CQC report explained · a nursing home
What the CQC found at Brookview Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2023
Rated Requires Improvement; inspectors found kind care and activities, but serious weaknesses in cleanliness, staffing, records and management.
This was an unannounced comprehensive inspection. Inspectors visited on 25 September and 9 October 2023. They spoke with people, relatives and staff, observed care, and checked care records, medicines records and management documents.
The home was not consistently safe or well managed. Inspectors found dirty and damaged areas, poor signage, gaps in care plans, missed or delayed health referrals, weak hydration monitoring and medicines checks that were not always completed. Staff training and supervision were also not up to date.
There were positive findings too. Staff often treated people with dignity and knew them well. People were supported with meals, activities, family contact and end of life care. However, care was not consistent enough, and the home was rated Requires Improvement in all five areas.
The home had also been rated Requires Improvement at the previous inspection, published in January 2021. CQC said sufficient improvements had not been made and that the home had been rated Requires Improvement at its last two consecutive inspections.
Medicines usually given safely
Staff giving medicines had training and competency checks. Inspectors observed appropriate checks and records when medicines were administered.
“We observed staff giving people's medicines and saw they made appropriate checks and records, to ensure people's medicines were safely given and accounted for.” from the report
Dignity and privacy
Staff often protected people's privacy and dignity during personal care and supported people respectfully.
“We observed staff often promoted people's privacy and dignity when they provided care.” from the report
Meals and dietary needs
People were generally supported to eat enough food, with alternative meals and required food textures available. However, hydration was not consistently managed.
“We observed staff supporting people to eat and drink sufficient amounts at mealtimes.” from the report
Activities and relationships
The home arranged group and individual activities and helped people keep in touch with family and friends. Staff could hire a minibus for trips into the community.
“Otherwise, a range of group and individual social, recreational and leisure activities were regularly organised in consultation with people and relatives, to enable people's engagement as they chose.” from the report
End of life care
Inspectors found that end of life plans and anticipatory medicines were in place to support comfort, dignity and choice.
“People could be supported at the end of life to have a comfortable, dignified, pain free death.” from the report
Cleanliness and equipment
seriousSeveral bedrooms and communal areas had dirt, dust, staining or smells. Some equipment and furnishings were damaged or not easy to clean, creating an infection risk.
“We found areas of malodour and a build of dirt, dust and debris to the floorings in 5 people's bedrooms.” from the report
Staff training and supervision
seriousMany training modules were incomplete and staff did not receive regular supervision. The improvement plan sent after the inspection did not cover all outstanding training.
“Staff training was not up to date.” from the report
Hydration and timely help
needs fixingSome people waited for help with drinks, and drinks were left out of reach. Fluid records did not always show the required daily amount and recorded intake was often low.
“We observed delays for 4 people, cared for in their rooms; who had varying levels of dementia and needed staff assistance to eat and drink.” from the report
Care records and health referrals
needs fixingSome care plans did not contain enough information about people's individual needs. One health referral was not made without delay, increasing the risk of inconsistent care.
“We found gaps in some people's care plan records, with regard to their individual nutritional, skin, emotional and least restrictive care needs.” from the report
- 01What has been done to make bedrooms, bathrooms, communal areas and care equipment consistently clean and safe?
- 02How many staff have now completed the outstanding training, including dementia, nutrition and hydration, dignity and oral care training?
- 03How are you checking that people at risk of dehydration receive enough fluids and that drinks are within reach?
- 04How are care plans being checked to make sure they contain up-to-date information about each person's health, skin, nutrition and least restrictive care needs?
- 05How are medicines audits, staffing levels and other identified risks now brought together into a clear improvement plan?
This was an unannounced comprehensive ratings inspection covering all five key questions, including the premises and the care provided. This explanation was written from the published report of 14 December 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 2021
Overall rating Requires Improvement; inspectors found safe, well-led care, but identified recording and care-planning issues.
This was an unannounced focused inspection. Inspectors looked mainly at safety, infection control and how the home was managed. They spoke with staff, relatives and a social care professional, and checked care, staffing, medicine and management records.
The safe and well-led ratings improved from Requires Improvement to Good. Inspectors found enough staff, suitable recruitment checks, better risk assessments and safer medicine systems. They were also assured about infection control measures, although some minor issues were fixed during the inspection.
The overall rating stayed at Requires Improvement because ratings from the previous comprehensive inspection were used for areas not reviewed this time. Inspectors found kind staff and a choice of meals, but the home was still developing more person-centred care plans.
Improved risk management
People had individual plans for risks such as falls, sore skin and nutrition. Staff used equipment and professional advice to reduce these risks.
“At this inspection we found that risks had been assessed and measures put in place to reduce the risks.” from the report
Kind staff
Inspectors saw positive interactions. Staff knew about people's lives and families, and relatives praised their kindness.
“All the interactions we observed were positive and reflected staff who cared about the person and the support they required.” from the report
Stronger management checks
The home had introduced regular audits and a weekly clinical report. These checks helped identify actions and monitor people's needs.
“The registered manager completed monthly audits in all areas of the home.” from the report
Infection control measures
Inspectors were assured that the home had measures for PPE, testing, visiting, social distancing and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Medicine records
needs fixingSome medicines in the fridge had not been dated when opened, and some daily temperature checks were missing. The home dealt with these issues immediately and introduced a weekly check.
“We found some items in the fridge had not been dated on opening and some temperature checks had not been completed daily.” from the report
Care plans still developing
needs fixingThe report says the care plan format was not always easy to use or person-centred. The provider was reviewing it, and inspectors planned to check progress later.
“The provider and registered managers within the providers organisation were reviewing the care plan format as the current model was not always easy to navigate or reflected a person-centred approach.” from the report
Sharing safeguarding learning
minorStaff did not always feel informed after safeguarding incidents. The manager agreed to make this a regular staff meeting item.
“Care staff did not always feel informed following a safeguard, the registered manager agreed to add this as a standing item to the staff meetings and ensure the information was shared.” from the report
Minor infection control improvements
minorInspectors found some minor infection control areas that could be improved. These were addressed immediately.
“During the inspection we identified some minor areas which could be improved, these were addressed immediately to reduce the risks of spreading the infection.” from the report
- 01What changes have been made to the care plan format since this inspection, and how do you make sure plans reflect each person's life and preferences?
- 02How are fridge opening dates and medicine storage temperatures checked now?
- 03How do you make sure all care staff hear about learning from safeguarding incidents?
- 04What were the minor infection control issues found at the inspection, and how were they corrected?
- 05Which ratings from the previous comprehensive inspection still apply to the areas not assessed during this visit?
This was a focused inspection of Safe and Well-led, including infection prevention and control; ratings from the previous comprehensive inspection were used for the other areas. This explanation was written from the published report of 15 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 Brookview Nursing Home
6 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- December 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2021Requires improvementstayed Requires improvementSafe: GoodWell-led: Good
- December 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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