Broxbourne Nursing Home

Broxbourne Nursing Home is a purpose-built residential care home providing personal and nursing care to up to 77 people. The service provides support to older people, some of whom live with dementia. At the time of our inspection there were 26 people using the service.

People’s experience of using this service and what we found

There had been improvements since the last inspection. Work had been completed to minimise risks and use governance systems more robustly. Good progress had been made with the action plan developed by the provider after the previous inspection. People, relatives and staff told us they felt there had been improvements.

We found that while risk management and safeguarding was more effective, there were still some areas of practice that needed to be embedded to ensure the improvements were sustainable. We found there had been an issue with a person’s ‘as needed’ medicines, ensuring a person ate foods that did not impact on their heath and whether pressure care mattresses were consistently checked appropriately. However, the management team’s response to these points assured us that robust systems were in place.

People and their relatives told us they were happy with the care provided and living at the service. They told us they felt safe. Infection control was promoted and medicines were managed well for the most part.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to eat and drink well and choose how they spent their days. The building was decorated nicely and people had access to ample communal areas and a pleasant garden which was in use on the day of our visit.

Activities were available and people told us they enjoyed these. The provider had systems in place to aid communication between people and staff.

Complaints systems were used and people and their relatives told us they could speak up. There were meetings and contact with people, relatives and staff to get their views. Feedback was collated and shared.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was inadequate (published 12 January 2023) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 12 January 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from inadequate to good based on the findings of this inspection.

We have found evidence that the provider needs to make some further improvements. Please see the safe sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Broxbourne Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Broxbourne Nursing Home is a residential care home providing nursing care to up to 77 people. The service provides support to elderly people some of whom may live with dementia. At the time of our inspection there were 33 people using the service.

Broxbourne Nursing Home is a purpose-built, nursing home. The environment is adapted to meet the needs of people who live with a physical or sensory disability over two floors. Bedrooms and communal areas are spacious and comfortable for people to spend their time.

People’s experience of using this service and what we found

People told us they felt safe living in the home. However, we found that safeguarding concerns were not always investigated or reported to the local authority. Incidents and accidents were not thoroughly analysed and further measures to mitigate risk of re-occurrence not considered.

People were not always admitted into the home safely. Pre-admission assessments were not thoroughly completed to ensure people’s needs could be met safely. Care plans were incomplete and lacked detail and guidance for staff to know how to keep people safe and in good health.

Checks were not in place to assess staff’s understanding following the on-line training they completed. Practical training sessions were not provided for training such as moving and handling people safely. This meant staff had not had the opportunity to practice how to safely support people with equipment such as a hoist. Staff had not received regular one to one support to discuss their performance and review their work practices.

People were not always supported in a kind way. Whilst staff were kind and compassionate towards people, they had insufficient details and guidance in place to enable them to support people in a kind way. The care and support people received was not person centred. People’s likes and dislikes were not considered when their care and support was planned and delivered. People were bored due to the lack of social activities provision.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The registered manager failed to provide effective leadership and support to enable staff to understand how to provide people with quality care. They failed to maintain an effective oversight of the service to ensure the care and support people received was safe. The registered manager lacked understanding of how to effectively use the provider’s governance systems. As a result, people were put at risk of, or sustained harm. The provider had failed to address consistently poor practice in relation to the management and oversight of the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 09 June 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, risk management and leadership. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found that people were at risk of harm from these concerns. You can see what action we have asked the provider to take at the end of this full report.

The provider took immediate action to ensure people were safe. They stopped new admissions into the home, increased staffing and developed a service improvement plan to address areas of concern.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding, safe care and treatment, person centred care, staffing, failure to notify CQC of notifiable incidents, failure to be open and hones about accidents and incidents, and leadership at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.