We carried out a review of the data available to us about Browfield Residential 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 Browfield Residential Home, you can give feedback on this service.
There is no passenger lift, but double handrails are fitted to all stairways. On street parking is available to the side of the home. The home is situated approximately one mile from Bury town centre and is close to all local amenities and public transport. The home had undergone a period of refurbishment since our last inspection and this was still in progress. At the time of our inspection there were 12 people living at the home.
People’s experience of using this service and what we found
Medicines were being managed safely at this inspection. Medication processes were in place and staff practice had improved. People had their care and support needs met by sufficient numbers of suitably trained staff. Face to face training delivered by the local authority was now available following the COVID-19 pandemic. Staff were scheduled to attend various sessions.
Support plans and risk assessments provided staff with relevant information so that appropriate care could be provided for people. The service worked in partnership with people, their families and staff. We received positive feedback from people and staff about the service.
A major refurbishment programme was in progress at the time of this inspection. Communal areas and most bedrooms had been modernised and decorated. A new kitchen had been fitted. Plans were in place to modernise bathrooms and office spaces. The positive changes to the home environment were apparent and people told us the difference this had made to their lives.
The care environment was clean and comfortable throughout. Infection control procedures were in place and staff used PPE effectively. Additional cleaning had been introduced during the COVID-19 pandemic. The service had good working relationships with GPs, district nurses and mental health professionals.
The service had good governance arrangements in place and completed regular internal quality checks. Findings from audits were reviewed by the registered manager and used to drive improvement within the service.
People told us they were happy and settled. There was a positive response to the changes being made to the home. A member of staff was now responsible for the development of activities and opportunities to help enable people to develop their daily living skills and access the local and wider community.
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.
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 9 August 2021) and there were 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 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.
We carried out an unannounced comprehensive inspection of this service on 21 June 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Browfield Residential Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Browfield provides accommodation for up to fourteen people with enduring mental health needs who require support with personal care. Accommodation is provided on three floors. There is no passenger lift. On street parking is available to the side of the home. The home is situated approximately one mile from Bury town centre and is close to all local amenities and public transport. At the time of our inspection there were 11 people living at the home.
People’s experience of using this service and what we found
Whilst the service had a registered manager, they were not in day to day management of the service. Alternative management arrangements had been put in place however these had been unsuccessful. Arrangements were being made for the area manager to register with CQC so that some stability could be provided.
Thorough governance systems were not in place to evidence clear oversight of the service; identifying areas of improvement and learning.
Concerns had been raised about the safe care and treatment of people living at Browfield. Managers were assisting the local authority with their investigations. Notifiable events such as serious injuries or abuse and allegations had not always been reported to CQC, as required by law.
Robust recruitment processes were not in place. Staff said the team worked well together and there was good communication and support. Further training and development opportunities were being explored to enhance the knowledge and skills of staff.
The management and recording of people’s prescribed medicines needed to be improved. Staff worked closely with relevant health and social care professionals so people’s current and changing needs were met, including the care of someone at the end of their life.
People told us they were happy and settled. There was a positive response to the changes being made to the home including the development of activities and opportunities enabling people to develop their daily living skills as well as accessing the local and wider community.
Care records outlined the individual needs of people and how they wished to be supported. Areas of risk were assessed and planned for. 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.
The new provider was making considerable improvements to the physical environment. All areas were being refurbished so people were provided with a good standard of accommodation. Relevant health and checks were also being completed to ensure the premises and any equipment were safe.
Good hygiene standards were maintained within the home. Additional guidance in relation to COVID-19 was being adhered to.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 20 November 2020. We carried out a focused inspection in December 2020, at that time the service was not rated. The last rating for the service under the previous provider was Good, published on 3 October 2018.
Why we inspected
This was a planned inspection, as a new provider and due to concerns received about the recruitment and training of staff, management and administration of people’s medication, record keeping, confidentiality and the care and support of people. As this was the provider’s first inspection, we reviewed all five domains.
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 have identified breaches in relation to staffing and recruitment, training and support of staff, management of people’s medication and good governance systems at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Browfield provides accommodation for up to fourteen people with enduring mental health needs who require support with personal care. Accommodation is provided on three floors. There is no passenger lift. The home is situated approximately one mile from Bury town centre and is close to all local amenities and public transport. At the time of our inspection there were 13 people living at the home.
People’s experience of using this service and what we found
The provider had only taken over ownership of the service three weeks prior to our visit.
During this inspection we found environmental standards were poor. We were provided with assurances from the new provider and manager of the plans in place and the checks made to ensure the safety and suitability of the building. A full refurbishment plan had been drawn up showing how the environment was to be enhanced and facilities improved. Servicing of the mains supplies and equipment were also being reviewed to ensure the safety of the building. Whilst at the home and from information received, we saw immediate action was being taken.
Infection Prevention and Control (IPC) practices, in line with current government guidance, had been implemented so the risks to people living and working at Browfield were minimised.
Domestic and care staff took responsibility for cleaning the home. Cleaning schedules were in place along with monthly audits. Due to the pandemic, increased cleaning of touch surfaces and bathrooms were being carried out to reduce the risk of cross infection to people.
The home was part of the testing programme. People living at the home had been consulted and their consent sought prior to testing. Where this had been refused risk assessments had been completed and measures put in place to minimise potential risks. In addition temperature checks were being completed with people so that changes in need could be responded to.
Staff were provided with sufficient supplies of personal protective equipment (PPE). Training in the safe ‘donning and doffing’ of PPE had been carried out and further training in infection control procedure was planned. Staff travelling to and from work were asked not to wear their uniform, changing before and after their shift.
People were able to maintain contact with family and friends. Visiting arrangements were to be revised in line with new guidance and local arrangements. Where people accessed the local and wider community appropriate PPE was worn.
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 the service under the previous provider was Good, published on October 2018.
Why we inspected
As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.
Due to concerns identified during our visit we widened the scope of the inspection to become a targeted inspection reporting on the environment.
CQC have introduced targeted inspections to follow up on specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.