Broomhill Care Centre

Broomhill Care Centre is a residential care home for people living with dementia and complex mental health needs. The care is provided in a purpose-built home with accommodation over three floors; bedrooms are on the first and second floor and can be accessed by a lift. There is a secure garden for people to use and there is access to public facilities. The service can support up to 16 people and there were 10 people at the time of the inspection.

People’s experience of using this service and what we found

Improvements were needed to ensure best practice guidelines were followed to maintain standards of infection prevention and control and management of COVID-19. The use of Personal Protective Equipment (PPE) was reviewed following our inspection to ensure all staff used PPE as required and regular cleaning around the home was completed. Where new people were admitted to the service, people could use the second floor to ensure there was a period of isolation.

People’s care had been reviewed to reflect any changing support needs. Risk management was generally comprehensive and guidance for staff was up to date and detailed. One person's risk plan associated with physical intervention and risks associated with personal care, needed more detail; this was discussed with the registered manager who took immediate action.

Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People were protected against the risk of abuse, as checks were made to confirm staff were of good character and suitable to work in a care environment. There were sufficient staff available to support people. Medicines were managed safely, and people were supported to take their medicine as prescribed. The provider analysed accidents and incidents and used this information as a learning tool to improve the service.

Staff had reviewed how people could be supported during the COVID-19 pandemic and restrictions in the community and supported people to be involved with activities in the home and do the things they enjoyed. People were encouraged to express their views about their care and staff were responsive to their comments and any concerns.

There were systems in place to monitor the quality of the service and enable the provider to drive improvement. Staff had regular meetings to keep them updated on training and good care practice. The provider had an ongoing action plan that showed how the service was continually improving.

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 Requires Improvement (published 2 July 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, we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating to review improvements and prompted in part due to concerns received regarding how people were supported, care was recorded, and medicines managed. A decision was made for us to inspect and examine those risks. 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 coronavirus and other infection outbreaks effectively.

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.

We have found evidence that the provider needs to make improvement within the key question of Safe.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Broomhill Care Centre on our website at www.cqc.org.uk.

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.

People’s experience of using this service: Risks associated with people’s care were identified but actions to minimise risks occurring had not been highlighted. The management of people’s medicines was not always carried out in a safe way. People were safeguarded from the risk of abuse and staff we spoke with knew what action to take if required. Accidents and incidents were monitored to ensure any trends and patterns were identified and addressed. The service had enough staff available to meet people’s needs, however, the provider was using a high number of agency staff and was in the process of recruiting more staff. There was a safe recruitment process in place.

Staff received mandatory training and support to carry out their role. However, specific training such as dementia care, was required to enable staff to understand their role and to enable them to support people better. Healthcare professionals were involved in people’s care where appropriate and their advice was adhered to. People had access to outside space, although this could be more pleasant. The home was designed and adapted to meet people’s physical needs but needed to be dementia friendly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, decisions made in people’s best interest needed to be documented better.

During our inspection we spent time observing staff interacting with people. We found staff were kind and caring, however, we raised a couple of interactions which could have been delivered in a more respectful way. Staff ensured people’s dignity and privacy were upheld.

People did not always receive person centred care which met their needs and took in to consideration their preferences. The provider had employed an activity co-ordinator, but they were currently covering a support worker role due to staffing issues. No meaningful activities took place during our inspection. The provider had a complaints procedure which was available to people.

The management team completed several audits to identify areas which may require attention. However, the audits had identified some areas we raised on inspection, but they had not been addressed. Some audits had not identified concerns. People we spoke with told us the home was managed well and had confidence that they could approach staff and management if they needed to.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in; Regulation 12; safe care and treatment, regulation 17; good governance and Regulation 9; person-centred care.

Rating at last inspection: This was the first inspection of this service which registered with CQC in June 2018.

Why we inspected: This was a planned comprehensive inspection.

Follow up: We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk