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CQC report explained · a nursing home

What the CQC found at Brooke House

Outstandingpublished 19 May 2022, 4 years ago

Rated Outstanding: inspectors found the home performing exceptionally well.

The five questions inspectors ask
Safe?
Good
Inspectors found safe medicines management, suitable staffing, safeguarding systems and regular safety checks. They identified an initial risk from access to hot catering equipment and inconsistent screening of one professional visitor.
Effective?
Good
This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
Caring?
Outstanding
This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
Responsive?
Good
This key question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
Well-led?
Outstanding
Inspectors found exceptional leadership, a strong personalised-care culture, effective audits and action plans, and very good partnership working with health and care professionals.
The latest report, explained

What inspectors found, May 2022

Brooke House: Rated Outstanding overall; inspectors found exceptional leadership and safe care, but identified two safety checks needing consistent attention.

This was an unannounced focused inspection after a COVID-19 outbreak. Inspectors checked Safe and Well-led, spoke with relatives, staff and care professionals, observed a meal, and reviewed care, medicines, recruitment and management records.

The home was rated Good for Safe and Outstanding for Well-led. Inspectors found medicines were managed safely, infection control was generally effective, staffing was sufficient, and risks were monitored. They also found strong personalised care, committed leadership, detailed quality checks and excellent partnership working.

Inspectors did find that people with dementia-related conditions had initially been left near hot catering equipment without supervision. The home acted immediately to reduce this risk. Visitor screening was also not completed consistently on one inspection day. The overall Outstanding rating remained unchanged from the previous inspection, partly because other areas were not inspected and their previous ratings were carried forward.

What inspectors praised
  • Personalised care

    The home focused strongly on individual needs. Inspectors found examples where tailored support improved people’s wellbeing and reduced falls and incidents.

    “The service had a strong ethos of individualised care.” from the report
  • Strong leadership

    Management was described as committed and supportive. Quality checks were regular, with actions recorded and reviewed by senior managers.

    “Numerous regular audits were carried out and any required actions were set out in an overarching action plan which was kept under continuous review by senior managers.” from the report
  • Good partnership working

    The home worked closely with health professionals to review people’s needs and medicines, and to arrange timely support.

    “The home held weekly reviews involving a GP, specialist nursing services and a pharmacist.” from the report
  • Safe medicines management

    Medicines records were clear and current. Staff had medicines training and competency checks, and medicines were reviewed regularly with health professionals.

    “Medicines were managed in a safe way. Staff had training and competency checks in medicines management.” from the report
What inspectors were concerned about
  • Access to hot equipment

    serious

    At the first visit, some people with dementia-related conditions could reach hot catering equipment and fridges without supervision. The home took immediate action, including installing locks and reminding staff of the required arrangements.

    “During the first inspection visit, we found people with dementia-related conditions had been left unattended in dining areas where there was access to hot catering equipment and fridges.” from the report
  • Visitor screening

    needs fixing

    Screening checks were not completed for one professional visitor on one inspection day, although checks were completed on other visits. The home was told this needed to be consistent.

    “On one day of inspection, appropriate screening checks were not carried out of a professional visitor but were on other visits.” from the report
Questions to ask them, based on this report
  1. 01What changes have been made to stop people accessing hot catering equipment without supervision?
  2. 02How do you now make sure every visitor, including professional visitors, completes the required infection screening?
  3. 03What were the ratings for Effective, Caring and Responsive at the previous inspection?
  4. 04How are the weekly reviews with the GP, specialist nursing services and pharmacist arranged for residents?
  5. 05How do you monitor whether the changes to lighting and one-to-one support continue to reduce falls and incidents?

This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection published on 4 February 2020. This explanation was written from the published report of 19 May 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.

An earlier report, explained

What inspectors found, February 2020

Rated Outstanding overall; inspectors found exceptionally caring and well-led support, with one mealtime practice issue addressed during the inspection.

The CQC carried out an unannounced, planned inspection over three visits in August and November 2019. Inspectors spoke with people living at the home, relatives, staff and visiting health and social care professionals. They observed care and checked care records and management records.

The home was rated Outstanding overall. Caring and well-led were rated Outstanding. Safe, effective and responsive were rated Good. Inspectors found kind and person-centred care, enough staff, safe medicines systems, meaningful activities and strong management oversight.

One issue was found during some mealtimes. Staff did not always follow best practice guidance for people living with dementia. Inspectors raised this with the provider, who took immediate action. The previous overall rating was Good, and caring and well-led had improved from Good and Requires Improvement respectively.

What inspectors praised
  • Kind and compassionate care

    Inspectors observed staff being gentle, respectful and understanding. People and relatives consistently described the staff as caring.

    “Care and support was delivered by staff who were exceptionally compassionate and kind.” from the report
  • Respect and independence

    Staff asked permission before providing support and encouraged people to do what they could for themselves. Care plans recorded people's preferences and abilities.

    “Staff always asked permission before carrying out any support task and told people what was happening throughout their interaction.” from the report
  • Strong leadership and improvement

    The management team used audits, action plans and reviews of accidents and incidents to improve care. A registered manager was now in post.

    “Governance systems were embedded within the service to monitor quality and drive continuous improvement.” from the report
  • Activities and social contact

    The home provided individual and group activities based on people's interests and needs. This included links with a local school.

    “A range of meaningful activities were available for people.” from the report
What inspectors were concerned about
  • Mealtime practice

    needs fixing

    Some observations showed that staff did not always follow best practice guidance at mealtimes for people living with dementia. The provider was told about this and took immediate action, but families should ask how this is now checked.

    “Some meal time observations did not always demonstrate staff followed best practice guidelines.” from the report
Questions to ask them, based on this report
  1. 01What immediate changes were made to mealtime support after the inspection, and how do you check staff follow best practice for people living with dementia?
  2. 02How will you assess whether my relative needs additional staffing or one-to-one support?
  3. 03How do you involve residents and their relatives in agreeing and reviewing care plans?
  4. 04What activities would suit my relative's interests, history and communication needs?
  5. 05How do your audits and accident reviews lead to changes in care?

This was an unannounced, planned inspection covering all five CQC questions, the care provided and the care home premises. This explanation was written from the published report of 1 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.

The story over the years

Every inspection of Brooke House

4 rated inspections over 7 years: the service has improved, from Requires improvement to Outstanding.

  1. May 2022Outstandingcurrent ratingstayed Outstanding
    Safe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Outstanding

    Read what inspectors found at Brooke House →

  2. February 2020Outstandingup from Good
    Safe: GoodWell-led: Outstanding

    Read what inspectors found at Brooke House →

  3. February 2017Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read this report on cqc.org.uk

  4. July 2015Inspected but not rated
    Responsive: Requires improvement

    Read this report on cqc.org.uk

  5. April 2015Requires improvement
    Safe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  6. June 2014

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  7. March 2014

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  8. August 2013

    Registered with the Care Quality Commission on 2 August 2013.

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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