CQC report explained · a residential care home
What the CQC found at Brownlow House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Medicines were not always recorded or accounted for properly, and the home was asked to improve its medicines audits. Other safety checks, staffing and infection control arrangements were found to be in place.
- Effective?
- Good
- Staff received induction, training and regular supervision. People were supported with eating and drinking, healthcare appointments and decisions about their care.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in care decisions and supported to remain independent.
- Responsive?
- Good
- Care plans recorded people's needs and preferences. People could take part in activities, go into the community and have their complaints responded to.
- Well-led?
- Good
- The home had a positive culture, regular audits and an improvement plan. Staff and people said they felt able to approach the registered manager.
What inspectors found, August 2022
Rated Good overall; inspectors found kind, personalised care, but medicines systems were not always safe and the Safe rating was Requires Improvement.
Inspectors visited without notice on 8 June 2022. They reviewed care plans, medicines, audits and recruitment records. They spoke with four people and four staff, and observed care in communal areas.
The home was clean and staff used protective equipment properly. People received kind and dignified support. Care plans were personalised, activities were available, and staff helped people with food, drinks and healthcare.
The main weakness was medicines management. Some medicines had not been given as prescribed or were not fully accounted for, and audits needed to improve. The overall rating rose from Requires Improvement to Good since the last inspection, but Safe remained Requires Improvement.
Kind and respectful care
People were treated with kindness and dignity. Staff knew people well and responded promptly to requests.
“People were referred to by their preferred name. Staff spoke to people with kindness.” from the report
Personalised care plans
Care plans recorded people's health, social needs, choices and preferences. Staff recorded care in real time.
“Care plans contained accurate information for staff to enable them to safely support people.” from the report
Support with activities
People were supported to choose activities, go for walks and access the community.
“Staff supported people to participate in activities of their choice.” from the report
Staff support and training
Staff had an induction, ongoing training and regular supervision. Inspectors found that staff knew how to support people.
“Staff received regular supervisions from the management team.” from the report
Medicines records and checks
seriousSome medicines had not been given as prescribed or were not fully accounted for. Inspectors recommended better audits so problems were found and acted on quickly.
“Stock counts showed that some medicines had not been given as prescribed or were not fully accounted for.” from the report
Trip hazard
needs fixingThe hallway floor was not level and could cause someone to trip. Risk assessments were in place and reports were being arranged.
“At the time of the inspection, the floor in the hallway was not level and was a potential trip hazard.” from the report
Bath maintenance
minorThe enamel in one bath had started to come away. The manager said this would be repaired, and refurbishment work was included in the improvement plan.
“During this inspection we found the enamel in one of the baths had started to come away.” from the report
- 01What changes have been made to medicines storage, recording and stock checks since the inspection?
- 02How do you make sure medicines are given as prescribed and that any missing medicines are found quickly?
- 03Has the uneven hallway floor been repaired, and what action was taken to reduce the trip risk?
- 04Has the damaged bath enamel been repaired?
- 05How will you keep us informed about changes to our relative's care plan and medicines?
This was an unannounced inspection covering all five key questions and infection prevention and control measures; the report says the overall rating changed from Requires Improvement to Good. This explanation was written from the published report of 3 August 2022 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, September 2019
Rated Requires Improvement; inspectors found caring staff and personalised care, but safety, respectful treatment, activities and management systems needed further improvement.
This was an unannounced inspection on 3 and 4 July 2019. Inspectors spoke with people living at the home, a relative and staff. They observed care and checked care plans, medicines records, staff files, training records and quality checks.
The home was clean and people generally felt safe. Staff knew people well, care plans were personalised and people received support with meals and healthcare. However, inspectors found problems with the safety of the building, medicines records and staff training about mental health and substance or alcohol misuse.
Inspectors also saw some staff interactions that did not show enough respect or reassurance. There were few organised activities, and some people felt bored. Management had improved since the previous inspection, but its checks had not found or fixed all the problems.
The overall rating was Requires Improvement. Safe, caring, responsive and well-led were all rated Requires Improvement. Effective was rated Good. This was the fourth consecutive Requires Improvement rating over three years.
People generally felt safe
People told inspectors that staff treated them well and that they felt safe. Staff understood how to report safeguarding concerns, and records showed concerns had been reported when needed.
“People told us staff treated them well and that they felt safe.” from the report
Personalised care
Care plans included people's needs, preferences, routines and communication support. Staff could describe the people they supported and generally followed their care guidance.
“People's care plans provided details that would help staff provide personalised care that met people's needs and preferences.” from the report
Support with food and healthcare
People spoke positively about the food. Mealtimes were unhurried, alternatives were offered, and healthcare professionals were involved when needed.
“Meal times were unhurried, and people could take as much time as they needed to eat their meals.” from the report
More manager oversight
Since the previous inspection, the manager had stopped overseeing two homes and was now based full-time at this home. This gave them more control over day-to-day performance.
“The registered manager now only worked at Brownlow House, and the provider had recruited another manager to oversee the sister service they were also previously managing.” from the report
Choice and least restriction
People were supported to make choices and, where possible, to have control over their lives. Staff understood the principles of the Mental Capacity Act and people's legal safeguards.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Premises safety
seriousInspectors found problems including a loose window restrictor, unsecured wardrobes, missing electrical safety evidence and poor management of legionella risks. This was a legal breach.
“The provider was not taking reasonable steps to ensure the safety of the premises.” from the report
Medicines records and handling
needs fixingRecords did not always accurately show medicines carried over between months. Controlled drug storage was not fully secure, and inspectors saw a tablet picked up by hand after it was dropped.
“This made it more difficult to check people had received their medicines as prescribed.” from the report
Respectful interactions
needs fixingMost interactions were warm, but inspectors saw staff support and move a person without communicating or offering reassurance. They also saw a lack of acknowledgement when a person made way for staff.
“On two occasions we observed staff supporting a person with moving and handling and they did not communicate with the person, offer reassurance, or interact in any way.” from the report
Too few activities
needs fixingThe activities coordinator had left and the home was recruiting. Inspectors saw no organised activities on either inspection day, and some people said they felt bored or under-stimulated.
“We saw no organised activities within the home on either day of our visit.” from the report
Weak quality checks
seriousAudits had not identified several problems found by inspectors. Incident records were not always linked to care plans or risk assessments, and there was no written record of staff handovers. This was a legal breach.
“The provider was failing to operate effective systems to assess, monitor and improve the quality and safety of the service.” from the report
- 01What has been done to fix the loose window restrictor, unsecured wardrobes and electrical safety checks?
- 02How are water temperatures, infrequently used outlets and legionella risks now monitored?
- 03How do you check that medicines balances and controlled drug storage are accurate and safe?
- 04What training have staff completed about mental health and drug or alcohol dependence?
- 05What regular activities are now available, including for people who feel bored or need one-to-one support?
This was an unannounced inspection that looked at the care and the premises and assessed all five key questions. This explanation was written from the published report of 14 September 2019 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 Brownlow House
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- August 2022Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 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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