CQC report explained · a nursing home
What the CQC found at Broadway Nursing
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People generally felt safe, and risks to their health had been assessed. However, staffing needed review, some water safety checks and storage arrangements needed attention, and one medicines stock discrepancy had to be investigated.
- Effective?
- Good
- People's outcomes were consistently good. Staff supported nutrition, specialist diets and access to healthcare well, although some training and supervision were overdue.
- Caring?
- Good
- People were treated with dignity and respect. Inspectors observed warm interactions, and people and relatives described staff as caring and supportive.
- Responsive?
- Good
- Care plans contained detailed, person-centred information and were reviewed when needs changed. Activities, communication support, complaints handling and end-of-life support were responsive to people's needs.
- Well-led?
- Good
- The home was consistently managed and well-led. People, relatives and staff felt involved and listened to, and the management team used audits and feedback to improve the service.
What inspectors found, September 2019
Rated Good overall; inspectors found kind, person-centred care, but the Safe rating Requires Improvement because staffing and some safety checks needed attention.
Inspectors visited the home unannounced on 11 and 13 September 2019. They spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicines records, staff files and management records.
The overall rating was Good. Effective, Caring, Responsive and Well-led were rated Good. The Safe rating remained Requires Improvement. Inspectors found that people generally felt safe and well cared for, but staffing levels, some water safety checks, storage, medicine records and learning from incidents needed improvement.
The home had introduced electronic care plans with detailed information about people's needs and preferences. Inspectors also found warm relationships, good support with food and specialist diets, suitable access to healthcare, and activities that reflected people's interests.
The previous overall rating was Requires Improvement, and the home had been in breach of safe care and treatment regulations. Inspectors found improvements and said the home was no longer in breach. This inspection was planned because of the previous rating.
Person-centred care plans
The new electronic care plans contained detailed information about people's histories, likes, dislikes and needs. Inspectors said this helped staff provide personalised care.
“These provided rich and detailed information which showed particularly good person-centred knowledge and care.” from the report
Kind and respectful care
People were treated with dignity, privacy and respect. Inspectors saw warm relationships between people and staff, supported by a long-standing staff team.
“We observed warm and caring interactions. People were chatting happily with staff and it was clear that both knew each other well.” from the report
Food and hydration support
People had enough to eat and drink. The home supported specialist and faith-based diets and was working on improving hydration.
“People had enough to eat and drink. We heard positive comments regarding the service's support to people's specialist diets.” from the report
Involvement and listening
People, relatives and staff were involved in developing the service. Meetings, coffee mornings, newsletters and feedback boards helped people share their views.
“Regular meetings took place for people, relatives and staff, who felt listened to by the registered manager.” from the report
Staffing levels
needs fixingStaffing needed further review so people's needs could be met quickly and consistently. Shortages had occurred at times during holiday periods, and recruitment was ongoing.
“Staffing needed to be reviewed to ensure people's needs were met quickly and consistently.” from the report
Overdue training and supervision
needs fixingManagement records showed that some staff training and supervision were overdue. Training had been booked to address this.
“The service's management overviews showed that staff supervisions and some training were overdue.” from the report
Medicines rounds and records
needs fixingSome morning medicine rounds took a long time, although people received medicines at the right time. Inspectors also found one stock discrepancy that needed investigation.
“At times morning medication rounds took a long time and did not finish until after 11am, although people still received their medicines at the right time.” from the report
Safety checks and storage
minorA few additional water safety checks were needed, and equipment no longer in use needed to be kept away from public areas. The provider was addressing these points.
“We identified a few additional water safety checks required, which the provider was addressing.” from the report
- 01What changes have been made to staffing levels and deployment, particularly during holiday periods?
- 02Have all overdue staff training and supervision sessions now been completed?
- 03How are medicines rounds being monitored so they finish promptly, and what was the outcome of the stock discrepancy investigation?
- 04Have all additional water safety checks been completed, and has unused equipment been removed from public areas?
- 05How are the new electronic care plans checked to make sure they remain accurate and up to date?
This was an unannounced planned inspection based on the previous rating and covered all five key questions, including the areas that had previously required improvement. This explanation was written from the published report of 25 September 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, January 2019
Rated Requires Improvement; inspectors found kind and responsive care, but safety, medicines records and management checks still needed work.
Inspectors visited the home without notice on 7 and 9 January 2019. They spoke with people, relatives and staff, observed care, and checked care files, medicines records, accident records, training and quality checks.
People generally said they felt safe and that staff were kind, respectful and familiar with their needs. Inspectors found good examples of personalised care, support at mealtimes, complaints handling and end-of-life care.
There were still important shortfalls. Locks protecting rooms containing chemicals and tools had not been secured effectively. Medicines records, nutrition records, the dementia-friendly environment and some care records also needed improvement. The overall rating and the ratings for Safe, Effective and Well-led were Requires Improvement. Caring and Responsive were rated Good.
Kind and respectful care
Inspectors saw warm, personalised interactions. People and relatives said staff knew them and treated them well.
“We observed interactions between staff and people who lived at the service. Staff spoke to people respectfully.” from the report
Progress since the last inspection
The home had followed its action plan and corrected three of the four previous breaches. Mealtime dignity, staff supervision and confidential records had improved enough for those breaches to end.
“At this inspection we found their action plan had been followed and three of the breaches had been rectified but further improvements were needed.” from the report
Support at the end of life
The home had dedicated staff and care plans for end-of-life support. Inspectors saw positive feedback from a palliative care professional.
“The service supported people at the end of their lives with dignity, compassion and respect for the person's wishes.” from the report
Safeguarding and risk work
Staff understood safeguarding responsibilities, concerns were investigated, and individual risks such as falls, malnutrition and pressure sores were assessed.
“Staff were knowledgeable about Safeguarding procedures and had confidence that managers would address any concerns.” from the report
Hazardous rooms were not secured
seriousOn the first inspection day, locks on the laundry and maintenance rooms had not been secured. These rooms contained detergents and tools that could harm people, particularly people living with dementia.
“These rooms contained openly displayed laundry detergents and tools that would pose a danger, particularly to people living with dementia if they accessed these rooms unsupported.” from the report
Medicines records needed improvement
needs fixingStock levels were correct, but records were not always completed properly, especially for controlled drugs. Instructions and records for as-required medicines also needed to be clearer.
“When we checked people's medicines with a deputy manager, we found the stock levels were correct, but staff needed to improve on how they recorded this, particularly around controlled drugs.” from the report
Some problems kept recurring
needs fixingAudits identified issues, but corrective action did not always stop them happening again. This included personal care records, medicines records and some equipment checks.
“We found improvements had been made where issues were identified, however some themes were recurring and needed to be addressed more effectively.” from the report
Environment and records needed development
needs fixingThe home was not yet fully accessible or dementia-friendly. Some information about weights, nutrition, health needs and care plans was incomplete or unclear.
“Improvements were required to make the service more accessible and dementia-friendly.” from the report
Activities were limited
minorThe home had identified that activities needed to become more varied and stimulating. There were no trips out, and activity staffing was affected by absence and other staffing demands.
“Activities were being developed to become more varied and stimulating for people.” from the report
- 01How do you now make sure the laundry and maintenance-room locks are secured and checked every day?
- 02What changes have you made to medicines recording, especially for controlled drugs and as-required medicines?
- 03How do you check that recurring problems found in audits are fully corrected and do not happen again?
- 04What improvements have been made to make the home more accessible and dementia-friendly?
- 05How are activities provided when an activities coordinator is absent or needed for other duties?
This was an unannounced comprehensive inspection covering all five key questions, with the home, care, records, medicines, staffing and quality checks examined. This explanation was written from the published report of 30 January 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.
Every inspection of Broadway Nursing
5 rated inspections over 5 years: the service has held its Good rating throughout.
- September 2019Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 5 January 2011.
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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