Archived: Brookfield Nursing Home

Updated 23 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 October 2016 and was unannounced. At the time of our inspection there were 21 people using the service. The inspection team consisted of two adult social care inspectors and an expert-by-experience. An expert-by-experience is someone who has personal experience of using or caring for someone who uses this type of service. On this inspection we were accompanied by someone with experience of supporting someone living with dementia.

Before the inspection we reviewed all the information we held about the service, including incidents which have to be reported to the Care Quality Commission (CQC) by the provider and past inspection reports. We also contacted the local authority and Healthwatch to ask if they held any information which may assist our inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We did not send a Provider Information Request (PIR) before this inspection. A PIR is a document which the provider completes to tell us what they do well and improvements they plan to make.

During the inspection we spent time looking around the service, speaking with people and reviewing documents. We spoke with the registered manager, owner, administrator, four members of care staff, two nurses, eight people who used the service and five visiting relatives. We looked in detail at the care plans of four people, stocks of medicines and related records and other documents relating to the running of the home.

Updated 23 November 2016

Our inspection took place on 5 October 2016 and was unannounced. At our last inspection in 2014 we found the service was meeting all the standards we looked at.

Brookfield Nursing Home is located in a residential area of Urmston, close to local amenities and transport links. It provides accommodation and nursing care for up to 21 people in a detached property with a garden area to the rear. There were two lounges, a dining room and a mix of single and shared bedrooms over three floors connected by a passenger lift.

There was a registered manager in post on the day of our inspection. 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.

We found there was a lack of organised activity in the home for people to engage with, and saw people had given this feedback to the provider at a recent residents meeting. The provider acknowledged this was an area in which they needed to improve, and we saw this had been included in the 2016-2017 service plan. .

People felt safe living in the home, and we saw evidence the provider had care plans which identified risks associated with people’s care and support and had put measures in place to ensure people’s safety. People lived in an environment which was safe. There was a programme in place for rolling improvements to the décor of the home, and all maintenance was kept up to date.

The provider ensured people who used the service were cared for by staff whose employment backgrounds had been appropriately checked. Staff files contained copies of employment references and confirmation they were not barred from working with vulnerable people. There were enough staff on duty to meet people’s needs.

We found there was a good understanding of the principles of safeguarding people from abuse. Staff had regular training in this area and knew when and how to report any concerns.

We saw medicines were managed safely. Records were up to date and contained no gaps, and the stocks of medicines matched these records. Some blood glucose monitoring records had not always been kept up to date, and the registered manager took action to rectify this during the inspection.

Staff were supported to be effective in their roles. There was a thorough induction and on-going refresher training in place, and staff had regular opportunities to discuss their performance and any training needs in supervision and appraisal meetings.

The service was working within the principles of the Mental Capacity Act 2005 (MCA). People were offered choices which were respected, and their capacity to make decisions was appropriately recorded. When people lacked capacity to make certain decisions, best interests decisions had been made on their behalf. Where people’s liberty had been restricted to ensure they remained safe, we saw applications for the appropriate Deprivation of Liberty Safeguards had been made to the local authority.

People had access to fresh food which looked appetising, as well as snacks and drinks during the day. Where people needed assistance or a specialised diet this was provided. We found the meal time lacked a sociable atmosphere .

We received good feedback about people’s relationships with staff, and observed good practice throughout the inspection. We saw staff engaged with people in a friendly and appropriately familiar way, and staff were able to tell us ways in which they ensured people’s privacy and dignity were respected.

The provider carried out an assessment of people’s care and support needs before they started using the service, and this information was used to prepare a series of care plans which showed how the care and support was to be delivered. Care plans were kept under regular review to ensure they always reflected people’s up to date care and support needs.

We saw there were systems and process in place to ensure concerns and complaints were addressed, and people said they would know how to raise these. We saw the provider received a large volume of written compliments which expressed people’s appreciation for the good standard of care they or their relatives received.

There was good feedback about the registered manager and provider’s leadership in the home. We saw they were a visible presence who were known to people who used the service, and worked alongside staff in delivering care and support.

There were appropriate systems in place to measure, monitor and improve quality in the service. Staff, people who used the service and relatives had opportunities to attend meetings to discuss the service, and we saw this feedback had been used in preparing the 2016-2017 plan for the service. In addition the registered manager undertook planned audits to further monitor and improve the service.