CQC report explained · a nursing home
What the CQC found at Brunswick House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff and nurses, safe medicines arrangements, suitable safety checks and effective cleaning arrangements. They were only somewhat assured that personal protective equipment was being used effectively and safely.
- Effective?
- Good
- Care records had improved and gave staff clearer guidance. People received support with food, drink, health needs and access to health professionals.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward, but that rating is not stated in the report text.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was carried forward, but that rating is not stated in the report text.
- Well-led?
- Good
- Inspectors found stronger quality monitoring, clearer improvement plans and a positive, open culture. At the time of the visit there was no registered manager in post.
What inspectors found, March 2023
Rated Good after improvements, with safe and effective care found, but the inspection was focused and a registered manager was not yet in post.
Inspectors visited without notice on 1 and 2 February 2023. They spoke with people, relatives, staff and health professionals. They observed care and reviewed care records, medicines, staff recruitment, training, cleaning and management checks.
The home was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, safe medicines arrangements, improved care records, suitable training and stronger quality checks. People said staff were caring, friendly and available to help.
The previous rating was Requires Improvement, published in November 2021. Inspectors found the required improvements had been made and said the home was no longer in breach of regulations. This was a focused inspection of Safe, Effective and Well-led, so the other two ratings were carried forward from the previous inspection.
Enough staff
Inspectors found enough care staff and nurses to meet people's care and health needs. Additional care support assistants helped people with drinks, snacks, toileting and reassurance.
“There were enough care staff and nurses employed to meet people's care and health needs.” from the report
Improved care records
Records were more accurate and detailed than at the previous inspection. Care plans gave staff clearer instructions about people's needs and preferences.
“People's care records had improved, and they now provided a more accurate and detailed record of the care delivered, which was in accordance with people's care plans.” from the report
Better quality checks
The provider had improved its audits and used a service improvement plan to track actions. Monthly checks gave senior management better oversight.
“It enabled them to identify patterns, trends and areas for improvement, across all their services.” from the report
Support with food and drink
People were supported to eat and drink, with choices and cultural preferences taken into account. Staff helped people in a dignified and unrushed way.
“We observed care staff assisting people to eat in a dignified and unrushed way.” from the report
Use of protective equipment
needs fixingInspectors were only somewhat assured that personal protective equipment was being used effectively and safely. They signposted the provider to resources to develop its infection prevention and control approach.
“We were somewhat assured that the provider was using PPE effectively and safely.” from the report
No registered manager in post
needs fixingThe previous registered manager had left. The new home manager had been in post for six weeks and was completing an application to become the registered manager.
“At the time of our inspection there was not a registered manager in post.” from the report
Activity staffing
minorA new activities co-ordinator had just been recruited, but a second activity support worker was still expected to start.
“It was hoped a second activity support member of staff would also start soon.” from the report
- 01What steps have been taken to ensure PPE is used effectively and safely?
- 02Has the new home manager completed the application to become the registered manager?
- 03How are the improved care records checked to make sure they remain accurate?
- 04Has the second activity support member of staff started, and what activities are currently available?
- 05Which ratings for Caring and Responsive were carried forward from the previous inspection?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 10 March 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 2021
Brunswick House Nursing Home: Rated Requires Improvement; inspectors found kind care and improving leadership, but incomplete records and weak checks created risks.
Inspectors visited without notice on 15 and 16 September 2021. They spoke with people, relatives, staff and a healthcare professional. They observed care and checked care, medicines, mental capacity and management records.
The home was rated Requires Improvement overall. Effective care and leadership were both rated Requires Improvement. Safe was inspected for infection control but was not re-rated. The inspection was focused on Effective and Well-led because of concerns about care quality.
People said they felt safe and that staff were kind. However, staff were often busy, so people sometimes had to wait. Care records were sometimes incomplete or inaccurate, including records about drinks, personal care and repositioning. One person also missed medicines for a day after a delay registering with a GP.
The new manager and area manager understood what needed to improve and had started making changes. Inspectors found that these changes had not yet been fully effective or firmly established.
People felt safe
People told inspectors they felt safe and looked after. They described staff as friendly and kind.
“People told us they felt safe and looked after.” from the report
Healthcare access
People could access regular medical reviews and other health services. A GP visited weekly to review health and medicines when needed.
“People had access to medical support and review, along with access to other health related services.” from the report
Mental capacity decisions
The home had processes for making decisions in people's best interests when they could not decide for themselves. Records were kept for these decisions and for deprivation of liberty applications.
“Processes were in place to ensure decisions made on behalf of people who lacked mental capacity, were made in their best interests.” from the report
Incomplete care records
seriousRecords about personal care, repositioning, drinks and wound care were not always accurate or complete. This meant staff could not always show that planned care had been delivered.
“People's daily care records were sometimes inaccurate and in places incomplete.” from the report
Medicines delay
seriousA person went without medicines for one day because they were not registered with a GP promptly after admission. Similar problems happened again despite new processes.
“One person had gone without their medicines for one day because of this delay.” from the report
Weak quality checks
seriousThe home's audits and monitoring systems did not reliably identify problems with records, hydration, repositioning, infection control or staff supervision. This was part of the breach of Regulation 17.
“We found no evidence that people had been harmed however, systems were either not robust enough or effectively operated to demonstrate safety and quality was effectively managed.” from the report
PPE storage checks
needs fixingInspectors were only somewhat assured that personal protective equipment was being used safely and effectively. They signposted the managers to specialist infection control support.
“We were somewhat assured that the provider was using PPE effectively and safely.” from the report
- 01How do you now check that records of drinks, personal care and repositioning are complete and accurate?
- 02What has changed to prevent people missing medicines after hospital discharge or admission to the home?
- 03How do you check that staff receive supervision when it is due?
- 04What changes have been made to the storage and safe use of PPE?
- 05How will you show families that the improvements identified by the inspection have been completed and are lasting?
This was a focused inspection of Effective and Well-led, with infection prevention and control checked under Safe; the other key questions were not inspected and their previous ratings carried over. This explanation was written from the published report of 4 November 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 Brunswick House Nursing Home
6 rated inspections over 7 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Brunswick House Nursing Home →
- November 2021Requires improvementdown from GoodSafe: Inspected but not ratedEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Brunswick House Nursing Home →
- December 2020Goodstayed GoodSafe: GoodWell-led: Good
- April 2019Goodup from Requires improvementSafe: GoodEffective: GoodResponsive: Requires improvementWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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