Brookfield Residential Home

Updated 5 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by 2 inspectors on site, with another supporting remotely.

Service and service type

Brookfield Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Brookfield Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we held about the service and sought feedback from other stakeholders. We used all this information to plan our inspection.

During the inspection

We reviewed 4 people’s care records and various medicines administration records. We reviewed the building and records related to its maintenance. We spoke with 4 people about their care, where they were able to speak with us, and made observations of staff interaction and support of people, including during mealtimes.

We invited relatives to give feedback on care at the service and received feedback from 8 people’s relatives. We spoke with 6 members of staff, including the chef, and the registered manager. We spoke with visiting professionals. We reviewed training records, policies, audits and other records related to the running of the service.

Updated 5 May 2023

About the service

Brookfield Residential Home is a residential care home providing personal care to up to 29 people. The service provides support to older people who may be living with dementia. At the time of our inspection there were 25 people using the service.

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

Some risks to people’s individual health and safety were not fully assessed, and management plans were not always up to date or consistent, however staff knew people well. There were safety and maintenance issues related to the building, including risks related to fire. Aspects of medicines were not appropriately managed. There were enough staff deployed to keep people safe.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People’s mental capacity to consent had not been assessed in line with relevant legislation. Visiting restrictions remained in place where government guidance had been withdrawn, and the service had not demonstrated this had been risk assessed in line with people’s needs and best interests.

The service did not always ensure relevant healthcare professionals’ advice and guidance was sought related to food and drink, or that their advice was incorporated into care plans and escalated if there were issues in implementing it. Staff skills varied. We observed most staff were skilled, with some very good practice but we also observed some poor practice by staff when supporting people.

The governance system within the home, maintenance of the building and record keeping required improvement to ensure the home was providing safe and effective care to people.

People were positive about the food and appeared comfortable with the staff. Staff we spoke with knew people well and were positive about the management and support in the home. People’s relatives praised the home and felt their loved ones were well looked after. We received positive feedback from the local GP partnership regarding their working relationship with the home.

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 23 October 2019). The last inspection of the service was 20 December 2020; however, the service was not rated at that inspection.

Why we inspected

We received concerns in relation to infection control, medicines management, the condition of the building, poor quality care and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We inspected and found there was a concern with consent to care and eating and drinking, so we widened the scope of the inspection to include the key question of effective. 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.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to consent, safe care and treatment, premises and equipment and good governance.

Please see the action we have told the provider to take at the end of this report.

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.