hepatitis.

The judgement for Infection prevention and control is based on the latest evidence we assessed for the Safe key question.

The judgement for Medicines optimisation is based on the latest evidence we assessed for the Safe key question.