CQC report explained · a residential care home
What the CQC found at Brookmead
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some safety arrangements were not reliable. Inspectors found missing sensory assessments, overdue risk reviews, an ineffective fire precaution and missing instructions for some medicines to be given when needed.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. The report's findings included kind and compassionate care, respect for privacy and dignity, and support for people's choices.
- Responsive?
- Good
- This key question was not inspected during this visit. The previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Quality monitoring did not reliably identify risks, missing medicine information, incomplete care records or maintenance problems. Leaders were supporting people's wishes and working with relatives and other professionals.
What inspectors found, April 2023
Brookmead rated Requires Improvement; inspectors found kind care and enough staff, but gaps in risk checks, medicines records and quality monitoring.
This was an unannounced inspection on 10 and 13 March 2023. One inspector spoke with all five people living in the home, two relatives and seven staff. They observed care and checked care plans, medicine records, recruitment and training files, and safety records.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe and Well-led. Inspectors found enough staff, kind care, appropriate safeguarding and good support for people's independence. Infection prevention arrangements were also found to be effective.
However, sensory needs had not been formally assessed, some risk assessments were overdue and fire risks had not always been assessed properly. Information for some medicines to be given when needed was missing. Quality checks had not found these problems or some maintenance issues. The overall rating fell from Good at the last inspection, published in September 2017.
Kind and respectful care
People received compassionate care. Staff protected privacy and dignity and responded to individual needs.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Enough staff
Staffing levels included one-to-one support for activities, visits and health appointments. Recruitment checks and staff training supported safe care.
“There were enough staff to support people. This included 1 to 1 support for people to take part in activities and visits how and when they wanted.” from the report
Supporting independence
Staff supported people to manage their own medicines and health checks where possible, and encouraged positive risk-taking.
“People were supported to take their own medicine and manage daily health checks where they could.” from the report
People's involvement
People had regular meetings and could influence how the home worked. Staff supported individual wishes and interests.
“Staff encouraged people to be involved in the development of the service.” from the report
Weak quality checks
seriousThe provider's systems did not reliably identify or address risks, missing medicine information, incomplete care records and some maintenance problems. This was a breach of Regulation 17.
“The provider had failed to establish adequate systems and processes to assess and improve the quality and safety of the service provided or to assess and monitor risks.” from the report
Fire and risk assessments
seriousSome general risk assessments had not been reviewed for over a year. An office door was wedged open and would not have automatically closed during a fire, although automatic closures were fitted during the inspection.
“Risks to people from fire had not always been assessed effectively.” from the report
Missing medicine instructions
seriousInstructions for medicines given when needed did not explain the purpose, dose or signs and symptoms to look for. The information was put in place immediately after the inspection, and inspectors found no harm had occurred.
“'As required' medicine (PRN) protocols were not in place to guide staff describing what the medicine was prescribed for and did not included details such as dose instructions, signs and symptoms.” from the report
Sensory needs and care records
needs fixingPeople did not have formal sensory assessments, and some care plans did not fully describe people's needs or use respectful, empowering language.
“People did not have assessments of their sensory needs. This meant potential adaptions to the environment had not been fully considered.” from the report
Maintenance issues
minorQuality systems had not dealt promptly with damaged furniture, scraped flooring and marked or damaged walls and woodwork.
“systems had not been used to address the lack of timely maintenance” from the report
- 01Have all people's sensory needs now been formally assessed, and how have the findings changed their support?
- 02Have all risk assessments been reviewed, including fire risks and the practice of wedging doors open?
- 03How are medicines given when needed now recorded, including their purpose, dose and signs or symptoms to monitor?
- 04What checks now make sure support plans use respectful language and record clear goals and aspirations?
- 05What maintenance problems identified in the report have been repaired, and how are they now monitored?
This was a focused inspection of Safe and Well-led; the other key question ratings were not inspected and the previous ratings were used to calculate the overall rating. This explanation was written from the published report of 25 April 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, November 2017
Rated Good; inspectors found safe, kind and personalised care, with a new manager not yet registered with the CQC.
The announced inspection took place on 28 September 2017. One inspector observed care, spoke with four relatives, the manager and two care staff, and checked care records, staff files, medicines and quality checks. People could not talk directly with inspectors, so their experience was also assessed through observation and relatives' views.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough skilled staff, safe medicines arrangements, detailed care plans, regular activities and kind, respectful care. People were supported with food, healthcare, choices and independence.
The overall rating remained Good, the same as at the previous inspection on 4 November 2014. The manager had been in post for about two months and was not registered with the CQC at the time of this inspection.
Safe staffing
People received one-to-one care. Inspectors found consistent staffing and enough skilled and experienced staff to keep people safe.
“We saw there was enough skilled and experienced staff to ensure people were safe and cared for.” from the report
Safe medicines
Medicines were administered, stored, checked and disposed of safely. Records inspected were accurate.
“People continued to receive their medicines safely.” from the report
Kind and respectful care
The home was described as relaxed and homely. Staff respected people's privacy, dignity, choices and individual ways of communicating.
“The service continued to have a relaxed and homely feel.” from the report
Personalised activities
People were supported to take part in activities they enjoyed at home and in the community, including trips out and leisure activities.
“The provision of meaningful activities remained good and staff undertook activities with people both at the service and in the community.” from the report
Manager not yet registered
minorThe manager had been in post for about two months and had not registered with the CQC when inspectors visited. The report still rated the well-led area Good.
“They were not at the time of our inspection registered with the CQC.” from the report
- 01Is the manager now registered with the CQC, and who is responsible for the home if the manager is away?
- 02How will you provide one-to-one staffing if a permanent staff member is absent?
- 03How are relatives involved in care plan reviews and decisions about their family member's care?
- 04What activities are available each day, and how do you make sure they match each person's preferences?
- 05How do you check that medicines are given correctly and that records remain accurate?
This was an announced inspection covering all five key questions and the overall quality of the home; people could not speak directly with inspectors, so observation and relatives' views were also used. This explanation was written from the published report of 7 November 2017 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 Brookmead
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
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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28 live-in carers within about an hour of West Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
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