CQC report explained · a residential care home
What the CQC found at 50 Broadfields
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were recorded correctly, risks were reviewed and there were enough permanent staff. The home was clean and accidents and incidents were reviewed, although one incident had not been notified to CQC.
- Effective?
- Good
- Staff were trained and supported, and worked with health professionals. People chose their meals, were supported with their health needs and were helped to make their own decisions.
- Caring?
- Outstanding
- Inspectors found exceptionally caring support and strong relationships based on trust and respect. People were helped to achieve personal goals, take positive risks and live the lives they wanted.
- Responsive?
- Good
- Care was personalised and regularly reviewed with the people using the service. People were supported with communication, activities, community access and relationships, and knew how to complain.
- Well-led?
- Good
- Managers and staff were seen as approachable, organised and focused on person-centred care. Quality checks and reviews were in place, and the previous breach relating to governance had been resolved.
What inspectors found, November 2019
Rated Good overall, with Outstanding caring; inspectors found safe, person-centred support and improvements since the previous inspection.
The inspection was unannounced and took place on 22 October 2019. One inspector spoke with both people living at the home, staff, the manager and a development director. The inspector also reviewed care plans, medicines records, risk assessments, recruitment files and quality records, and contacted health professionals and a relative.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Caring was rated Outstanding. Inspectors found that people were safe, had choice and control, received personalised support and were treated with exceptional kindness and respect.
The home had improved since the previous inspection, when it was rated Requires Improvement and breached Regulation 17. At this inspection, the provider had made enough improvement and was no longer in breach. The report also says the home did not use restraint, seclusion or segregation.
Kind and respectful care
People were treated as individuals and staff built trusting relationships with them. Inspectors saw staff listen to people and respect when they wanted space or conversation.
“People were treated with respect and their dignity was always promoted.” from the report
Choice and independence
People were involved in decisions about their care and daily lives. Staff supported them to develop skills, take positive risks, use local services and work towards employment.
“People were in control of their care and fully involved in decision making.” from the report
Personal goals
Staff supported people to achieve goals such as holidays, exercise, voluntary work and visits to places that mattered to them.
“People had been supported individually to make decisions about where they wanted to go.” from the report
Safe medicines and staffing
Medicines were stored with daily temperature checks and administration records had no gaps. Staffing levels were sufficient and the home used a permanent staff group.
“People were supported by sufficient numbers of staff.” from the report
Improved management
The provider had introduced stronger monitoring, reviewed incidents and used checks to identify improvements. This addressed the governance problem found at the previous inspection.
“Quality monitoring systems were in place which supported the provider to identify any improvement needed.” from the report
One incident was not reported
needs fixingInspectors found one incident that had not been notified to CQC. The manager acted immediately to address this, but families should ask how reporting is now checked.
“We saw there was one incident which the provider had not notified us of.” from the report
- 01What checks are now in place to make sure every incident that should be reported to CQC is notified promptly?
- 02How would you match the permanent staff team to my relative's communication, health and support needs?
- 03How are people supported to take positive risks while remaining safe, for example with going out alone or using community facilities?
- 04How often would my relative and family be involved in reviewing and changing the care plan?
- 05How would you support my relative to pursue personal goals such as work, activities, holidays or exercise?
This was a planned inspection covering all five CQC questions, including the premises and care provided; no one was receiving end of life care at the time. This explanation was written from the published report of 16 November 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2018
50 Broadfields was rated Requires Improvement; care was kind and responsive, but medicines safety and quality checks needed improvement.
This was the home’s first inspection since registration. It was an announced inspection on 10 and 11 October 2018. The inspector spoke with both residents, staff, the manager, a relative and healthcare professionals, and checked care plans, medicines records, recruitment files and quality checks.
Inspectors found that people received kind, person-centred care. Their health needs were supported, care plans were regularly reviewed, and people were helped to make choices, stay independent and use local services. The home was clean and staff knew people well.
The overall rating was Requires Improvement. Safe and well-led were rated Requires Improvement. Effective, caring and responsive were rated Good. Medicines were not always stored safely, recruitment checks were incomplete, and the provider did not reliably use feedback, incidents and audits to make improvements.
Kind, respectful care
Inspectors saw warm interactions. People said they liked living at the home, and staff promoted privacy, dignity and choice.
“Interactions we observed were kind and caring. Staff were relaxed around people who in turn were relaxed, this created a friendly atmosphere.” from the report
Personalised support
Care plans described people’s individual needs and preferences. People helped plan their support and were encouraged to do as much as possible for themselves.
“People had care and support plans in place that were personalised and gave staff guidance on how to give support.” from the report
Good access to healthcare
People’s health was monitored and referrals to healthcare professionals were timely. Health action plans and hospital passports were in place.
“People had good access to healthcare professionals when they needed and we saw that referrals were timely.” from the report
Clean and suitable home
The home was clean, well maintained and adapted to people’s needs. People had private rooms and could personalise them.
“The service was very clean in all areas with no odours.” from the report
Staff support and training
Staff had training relevant to their roles and said they felt supported. There were enough staff on duty, including arrangements for agency staff to work with permanent staff.
“There were sufficient numbers of staff deployed. People and staff told us there was always enough staff on duty” from the report
Medicines storage
needs fixingMedicines were not always stored safely because room temperatures were not checked. One medicine had also not been counted and checked when received.
“Medicines were not always managed safely. People received their medicines as prescribed however they were not stored safely.” from the report
Incomplete recruitment checks
needs fixingThe provider did not always obtain a full employment history or investigate gaps before staff started work.
“The provider had not always obtained a full employment history or explored gaps in employment.” from the report
Incidents were not used to learn
needs fixingIncidents and accidents were recorded, but they were not properly analysed for patterns or lessons. Inspectors were also concerned that staff did not always follow behaviour support plans.
“Incident forms had been completed following incidents or accidents. We reviewed some incident forms and found that staff had not always taken the action recorded in the person's behaviour support plan.” from the report
Weak quality monitoring
seriousAudits identified problems such as a broken emergency light and broken guttering, but records did not show that action had been completed. The provider’s systems did not give enough oversight of improvements.
“Quality monitoring systems were not robust. There were systems in place to monitor the quality and safety at the service but they had not always generated an action plan.” from the report
Feedback was not acted on
needs fixingPeople’s views were collected, but repeated comments about going out more and variable food quality did not lead to a recorded action plan.
“The feedback had been sought but there was no action plan produced. We were not able to see that people's comments had been used to make any changes or improvements.” from the report
- 01How are medicine storage temperatures now checked and recorded?
- 02How do you make sure every new staff member has a complete employment history and that gaps are explored?
- 03What changes have you made after analysing incidents and accidents?
- 04How are residents’ comments about activities and food recorded, acted on and reviewed?
- 05What action was completed after the inspection on the emergency light, guttering and medicines audit?
This was the first comprehensive inspection since registration and covered all five rating areas, as well as the accommodation and care provided. This explanation was written from the published report of 16 November 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 50 Broadfields
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- November 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017
Registered with the Care Quality Commission on 8 December 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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