CQC report explained · a residential care home
What the CQC found at Brookland House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Brookland House is rated Good overall, with safe and effective care, but well-led Requires Improvement.
This was an announced focused inspection on 15 December 2022. One inspector spoke with staff, relatives and professionals, observed people in a communal area, and checked care, staff and management records.
The home was rated Good for Safe and Effective. Inspectors found improvements since the previous inspection, including better safeguarding systems, window safety checks, lawful decision-making and personalised care records.
Well-led remained Requires Improvement. The home had no registered manager and had been without one since August 2022, although an interim manager was in place and management checks had improved.
The overall rating changed from Requires Improvement to Good. However, this inspection only directly assessed Safe, Effective and Well-led. The other ratings were carried forward from the previous inspection.
Improved safeguarding
Safeguarding processes had been put in place and were being used. The home was no longer in breach of the safeguarding regulation.
“At this inspection we noted processes and systems had been embedded to protect people from the risk of harm or abuse.” from the report
Personalised support
Staff knew people's individual needs and preferences. Care records reflected current needs and were updated when those needs changed.
“People's care records reflected their needs and were personalised.” from the report
Staff skills
Staff had training and induction relevant to the people living in the home. Inspectors found enough staff to meet people's needs and support activities outside the home.
“People were supported by staff who had received training that met people's individual needs.” from the report
Safer windows
The home acted on the previous recommendation about window safety. Restrictors and safety checks were in place.
“At this inspection the provider had made improvements, window's had window restrictors in place and safety checks were completed.” from the report
No registered manager
needs fixingThere was no registered manager at the inspection. An interim manager was overseeing the home while the provider sought a new manager.
“The service had been without a registered manager since August 2022.” from the report
Incomplete reference checks
needs fixingSome staff records did not contain enough background information to support safe employment decisions. Inspectors recommended that the provider review its recruitment arrangements.
“We found that staff did not always have reference checks completed to a satisfactory standard.” from the report
- 01When do you expect to have a registered manager in post?
- 02What has been done to make sure all staff references are checked to a satisfactory standard?
- 03How will you continue checking window restrictors and other safety measures?
- 04How are best-interest decisions and any restrictions on people's liberty reviewed and kept legally authorised?
- 05How will relatives be kept informed while the management arrangements change?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 17 January 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 2020
Rated Requires Improvement; inspectors found kind, personalised care but serious gaps in safeguarding, consent and oversight.
This was an unannounced planned inspection on 3 December 2019. The inspector spoke with relatives, staff and professionals, observed people in the home, and checked care records, staff files, medicines records and management documents.
People were treated kindly and supported to enjoy activities, go out and build independence. Staff knew people well, medicines were managed properly, staffing levels were sufficient and the home was clean.
However, a safeguarding concern was not reported for four weeks. Restrictions on people's liberty had expired without the necessary follow-up, and records did not show that some restrictions had been agreed in their best interests. Checks by the provider and manager did not identify these problems or window safety concerns.
The overall rating was Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement, and all three had fallen from Good at the previous inspection.
Kind and respectful staff
Inspectors saw staff treating people gently and with respect. Relatives and professionals also said people were happy and well cared for.
“Interactions between staff and people we heard were gentle, patient, and friendly.” from the report
Personalised support
Care was tailored to people's preferences, communication methods and abilities. Staff helped people make progress with everyday skills and confidence in the community.
“Staff supported people to achieve positive outcomes, such as one person being able to enter a supermarket after a period of finding this difficult.” from the report
Activities and community life
People went out regularly and were supported to enjoy places, food and activities that interested them.
“There was an increase since the last time we visited in how often people were supported to get out and about.” from the report
Medicines and staffing
There were enough staff to meet people's needs, recruitment checks were robust and medicines records were complete.
“Administration records were complete and clearly filled out.” from the report
Safeguarding was not always prompt
seriousA safeguarding concern was left unreported for four weeks. Some staff also could not show that they understood how to recognise and report abuse promptly.
“One safeguarding concern was left unreported for four weeks.” from the report
Liberty restrictions lacked legal authority
seriousDeprivation of Liberty Safeguards for both people had expired. One application was not made again and another was not followed up.
“People's liberty was being restricted without legal authority.” from the report
Missing best-interest records
seriousRecords did not support decisions about restrictions such as locked furniture and keypad access to bathrooms.
“Where decisions had been made for people in their best interests there were no records available to support this.” from the report
Weak quality checks
seriousThe provider's and manager's checks did not identify the safeguarding, consent and safety problems. The provider did not have a documented quality assurance system with evidence of actions taken.
“The provider and registered manager failed to ensure a robust quality assurance system was in place to assess, monitor and improve the quality and safety in the service.” from the report
Window safety
needs fixingWindows upstairs and downstairs were not restricted in line with the best practice guidance. Inspectors recommended that all windows be checked and that ongoing safety checks be introduced.
“At this inspection we found windows both upstairs and downstairs did not follow this best practise guidance and were not restricted according to the guidance.” from the report
- 01Have both people's Deprivation of Liberty Safeguards applications now been made, followed up and legally authorised?
- 02How are best-interest decisions now recorded for restrictions such as locked furniture and keypad access?
- 03What system is now used to make sure safeguarding concerns are reported promptly?
- 04What has been done to restrict and check all upstairs and downstairs windows?
- 05How does the provider now check the manager's work and record actions from quality assurance meetings?
This inspection looked at all five CQC questions and both the premises and care provided; Safe, Effective and Well-led had deteriorated from Good, while Caring and Responsive remained Good. This explanation was written from the published report of 8 January 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.
Every inspection of Brookland House
5 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- January 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 7 February 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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