Brooklyn House Nursing Home

Updated 17 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection was unannounced and carried out by one inspector, an Expert by Experience and a Specialist Advisor in nursing care on 5 September 2018. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection the provider completed a provider Information Return (PIR). This is a form that asks the provider to give some information about the service, what the service does well and improvements they plan to make.

We reviewed the previous inspection report and the action plan sent to us by the service with regard to the previous inspection to help us plan what areas we were going to focus on during our inspection. We looked at other information we held about the service including statutory notifications. This is information providers are required to send us by law to inform us of significant events.

We spoke with seven people who used the service and four people’s relatives. We observed the care and support provided to people and the interactions between staff and people throughout our inspection.

We looked at records in relation to five people’s care. We spoke with an area manager, the deputy manager, service administrator, two qualified nurses, the chef, maintenance person and two care assistant staff.

We looked at records relating to the management of medicines, staff recruitment, staff training, staff rotas, complaints and compliments, service policies and procedures and systems for monitoring the quality and safety of the service.

Updated 17 October 2018

We carried out this unannounced inspection on 5 September 2018.

Brooklyn House Nursing Home is a nursing home which provides accommodation and nursing support to older people and those living with dementia. The service can accommodate a maximum of 38 people. On the day of our inspection there were 32 people using the service and two of those people were in hospital.

Following our last inspection of 4 July 2017, we rated the service as requiring improvement overall. We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service had failed to identify risks to the health and safety of people living in the home. The service had not ensured there were enough staff deployed to meet people’s needs. Not all of the systems in place to monitor the service were effective at identifying and improving the quality and safety of the care provided. Not everyone received personalised care that met their individual needs.

In the key questions for safe, effective, caring, responsive and well-led, we rated the service as ‘requires improvement’. This resulted in the overall rating of the service for that inspection being ‘requires improvement’.

At this inspection of 5 September 2018, we noted there had been improvements and there were no breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We rated the service ‘good’ in all key lines of enquiry and therefore the overall rating of the service was ‘good.’

The service had a registered manager in post. 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.

The registered manager used a dependency tool to identify the number of staff required to be on duty to meet the assessed needs of the people using the service. There were sufficient numbers of qualified nurses and care staff to meet people’s identified needs. Nursing staff, with the support of the team leaders, organised the care to be provided to each person by the staff team.

Staff received training in safeguarding and were aware of what actions they should take to safeguard people from potential, or actual, abuse and knew what actions to take to promote people’s safety and well-being.

There was a robust staff recruitment policy and procedure in place. This was operated to ensure only suitable staff were employed. Once employed staff were supported by an induction process and regular supervision and a yearly appraisal. Training was organised to develop and maintain staff skills, including the nursing staff who had all revalidated their qualification.

There were suitable arrangements for the safe storage, management and disposal of medicines. There was a process and procedure in place for the recording of topical creams and lotions. All of the staff administering medicines had received on-going training in the administration of medicines.

Care and support was delivered in line with the assessed needs and choices of the people living at the service.

People had their nutrition and hydration needs met through effective planning and delivery of nutritious menus. Menus were varied and took into account people’s dietary preferences.

The service had built up an effective and supportive relationship with the general practitioner service.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were knowledgeable with regard to Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The service had made referrals and worked with the local authority to support people who used the service with regard to the MCA and DoLS.

People’s privacy and dignity were respected by staff who were familiar with their needs and took into account how people wanted to be cared for.

Prior to coming to the service people and their families were given information about the service. Each person had a recorded needs assessment and a care plan which was regularly reviewed in order for the staff to provide personalised care.

The service had a complaints procedure which was available for people to use if so required. There were a range of activities organised from discussions with the people and their families.

Surveys were carried out by the manager to identify how the service could continue to be improved.