CQC report explained · a residential care home
What the CQC found at Brooke House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found risks that were not always assessed or managed, including unsecured items, unsafe surfaces, equipment problems, poor cleanliness and gaps in personal care. Some incidents had not been reported to the safeguarding team or CQC.
- Effective?
- Good
- This question was not inspected during this focused visit. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Inspectors did observe caring and friendly interactions.
- Responsive?
- Good
- This question was not inspected during this focused visit. Inspectors found that people were supported to see visitors and take part in community activities.
- Well-led?
- Requires improvement
- The provider's audits had not found some of the risks identified by inspectors. There was no registered manager, which affected the rating.
What inspectors found, June 2023
Brooke House was rated Requires Improvement; inspectors found risks in safeguarding, the environment, medicines and management, although staff were caring and responsive.
This was an unannounced focused inspection on 4 May 2023. Inspectors looked mainly at Safe and Well-led. They spoke with people, staff and a relative, observed care, and checked care, medicine, staffing and management records.
The home was not always safe. Inspectors found incidents that had not been reported as required, unsecured risk items, unsafe hot surfaces, equipment needing replacement, dirty areas and gaps in some personal care records. Some medicine arrangements also needed improvement.
The home was rated Requires Improvement overall. Safe was rated Requires Improvement, as it was at the previous inspection. Well-led fell from Good to Requires Improvement because quality checks had missed risks and there was no registered manager.
There were also positive findings. Staffing levels met people's needs, staff were kind and responsive, people could see visitors, and pressure care, nutrition risks and mental capacity arrangements were generally managed well. The provider acted promptly on some issues after inspectors raised them.
Caring staff
Inspectors saw caring and friendly interactions. Staff responded quickly when people were distressed or agitated and knew how to help them feel safe.
“We observed caring and friendly interactions by staff and members of the management and provider team with people and their relatives.” from the report
Staffing and recruitment
Inspectors found enough trained staff on shift to meet people's needs. Required pre-employment checks were in place and mandatory training completion was high.
“We observed there to be sufficient numbers of trained staff on shift to respond to people's needs.” from the report
Pressure and nutrition care
Records showed that skin risks, repositioning and bowel care were regularly managed and recorded. Nutrition and choking risks were managed using professional guidance.
“Individual risks relating to the management of nutrition and choking were well managed, and records were reviewed and updated following guidance from Speech And Language Therapists, GPs and dieticians.” from the report
Social contact
People could spend time with visitors and attend activities involving relatives, friends and the local community. Inspectors found strong community links that helped reduce isolation.
“People were able to spend time with visitors on and off site. Social events were regularly planned at the service involving people's relatives, friends and members of the local community.” from the report
Response to feedback
The provider acted promptly on issues raised during the inspection and kept CQC updated about replacement equipment and other actions.
“We found the provider responsive to our inspection feedback and prompt to take action to address the shortfalls we identified.” from the report
Safeguarding reports
seriousSome incidents had not been reported to the local safeguarding team or CQC as required. This was a breach of Regulation 13.
“Safeguarding reporting processes were not consistently followed to protect people from risk of harm and abuse.” from the report
Environmental safety
seriousInspectors found unsecured products, windows without restrictors, unsafe hot surfaces and equipment needing replacement. These risks were especially important because many people were living with dementia.
“We identified risk items unsecured within the service.” from the report
Medicines
seriousOut-of-date and discontinued medicines remained accessible. Instructions for some as-required medicines did not give staff enough detail.
“We identified out of date medicine, and medicine that had been discontinued by the prescriber to still be accessible to staff in the medicine room, increasing the risk of unsafe or accidental use.” from the report
Leadership and oversight
needs fixingThe provider's audits had not identified several risks found by inspectors, and some earlier action points remained unfinished. There was no registered manager in post.
“A rating limiter for this service, resulting in a requires improvement rating for well-led was the lack of a registered manager being in post, in line with the provider's conditions of registration.” from the report
- 01Which safeguarding incidents were not reported, and what system is now in place to ensure all required reports are made?
- 02Have all unsecured items, unsafe hot surfaces, windows without restrictors and damaged equipment now been dealt with?
- 03How are out-of-date and discontinued medicines removed, and how have the instructions for as-required medicines been improved?
- 04What checks now ensure people's teeth, nails and other daily personal care tasks are completed and recorded?
- 05Has a registered manager been appointed, and how are the provider's audits checking that previous shortfalls have been fixed?
This was an unannounced focused inspection of Safe and Well-led; the other key-question ratings were not inspected and carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 9 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, March 2021
Brooke House was inspected but not rated; inspectors found strong infection control but some cleaning pressures.
This was a targeted inspection on 25 February 2021. It looked at infection prevention and control during the coronavirus pandemic. One inspector visited for several hours, and the visit was announced the day before.
Inspectors were assured that the home was managing visitors, testing, personal protective equipment, social distancing, admissions and possible outbreaks safely. Staff had infection control training, and the home had testing, vaccination and cleaning arrangements in place.
The home was usually well staffed, but one domestic worker was unavailable because of isolation. Inspectors found gaps in cleaning records and said domestic staff were under pressure. The service was inspected but not rated, so this report does not give a Good, Requires improvement or Inadequate rating.
Infection control
Inspectors were assured that the home had effective arrangements to prevent and manage infections. Staff understood how to use and dispose of PPE safely.
“We were assured that the provider was using PPE effectively and safely.” from the report
Testing and vaccination
Staff were regularly tested, and almost all staff and residents had received their vaccines at the time of the inspection.
“Staff were regularly tested for the presence of the virus and all, but two staff and people had received their vaccines.” from the report
Communication with relatives
The home kept relatives informed about visiting arrangements. It provided a screened conservatory so families could maintain contact while reducing infection risks.
“Good communication was maintained with relatives, so they were clear about visiting and under what circumstances.” from the report
Activities
Inspectors saw people taking part in activities suited to their needs, including making bread. The home also used activity boards and photographs.
“Throughout our morning we saw evidence of people being engaged in appropriate activities” from the report
Cleaning cover
needs fixingOne domestic worker was absent, leaving the remaining domestic staff under pressure. Inspectors found gaps in cleaning records and concerns that cleaning might not happen later in the day or evening.
“Gaps in cleaning rotas were observed and there was some concern expressed by staff that cleaning did not always take place when the domestic staff were no longer on shift later in the day and evening.” from the report
Visitor room cleaning
needs fixingThe conservatory used for family visits was also used by staff for breaks. Inspectors did not see it being cleaned between these uses.
“We did not observe this room being cleaned between staff use and would suggest staff either need to use another area or cleaning of this area should be stepped up.” from the report
- 01How do you maintain cleaning standards when domestic staff are absent or isolating?
- 02How often is cleaning completed later in the day and during the evening?
- 03Is the conservatory still used for staff breaks, and how is it cleaned between staff use and family visits?
- 04How are visitors currently managed, including PPE, testing and screening arrangements?
- 05What infection control training and support do staff receive now?
This was a targeted inspection of infection prevention and control only; the service was inspected but not rated and the other areas of care were not assessed. This explanation was written from the published report of 17 March 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 Brooke House
3 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- June 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- November 2017Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- October 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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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