Brook House Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

All accidents and incidents reviewed were investigated appropriately and escalated to senior staff. The service used these events as learning opportunities, with lessons identified and shared with staff to improve practice. There was a strong focus on openness and transparency, and staff felt confident to report incidents and safeguarding concerns. Actions identified following investigations were implemented and clearly communicated to staff, helping to reduce the risk of incidents happening again.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Managers and staff had a good understanding of people’s needs, risks, and the support required to keep them safe and well. Systems were in place to support safe admissions and discharges, including the use of hospital passports to share key information. Clear processes ensured that people’s needs were assessed and relevant information was shared with external professionals when people moved temporarily or permanently between the service, hospital, or another care setting. This helped to support safe and well-coordinated transitions.

Before any new admission, a thorough assessment of the person’s needs was completed. This involved consulting with the person, their relatives, and other professionals involved in their care to ensure the service could meet their needs safely. People had access to health services they required. Staff recognised people’s changing health needs and referred people appropriately.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Systems and processes were in place to protect people and to record, report, and monitor safeguarding concerns, including Deprivation of Liberty Safeguards (DoLS). Safeguarding concerns were documented appropriately, escalated promptly, and actions were taken to reduce risks and protect people from harm. The service worked closely with the Local Authority safeguarding team and responded appropriately when concerns were raised.

All people who required DoLS authorisations had applications in place, which showed the provider understood and met their legal responsibilities. Where people lacked capacity to consent to their care arrangements, legal authorisations were requested, and decisions were made in people’s best interests and to support their safety and wellbeing.

Staff had a good understanding of safeguarding and their responsibility to protect people from abuse. They were confident about reporting concerns and knew who to escalate issues to. One staff member told us, “I can report any concerns to the nurse or deputy or manager. I know they will do the needful.”

People told us they felt safe with the care and support provided. Relatives also spoke positively about safety, with one relative commenting, “They are excellent on safety.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The service was spread across three floors, with each floor having its own dining and food-serving area. At the time of the inspection, there was no clear information available to show people’s modified diets or food allergies on any of the floors. On the day of the inspection, an agency staff member was working in hospitality on one floor and was assigned to serve meals to people. This increased the risk of people being given food that was not suitable for their needs. The concern was raised with the manager, who responded promptly and ensured that up-to-date lists of modified diets and allergies were available on all three floors.

There were examples of people being involved in managing their own risks where possible. For example, one person with swallowing difficulties had been referred to the Speech and Language Therapy (SALT) team. The person did not like the recommended modified diet, and staff worked with the GP, SALT team, and the person’s family to agree a plan that balanced managing the risk while respecting the person’s wishes.

People had risk assessments in place for known risks, such as falls, choking, pressure damage (Waterlow), and nutrition (Malnutrition Universal Screening Tool). However, some improvements were needed to ensure risks were managed consistently. Equipment such as sensor mats and bed rails was used where required, but the associated risk assessments were brief and did not clearly explain how the equipment should be used safely, how people should be monitored, or what actions staff should take.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Effective fire safety procedures were in place, with clear signage displayed throughout the service to help keep people safe. Information about people’s needs in the event of an emergency evacuation was up to date and easy for staff to access.

The service was clean, well maintained, and free from unpleasant odours. Health and safety checks were completed regularly and were up to date. People’s bedrooms were spacious, personalised, and contained well-maintained equipment to support their needs safely.

The provider also had business continuity plans in place to manage emergencies, including outbreaks, loss of power, fire, and other unexpected events. These plans helped ensure people’s safety and continuity of care during challenging situations.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The service made regular use of agency staff to support staffing levels. On the day of the inspection, three agency staff were on duty, and induction records and agency profiles were available for review. However, one agency staff member had expired mandatory training. This was raised with the manager, who addressed the issue promptly with the agency and confirmed that checks of agency staff training records would be strengthened going forward.

Relatives were generally positive about staffing arrangements. One relative told us, “Now and again there are some agency staff (new faces) on duty, but it never affects the care that she receives.” The service used dependency tools to support staff allocation. There were enough staff deployed, in line with the rotas. However, some staff said they felt overstretched at times. The manager acknowledged this and confirmed that staffing levels would be reviewed. Another relative commented, “I’m not aware that they are short staffed, but on the second floor the residents are quite poorly, and the buzzers (could we maybe add something like [call bells] here just to clarify what the relative meant by buzzers?) are often going quite often.”

New staff were recruited safely, with appropriate pre-employment checks completed. Staff received induction and essential training related to people’s health, safety, and welfare, which supported them to carry out their roles effectively. Staff had their competencies checked regularly to make sure they were safe and able to carry out their roles. Nurses were supported to keep their professional skills and knowledge up to date.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Infection prevention and control (IPC) practices were effective, and the environment was clean, well maintained and free from any unpleasant odours. Staff were observed using appropriate personal protective equipment (PPE) for the care they were providing. All areas of the care home used by people were visibly clean.

People and relatives spoke positively about hygiene and cleanliness. One person told us, “The housekeeping staff are very good and they clean my room every day. They do a very good job.” Housekeeping staff followed daily cleaning schedules to maintain cleanliness throughout the service.

Clear processes were in place to ensure staff, people using the service, and their relatives were informed promptly if there were any concerns relating to infectious outbreaks.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines safely and as prescribed. Medicines were generally well managed, and no widespread concerns were identified. Systems were in place to support the safe management of medicines.

One issue was identified where instructions for a person’s Laxido were unclear, and staff had not consistently recorded the dose given or the reason for administration. This was raised with the manager, who acted promptly to clarify the instructions with the GP and reminded staff of the importance of accurate recording.

Relatives spoke positively about medicines management. One relative told us, “They make sure she takes her medication,” and another said, “They give her medication always on time.”Staff received training and had their competency checked regularly to ensure medicines were managed safely. Clear, person-centred guidance was in place for the use of ‘when required’ (PRN) medicines. Controlled drugs were stored, recorded, administered, and disposed of safely.Effective governance systems were in place to oversee medicines management. Regular audits and checks were completed, and where any shortfalls were identified, actions were taken to improve practice.