7 October 2021
During an inspection looking at part of the service
Broadlands nursing home is a residential care home providing personal and nursing care to 13 people aged 65 and over at the time of the inspection. The service is registered to support up to 25 people. However, currently their maximum occupancy is 18 people as they are only offering rooms for single occupancy in response to the COVID-19 pandemic.
People’s experience of using this service and what we found
There were not sufficient staff to meet people’s needs. Copies of rotas and feedback from staff confirmed that at times the service was not staffed at the provider’s assessed level to support people’s needs, particularly at night. People fed back that they felt there were not enough staff to provide them with timely support.
Staff were not up to date with their mandatory training and the staff did not feel adequately supported. The staffing pressures at the service impacted on the ability of staff to undertake their required duties.
Risks to people’s safety were not adequately assessed and mitigated. This included environmental risks such as the risk of falling from height from an unrestricted window, the risk of burns from freestanding heaters and the risk of poisoning from access to harmful chemicals. People’s care records did not provide clear and accurate information about how to support people to manage individual risks, and we saw that one person was not supported to reposition as frequently as their care plan stipulated to reduce the risk of pressure ulcers developing.
There were systems in place to review the quality of service delivery. These systems had identified some of the concerns we found during inspection. This included some of the environmental risks and lack of compliance with the provider’s mandatory training. However, action had not been taken in a timely manner to address these concerns. In addition, the checks had not identified all of the concerns we found during inspection. Therefore, we could not be assured that the systems in place were adequate to review the quality of all areas of the service and ensure people’s safety.
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. Staff involved people in their care. They were aware of what decisions people had the capacity to make and supported them in line with their preferences. We observed staff providing support in a caring and compassionate manner. Staff supported people to access healthcare services and to ensure their nutrition and hydration needs were met. Safe medicines management practices were in place and people received their medicines as prescribed.
Staff were knowledgeable of safeguarding adults procedures and reporting processes should any incidents or accidents occur. Staff adhered to government guidance about how to protect people from the risk of infection in relation to the COVID-19 virus. There was a commitment within the staff team to improve practices and provide high quality care, but some of the systems in place at the time of inspection were creating barriers to this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 November 2017).
Why we inspected
We received concerns in relation to staffing levels, staff training and management arrangements. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment, staffing levels, staff training and governance at this inspection. Please see the action we have told the provider to take at the end of this report. 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 request an action plan from the provider to understand what they will do to improve the standards of quality and safety. 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. If we receive any concerning information we may inspect sooner.