Brooklands 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 assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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.

The service worked proactively with people to learn from experiences and continuously improve practice. Investigations were carried out following accidents and incidents, with time taken to reflect on the circumstances and identify any learning. Where learning was identified, this was shared with staff using a range of methods depending on the urgency and nature of the information. This included the distribution of memos, direct discussions with individual staff members where appropriate, and the sharing of wider learning during team meetings. Staff shared with us how lessons were learned, a member of staff said, “Management discusses incidents in staff meetings or handovers to prevent reoccurrence. For example, if a resident has a fall, the risk assessment is updated, and staff are informed about new mobility support measures.”

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 completed pre-admission assessments to determine whether the home could meet people’s needs. These assessments helped staff understand people’s needs and preferences, informed care plans and risk assessments, and were completed in partnership with people and their relatives.

When people needed to attend hospital, the service provided a hospital passport to help ensure important information about their health, care and communication needs travelled with them. Staff told us people's needs were communicated effectively when they moved into the service or returned following a hospital stay. One member of staff said, “We are kept up to date through handovers, care plan updates, staff meetings and daily communication. Any changes to people’s needs are clearly communicated to us in good time so we can provide the right care and support.”

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.

The people we spoke with all said they felt safe living at the service. When asked if they felt safe, one person told us, “I feel safe here because staff come in and see me and I feel I am looked after well.” Another person said, “I do feel very safe here because there are people around and everyone is so kind.”

The service had effective safeguarding systems and processes in place to protect people from abuse, neglect, harassment and breaches of their dignity. Safeguarding information was clearly communicated to people, staff and visitors. Staff demonstrated a good understanding of how to recognise and report concerns and were confident in raising issues with the registered manager. They also understood their responsibility to escalate concerns where necessary and were aware of external reporting routes, including local authorities, and the Care Quality Commission (CQC).

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found the registered manager understood their responsibility to make DoLS applications when required and did this in conjunction with people’s relatives and advocates.

The provider did not always work well with people to understand and manage risks. Although some risks had been identified and assessed, we found some people were living in shared bedrooms and there was limited documentation around this. Records did not clearly demonstrate how people's needs, preferences, dignity and compatibility had been considered, or whether these arrangements were subject to ongoing review.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. We reviewed a range of records relating to the safety and maintenance of the environment and equipment, including fire safety documentation, portable appliance testing (PAT) records, and electrical installation certificates. Staff had received appropriate health and safety training, including fire training.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs; however, the provider did not always carry out comprehensive pre‑employment checks.

Recruitment checks had been completed, including Disclosure and Barring Service (DBS) checks. DBS checks provide employers with information about any convictions or cautions held on the Police National Computer to support safer recruitment decisions. However, staff files did not always include a full employment history and had not always been cross references with peoples references to ensure they matched. This limited the provider’s ability to fully demonstrate that staff were suitable and safe. The management team addressed this and investigated the gaps identified when we fed this back to them.

Staff were supported to provide safe care through a structured programme of induction, regular supervision, and annual appraisal. Training relevant to each staff role was provided and competency assessments were regularly carried out to ensure staff maintained the knowledge and skills required to meet people’s needs.

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. Staff had completed appropriate infection prevention and control (IPC) training and had access to personal protective equipment (PPE) which was readily available throughout the service. Communal areas, bathrooms and people's bedrooms we viewed appeared clean.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Staff who administered medicines had received appropriate training and their competency was regularly assessed to ensure medicines were managed safely. During our inspection, we observed a medicine round and found medicines were stored in line with current best practice guidance and administered safely and as prescribed.

PRN (when required) protocols were in place for people who required them. However, the level of detail within these protocols varied. Some contained clear, person-centred information to guide staff, while others lacked important information, such as the maximum dose that could be administered within a 24-hour period. This meant staff did not always have consistent guidance to support the safe administration of PRN medicines.