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We are carrying out a review of quality at Broomhill. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 21 April 2021

This was an unannounced focused inspection, undertaken in response to concerns the care Quality Commission (CQC) had received in relation to two allegations of staff to patient assaults. The first report related to an allegation that a patient had been physically assaulted by a nurse on an acute ward. The second report related to an allegation that a patient had been assaulted by a member of staff on two separate occasions on a rehabilitation ward.

During the inspection, we looked at specific key lines of enquiry. Therefore, we have reported on the following domains:

  • Safe
  • Caring

We did not re-rate Broomhill as we did not inspect all aspects of the safe and caring domains.

  • The service did not always have enough nursing staff, who knew the patients. The provider was using high levels of agency staff. In January 2021, the provider reported that agency staff had been used to cover 56% of all shifts. However, 33% of agency staff had been blocked booked.
  • Staff did not fully understand how to protect staff from abuse or how to report it. The provider had not followed national guidance in the levels of safeguarding training provided. Staff were unable to apply training received into practice. The provider had not updated the risk register to reflect current concerns relating to safeguarding.
  • Staff had not always managed risks to patients well. Patients had not always been protected from verbal and physical abuse from staff. Staff had not always ensured that patient care plans had been updated to reflect current patient risks.
  • The service had not always managed patient safety incidents well, once reported. We viewed a total of 192 provider incidents from 01 January to 01 February 2021. Managers had not closed most of these within the agreed time frame. Of the 192 incidents, 181 (94%) were overdue for review and relevant action/s by managers.
  • Staff had not always ensured that physical health observations were recorded after administration of rapid tranquillisation. The provider had not ensured that emergency medication had been prescribed before administration under the Mental Health Act.
  • The provider had not ensured that staff on one ward had easy access to technology for them to maintain high quality clinical records on one ward.
  • The provider had not ensured that all staff were up to date with their mandatory training in respect of the prevention and management of violence and aggression, basic life support and manual handling.
  • Staff had not always treated patients with kindness and compassion. We were given an example where staff were mimicking and copying a patient behind their back. Patients and staff told us that they had heard staff talking in languages other than English in front of patients.
  • Staff had not always involved patients in care planning and risk planning.

However:

  • All wards were safe, clean, well equipped, well furnished, well maintained and fit for purpose. Staff followed infection control policy, including handwashing. Staff and visitors had their temperature recorded on entry to the building. The provider had ensured that staff had access to personal protective equipment (PPE).
  • Staff completed risk assessments for each patient on admission, using a recognised tool and updated risk assessment after incidents.
Inspection areas

Safe

Inadequate

Updated 21 April 2021

Effective

Inadequate

Updated 21 April 2021

Caring

Inadequate

Updated 21 April 2021

Responsive

Requires improvement

Updated 21 April 2021

Well-led

Inadequate

Updated 21 April 2021

Checks on specific services

Long stay or rehabilitation mental health wards for working age adults

Updated 21 April 2021

We did not rate this service at this inspection. The current rating of long stay/rehabilitation wards for working adults remains.

For more information on our overall judgement please see the overall summary at the beginning of this report.

Acute wards for adults of working age and psychiatric intensive care units

Updated 21 April 2021

We did not rate this service at this inspection. The current rating of acute mental health wards for working adults remains.

For more information on our overall judgement please see the overall summary at the beginning of this report.