CQC report explained · a nursing home
What the CQC found at Brooklands Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People generally felt safe, and staff understood safeguarding. However, inspectors found delayed responses, unreachable call bells, an incorrectly set pressure mattress, unsafe mealtime positioning and gaps in medicines records.
- Effective?
- Good
- This question was not assessed during the targeted inspection.
- Caring?
- Good
- This question was not assessed during the targeted inspection, although people and relatives told inspectors that staff were kind.
- Responsive?
- Good
- This question was not assessed during the targeted inspection.
- Well-led?
- Requires improvement
- Inspectors found kind staff and some good communication, but staff training and supervision were not up to date. There was no manager registered with the CQC at the time.
What inspectors found, December 2020
Brooklands Nursing Home was rated Good; inspectors found kind care and good infection control, but concerns about staffing, risks, medicines records and staff training.
This was a targeted inspection on 9 November 2020. Inspectors looked only at selected parts of Safe and Well-led because of concerns about medicines, unsafe care and management oversight. They spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
People generally said they felt safe and that staff were kind. Inspectors found good safeguarding practice, action after accidents and no major infection control concerns. However, some people waited too long for help. Call bells were out of reach for four people, one pressure mattress was on the wrong setting, and some people were not positioned or supervised safely during meals.
There were gaps in medicines records, staff recruitment checks, training and supervision. The provider took or promised some action after the inspection, including adding a staff shift and updating evacuation information. The overall rating stayed Good, but Safe and Well-led were inspected without being given new ratings.
People felt safe
People and relatives generally said they felt safe in the home. Staff knew how to recognise and report safeguarding concerns.
“People told us they felt safe with staff.” from the report
Kind staff
People and relatives described staff as kind and supportive.
“Staff are kind, they speak to him very nicely.” from the report
Action after accidents
The home recorded and reviewed accidents and took steps to reduce the risk of further incidents.
“Where people had incidents or accidents, these were recorded, discussed and action taken.” from the report
Infection control
Inspectors found a clean environment and no major infection prevention and control concerns.
“People lived in a clean environment and we observed housekeeping staff carrying out cleaning tasks during our inspection.” from the report
People waited too long for help
seriousInspectors saw call bells ringing for long periods. One person who needed supervision during lunch did not receive it because of staff shortages.
“At our inspection, particularly during the morning, we were aware of people's call bells ringing for long periods of time.” from the report
Some risks were not managed properly
seriousFour people could not reach their call bells. One pressure mattress was on the wrong setting, and some people were not positioned or supervised safely while eating.
“we found four people's call bells were placed in a way that they could not have reached them.” from the report
Medicines records had gaps
needs fixingTwo medicines charts had gaps. A timed medicine was recorded as given at set times, rather than recording the actual time it was given.
“We found gaps in two people's MAR charts.” from the report
Staff training was incomplete
needs fixingRecords showed that some staff had not completed safeguarding, first aid, food hygiene or fire safety training.
“According to the records of 20 staff this showed 10 staff had not received safeguarding, eight first aid training, nine food hygiene and three staff had not undertaken fire safety training.” from the report
Supervision was out of date
needs fixingSome staff had not received supervision for several years, which meant they were not receiving the support set out in the home's policy.
“Staff were not receiving supervision in line with the provider's policy and the provider said that staff supervision was not up to date.” from the report
Hand hygiene was not always followed
needs fixingInspectors saw some staff move between people's rooms without using hand sanitiser between visits.
“we saw some staff going between different people's rooms without sanitising their hands in between.” from the report
- 01What has been done to make sure people can always reach their call bells?
- 02How do you now set and check pressure mattresses and make sure people are positioned and supervised safely during meals?
- 03What changes were made to staffing levels after the inspection, and how are staffing needs now linked to each person's dependency?
- 04Have all staff completed safeguarding, first aid, food hygiene, fire safety and other role-specific training?
- 05Are medicines records now complete, including the actual times that timed medicines are given?
This was a targeted inspection of selected parts of Safe and Well-led only; the other key questions were not assessed and the overall Good rating remained from the previous inspection. This explanation was written from the published report of 25 December 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, August 2018
Brooklands Nursing Home rated Good; inspectors found safe, kind and personalised care, but records and quality checks were not consistently up to date.
This was an unannounced comprehensive inspection on 19 and 20 July 2018. Inspectors spoke with people, staff, visitors and health professionals. They looked at care records, medicines, staffing, training, the building and the home's quality checks.
The home was rated Good overall. Safe, Effective, Caring and Responsive were all rated Good. Inspectors found enough staff, safe medicines systems, suitable training, respectful care, access to healthcare, personalised support and activities.
Well-led was rated Requires Improvement. Audits had been introduced and earlier legal breaches had been met, but some care records and risk assessments were not accurate or updated quickly enough. The inspection found the effect on people was low at that time because staff knew their needs well.
The overall rating improved from Requires Improvement at inspections in May 2016 and June 2017. Inspectors said the home needed to make sure these improvements became part of everyday practice.
Safe medicines
Inspectors found medicines were stored, given, recorded and audited safely. Staff had suitable training and competency checks.
“Medicines were managed safely and in accordance with current regulations and guidance.” from the report
Kind and respectful care
Staff knew people well and protected their dignity, privacy and choices. Inspectors observed calm and positive relationships.
“People were treated with kindness and respect and as individuals.” from the report
Personalised support
Care plans included people's preferences, histories and routines. Staff supported people to make choices and remain as independent as possible.
“People chose how and where they spent their time.” from the report
Activities and relationships
People could join group activities or have one-to-one time. Visitors were welcomed and people were supported to maintain family relationships.
“Activities at Brooklands were planned and tailored to meet peoples' preferences and interests as much as possible.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs, with staff available and not rushed. Training, supervision and appraisals were in place.
“Sufficient numbers of skilled and experienced staff contributed to the safety of people who lived at the home.” from the report
Care records were not always current
needs fixingSome care plans and risk assessments contained conflicting information or had not been updated promptly after people's needs changed. Staff understood people's needs, but written guidance was not always clear.
“Records relating to the care and treatment provided to people were not always accurate or up to date.” from the report
Nutrition records
needs fixingChanges in nutritional needs were not always reflected in risk assessments, and food and fluid charts were not completed consistently.
“food and fluid charts not being consistently recorded.” from the report
End-of-life medicines guidance
needs fixingGuidance about when to use anticipatory pain relief needed to be developed further so it could be started promptly when needed.
“Pain relief especially for those who had been prescribed anticipatory medicines as they approached the end of their life.” from the report
- 01How do you make sure care plans and risk assessments are updated promptly when a person's needs change?
- 02How do you check that food and fluid charts are completed consistently, especially for people at risk of malnutrition?
- 03What guidance is now in place for anticipatory medicines and pain relief at the end of life?
- 04How do you make sure all staff know about changes in a person's health, diet or risks?
- 05What evidence can you show that the improvements identified after the previous inspections have been sustained?
This was an unannounced comprehensive inspection covering all aspects of the home, including follow-up of previous breaches and the provider's action plan. This explanation was written from the published report of 29 August 2018 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 Brooklands Nursing Home
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- December 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Goodup from Requires improvement
- July 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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