29 April 2023
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was completed by 2 inspectors. An Expert by Experience made telephone calls to people’s relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Brooklands Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brooklands Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the Local Authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 7 people who use the service and 9 relatives about their experience of Brooklands Nursing Home. We spoke with 5 members of staff, the registered manager and qualified nurse. We also spoke with a visiting healthcare professional.
We reviewed a range of records. This included 6 people’s care records and 10 people’s medication administration records. We looked at 4 staff files in relation to recruitment, and a further 3 staff files relating to training and supervision records. A variety of records relating to the management of the service, quality assurance information and policies and procedures were viewed.
29 April 2023
About the service
Brooklands Nursing Home is a residential care home providing the regulated activity of personal and nursing care for up to 45 people in a purpose built building. The service provides support to older people and people living with dementia. At the time of our inspection there were 39 people using the service.
People’s experience of using this service and what we found
Whilst some improvements were noted since our last inspection in June 2019, not all risks were robustly assessed or recorded in sufficient detail to mitigate the risk or potential harm for people using the service. Not all information relating to people’s fire evacuation arrangements in an emergency were accurate, up to date or easily accessible. Although the premises was odour free, not all areas of the home environment were clean. Governance arrangements at the service continued to require improvement to ensure improvements were sustained in the longer term. Following the inspection the registered manager forwarded an action plan detailing the steps being taken to make the required improvements.
People told us they were safe. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff demonstrated a basic understanding of safeguarding and how to raise concerns. Whilst comments from people and their relatives relating to staffing levels were variable, the deployment of staff was appropriate. Staff recruitment practices at Brooklands Nursing Home were safe. Medication practices ensured people received their prescribed medication.
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.
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 Requires Improvement [published August 2019].
Why we inspected
We carried out an unannounced comprehensive inspection of this service between 10 and 18 June 2019. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection although improvements were still required, we found improvements had been made and the provider was no longer in breach of Regulations 12 [Safe care and treatment], Regulation 17 [Good governance] and Regulation 18 [Staffing].
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brooklands Nursing Home on our website at www.cqc.org.uk.
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.