Archived: Brookside Care Home

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found from speaking with people, observation and looking at care records that people's safety and welfare was not ensured and their individual needs were not always met. This included a risk of people not receiving their medication safely.

We found some improvements in the maintenance of the building and in the systems for checking for repairs required. However, there were still outstanding issues from our last inspection. Also, the systems in place did not always identify items for repair that we found during our visit.

The provider did not have a robust recruitment process to ensure people were cared for by staff who were of good character.

Is the service effective?

We found improvements in staff training as most staff were up to date with mandatory training. However, there was no evidence of specific training for staff to safely and correctly support a person with administering insulin.

People told us they did not have choices at mealtimes and were not always offered drinks and snacks during the day.

Is the service caring?

People gave us mixed views about the care they received in the home. One person said, 'They are looking after me well. They are alright." However, this person went on to say, 'They don't always speak to me with respect; sometimes they're not very nice.' We heard similar comments from other people.

From our observations during the inspection we found that staff did not always treat people with dignity and respect.

Is the service responsive?

We found that people were not always supported to make choices about their daily lives. Opportunities for people to participate in recreational activities were limited. People did not always have free access to the garden.

People told us they were reluctant to make complaints about the service.

Is the service well- led?

People had limited opportunities to express their views about the service they received.

Staff had not received adequate supervision to ensure they were able to deliver care and treatment safely and to an appropriate standard.

The systems for monitoring the quality of care and managing risks to people's safety and welfare were not effective.

Records were not always accurate or up to date and could not always be located promptly when needed.

One person told us "It's alright here. The staff are ok". Another person said "It's fine here. I haven't got any concerns". However, other evidence showed that people's safety and welfare was not ensured and people's individual needs were not always met.

We found that the provider was not carrying out appropriate, suitable or timely maintenance to the premises. There were a number of issue identified relating to broken or poorly maintained windows, risks of scalding and other potential hazards.

Staff were not receiving training required for them to provide care and support to people safely. There did not appear to be any structure to the provider's training plan and necessary training was not being organised.

The provider did not have effective systems to regularly assess and monitor the quality of the services provided. At our previous inspection in August 2013 we found that the provider had not met three essential standards of quality and safety. We told the provider to take action. At this inspection we found that the provider had not taken sufficient action to meet the same three standards.

Important events affecting the health, safety and welfare of people using the service had not been reported to the CQC as required.

People were not protected against the risks of unsafe or inappropriate care because the provider was not keeping accurate records.

Although we found an improvement in maintenance issues, we found that the provider was not carrying out appropriate, suitable or timely maintenance to the premises. There were still issues with windows needing repair and radiator covers not being attached to the wall.

Staff were not receiving training required for them to provide care and support to people safely. Although we could see that more training was being provided, no staff were suitably trained in first aid.

The provider did not have effective systems to regularly assess and monitor the quality of the services provided. The provider had implemented further audits and checks, however issues were not being identified or the paperwork not being completed.

People were not protected against the risks of unsafe or inappropriate care because the provider was not keeping accurate records.

We saw that records were being kept securely however they were still not accurate or fit for purpose.

We saw that people were receiving their medicine when prescribed. We also saw that medicine stock levels were accurate and the provider had appropriate procedures in place for controlled drugs.

We found that the provider was not carrying out appropriate, suitable or timely maintenance to the premises. There were a number of issue identified relating to the electrics in the home, risks of scalding and other potential hazards.

We saw that there were sufficient staff to meet the needs of people using the service. People using the service said that the staffing levels were fine.

Staff were not receiving training required for them to provide care and support to people safely. There did not appear to be any structure to the provider's training plan and they were many gaps on the training matrix.

People's personal records were not kept securely by the provider. Records containing personal information was not locked away and was easily accessible by anybody in the home.

At our last inspection people told us told us they had concerns regarding communication with staff, and the food offered at Brookside care home. People told us they had concerns about the level of choice about how to spend their day and independence people had at Brookside care home. They told us they did not have any concerns regarding the management of medication for their relative and felt they could raise any concerns with the manager.

The people we spoke with told us they had concerns about the maintenance and repair of Brookside care home

We found that the provider had made improvements since our last inspection and people were experiencing care that met their needs. We found that quality and choice of food had improved and the building was well maintained. We saw that concerns we raised regarding administration had been addressed.

At the time of that visit we used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

We also spoke with the relatives of two people using the service they told us they had concerns regarding the maintenance of the building.

During this inspection we saw the provider had taken steps to address the concerns we raised at our visit in September 2012.