CQC report explained · a nursing home
What the CQC found at Brook House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People had clear risk assessments, enough staff and safe medicines arrangements. The home also reported and reviewed safeguarding incidents appropriately.
- Effective?
- Good
- Staff were trained and supported, worked with health professionals and helped people make choices about food and healthcare. Some mental capacity and best-interest records were not initially available, but these were provided after the inspection.
- Caring?
- Good
- People and relatives said staff were kind and caring. Staff respected privacy, supported independence and involved people in everyday decisions.
- Responsive?
- Good
- Care plans gave staff detailed guidance and information was provided in pictures and other accessible formats. Activities had increased, but inspectors recommended more individualised and meaningful activities.
- Well-led?
- Good
- Staff and relatives described open and supportive management. Audits were carried out, although the home did not have formal satisfaction surveys at the time.
What inspectors found, February 2020
Brook House was rated Good overall; inspectors found safe, kind and personalised care, with more individual activities still needed.
This was a planned, unannounced inspection on 23 January 2020. One inspector spoke with two people using the home, three relatives, five staff members and two social care professionals. They also checked care records, medicine records and management documents.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People were described as safe, treated kindly and supported to make choices, build skills and live as independently as possible. The home was clean and people had private living spaces.
The main improvement needed was more individual activities that were meaningful to each person. Inspectors also found some missing records about mental capacity and best-interest decisions, but the manager sent the missing documents immediately after the inspection.
The previous inspection in 2017 also rated the service Good. This inspection found that the home had sustained that rating.
Enough staff
Inspectors found enough staff to meet people's needs and support people to go out when they wished.
“People were cared for by a sufficient number of staff.” from the report
Safe medicines
Medicine records, storage, checking and disposal were well managed. Staff understood how to support people who refused medicines.
“Storage, auditing, disposal and checking of medicines was robust and helped to ensure medicines were at their optimum.” from the report
Respect and independence
People had private living spaces and were supported to make food, clean, do laundry and make everyday choices without staff taking over.
“Within their own flats people are supported to be as autonomous and independent as they are able and comfortable to be.” from the report
Personalised support
Support plans gave staff detailed information about people's needs, communication and how to respond when someone was anxious or agitated.
“People's support plans were comprehensive and contained guidance, advice and direction for staff in how to meet the person's individual needs in the best way.” from the report
More individual activities needed
needs fixingAlthough activities had become more varied, inspectors found that some people needed more individual activities of their choice. A wish to learn to swim had not progressed, and records did not always reflect activities taking place.
“We recommend the registered provider enables people to access more individualised meaningful activities to help reduce the risk of social isolation.” from the report
Some decision records were missing
needs fixingInspectors could not initially find all capacity assessments and best-interest decisions. The manager provided the missing documents immediately after the inspection and said they would be placed in people's individual files.
“However, we could not locate all of the documentation with regard to capacity assessments and best interests decisions for people.” from the report
- 01How have you increased individual activities since the inspection, including helping people achieve activities they have requested?
- 02How do you record all activities and outings so the records reflect what each person has done?
- 03Where are each person's mental capacity assessments and best-interest decisions kept, and how do you make sure they are up to date?
- 04How do you involve people and their relatives in reviewing care plans and activity choices?
- 05Has the manager's application to become registered manager been completed?
This was a planned, unannounced inspection covering all five CQC questions, including the care provided and the premises; all five ratings were assessed at this visit. This explanation was written from the published report of 13 February 2020 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, September 2017
Brook House rated Good; inspectors found safe, kind and well-organised care, with some activities and medicines checks needing improvement.
Inspectors made an unannounced visit on 15 August 2017. One inspector spoke with three people living at the home, three staff, three relatives and a social care professional. They also observed care and checked care records, medicines, staff training, meetings and quality checks.
The inspectors found enough staff, detailed care plans and safe medicines management overall. People were supported with food, healthcare, independence and daily choices. Staff were described as caring, respectful and familiar with people's needs.
The home had good records, checks and management oversight. However, some people and relatives said there were not enough meaningful activities. Inspectors also found that medicines records were not always completed correctly and there was no formal or external medicines audit.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This was the first inspection of the home.
Detailed care plans
Care plans explained people's needs, risks and preferred support. Staff were able to describe how they should support each person.
“People's support plans were detailed and included guidelines to staff on how to provide the care and support people needed.” from the report
Enough staff
Staffing was planned around people's needs, including support for activities and one-to-one support. Inspectors saw staff available when people needed them.
“There were enough staff on duty on each shift to meet people's needs and keep them safe.” from the report
Kind and respectful care
Staff knew people well, encouraged them to speak for themselves and respected their privacy, choices and independence.
“People were shown respect by staff. We only heard respectful conversations between staff and people during our inspection.” from the report
Good management checks
The home used staff meetings, handovers, audits and other checks to monitor care and act on problems.
“There was an effective quality monitoring system in place.” from the report
Medicines records and auditing
needs fixingSome handwritten medicines entries had not been double-signed. Inspectors also found no formal or external medicines audit, although senior managers said this would be acted on.
“We also noted that where handwritten entries were included in people's MARs these had not been double-signed.” from the report
More meaningful activities
needs fixingSome people and relatives wanted more stimulating activities. The manager said this would continue to be reviewed.
“I would like to do more things, like go to the day services. Sometimes I get bored.” from the report
- 01What meaningful and stimulating activities are now available for each person?
- 02What action was taken after the inspection found that some handwritten medicines entries were not double-signed?
- 03Is there now a formal or external medicines audit, and how often is it completed?
- 04How will you make sure staffing remains sufficient for one-to-one support and activities?
- 05How are people and relatives involved in reviewing care plans and choosing activities?
This was an unannounced first inspection covering all five key areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 21 September 2017 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 Brook House
2 rated inspections over 2 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016
Registered with the Care Quality Commission on 17 February 2016.
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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