CQC report explained · a residential care home
What the CQC found at Brockholes Brow - Preston
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2022
Rated Requires Improvement and still in special measures; inspectors rated Safe Inadequate and found risks with medicines, care planning and infection control.
This was an unannounced follow-up inspection on 13 January 2022. Two inspectors, a medicines specialist and a learning disability specialist visited. They spoke with people, staff and relatives, reviewed care and medicines records, and observed the home. They also looked at the domiciliary care service.
Inspectors found some improvements since the previous inspection. Safeguarding processes, staff training, recruitment, consent checks, healthcare reviews and complaints handling had improved. However, people were still at risk from unsafe medicines, poor risk monitoring, fire safety delays and infection control problems. Care records were often incomplete, and people did not always receive personalised support, meaningful activities or enough help to develop independence.
The overall rating improved from Inadequate to Requires Improvement. Effective and well-led also improved from Inadequate to Requires Improvement, but Safe remained Inadequate. Caring and Responsive remained Requires Improvement. The home remained in special measures because at least one key question was Inadequate at two consecutive comprehensive inspections.
Safeguarding
Safeguarding concerns were being reported, investigated and shared with the relevant organisations. Relatives said they felt confident that their loved ones were safe.
“The registered manager and staff ensured that all safeguarding incidents were reported and investigated in line with their safeguarding policy.” from the report
Staff training
The home had made a significant effort to improve induction, essential training and specialist training for staff supporting people with complex needs.
“A significant effort had been made to address the learning needs of staff and to promote staff learning.” from the report
Some progress
The report says eight breaches and related shortfalls from the previous inspection had been addressed. Consent, staff training and incident reporting were among the areas that had improved.
“At this inspection eight of the breaches and associated shortfalls had been addressed.” from the report
Complaints
Complaints were handled in line with regulations, and the manager said learning from complaints was used to reflect on staff practice.
“Complaints had been dealt with in line with regulations and measures had been put in place to address the complaint satisfactorily.” from the report
Medicines
seriousPeople missed prescribed doses because medicines were not available. Some medicines were out of date or given at the wrong dose or time, and records did not always show what had been given.
“People missed some doses of their prescribed medicines because there was no stock available in the home for them and this had not been identified by the home's medicines audits.” from the report
Risk and infection control
seriousRisk assessments and care plans did not always give staff the guidance needed to prevent harm. During a COVID-19 outbreak, PPE and laundry practices also increased infection risks.
“practices for managing laundry exposed people to the spread of infections.” from the report
Person-centred care
seriousCare did not consistently reflect people's preferences, ambitions or goals. Some people had limited opportunities to develop independence or take part in varied daytime activities.
“The provider had failed to ensure that people's care and treatment was delivered in a person-centred care.” from the report
Communication
needs fixingSome staff could not communicate effectively with people who used British Sign Language. This sometimes meant people had to wait for suitable staff before receiving help.
“Sometimes if I need help, I will have to wait for staff who can use BSL to come on shift which can cause delays for me.” from the report
Management oversight
seriousQuality checks had not found or quickly corrected several problems. The report also found no evidence that care delivered through domiciliary arrangements was being monitored.
“we found no evidence to demonstrate that the provider was monitoring care provided to people in their own homes under domiciliary care arrangements.” from the report
- 01What has changed to make sure medicines are always in stock, in date, given correctly and accurately recorded?
- 02How are risks such as skin damage, dehydration and fire safety now monitored and acted on?
- 03How will you make sure care plans reflect each person's goals, preferences and plans to develop independence?
- 04How many staff on each shift can communicate using British Sign Language, and what happens when they are not available?
- 05How do you check the quality and safety of care delivered to people in their own homes?
This was an unannounced follow-up inspection covering all five key questions, the residential service, the domiciliary care service and infection prevention and control. This explanation was written from the published report of 21 September 2022 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, June 2021
Inadequate and in special measures; inspectors found serious risks in safety, staff training, consent and management, despite some kind care.
This was an unannounced comprehensive inspection. Inspectors visited on 08 April 2021, 13 April 2021 and 21 April 2021. They spoke with people and staff, reviewed care, medicine, incident and recruitment records, and checked the premises.
The home was rated Inadequate overall. Safety, effectiveness and leadership were Inadequate. Caring and responsiveness Requires Improvement. Inspectors found poor risk management, missed safeguarding reports, weak medicines records, unsuitable staff training, problems with consent and person-centred care, and poor quality monitoring.
People said staff were kind and caring, and inspectors saw some positive interactions. However, the home did not consistently protect people from avoidable harm or respect their rights. The previous overall rating was Good, published on 17 September 2018. The home was placed in special measures and CQC planned to monitor progress and re-inspect.
Kind staff
People told inspectors that staff were kind and caring. Inspectors also saw some caring interactions.
“People told us staff were kind and caring and we observed some caring interactions between staff and people.” from the report
Safe recruitment
The registered manager carried out the required recruitment checks.
“The registered manager followed safe staff recruitment procedures. All the necessary background checks were carried out.” from the report
Links with professionals
Staff worked with local health professionals, and the home had community links with health and social care services.
“Staff had worked with healthcare professionals to ensure people's healthcare needs were met.” from the report
Activities and independence
Staff arranged activities and local trips, including during the pandemic. Some people could use a local bus independently.
“There were adaptations in various areas to support people with sensory impairment.” from the report
Risks were not managed
seriousRepeated falls, unexplained injuries, self-harm and weight loss were not consistently assessed, monitored or acted on. Some safeguarding concerns were not reported to the appropriate authorities.
“The provider had failed to protect people from the risk of harm.” from the report
Poor infection control and premises
seriousSome areas were mouldy or visibly dirty. The home lacked some hand-sanitising equipment and COVID-19 guidance was not properly followed.
“Some parts of the premises were not clean, including areas with mould and parts of the toilets and bathrooms that were visibly not clean and stained.” from the report
Staff lacked key training
seriousMany staff had not completed or updated important training. Staff and the registered manager also lacked specialist training for learning disabilities, autism, mental health, diabetes and positive behaviour support.
“We found significant shortfalls in staff training, knowledge and skills.” from the report
Consent and restrictions
seriousStaff did not always assess mental capacity before making decisions or applying for restrictions. Care was not consistently the least restrictive or in people's best interests.
“Staff had not completed capacity tests to check whether people could make specific decisions or required decisions to be made in their best interest where they lacked capacity.” from the report
Care was not consistently personal
seriousCare records did not always reflect current risks and needs. The campus-style model and some practices did not support enough choice, control or independence.
“People did not always receive care that was personalised to meet their preferences and choices.” from the report
Weak management oversight
seriousThe provider's systems did not reliably identify problems, learn from incidents or ensure improvements were made quickly.
“The provider and the registered manager had failed to have effective oversight on the delivery of care to identify areas of improvement in a timely manner.” from the report
- 01What changes have been made to assess and monitor repeated falls, unexplained injuries, self-harm and weight loss?
- 02How are safeguarding incidents now recorded, investigated and reported to the local authority?
- 03Which staff have completed training in medicines, infection control, moving and handling, the Mental Capacity Act, deaf awareness and the specialist needs of residents?
- 04How do you check that consent and mental capacity are assessed before restrictions or best-interest decisions are used?
- 05What has changed in the care model and quality monitoring system since this inspection, and what evidence can you show of improvement?
This inspection began because of concerns about health and safety and COVID-19 infection control, then widened to a comprehensive inspection covering all five key questions. This explanation was written from the published report of 11 June 2021 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 Brockholes Brow - Preston
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingup from InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2021Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 2010.
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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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.