Archived: Broomfield Grange

We spoke with four people who used the service. We were unable to speak with some people directly due to their complex needs; however we used a number of different methods, including looking at their records and observed the support provided by staff, to understand their experience of the service. People told us that they felt safe and relaxed with staff, they all said they had no complaints about their care but if they had concerns they would tell the manager.

We found that the service had systems in place to protect vulnerable people from the risk of abuse. We found that staff were aware of whistleblowing procedures and clearly described to us what whistleblowing was and when they would need to use this procedure.

We found that the service had improved the management of health and safety at the service. There were clear procedures in place for the management of Legionella, equipment was now being maintained to an acceptable standard, and equipment required to provide care was now readily available.

We found there were sufficient staff to care for people at the service. Staff were trained and supported appropriately to develop skills and attitude to provide effective care. The provider had improved the guidance to staff on promoting people's dignity and caring for people living with dementia.

The provider had restricted the admissions to the service, and was implementing an improvement plan, in order to develop staff and systems to ensure a safe service was being provided. In addition there had been investment in temporary management support and a new manager of the service had been appointed. Although the provider had implemented additional systems and checks of aspects of quality we found that some risks to people's safety had been overlooked.

We spoke with five relatives of people who used the service who told us that they had seen some improvements but expressed anxieties in relation to the changes that had taken place with people being moved from the first to the second floor without being asked. Two relatives on the ground floor informed us that things had improved. One relative told us they felt their relative's care had improved and they were less concerned.

We found that people were not always being supported to move in a safe manner in the service. We observed poor moving and handling practices which placed people at risk from harm.

There was not sufficient numbers of skilled and experienced care staff to meet all the needs of people at Broomfield Grange. We observed insufficient numbers during our inspection and we found some people were at risk.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place for the safe storage, administration and recording of medicines. There was insufficient guidance for staff on the use of some medicines.

This visit took place following receipt of information of concern and to see if any improvements had been made.

At this time the service was being closely monitored and supported by the local authority and the local Clinical Commissioning Group.

We spoke with three relatives who told us that they had seen some improvements but expressed anxieties in relation to the high use of agency staff and continued lack of permanent and experienced care staff. They felt this had a direct impact on the quality of care their loved one received.

We saw improvements in outcomes for some people using the service who were more independent. They were positive about the home and the care staff. However people with high dependency needs, complex and dementia related needs did not always experience care, treatment and support that met their individual needs and protected their rights. We found some people socially isolated. There was a lack of meaningful interaction and engagement with people living with dementia and as a consequence they became very distressed and agitated.

There was not sufficient numbers of skilled and experienced care staff to meet all the needs of people at Broomfield Grange and at key times we found some people were at risk.

The provider did not have effective systems in place to improve the quality and safety for people using the service.

As part of our ongoing regulation of the service we received information from family members, the local authority and the Mid Essex Clinical Commissioning Group which raised concerns about care not being delivered how people using the service would like it and how their dignity was not respected.

People did not always experience care, treatment and support that met their individual needs and protected their rights. People's dignity and independence was not always respected and people's views were not taken into account in the way their care and support was provided. There was not sufficient numbers of skilled and experienced care staff to meet all the needs at Broomfield Grange.

We found that steps had been taken to improve the hygiene and cleanliness of the home and the quality of the food.

People's dignity was not always maintained and people and their relatives described instances of poor staff attitude that was disrespectful. One person told us: 'It's ok here but actually I am disappointed overall. The attitude of the staff is not good. Some are good and others don't care whether they care for you or not, I was really surprised. It's nice to have a room of your own but you want the care as well.'

We found that people's health care needs were addressed however care was not provided in a way that met people's individual personal and social care needs. There was very little stimulation and engagement with people to promote their well being, particularly people living with dementia.

Although some people said that the food was good; others found difficulty in eating the choices offered.

Appropriate levels of competent staff were not always in place to meet people's needs. Staff told us that they needed more in depth training to enable them to meet the needs of people living with dementia.

Although the premises were of a good standard we found that there were not sufficient arrangements in place to clean furniture; chairs were unclean and smelt of urine.