CQC report explained · a residential care home
What the CQC found at Broome End
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from harm, there were enough staff, and medicines were managed safely. Recruitment checks, infection control and falls prevention systems were also in place.
- Effective?
- Good
- Staff had access to different types of training and their skills were checked. People received suitable food, fluids and healthcare, although oral health training was basic and the dementia unit's layout needed further consideration.
- Caring?
- Good
- Inspectors saw kind and respectful interactions. People were supported to make choices, keep their independence and have their privacy and dignity respected.
- Responsive?
- Good
- Care plans had improved and generally included people's needs, preferences and risks. Activities and complaints systems were available, but some oral health information in records was basic.
- Well-led?
- Good
- The new manager had introduced regular audits, meetings and action plans. People, relatives and staff were involved in giving feedback and described the management and improvements positively.
What inspectors found, December 2018
Rated Good; inspectors found significant improvements and kind, safe care, but some oral health, meal support and dementia-unit issues remained.
Inspectors visited without notice on 17 and 19 October 2018. They spoke with people living in the home, relatives, staff and visiting health professionals. They observed care and reviewed care records, medicines, recruitment, training, complaints, premises and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found medicines were now managed safely, staffing had improved, care plans were more useful, and managers had stronger checks on the quality of care.
People were treated kindly and supported to make choices, remain independent and take part in activities. There were still some shortfalls. Oral health training was basic, the dementia unit's layout needed more thought, and there were isolated examples of limited interaction during mealtimes.
Improvement since the last inspection
The home had made substantial progress since its previous Requires Improvement rating. A new manager, deputy manager and additional care staff had strengthened the service.
“At this inspection we found significant improvements had been made.” from the report
Kind and respectful care
People, relatives and professionals spoke positively about staff. Inspectors saw people treated with kindness, dignity and respect, with support for independence.
“Staff treated people with kindness, promoted their independence and respected their privacy and dignity.” from the report
Personalised support
Care plans contained information about people's abilities, preferences and risks. People could choose when to get up, how to spend their time and which activities to join.
“People received personalised care that was responsive to their needs.” from the report
Stronger management checks
The manager had introduced regular audits, team meetings and action plans. Complaints, incidents and safeguarding concerns were reviewed and used to improve the service.
“Systems were in place to ensure performance, risks and regulatory requirements are understood and managed.” from the report
Basic oral health training
needs fixingInspectors found staff training about oral health was basic. The deputy manager had plans to improve training, but this was not yet complete.
“However, we identified that oral health training for staff was basic and further training would increase their awareness.” from the report
Dementia-unit layout
needs fixingThe premises had been redecorated and some signs and features had been improved. However, inspectors said the layout and living space in the dementia unit needed further consideration.
“Further consideration was needed in relation to the suitability of the layout and living space in the dementia unit.” from the report
Some mealtime interactions
minorMost mealtimes were positive and sociable, but inspectors saw isolated examples where staff did not engage enough with people while supporting them to eat.
“There were occasions where staff interaction was lacking.” from the report
- 01What oral health training have staff completed since this inspection, and how do you check that they can provide effective mouth care?
- 02How do you record and follow up when someone declines mouth care?
- 03What changes have been made, or are planned, to improve the layout and living space in the dementia unit?
- 04How do you make sure staff engage with people throughout mealtimes, not only with their food and drinks?
- 05How many regular staff and agency staff are currently used, and how do you maintain continuity for people living here?
This was an unannounced comprehensive inspection covering all five ratings, with a dental inspector looking in detail at oral health support. This explanation was written from the published report of 1 December 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.
What inspectors found, October 2017
Rated Requires Improvement; inspectors found kind staff and some better management, but serious concerns about staffing, medicines and personalised care remained.
This was an unannounced inspection on 12 July 2017. Inspectors observed care, spoke with people, relatives, staff and healthcare professionals, and reviewed care plans, medicines, staffing, training, recruitment, complaints and quality checks.
The home had made some changes since the previous inspection, including appointing a new home manager and deputy manager. However, there was still no registered manager, night staffing remained a concern, and the home relied heavily on agency staff. Inspectors found medicines records and storage checks were not always reliable, some care plans did not give staff enough guidance, and people did not always receive enough support or meaningful activity.
All five areas were rated Requires Improvement: Safe, Effective, Caring, Responsive and Well-led. The home was in breach of Regulation 12 about safe care and treatment. This rating means improvements were needed and the regulator said it would check that the provider acted.
Safe recruitment
The home carried out the required background checks, identity checks and references before staff started work.
“Robust systems were in place to ensure that staff were recruited safely.” from the report
Kind and respectful care
Inspectors saw staff speaking kindly to people and protecting their privacy during personal care.
“We observed that the individual staff who supported people were kind and caring and treated people with dignity and respect.” from the report
Healthcare links
The management team had rebuilt working relationships with local healthcare professionals, and advice was being followed.
“The manager and deputy manager had an effective working relationship and had worked hard to establish good relationships with local healthcare professionals” from the report
Complaints handling
People and relatives knew how to complain, and inspectors found that complaints had been investigated and answered appropriately.
“The service had a complaints procedure in place.” from the report
Medicines records
seriousMedicine temperatures, stock balances, opening dates and cream or patch application records were not consistently recorded. This was a breach of Regulation 12.
“Effective systems were not in place to ensure that medicines were consistently stored and managed safely.” from the report
Staffing levels and agency use
seriousThe home relied heavily on agency staff, including three of the five care staff on duty during the inspection. Inspectors also remained concerned about periods when night units could be left unattended.
“On the day of the inspection we found that staff were not deployed effectively to meet people's needs and the service continued to rely upon agency staff to back fill vacant posts.” from the report
Incomplete care and risk guidance
seriousSome care plans did not reflect current needs or explain clearly how risks should be managed. Repositioning records were also not completed consistently for a person at risk of pressure wounds.
“Whilst care plans were person centred and detailed in places some lacked specific information about people's care and therefore did not reflect their current needs.” from the report
Training checks
needs fixingMost training was online, with no evidence that staff competencies were checked afterwards. Inspectors were concerned that agency staff were not given enough information about residents.
“There was no evidence that staffs competencies had been assessed following the training to ensure that they had understood what they had learnt and were able to effectively apply it to their daily practice.” from the report
Limited meaningful activity
needs fixingSome people joined activities, but people with higher needs or those staying in their rooms could be left for long periods with little interaction.
“We observed that other people spent much of their time just sitting in the lounge with the television or music on without meaningful engagement.” from the report
Quality checks
needs fixingAudits did not identify all the problems inspectors found, including cleaning issues and weaknesses in medicine records.
“Quality assurance systems were in place but had not always identified areas for improvement.” from the report
- 01How many permanent care staff are now employed, and how often are agency staff used, especially at weekends and overnight?
- 02How do you check that medicine temperatures, stock balances, opening dates and cream or patch applications are recorded correctly?
- 03How are care plans kept up to date, particularly for people who need repositioning or monitoring for health risks?
- 04How do agency staff learn about each person's needs, preferences and communication before providing care?
- 05What changes have been made to audits and meaningful activities since this inspection?
This was an unannounced comprehensive inspection covering all five rating areas, with findings based on observations, records and discussions with people, relatives, staff and healthcare professionals. This explanation was written from the published report of 26 October 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 Broome End
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- December 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- February 2013
Registered with the Care Quality Commission on 1 February 2013.
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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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 £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.