Brooklands Homecare Ltd - Edenbridge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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 make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The provider did not always effectively assess, review and record people’s needs and risks in a timely way when these changed. While initial assessments were usually completed with people and their relatives, care plans and risk assessments were not consistently updated as needs evolved.

For example, a person developed a pressure sore and district nurses altered the way they needed to be positioned, but the care plan and moving and handling assessment were not updated. We fed this back to the provider who took action to update the persons records.

People and relatives told us staff had visited them before care started and involved them in drawing up plans. A relative said, “They assessed the property and [completed a] detailed assessment of [relative’s] care needs and medical history.” Staff described a clear process for new packages, including home visits, care plans and risk assessments in ‘blue folders’ kept in people’s homes.

Although staff knew people well and adapted care day‑to‑day and people felt included in their care planning, the lack of consistently updated assessments and risk management meant there was a risk that important changes in need could be missed or not communicated to all staff.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider did not always ensure care and treatment followed evidence‑based guidance and its own policies, particularly in relation to medicines. Medicines management was not consistently in line with the provider’s medicines policy or NICE guidance for adults receiving social care in the community which placed people at risk of harm. This has been reported on under the Medicines Optimisation Quality Statement in further detail.

Some condition‑specific risks such as epilepsy, breathing difficulties and catheter care were not assessed and only documented following inspector feedback. Where care practice was strong, it was often due to individual staff rather than embedded systems.

Despite these findings, people and relatives said staff looked after their health well, monitored skin and mobility and reported concerns. A relative told us, “[Staff] reported [a health concern].[Staff] also record it in the log and I read it daily.” Another relative highlighted staff noticing signs of infection and recording this promptly. A person said, “I couldn’t ask [staff] for anything more.” Staff described using nationally recognised tools such as Waterlow pressure risk tools, air‑flow mattresses and specialist equipment such as hoists, and seeking input from district nurses and GPs when they identified issues.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider made sure staff worked well together and with professionals, so people usually received coordinated, effective support. There were some examples of positive partnership working and continuity of care. A relative told us, “The staff are very professional about [overlapping care with other professionals].”

Staff told us they felt part of a small, supportive team where office staff stepped in to cover care calls when needed and communication flowed through regular contact, and instant messaging groups and handovers. They described the culture as friendly and open, and said they would feel able to raise concerns. A staff member said, “We work really well, we all communicate and work as one.”

A professional told us, “I speak and meet with the team when reviewing [people] they support. My interactions have always been very positive.” Leaders requested reassessment when packages of care were no longer sufficient. Staff described good relationships with district nurses and GPs, including direct contact to escalate skin, mobility or catheter concerns.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The provider did not always use a structured, proactive approach to support people to maintain and improve their health and wellbeing, although individual staff promoted independence and healthy choices in day‑to‑day care. Systems to monitor and act on changing health risks were not consistently robust. Risk assessments and care plans did not always give staff clear, proactive guidance about how to reduce longer‑term health risks. Examples included diabetes plans that did not fully link diet and fluid advice to risk.

However, staff supported people with food and drink, checking what they had eaten and leaving drinks between calls. People said they were offered choices and that staff reminded them to drink. Concerns with people’s care such as medicine issues or reports of skin changes were not always reported to the office. The lack of systematic monitoring and condition‑specific guidance meant the provider could not be assured they were consistently helping people to live as healthily as possible.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. However, staff had ensured that outcomes were positive, and that they met both clinical expectations and the expectations of people themselves.

The provider was behind their schedule for monitoring people’s care notes and MAR charts. This meant the provider lacked oversight of the service’s performance to achieve positive outcomes for people and had not identified issues with people’s care that we found at this inspection. They had begun to strengthen governance where gaps were identified but further work was required to bring monitoring up to date and ensure the newly established systems were effective in consistently ensuring safe and positive outcomes for people.

Despite this, people, relatives and professionals described good outcomes from care provided by staff. Positive outcomes included improved mobility, reduced anxiety and people being able to remain at home. A professional had complimented the service stating, ‘what a fantastic job the staff are doing with [Person’s name], the difference in [Person’s name’s] capabilities is amazing.’

Although the provider had not always effectively monitored people’s care to ensure the care they received was as care planned and in line with guidance from professionals; the provider had monitored people’s satisfaction with the service. Telephone monitoring in March 2026 showed all 18 respondents would recommend the service and largely scored it 5 out of 5.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider did not always ensure people’s consent to care and treatment was obtained and recorded in line with legislation and guidance. In several cases, consent to care and support forms were old or unsigned, and the branch manager reported “carrying consent over” year‑on‑year without clearly reviewing this with people. Mental capacity assessments and consent records lacked consistency. For example, 1 person’s medicines mental capacity form indicated a person had capacity, while a best‑interests decision section was also ticked, suggesting staff were not always applying the MCA framework correctly.

However, staff we spoke with understood the general principles of the Mental Capacity Act 2005 and told us they assumed people had capacity unless proven otherwise. They described encouraging people with dementia to make choices about day‑to‑day matters such as clothes or personal care and seeking family input where people struggled to decide.