Brookview 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 inspection we rated this key question as Good. At this inspection the rating has remained Good. This meant people were safe and protected from avoidable harm.

At our last inspection we rated this key question Requires Improvement. There had been a breach of regulation. This related to the provider failing to ensure all the premises and equipment used for the purposes of people's care was kept clean and secure. That it was suitable for the purpose for which they are being used, as well as being properly used and maintained.

Improvements were found at this inspection, and the rating has improved to Good. The provider was no longer in breach of this regulation. This meant people were safe and protected from avoidable harm.
 

This service scored 75 (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.

People were encouraged and supported to raise safety concerns with the provider. The manager and staff understood the importance of reporting safety concerns and learning lessons when things went wrong.

Systems were in place to support staff to report and record safety concerns and events when they arose. The manager investigated safety concerns and events and used the learning from these to support staff to continually improve their practice, reduce risk and keep people safe.

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 could not accept new placements of people moving into the care home at the date of the inspection but was in discussion with the Local Authority about beginning to accept new referrals again in the future.
The provider had an appropriate process for new referrals, obtaining a copy of the person’s initial assessment, and then carrying out their own assessment of need, before deciding whether they would be able to provide support. There was an electronic care record system in place, which care staff had access to. This helped ensure people’s care was provided in a planned, responsive and organised way.
People were listened to by the provider’s staff when their initial care plans were being created. This helped ensure people were supported to receive continuity of care when they started receiving care from this service.
The provider had policies and procedures in place which reflected best practice in terms of assessing people’s safety and effective ways of working.
 

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.
People told us they felt comfortable when staff interacted with them. A person’s relative told us, “As a family we haven’t come across any incidents which would make us feel my [relative] wasn’t safe, and all members of staff have been friendly and sympathetic to [person’s] needs.”
Staff used respectful language when describing people and their care needs. The provider had a comprehensive safeguarding policy and procedure in place, which included consideration of sexual safety and online safety. Staff received regular safeguarding training.
People also had access to people outside of the service with whom they could raise concerns about their safety if necessary. For example, social workers, other visiting health care professionals, and family members.
The provider carried out investigations into any incidents which occurred while providing a service to people. They also co-operated with safeguarding enquiries carried out by the Local Authority. The provider’s investigation findings were used by the manager to identify any lessons learned and actions to be taken to ensure people were protected from abuse.

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.
The provider reviewed any incidents for recurrent trends or triggers. Information was shared with the staff so support arrangements could be changed to reduce recurrences. People were involved in deciding how their individual risks would be managed and mitigated.
People’s individual risks were regularly assessed, and people were supported to make choices and maintain as much independence as possible. For example, a person told us, “I'm not a mixer, I go downstairs for my breakfast, but then I like to be here in my room. I like to do my own thing. I am not interested in doing things with other people really.”
People’s care plans detailed how to support them with their complex care and health needs. The provider’s staff did not use restraint techniques when people became distressed or upset. Instead, staff used distraction techniques to positively support people and keep them safe.
People’s individual risks were identified and assessed in their care plans. Care plans were regularly assessed and amended when people’s needs changed or when they changed how they wanted to receive care from staff.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
At the previous inspection we found the provider failed to ensure the care home premises and equipment were kept clean and well maintained. This was a breach of regulation and placed people at a potentially increased risk of harm. At this inspection we found the provider had made improvements to their arrangements for hygiene and maintenance at the care home. The provider was no longer in breach of regulations.
People were cared for in a safe environment which had been adapted and built for use as a care home. Facilities and equipment were now well-maintained and supported staff to deliver safe and effective care.
The provider had standard environmental safety assessments in place to identify any potential risks in the care home which may have an impact on people or the care staff. Issues requiring action were logged by the provider on their continuous improvement plan, so progress could be tracked.

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

At the previous inspection we found the provider failed to ensure staff received the necessary training, support and supervision, for their roles and responsibilities. This was a breach of regulation and placed people at a potentially increased risk of harm. At this inspection we found the provider had made improvements to their staff training arrangements. The provider was no longer in breach of regulations.

The manager had an effective programme of appropriate staff training in place, and staff told us they received the training they needed to support people safely. Staff received training to ensure they could meet people’s needs. This included training related to health conditions.

The manager encouraged staff to develop their skills and knowledge. A staff member told us, “If you complete training outside your working hours you will be paid for that time. The management team are also very encouraging about future development if staff want it.”

The manager ensured enough suitably trained and experienced staff were rostered on duty to meet people’s assessed care and support needs. When agency staff were required, the provider used regular agency workers who knew the person they would be supporting well. Where instances of staff poor performance were identified these were dealt with appropriately by the provider.
The provider had robust and safe recruitment practices in place to make sure all staff, including agency staff, were suitably experienced, competent and able to carry out their role.

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.

There was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. The provider had an infection prevention and control (IPC) policy and procedure in place, which staff had access to.
The provider’s IPC policy and procedures set out the clear roles and responsibilities around infection prevention and control. The provider ensured their staff had access to the necessary personal protective equipment (PPE) to support effective hygiene and infection prevention.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People were involved in decisions about their medicines, and their medicines were appropriately prescribed, supplied, stored, and administered in line with the relevant legislation.
People’s prescribed medicines were regularly reviewed by external medical professionals as part of their individual health care support.

The provider had appropriate arrangements in place for the safe management, use and oversight of controlled drugs. The provider carried out regular medicines audits which were used to check compliance with the provider’s medicines policy and procedures. Any medicine errors were investigated by the provider and dealt with appropriately. The manager notified the Local Authority and any other relevant external bodies when necessary.
People had up-to-date information about their medicines available in their care plans and the provider’s medicine records.