Brookfields Private Nursing Home

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good.

At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have a proactive culture of safety as reviews of accidents and incidents did not always happen in a timely manner. Some, but not all lessons were learnt to continually identify and embed good practice.

Staff reported accidents and incidents and recorded any steps they had taken in response to help reduce risks. Whilst the registered manager told us they would be informed of any incidents and actions taken on the day, formal reviews by leaders to help check that all steps had been taken as appropriate were not always made in a timely manner. We found examples of where not all expected steps had been taken in response to accidents and incidents. This meant actions to ensure lessons were learnt and to identify and embed good practice were not always taken in a timely manner.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were helped to settle into their home when they moved in, and staff knew about their care needs. One relative told us, “We were recommended Brookfields by the palliative care nurse in hospital. From our very first enquiry with the care home, they welcomed us to visit that same day. I met with the manager, and she took a really detailed scenario.”

Referrals to other health care services were made when needed and people were reviewed regularly by the visiting community matron and GP.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately, however some aspects of care planning regarding the Mental Capacity Act (MCA) needed improvement and these improvements were being implemented.

People told us they felt safe. One person said, “Yes, I do feel safe. Definitely. From the day I came up the drive, I was welcomed. It’s absolutely amazing. The staff can’t do enough for you.” Staff understood how to check for any signs of potential abuse and how to report these. Records showed people were asked if they would like to make a safeguarding referral if something had gone wrong.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The provider had a system to track when people required a Deprivation of Liberty Safeguard. However, some aspects of care planning in respect of the MCA needed improvement, for example not all potential restrictions had been assessed in people’s mental capacity assessment care plans. Whilst there was an action plan in place to address these improvements, these had not been fully embedded at the time of our assessment.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People felt staff understood how to care for them and to keep them safe. One relative told us, “My [family member] has been here for a few months now and I do feel that they are safe. The buzzer is really effective. Staff seemed well briefed when they moved in and I’ve been involved in their care plan.”

Care plans and risk assessments helped to identity any risks to people and how to reduce these. Staff we spoke with were knowledgeable on people’s care needs and how to help reduce risks.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

We found some risks in the environment. Some cleaning products were found in communal bathrooms and unlocked sluice rooms.

Safety checks were in place to help reduce the risks from fire. Other safety features such as window restrictors and wardrobes secured to walls were in place to help reduce other risks in the environment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us there were enough staff to help them with their care needs. One person told us, “I’ve felt safe from the moment I arrived. Staff are everything. I have a buzzer and I can get help whenever I need it and I haven’t had to wait when I’ve rung for help.” A relative added, “Whenever we visit, there are always lots of staff around. You can tell who does what and there’s certainly always consistent faces.”

Checks had been completed when staff were recruited to help the provider appoint staff who were suitable to work in at the service.

The provider did not always assess or manage the risk of infection relating to the storage of Personal Protective Equipment (PPE).

We found improvements were needed to the storage of Personal Protective Equipment (PPE) used by staff when providing care to people. The current arrangements were not in line with either the provider’s policy or the recommendations from an infection prevention assessment tool audit completed by partner agencies. This shortfall had not been effectively identified through the provider’s audits.

People were happy that their home was clean and well-maintained. One person told us, “My room is kept nicely. They empty the bins every day and check the bathroom. They hoover a couple of times a week or whenever it needs it really.” A relative told us, “Whenever we visit, we always see cleaners coming in and out. The rooms are always clean and smell fresh.”

The provider did not always make sure that medicines management practices were safe.

Some medicines had been left unattended in a communal area. We found unlabelled topical medicines had been left in a communal bathroom. This meant medicines were not always stored safely. Whilst we did not see any people unaccompanied without staff present on the day of our assessment, these potential risks had not been effectivelyidentifiedthrough the provider’s audits and day to day checks.

The service had been working with partner agencies to improve their medicines management. Our checks showed improvements had been made and medicines administration records were following with good practice.

People told us staff knew about the medicines they needed. One person told us, “When I arrived, the staff seemed very well informed. The nursing team soon got to know my medication and what problems I have. Staff here did talk to me about my medication so yes, I do know what I’m having and why.”