Brownlands 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 remained good.

Good: This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Processes were in place to investigate, review and respond to accidents and incidents. The registered manager carried out investigations and shared learning with staff to help prevent similar issues happening again. Staff told us that lessons learned were discussed during supervisions and team meetings.

Records showed safeguarding referrals were made when needed, and appropriate action was taken. The provider had a safeguarding lead to support this process.

People and their relatives told us they felt able to raise concerns and were confident these would be acted on. One person said, “If I mention a concern, the manager will act immediately.”

There was an open and transparent culture, and staff felt confident to report incidents and safeguarding concerns.

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.

The provider had systems in place to support safe admissions and transitions into the home. Pre-admission assessments were completed with people and their families before moving in. These were detailed and ensured the service could meet people’s needs.

Staff worked closely with health and social care professionals to ensure good communication and that people received timely care and treatment.

People had personal emergency evacuation plans (PEEPs) in place. These were kept in an emergency evacuation bag and were available to support safe evacuation in an emergency.

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.

The provider had appropriate safeguarding policies, and procedures in place. People appeared relaxed and comfortable with staff. People and their relatives told us they felt safe and would raise any concerns. One relative said, “I have no concerns about my relative’s safety.” Another said, “My relative has only been here a few weeks, but we already feel they are safe.”

Systems were in place to record, report and monitor safeguarding concerns, including Deprivation of Liberty Safeguards (DoLS). Concerns were recorded clearly, reported promptly and actions were taken to reduce risks and protect people from harm. The service worked closely with the local authority safeguarding team and responded appropriately to concerns.

Where people lacked capacity to consent to care or treatment, the provider applied for DoLS in a timely way to ensure people were protected.Staff had received safeguarding training and felt confident to report concerns. One staff member said, “If I see any concern, I can report it to the manager, and I know they will take action.”

The provider generally worked well with people to understand and manage risks. However, some practices were not always fully person-centred, which meant individual risks were not always clearly assessed.

During the inspection, it was noted that seatbelts were not used when people were moved in wheelchairs, and individual risk assessments had not been completed to support this approach. As many people had high care needs and were at risk of falls, this may not fully reflect individual risks. The registered manager confirmed this had been reviewed and that person-centred risk assessments would be completed.

Some items in the first aid kits and body fluid spillage kits were found to be expired at the time of inspection. This indicated that checks were not always effective.

This was raised with the Registered Manager, and immediate action was taken to remove and replace the expired items during the inspection.

Staff received training in areas such as moving and handling, equipment use, first aid and health and safety. They were attentive to people’s safety and supported them to move around the home safely using appropriate equipment.

Staff knew people well and understood how to manage risks while respecting their dignity. They recognised signs of pain or discomfort, especially for people living with dementia, and provided support in line with care plans.

Referrals were made to healthcare professionals when needed. For example, people at risk of malnutrition or dehydration were referred to a dietitian based on their Malnutrition Universal Screening Tool (MUST) scores. Assistive technology, such as sensor equipment, was used to alert staff when people at risk of falls were moving around.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Health and safety checks were carried out regularly and were up to date. Fire safety procedures were in place, with clear signage throughout the home to help keep people safe. There was an emergency action plan in place for situations such as evacuation. This included fire drills and personal evacuation plans, which helped staff support people safely.

The home has been renovated in communal areas, including redecoration and new carpets. Bedrooms are being redecorated as they become vacant.

Several raised door threshold strips were noted, which could increase the risk of trips, especially for frail people and those using Zimmer frames. The provider was aware of this and had plans to address it. After this was highlighted during the inspection, a risk assessment was completed, and plans were put in place to slope the edges to reduce the risk.

There were systems in place to help ensure the environment and equipment were safe and well maintained. Regular checks were carried out, including making sure wardrobes and large furniture were secured to the walls. Equipment used for care was easily accessible and stored safely when not in use.

The provider also had business continuity plans in place to manage emergencies, including outbreaks, loss of power, fire, and other unexpected events. These plans helped ensure people’s safety and continuity of care during challenging situations.

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.

On the day of our visit, there were enough staff to support people safely, and the home had a calm atmosphere.The provider used a dependency tool to decide staffing levels based on people’s needs. This was updated when needs changed or new people moved in. Staffing levels were generally in line with this, and arrangements were mostly safe and effective. Relatives were positive about staffing, and staff interactions with people were kind and respectful.

Staff feedback about working at the service and management was mostly positive. However, some staff said that staffing can feel tight or stretched during late and night shifts. This was shared with the registered manager, who said she will speak with staff and review staffing levels if needed.

Supervisions, competency checks, and training were in place, with high compliance. The registered manager addressed any gaps promptly. Staff completed essential training, including safeguarding and moving and handling, and attended regular refreshers. New staff followed an induction programme with training and shadowing.

Agency staff were used when needed. Their profiles and induction records were available and up to date.Safe recruitment practices were followed. Staff had appropriate references and Disclosure and Barring Service (DBS) checks.Nurses had valid and up-to-date PINs, confirming they were registered to practise.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had effective infection prevention and control (IPC) policies, which staff could access. IPC practices were followed, and the home was clean, well maintained and free from unpleasant odours. Although the building was older and adapted, all areas used by people were visibly clean.

Staff used appropriate personal protective equipment (PPE), such as gloves and aprons, when providing care. They followed good hand hygiene practices to help prevent the spread of infection. Staff told us there were enough PPE supplies and cleaning materials.

Housekeeping and laundry staff worked hard to maintain cleanliness. Records showed that daily, weekly and monthly cleaning checks were completed. Food was stored safely, labelled and within expiry dates.

Medicines and treatments were mostly managed safely. However, some improvements were needed to ensure this was consistent.

Staff who administered medicines had received training, and their competency was checked by the registered manager. Staff we spoke with showed good knowledge of safe medicines practice. The medication room and fridge were clean, and fridge temperatures were recorded and within the correct range. Returned medicines were recorded and returned to the pharmacy. Medicines were reviewed regularly, and MAR charts were completed correctly. As required medication (PRN) records included reasons for use and whether the medicine was effective. Regular audits were carried out, and controlled drugs were checked weekly.

However, checks identified some concerns with stock control and storage. There were discrepancies in medication quantities, including missing tablets and extra stock. A discontinued medicine had not been removed from the trolley.We also found issues with creams and storage. Some creams did not have opening dates, and one item prescribed for short-term use was still in place after several months.These concerns were raised with the registered manager, who took immediate action and confirmed that they will ensure better practice going forward.