CQC report explained · a nursing home
What the CQC found at Brocklehurst Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People generally felt safe and risks were assessed, but medicines guidance was incomplete, some communal areas were unclean, and staff availability could lead to waits for support, especially at night.
- Effective?
- Good
- People's health, nutrition and hydration needs were supported. Staff received training, people had access to health professionals, and the home worked within the Mental Capacity Act.
- Caring?
- Good
- This key question was not inspected during this focused inspection.
- Responsive?
- Good
- This key question was not inspected during this focused inspection.
- Well-led?
- Good
- Managers were visible and approachable. Audits, incident reviews and feedback systems were in place, and relatives and staff said communication was good.
What inspectors found, June 2023
Rated Good overall; inspectors found effective, caring and well-led services, but safety requires improvement.
This was an unannounced focused inspection on 03 and 04 May 2023. Two inspectors and an Expert by Experience spoke with people, relatives, staff and a visiting professional. They also checked care records, medicines records, incidents, audits and the home.
People generally felt safe and received their medicines as prescribed. Staff were trained, risks were assessed, people's health and nutrition needs were supported, and the home worked with health professionals. Relatives described communication as good and managers as approachable.
The Safe rating remained Requires Improvement. Inspectors found gaps in guidance for some medicines, unclean communal areas, tired parts of the building and times when staff were too busy to respond promptly or spend time with people. The overall rating remained Good, but this was a focused inspection and not all five areas were reviewed.
Health and nutrition
People were supported with food, drinks and their health needs. The home made referrals to health professionals when needed.
“People were supported to maintain their nutrition and fluid intake.” from the report
Staff training
Staff received training for their roles and new staff completed induction and shadowing before joining the rota.
“New staff completed induction training and shadowed experienced staff to get to know people, their needs, and routines before working on the rota.” from the report
Choice and consent
Inspectors found that people were supported to make choices where possible, with best-interest decisions used when needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Management and communication
Relatives and staff described managers as approachable. The home used audits, meetings and incident reviews to monitor the service.
“Relatives said the communication with the home was good.” from the report
Medicines guidance
needs fixingSome guidance for as-required medicines did not give staff enough detail. Body maps were also not used to show where topical creams should be applied.
“PRN protocols did not always contain enough detail to guide staff when they needed to be administered.” from the report
Staff availability
seriousStaff were often busy and people sometimes waited for help, including at night when call bells were used. Inspectors noted that night staffing could leave no other staff member available when two staff were needed to reposition someone.
“Staff were very busy, and task focused. They did not have time to sit with people, especially in the morning.” from the report
Cleanliness
needs fixingSome communal areas, including parts around windows and skirting boards, were visibly unclean. Inspectors recommended reviewing the cleaning schedules.
“Parts of the communal areas of the home were visibly unclean, for examples around windows and skirting boards in corridors.” from the report
Building condition
minorSome parts of the home and some bedroom furniture needed repair or redecoration. A refurbishment plan was in place but needed to be completed promptly.
“Parts of the home looked tired and in need of re-decoration.” from the report
Care plan detail
needs fixingSome care plans did not contain enough detail to fully describe people's needs and the support required. An improvement plan and extra support for nurses were in place.
“Some areas of the care plans needed additional details to be included to fully capture people's needs and the support they required.” from the report
- 01What changes have been made to the guidance for as-required medicines and topical creams?
- 02How many staff will be on duty during the day and at night, and how will you respond when two staff are needed to reposition someone?
- 03What evidence can you show that communal cleaning schedules have been reviewed and are being followed?
- 04When will the planned redecoration and furniture repairs be completed?
- 05How are care plans being checked to make sure they contain enough detail about each person's needs?
This was a focused inspection of Safe, Effective and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 16 June 2023 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
Brocklehurst Nursing Home was rated Good overall; inspectors found kind, responsive care, but safety Requires Improvement because medicines and one risk assessment needed attention.
Inspectors visited on 26, 27 and 28 November 2018. The first day was unannounced. They spoke with people, relatives and staff, observed care, and checked records including care plans, medicines and recruitment files.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Safe was rated Requires Improvement because some medicines were not safely recorded or administered, and one person's swallowing risk had not been properly assessed.
The medicines concerns were corrected before the inspection ended. Inspectors also found significant improvements since April 2018, when the home had breached rules about consent, safe care and treatment, and governance. At this inspection, the provider was meeting those regulations.
Kind and respectful staff
People and relatives spoke positively about the staff. Inspectors saw staff supporting people patiently, respectfully and without rushing.
“People were supported in a friendly and respectful way.” from the report
Good care planning
Care plans included people's histories, preferences, cultural needs, dietary needs and end of life wishes. People and relatives were involved in reviews.
“Care plans reflected a holistic assessment of people's needs and included their personal history and individual preferences, interests, cultural considerations, dietary needs and end of life wishes.” from the report
Meaningful activities
The home offered group and one-to-one activities and recorded people's preferences. Inspectors saw activities taking place during the visit.
“People were engaged in meaningful activities and recreation.” from the report
Improvement in leadership
A registered manager had been in post since July 2018, supported by other senior staff. Inspectors found significant progress since the previous inspection.
“At this inspection we found significant improvements had been made and the provider was meeting the regulations.” from the report
Medicine records and administration
seriousInspectors could not confirm that some medicines were being given as prescribed because instructions were missing from medicine records. There was also no body map to record when one person's pain patch was changed. The concerns were corrected before the inspection ended.
“There were some aspects of the medicine administration that were not safe.” from the report
One incomplete risk assessment
needs fixingThe home had conflicting information about one person's swallowing ability and had not assessed the possible risk linked to drink consistency. A referral was made to the speech and language therapy team.
“The person had capacity to make choices regarding the consistency of their drinks. However we found the home had not considered and assessed any potential risk involved.” from the report
Audits missed medicine concerns
needs fixingThe home used medicine audits, but these checks had not identified the medicine problems found by inspectors. Feedback surveys had also not been formally analysed.
“However, we found concerns regarding medication management which medication audits had not identified.” from the report
- 01What changes were made to medicine administration and records after the inspectors found the problems?
- 02How do you now check that pain patches and other medicines are given exactly as prescribed?
- 03How was the swallowing risk identified in the report followed up, and what advice did the speech and language therapy team give?
- 04How do your medicine audits now make sure that similar problems are found quickly?
- 05What improvements have been made since the April 2018 inspection, and how are you checking that they have lasted?
This was an inspection of the overall service and all five CQC questions, including care, records, medicines, staffing, premises and management systems. This explanation was written from the published report of 16 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 Brocklehurst Nursing Home
6 rated inspections over 8 years: the service has improved, from Inadequate to Good.
- June 2023Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Goodup from Requires improvementSafe: Requires improvementEffective: GoodWell-led: Good
- July 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- May 2014
Registered with the Care Quality Commission on 1 May 2014.
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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