CQC report explained · a residential care home
What the CQC found at The Broughtons
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were managed safely, recruitment checks were completed and risk assessments covered issues such as falls, skin care and choking. Infection control arrangements were also judged suitable, although a COVID-19 outbreak meant people were temporarily isolating and visits were restricted.
- Effective?
- Good
- This key question was not inspected during this visit. The report says ratings for key questions not inspected were carried forward from the previous inspection, but it does not give a separate Effective rating in this report.
- Caring?
- Good
- This key question was not inspected during this visit. The report includes positive feedback from people and relatives about the care.
- Responsive?
- Good
- This key question was not inspected during this visit. The report says the inspection focused on follow-up actions and infection prevention and control under Safe.
- Well-led?
- Good
- Inspectors found that audits, meetings and surveys were used to monitor quality. People, relatives and staff were involved, and staff described a positive and supportive culture.
What inspectors found, May 2022
The Broughtons is rated Good; inspectors found safer medicines management, enough staff and stronger leadership since the last inspection.
This was a follow-up inspection. Inspectors visited on two days, spoke with people living in the home, relatives, staff and healthcare professionals, and checked care records, medicines records, recruitment files and management records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found that medicines were now managed safely, staffing was suitable and checks were in place to manage risks, buildings and infection control.
The home had improved from Requires Improvement at the previous inspection in March 2020. The provider was no longer in breach of Regulations 12 and 17. The home was experiencing a COVID-19 outbreak during the inspection, so visits were temporarily restricted except where essential.
Safer medicines
The home had fixed the medicine problems identified at the previous inspection. Records, storage, stock checks and staff training were all found to be suitable.
“Medicines were managed safely, with improvements made since our last inspection.” from the report
Safety systems
Risk assessments and building checks were in place. Inspectors found appropriate safeguarding procedures and suitable infection control arrangements.
“People and relatives told us they felt safe with the care they received.” from the report
Stronger leadership
The home had improved its audits and governance systems. People, relatives and staff were given ways to comment on how the home was run.
“Systems were in place to involve people, relatives and staff in how the service was run.” from the report
Positive staff culture
Staff said they felt supported and worked well together. Inspectors also received positive feedback from people, relatives and visiting healthcare professionals.
“The staff team spoke of a positive culture at the service and said they enjoyed their roles.” from the report
Inspectors raised no specific concerns in this report.
- 01What checks are now used to make sure time-critical, controlled and as-needed medicines are given correctly?
- 02How do you decide how many staff are needed each day, especially when people's needs change?
- 03What is the current visiting policy, and how would visits be managed during an infection outbreak?
- 04How often are medicines, care plans, infection control and environmental checks audited now?
- 05How are people and relatives able to raise concerns or give feedback about the service?
This was a follow-up inspection focused on Safe and Well-led, including infection prevention and control; ratings for key questions not inspected were carried forward from the previous inspection. This explanation was written from the published report of 10 May 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, April 2020
Rated Requires Improvement; inspectors found kind and responsive care, but serious weaknesses in medicines safety and quality checks remained.
This was an unannounced, routine comprehensive inspection on 3 and 6 March 2020. Inspectors spoke with people living at the home, relatives and staff. They also checked care plans, staff files, medicines records and management records.
People generally felt safe and said staff were caring and respectful. The home supported people's nutrition, healthcare, activities, communication and personal choices well. Effective and caring were rated Good, as was responsive care.
However, some medicines were not given at the right time, expired medicines were still in use and instructions for medicines given when needed were sometimes missing. Some fire safety actions were also unfinished. The systems used to check quality did not identify or resolve these problems quickly enough.
The overall rating remained Requires Improvement. Safe and well-led also remained Requires Improvement. The provider was still in breach of Regulations 12 and 17, although improvements meant the previous breach about consent was no longer present.
Kind and respectful care
People and relatives spoke positively about the care. Inspectors saw patient and pleasant interactions, with people treated with dignity and respect.
“We observed lots of nice, pleasant interactions between staff and people living at the home.” from the report
Consent and choice
The home had improved its approach to mental capacity, best-interest decisions and applications for restrictions. The previous breach about consent no longer applied.
“Improvements had now been made and the service was no longer in breach of regulation 11” from the report
Food and healthcare
People received suitable food and drinks, including modified meals where needed. Weight loss was monitored and referrals were made to other health professionals when necessary.
“Where people had lost weight, they had been appropriately referred to other health care professionals” from the report
Activities and communication
The home offered activities, trips and entertainment. Information could be provided in different formats, and care plans recorded communication needs.
“Trips out into the community also took place. These included sensory farms and community dance groups.” from the report
Medicines were not always safe
seriousSome time-critical medicines were not given at the prescribed times. Expired medicines were still in use, some instructions were missing and controlled drug records were not well maintained. This was a breach and placed people at risk of harm.
“Some medicines which had expired were still in use and meant there was a risk they might not be administered safely.” from the report
Fire safety actions unfinished
needs fixingWork identified in the previous fire risk assessment had not all been completed. This included external escape routes, fire walls or ceilings and fire doors.
“Some actions following this visit had not yet been completed by the service.” from the report
Quality checks were not effective enough
seriousAudits were in place, but they did not identify the medicines problems or ensure that fire safety actions were completed. This was a continued breach of good governance.
“Further improvements were required to ensure they were effective in identifying the concerns found during this inspection” from the report
A lounge was sometimes left without staff
minorAlthough staffing levels were judged sufficient overall, inspectors saw the main lounge left unattended at times. The manager was asked to consider how staff were deployed.
“At times, we observed the main lounge area was left unattended by staff.” from the report
- 01What has been done to ensure time-critical medicines are always given at the prescribed times?
- 02How do you check that expired medicines are removed and that medicines given when needed have clear instructions?
- 03Have all actions from the September 2019 fire risk assessment been completed, including work to escape routes, fire walls or ceilings and fire doors?
- 04How often are medicines and fire safety checks audited, and how do you make sure identified problems are resolved?
- 05How will staff deployment be managed so the main lounge is not left unattended?
This was an unannounced comprehensive inspection covering all five key questions, including both the premises and the care provided. This explanation was written from the published report of 21 April 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 The Broughtons
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 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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