CQC report explained · a residential care home
What the CQC found at Brookfield Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- People were generally protected from avoidable harm and there were enough staff. However, medicines records and some infection-control practice were not always up to date, and further work was needed.
- Effective?
- Good
- This question was not looked at during this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not looked at during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not looked at during this focused inspection. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Managers had introduced checks and audits, acted on problems and involved people, relatives and staff in improving the service.
What inspectors found, June 2021
Brookfield Care Home was rated Good overall, but Safe was Requires Improvement because medicines records and some infection-control practice were not always up to date.
Inspectors made an unannounced focused inspection on 13 May 2021. They spoke with people, relatives, staff and managers, and checked care plans, daily records, medicines records, staff files, training data and quality checks.
The home had improved since the previous inspection. Staff understood people's known risks, there were enough staff, the home was clean, and systems for visits and infection control were in place. However, some staff did not follow mask guidance, and some medicines records and processes were not yet fully up to date.
The overall rating was Good. Safe was rated Requires Improvement and Well-led was rated Good. The other three question ratings were not reassessed during this visit and were carried forward from the previous comprehensive inspection.
Improvement since the last inspection
The provider had made enough progress to meet the requirements breached at the previous inspection. The overall rating improved from Requires Improvement to Good.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Risk management
Staff understood people's known risks and how to support them safely. Incidents had reduced because lessons had been learned.
“Staff understood known risks and how to support people safely following their assessed needs.” from the report
Staffing and safeguarding
Inspectors found enough staff to meet people's assessed needs, with contingency plans in place. Staff had safeguarding training and understood how to report concerns.
“Enough staff were on duty to meet people's assessed needs and spend quality time with them.” from the report
Leadership and checks
The manager had introduced audits and checks to identify problems and improve standards. People and relatives felt able to raise concerns.
“The registered manager had implemented a range of checks and audits to maintain standards and identify any areas that may require improvement.” from the report
Medicines records
needs fixingSome medicines management and administration records were not always up to date. New checks and processes had started but still needed to become routine.
“We found some areas of medicine management and administration were not always up to date.” from the report
Use of masks
needs fixingSome staff wore face shields without face masks, contrary to current guidance. The manager addressed this during the inspection, but further work was still needed.
“Some staff did not always follow current guidance and wore face shields without face masks.” from the report
Staff supervision
minorStaff did not always receive supervision to support them in their roles and raise concerns. Work was planned to improve this.
“Staff did not always receive supervisions to support them in their roles.” from the report
Care plan updates
minorA deputy manager was working through an action plan, but further updates were needed to keep information current and relevant.
“Further updates were required to ensure information remained up to date and relevant.” from the report
- 01What changes have you made to medicines recording and stock checks since this inspection, and how do you check that they are working?
- 02How do you make sure every staff member follows the current guidance on face masks and face shields?
- 03How often will staff receive supervision, and how will missed supervision be followed up?
- 04How are care plans checked and updated when a person's needs or risks change?
- 05What were the ratings for Caring, Effective and Responsive at the previous comprehensive inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other three ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 23 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.
What inspectors found, January 2021
Rated Requires Improvement, with Inadequate safety: inspectors found infection control and risk management failures, although staffing levels were safe.
This was a targeted inspection during the coronavirus pandemic. Inspectors found concerns with infection prevention and control, so they widened it to a focused inspection of Safe and Well-led. They spoke with relatives, staff and a health professional, observed the home and reviewed care, medicines, recruitment and management records.
The home was rated Inadequate for Safe and Requires Improvement for Well-led. Inspectors found unsafe infection control practices, poor risk management and some medicines records that were not accurate or up to date. They also found that quality checks had not identified problems and that some recommendations from external professionals were not acted on quickly.
There were some positive findings. Staffing levels were considered appropriate, recruitment checks were followed and records showed people received their medicines regularly and as prescribed. Relatives said they were happy with communication and felt their loved ones were safe.
The overall rating fell from Good at the previous inspection, published on 13 March 2020. The provider was required to produce an action plan, and CQC said it would monitor progress and return for another inspection.
Staffing levels
Inspectors found enough staff to keep staffing levels safe, including during the outbreak. Recruitment practices followed the provider's policy.
“Staffing levels were appropriate and had remained safe during the recent outbreak.” from the report
Medicines given
Records showed that people received their medicines regularly and as prescribed, although some supporting records were inaccurate or incomplete.
“Records showed people were receiving their medicines regularly and as prescribed.” from the report
Communication with relatives
Relatives told inspectors they were happy with communication from the home and felt their loved ones were safe.
“People's relatives were happy with the communication from the home.” from the report
Infection control
seriousSocial distancing, staff zoning, PPE arrangements and cleaning were not managed safely. Staff who had symptoms or positive test results were reported to have been asked to work.
“The provider failed to follow government guidance regarding isolation of staff who had tested positive” from the report
Managing individual risks
seriousRisk assessments were not updated properly and pandemic assessments were too general. Weight monitoring did not identify weight loss or malnutrition risks, and water flushing checks were missed in some areas.
“Risks were not being effectively managed.” from the report
Medicines records
needs fixingSome medicines records were inaccurate or out of date. Guidance for medicines given when needed was not always available or regularly reviewed.
“Some medicines records were not up to date or accurate.” from the report
Management oversight
seriousAudits had not found the problems identified by inspectors. The manager had not acted promptly when concerns were raised, and staff said they did not feel supported.
“Quality assurance audits had not identified the issues we had found during this inspection.” from the report
Learning from incidents
needs fixingAccidents and incidents were recorded, but the home had not analysed them for patterns or trends. A new approach was being introduced after inspectors raised this.
“Accidents and incidents were recorded but no analysis was done to look for patterns or trends.” from the report
- 01What has been done to improve infection control, including staff isolation, PPE storage and disposal, cleaning, social distancing and staff zoning?
- 02How are individual risk assessments now updated and how are weight loss, malnutrition and water safety risks monitored?
- 03How have medicines records and guidance for medicines given when needed been checked and corrected?
- 04What changes have been made to quality audits so that problems are found and acted on promptly?
- 05What support and supervision do staff now receive from the management team?
This was a focused inspection of Safe and Well-led after a targeted coronavirus outbreak inspection; Effective, Caring and Responsive were not inspected or rated, and the other ratings were not reassessed. This explanation was written from the published report of 13 January 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 Brookfield Care Home
5 rated inspections over 5 years: the service has held its Good rating throughout.
- June 2021Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2021Requires improvementdown from GoodSafe: InadequateWell-led: Requires improvement
- March 2020Goodstayed GoodSafe: GoodWell-led: Good
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- November 2012
Registered with the Care Quality Commission on 15 November 2012.
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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