We carried out a review of the data available to us about High Broom Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about High Broom Care Home, you can give feedback on this service.
We found the following examples of good practice.
Due to a recent outbreak of COVID-19, the home was closed to visitors unless in exceptional circumstances such as for people receiving end of life care. The registered manager had identified an area of the home to use for visitors when the home was able to open again. There was a separate entrance for visitors which led them into a testing area. The testing area had tape on the floor to indicate where relatives needed to stand to receive their lateral flow test and an area to wait for the results was labelled.
Staff had taken over the role of providing all in-house activities for people. This had included linking with other care homes to play bingo. Staff had also supported people to attend virtual church services. Activities had been adapted to support social distancing. During the outbreak of COVID-19 people were supported with one to one activities in their bedrooms.
Throughout the pandemic, staff kept relatives up to date with changes to government guidance and what was going on in the home. Staff produced a weekly newsletter called the ‘HB Herald’ which kept people and relatives informed of activities, fun events, staff information and actions taken from the Feedback Friday meetings. Feedback Friday meetings were an opportunity for people living at the home to give feedback on various aspects of the service.
The home was clean and hygienic and communal areas had been adapted to support people to socially distance from each other. Staff were wearing personal protective equipment (PPE) in line with government guidance. There were plenty of PPE supplies at the home and this was regularly audited.
Staff had completed a COVID-19 workforce welfare form which was reviewed by the registered manager. This assessed how staff were feeling during the pandemic and allowed the registered manager to provide staff with extra support if needed. Staff had individual risk assessments in place to assess for factors that may increase the staff member’s risk from COVID-19. These risk assessments considered personal details about staff which may impact on their mental wellbeing during the pandemic such as living arrangements, health conditions and being a member of the lesbian, gay, bisexual and transgender (LGBQ+) community. Staff were supported by the registered manager and signposted to external support where needed.
High Broom Care Home is a residential care home providing care and support to 31 people aged 65 and over at the time of the inspection. The service can support up to 38 people. Care and support was provided to people living with dementia and physical disabilities. Support is provided in one adapted Victorian building and in nine cottages that are in the grounds of the service.
People’s experience of using this service and what we found:
Feedback from people and relatives was overwhelmingly positive. They consistently praised the exceptional caring and supportive nature of the staff at High Broom Care Home. Staff talked about people being 'the heart of the service'. Staff demonstrated a culture of inclusivity and positivity that was evident throughout the service. Staff constantly looked for ways to improve the service and ensure people received the outstanding care they deserved.
People received exceptional care that was tailored to their needs and wishes. This was provided by caring, attentive and compassionate staff. The service’s atmosphere was positively energetic with activity, very welcoming, warm, and inclusive with friendly staff providing care and support in a way people liked and enjoyed. Positive interactions took place between people, staff and each-other throughout our visit. Nothing was too much trouble. People had their privacy, dignity and confidentiality observed by staff, and they were encouraged and supported to be independent. Staff, the registered manager and provider recognised the importance of companionship and pet therapy. Animals regularly visited the service and the service had three cats who provided people with companionship and cuddles on tap.
The service was exceptionally well-led. The registered manager and provider had further built on the development of dementia care since the last inspection and were committed to further enhancing the quality and provision of care for people living with dementia. The registered manager's dedication to a person led approach to supporting people provided a positive model for all the staff. The registered manager and their staff team were passionate and committed in placing people at the heart of the service. The staff team were dedicated, compassionate and strove to provide high quality dementia care. Staff recognised the importance of seeing the person as an individual.
The registered manager's passion and commitment to achieving high standards was evident in how the service was managed, and supported by people, relatives and staff's comments. This translated into staff practice that provided people with very high standards of care. The registered manager understood the importance of the service within the local community and how family values and connections were vital to how people lived their lives. Community links were strong. People regularly accessed a dementia choir and a toddler group had been set up to help strengthen community links.
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 were skilled, motivated and knowledgeable. They had received appropriate training and support and were encouraged to develop their individual skills and interests. People received a balanced diet which met their individual needs and took into consideration their preferences. People spoke highly of the food provided.
People were supported by staff who were incredibly kind and caring and who maintained their dignity and privacy and treated them with utmost respect. People were fully involved in the service and had opportunities to give feedback.
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 (report published 26 April 2017)
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People, relatives and staff spoke highly of the service and the management team. One staff member told us, “We are one big family here.” One person told us, “The staff are absolutely lovely and I feel ever so safe living here.”
The management team and staff at all levels were committed to working in a person-centred way, respecting people's wishes and preferences and treating them with kindness and compassion. Visitors valued the relationships they and their loved ones had with the staff team, and told us they always felt welcome. All spoke highly of how caring the staff and managers were. Staff knew people and understood their care needs and preferences. They spent time with people, both during care tasks and at other times.
Staff demonstrated good knowledge and understanding of the Mental Capacity Act (MCA 2005). One staff member told us, “The Mental Capacity Act is about people’s ability to make specific decisions.” Mental capacity assessments were in place but had not considered people’s ability to make a capacitated decision about living at the service when an application for deprivation of liberty safeguard had been made. Improvements were made during the inspection. However, we have made a recommendation about the oversight of mental capacity.
The risks associated with falling were mitigated and actions were in place to prevent people from falling. The provider followed nationally recognised guidance and worked in partnership with external healthcare professionals to promote a safe environment for people. People’s falls risk assessments were reviewed monthly, however, these reviews failed to consider how many falls that person had experienced that month and whether the risk assessments remained effective. We have made a recommendation for improvement.
The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options had been considered. Staff sought and obtained people's consent before they helped them.
Systems were in place for the safe storage, administration and disposal of medicines. People told us they received their medicines on time and in their preferred manner. We identified a few omissions with the recording of medicines; however, these were addressed during the inspection. We have made a recommendation about the implementation of an overarching medicines audit.
People were protected from the risk of harm and abuse. Staff had received safeguarding adults training and were aware of their responsibility to report any concerns. Policies and procedures were in place to advice staff on what they should do if they had concerns. Safe recruitment practices were followed before new staff were employed to work with people.
The delivery of care met people's individual choice. Care plans gave information on people's likes, dislikes. People's changing health needs, such as changes to eating and drinking were reflected and therefore staff were informed of important changes to care. Information was available on people's life history and this fed into their care plan. This impacted positively on people's well-being.
Positive relationships had been developed between people as well as between people and staff. There was a friendly, caring, warm and relaxed atmosphere within the home and people were encouraged to maintain relationships with family and friends. A range of activities were available for people to participate in.
Systems were in place to monitor the quality of the service provided and regular checks were undertaken on all aspects of running the service. The registered manager had a range of tools that supported them to ensure the quality of the service being provided.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People spoke highly of the food provided and lunch was a sociable experience for people. Risks associated with eating and drinking were mitigated and where required staff provided one to one support in a kind and sensitive manner.