Brompton House Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Systems were in place to gather information regarding people’s health and care needs, but care plans and risk assessments did not consistently assess all known needs for people. Some care records did not hold person-centred information regarding people’s particular healthcare needs which could prevent staff from supporting people safely and effectively. Where people needed their health monitored in relation to nutrition or repositioning, observation results were not always clearly recorded or monitored in accordance with people’s assessed needs. In addition, care plans or risk assessments did not clearly document when and how risks were to be escalated. People had access to external healthcare professionals. When concerns were identified, staff made timely referrals to other professionals.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received mixed, but mostly positive feedback from people and their relatives about people’s care and treatment. People and their relatives told us they felt involved in people’s care. One person’s relative told us that all members of their family were welcomed and invited to a meeting. One person’s relative told us, “They did suggest a meeting with dad too, to alleviate his concerns. I bring my dad along on my visits, three times a week. It took quite a while for him to settle and accept Mum’s new living arrangements. but once he saw that she was well cared for he relaxed.”

Staff did not always assess people's needs thoroughly enough or in line with relevant guidance and best practice. The registered manager and nursing staff told us they were involved in carrying out assessments and writing care plans. They explained they liaised with other professionals to gather information about people's needs.

Assessments and care plans did not consistently assess all known needs for people. For example, one person’s care plan regarding their specific health condition lacked some information, while another person’s care plan related to this same condition was of good quality and very detailed.

People told us they were supported safely and could access health professionals if needed. People told us they enjoyed the meals provided at the service and had enough to eat and drink. One person told us, “I have absolutely no complaints about the food, it has all been first class.” Another person told us, “I asked for wine with my lunch and was pleasantly surprised when they said ‘yes, red or white’.”

Staff told us there were regular meetings where risks to people or people’s changing needs were discussed. Staff told us risks to people were passed on during handovers. However, handover documents were often brief and contained limited information. This resulted in important information not always being passed to staff on the next shift.

Processes did not support care and treatment to be provided in line with best practice. There was a lack of sufficiently detailed risk assessments and care plans. We saw that there was no clear evidence of people being repositioned as recorded in their care plans and risk assessments. We found concerns about the safety of the premises and concerns about fire safety. This showed care was not delivered in line with best practice guidance and people were at risk of not receiving safe care. We found that records showed long periods of time between people were assisted with their continence needs. sometimes gaps in records were 7 hours long. Some care plans for people with specific needs were of poor quality and did not provide staff with enough information to meet people's needs. People were not always appropriately supported to ensure they met hydration targets.

People confirmed staff supported them to access healthcare services to meet their needs. People told us they could see their GP if they were unwell and had no concerns regarding accessing healthcare services.

Management told us they worked effectively across teams and services to support people. However, staff did not always use advice and guidance provided by healthcare professionals or communicate openly with other healthcare providers. Some medicines errors were not reported, and some advice from other healthcare professionals, such as a diabetic nurse, was not always followed. The staff team was divided and some staff told us they had no confidence that if they reported to the registered manager issues relating to people’s care, these would be followed up. Some staff told us they felt they were penalised for speaking up and challenging the registered manager.

We received mixed feedback from healthcare professionals working with the service. While they praised the caring aspect of the service and the caring nature of staff, they criticised lack of the clinical oversight of the service.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us they were happy with the care they received and were supported by staff who knew them well. One person told us, “I think they know me very well.” Another person said, “I have received excellent care. I would say- kind care.”

Management told us they routinely monitored people’s care and treatment to continuously improve it and ensure that outcomes were positive and consistent. However, we found no evidence audits such as medicines audit, safeguarding audit, health and safety audit or care plan audit allowed the provider to effectively monitor the service. Staff and leaders were not always following or ensuring recognised practices to monitor health outcomes.

The processes for monitoring people's wellbeing had not always been followed. Staff regularly weighed people, and this was recorded. However, other monitoring charts were not always completed properly. The provider's systems had not always identified this. For example, repositioning was not always recorded with the frequency suggested in people’s care plans, there were long breaks between logs of continence care and there was no evidence of people receiving a shower or a bath. These issued remained unidentified until our assessment visit.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.