Broomgrove Trust Nursing Home

Broomgrove Trust Nursing Home provides accommodation and personal or nursing care for up to 40 older people with a range of support needs, including some people living with dementia. The home is an adapted building over two floors. At the time of our inspection there were 35 people using the service.

People’s experience of using this service and what we found

There were not always enough staff safely deployed within the service to meet people’s needs in a timely manner. The provider had no clear oversight or confidence as to whether staff were up to date with health and safety and other training to ensure they had the right skills and knowledge to support people safely.

Systems and processes to monitor the service had not been effective in assessing, identifying and addressing areas requiring improvement. There were inconsistencies across several records including capacity assessments and care plans. Some of the policies and procedures required for the management and safe running of the service had not been updated for over four years.

People received their medicines safely and as prescribed. Systems and processes were in place to keep people safe. Staff were recruited safely. The premises were clean and there was good infection control practice in place.

There was a friendly atmosphere at Broomgrove Trust Nursing Home, and we saw people looked well cared for. People and relatives told us staff were kind and caring.

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; the policies and systems in the service supported this practice although records kept required more consistency.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 17 March 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Broomgrove Trust Nursing Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Broomgrove provides accommodation and personal or nursing care for up to 40 older people with a range of support needs, including some people living with dementia. The home is an adapted building over two floors. At the time of the inspection 35 people were using the service.

People’s experience of using this service

Systems were in place to keep people safe from abuse. People’s risks were monitored and managed appropriately. The premises and equipment were well maintained. Staff were recruited safely and staffing levels were sufficient to meet people’s needs. Medicines were managed safely. The service had systems in place for infection prevention and control.

People’s needs were fully assessed before they were admitted to the home. Some records required updating. This was addressed immediately following the inspection. Staff training was thorough and on-going. People’s nutritional needs were met at the home and people enjoyed the food. The service worked with other agencies when required. The environment was appropriate for people with restricted mobility to move around with ease.

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; the policies and systems in the service supported this practice.

People were seen to be treated with compassion and kindness. People were encouraged to express their opinions and were involved in all aspects of their care and support. People’s privacy and dignity was respected and there was a strong ethos at the home of promoting independence.

Choices were promoted and staff were alert to people’s needs. Requests for assistance were answered promptly. People were supported to maintain relationships with family and friends. There was a wide range of outings and activities for people to participate in. Complaints were dealt with appropriately and used to inform improvement to care provision. Staff had end of life training and were able to care for people at the home if this was their wish.

The values of putting people first and providing a quality service were apparent throughout the inspection. The service engaged well with the wider community, including the local church and the local school. They encouraged and welcomed religious and lay visitors to the home. Systems were in place to inform learning and improvement of service provision.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 4 November 2016).There was an inspection in April 2019 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Broomgrove Trust Nursing Home is operated by a registered charity which was established in 1964 to meet the needs of older people in Sheffield. Nursing care is provided by a team of nurses and care staff. The home provides care for those who have recently been in hospital and respite care for people whilst their family or carers take a holiday; it also offers a number of places for permanent care. Sheltered accommodation is provided in three flats situated within the service. End of life care is also provided. They can accommodate up to 40 people at the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were positive, along with their relatives and visitors about the care and facilities provided.

Health care professionals confirmed people received the care and support they required to maintain their health. They said staff acted upon their advice to promote people’s wellbeing.

Staff understood they had a duty to protect people from harm and abuse. Staff knew how to report abuse and confirmed they would report any issues straight away. This helped to protect people.

People living at the service had their needs met by adequate numbers of trained and skilled staff. People told us they felt safe living at the service. Staff gained help and advice from relevant health care professionals which helped maintain people’s wellbeing.

A physiotherapist and music therapist was provided at the service. Support was provided to help people gain their strength during respite stays so people were able to go back home. Some people chose to take a holiday at the service whilst their carers had a break.

There were good links in place with the local hospital and hospice. The service offered end of life care medicines required to help keep people comfortable along with the equipment needed to administer them.

Medicine systems in operation were robust. Any issues identified with medicines were quickly addressed to help to protect people’s wellbeing.

People living at the service were provided with home cooked food. Their fluids and food intake was monitored to make sure their nutritional needs were maintained. People who required prompting or support to eat were assisted by patient and attentive staff.

People’s privacy and dignity was respected. People were involved in making their own decisions about their care and treatment. They made decisions about what they wanted to do and how they wanted to spend their time. Staff reworded questions or information to help people living with dementia to understand what was being said. This promoted people’s independence and choice.

There was a complaints procedure in place. Complaints received were investigated and issues raised were dealt with.

People and their relatives were asked for their opinions about the service and their views were acted upon.

Regular audits of the service were undertaken which helped to monitor, maintain or improve the quality of service provided. A board of trustees supported the registered manager, they had health care backgrounds and promoted effective care within the service. The registered manager monitored the service and acted swiftly to correct any shortfalls which helped people to remain satisfied with the service they received.

The registered manager promoted good links within the community. They undertook talks at a local school about care of the elderly as well as writing a column for a local newspaper about the health and care sector.

People told us that the staff looked after them well and they were happy with the care they received. One person said, "on the whole it's very good. I have a nice view of the garden. I find everything alright, it's a good place, I've settled.'

People using the service said they felt 'safe' living in the home.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The home had an effective complaints system available. We found that comments and complaints people made were responded to appropriately.