Broome Park Nursing Home

Broome Park Nursing Home is a care home providing personal and nursing care. The service can support up to 56 people in two separate buildings, the main house and Stable Cottage. Broome Park cares for people with a range of needs including people with learning disabilities and autism, people living with dementia and older people with nursing care needs. There were 51 people using the service at the time of the inspection.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

People had limited access to meaningful activities and care plans were not person centred. People’s support was not always well structured and some people did not have end of life care planning in place. There was a lack of opportunity for people to identify goals and outcomes and plan the support they needed to achieve these.

Right Care

Poor risk management meant people were not always safe. There was a high use of agency staff at the service meaning that some people were supported by staff who did not know their needs well. However, people with learning disabilities lived in one part of the service which had its own settled staff team who knew people’s needs well. People were not always treated with dignity and respect. Staff understood their responsibilities to protect people from abuse and knew how to report concerns should they need to.

Right Culture

Governance at the service was not effective which placed people at risk of receiving poor care. People’s privacy was not always respected, and people and their families had limited opportunities to contribute to planning their support. Relatives told us that communication from the service was often poor and professionals said they could not always get the information from the service they needed about people. People were supported to develop their skills and to be as independent as possible.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support 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

The last rating for this service was good (published 10 March 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and risk management. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care, dignity and respect, safe care and governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Broome Park Nursing Home is a care home providing personal and nursing care. The service can support up to 56 people in two separate buildings, the main house and Stable Cottage. Broome Park cares for older people with a range of needs including people living with dementia and other mental health conditions. There were 44 people using the service at the time of the inspection.

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

Prior to the inspection, we were aware that people had been put at risk by a delay in the completion of essential fire safety work to the building which included the replacement of fire doors and upgrading the fire alarm system. However, this work had started by the time of our visit and people told us they felt safe living at Broome Park. There were robust Infection Prevention and Control procedures in place and people’s records had accurate information about their care and support needs.

People’s needs were assessed and kept under review. People were supported to maintain good health and had choice over their meals. Staff had access to the training they needed and there was good communication within the team. Staff took appropriate steps to ensure people’s legal rights were promoted and upheld regarding consent for care.

We heard positive feedback about the registered manager. People had confidence in how the service was being run and how the provider had handled the risks of COVID-19. Action was taken to effectively engage with stakeholders and ensure their views were included in the ongoing development of the service.

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 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 18 December 2019) and there were multiple breaches of regulation. 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

We received concerns in relation to fire safety and safeguarding people who used the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We also carried out this inspection to follow up on breaches of legal requirements found at the comprehensive inspection on 18 September 2019.

We reviewed the information we held about the service. 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.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

We found no evidence during this inspection that people continued to be at risk of harm from the concerns raised. Please see the safe and well-led sections of this full report.

The provider has taken action to reduce the risk to people related to fire safety by undertaking necessary remedial work at the service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Broome Park Nursing Home 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.

Broome Park is a ‘care home’. It delivers care for up to 56 people living in two separate buildings, the main house and Stable Cottage. At the time of our inspection there were 50 people living at the service who had a range of needs including living with dementia and a mental health diagnosis.

People’s experience of using this service

The new provider had taken over the service a year ago, and the new manager had started in June 2019. They had identified the issues we raised on the day of the inspection, and plans were already in place to resolve them.

Risks to people were not always appropriately recorded and managed. People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not always support this practice. The environment was not suited to people with cognitive impairments such as dementia, and activities that occurred within the home were not always meaningful or accessible to people. The dining experience for people in the main building was chaotic and unorganised but was much calmer in Stable Cottage. Safe infection control practices were not always followed as continence pads were being stored outside of their protective packaging.

There were a sufficient number of staff to meet people’s needs. However, they were not up to date with their essential training and some had not received a recent supervision meeting. Staff, along with the management team were working hard to resolve this and were on track to achieving this. A visiting professional informed us people were referred to healthcare professionals where required, and communication between staff was effective.

People and their relatives told us they felt safe at the service, and staff were aware of their responsibilities in safeguarding people from abuse. Medicines were recorded and administered safely, and accidents and incidents were recorded and analysed for any trends. The manager and provider had informed CQC of all notifiable incidents that had occurred.

We observed friendly interactions between people and staff, and people and their relatives told us staff were kind and knew people well. People were involved in decisions around their care where possible, and their families and representatives were involved where they lacked capacity. Where possible, people were being upskilled to be more independent so they could be considered for their own accommodation in the community. People’s dignity and privacy was respected, with staff asking if they required assistance to the toilet discreetly. Complaints had been dealt with in line with the provider’s policy and the service had received a number of compliments. People’s communication needs were considered and recorded.

People, relatives and staff felt the management team were approachable and supportive. There were plans in place to improve the service for people, as well as audits identifying existing areas of improvement required. People, relatives and staff were engaged in the running of the service and their feedback considered and acted upon.

Rating at last inspection

This is the service’s first inspection since it was registered with a new provider (24 October 2018).

Why we inspected

This was a planned fully comprehensive inspection in line with our inspection scheduling based on the service’s registration with CQC.

Follow up

We identified two breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We will follow up on the breach and recommendations made in this report. We will continue to monitor all information received about the service to ensure the next planned inspection is scheduled accordingly.