CQC report explained · a residential care home
What the CQC found at De Brook Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found systems to protect people from harm, safe recruitment, improved staffing levels and monitoring of falls and weight loss. They found a medicines fridge at the wrong temperature and incomplete records for one person, which were corrected during the inspection.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- Care plans recorded people's routines, choices and preferences. Inspectors saw staff respond promptly and kindly, and found a range of activities and ways for people and visitors to raise concerns.
- Well-led?
- Good
- A new manager and the regional director had introduced a comprehensive improvement plan, regular audits and better communication with people, relatives and staff. The home was working with the local authority to address recent concerns.
What inspectors found, October 2021
Rated Good; inspectors found kind, personalised care and improvements in staffing and oversight, but identified recent medicines record problems.
This was an unannounced focused inspection on 2 and 7 September 2021. Inspectors looked at Safe, Responsive and Well-led, including infection control. They spoke with eight people, four relatives or friends and seven staff, and reviewed care records, medicines records, staff files, rotas and quality checks.
The home was rated Good overall, with Good ratings for Safe, Responsive and Well-led. Inspectors found that staffing levels had been increased, risks such as falls and weight loss were being monitored, and care plans were personalised. People and visitors described staff as kind and said they felt able to raise concerns.
There had been recent concerns about falls, weight loss and how the home was managed. A new manager had introduced an improvement plan, audits and checks. Inspectors found a medicines fridge at the wrong temperature and incomplete records for one person, but the provider corrected these issues during the inspection.
Effective and Caring were not inspected during this visit. Their previous ratings were used when calculating the overall rating. The previous overall rating was also Good, published on 28 September 2020.
Personalised care
Care plans recorded people's routines, choices and preferences. Staff were observed responding to individual needs and requests in a kind and timely way.
“Care plans were personalised and included individual routines, choices and preferences.” from the report
Kind staff
People and visitors spoke positively about the care. Inspectors observed staff treating people with respect and understanding their individual needs.
“During the inspection we observed staff being kind and caring to people, understood the individual needs of people and responded to requests for help in a timely manner.” from the report
Improved oversight
The new manager had introduced an improvement plan and regular checks covering areas such as medicines, accidents and incidents.
“Following a full review of the service a comprehensive improvement plan had been implemented, identifying areas of improvement and how these were to be met.” from the report
Activities and relationships
People had access to a variety of activities, including singing, reading, reminiscing, skittles and films. Some people were also supported to develop relationships with befrienders.
“Throughout the inspection we observed a range of activities taking place on each of the units.” from the report
Infection control
Inspectors were assured that the home was following arrangements covering personal protective equipment, testing, visitors, hygiene and infection outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Recent staffing pressure
needs fixingOne person said there were not always enough staff. Managers accepted that staffing levels had previously been inadequate and had increased them, with further recruitment and changes to shifts taking place.
“People told us they felt enough staff were not always available.” from the report
Medicines checks
needs fixingThe medicines fridge in one unit was not at the correct temperature. Records for one person who had recently returned to the home were incomplete or inaccurate, although the provider acted during the inspection.
“During the inspection we found the medication fridge on one of the units was not maintained at the correct temperature and records for one person who recently returned to the home were not accurate or complete.” from the report
Recent falls and weight loss
needs fixingConcerns had been raised about a high number of falls and people's weight loss. The home had introduced audits, weekly weights for people at high risk and other monitoring, and inspectors found a reduction in falls over the previous month.
“Concerns had been raised in relation to a high number of falls and people's weight loss.” from the report
- 01How many staff are now planned for each shift, and have the increased staffing levels and new shift patterns continued?
- 02How do you check medicines fridge temperatures and make sure records are complete when someone returns to the home?
- 03What has happened to falls and weight loss since the inspection, and how are people at higher risk monitored?
- 04How is the improvement plan being tracked, and what changes are still outstanding?
- 05How will you keep families informed about changes in management, care or their relative's needs?
This was an unannounced focused inspection of Safe, Responsive and Well-led, including infection control; Effective and Caring were not inspected and their previous ratings were carried over. This explanation was written from the published report of 7 October 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.
What inspectors found, September 2020
Rated Good; inspectors found safer medicines management and stronger leadership, with one care plan still containing conflicting information.
This was an unannounced focused inspection. The inspector visited on 1 September 2020, spoke with people, staff and relatives, and checked care records, medicine records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Medicines were available and records were complete. Staff used personal protective equipment, cleaning and testing arrangements had been strengthened, and there were enough staff on duty.
The home had improved its checks and audits. Staff knew how to report accidents and concerns. Relatives said they could contact staff and managers and were involved in care planning.
The previous inspection found Requires Improvement and a breach about safe care and treatment. This inspection found that improvements had been made and the home was no longer in breach. Inspectors did identify one care plan with conflicting information about food texture and made a recommendation to improve consistency.
Medicines managed safely
Inspectors found no recent out-of-stock medicines in the records they checked. Medicines given when needed were recorded with the correct time intervals.
“MARs were fully completed. They were checked daily and any issues rectified.” from the report
Improved quality checks
Audits were carried out by different managers, rather than by the person responsible for the department being checked. Action plans recorded when improvements had been completed.
“The quality assurance system had been improved with audits being completed by a range of managers so the head of a department was not auditing themselves.” from the report
Open communication
Relatives said they could contact staff and managers when they had concerns. They also said they had been involved in agreeing care and support plans.
“Relatives said they had been involved in agreeing their relatives care and support plans.” from the report
Conflicting care plan information
needs fixingOne care plan gave contradictory information about the food consistency needed to reduce choking risk. Kitchen staff had the correct information, so inspectors did not find that the person was put at increased risk, but they recommended better checks.
“One person's care plan contained some contradictory information about the consistency of the person's meals to reduce the risk of choking.” from the report
- 01How do you check that every part of a care plan is updated when a person's needs change?
- 02How will you make sure food texture instructions remain consistent across care plans, kitchen records and staff guidance?
- 03How do you check medicines given when needed, including the time between doses?
- 04How are medicines supplies checked to prevent them running out?
- 05How do you track actions found through audits and confirm they have been completed?
This was a focused inspection of Safe and Well-led; the other question ratings from the previous comprehensive inspection were used in calculating the overall rating. This explanation was written from the published report of 29 September 2020 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 De Brook Lodge
7 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: GoodWell-led: Requires improvement
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Registered with the Care Quality Commission on 18 May 2014.
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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