Broom Lane Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

During the assessment we carried out a tour of the home and found many areas were in need of a deep clean and some items such as armchairs were worn and stained. We informed the management team who took actions to address these areas. However, these had not been identified prior to our inspection and we need to be confident infection control is identified and actioned in a timely way. Medicine management was not always effective. We found 2 breaches of regulation in relation to infection prevention and control and medicine management. People were safeguarded from the risk of abuse and risks associated with people’s care were identified. However, care plans required more detail and information was not always current. Staff knew people well and explained how they mitigated risks.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt safe living at the home. One person said, “Yes, I do feel safe here [Broom Lane]. I feel looked after.” Another person said, “I feel safe enough.” Relatives also felt the home provided safe care. One relative said, “Yes, absolutely [relative] is safe here. It’s very secure and staff are lovely.”

Staff felt they were listened to, they told us the new management team were approachable and took concerns seriously to promote safety.

Accidents and incidents were analysed, and actions taken to mitigate risks. Staff felt they were listened to, they told us the new management team were approachable and took concerns seriously to promote safety. Actions taken were the completion of body maps, observations, and reassurances. Staff understood their roles and responsibilities to record and report accidents and incidents. Lesson learned following incidents were also discussed through supervisions and staff meetings. Following our assessment the manager acted to further improve systems and processes.

People and their relatives were happy with the way the service worked in partnership with external professionals. People told us staff responded quickly if they required any support from healthcare professionals. One relative said, “[Relative] was taken ill and is now in hospital. They [staff] reacted really quickly and let me know straight away. They [staff] are good here, they do try their best.” Another relative said, “They [staff] are good. They keep an eye on [relative]. I think they know [relative] well.”

Staff and leaders were knowledgeable about the process to follow to assist with transitions between care services. Staff told us hospital packs provided information about people’s current care needs.

People had been referred to healthcare professionals as required. Dieticians, GP's, district nurses etc. Healthcare professionals had been supporting staff with improvements. Some visiting professionals had recently observed the mealtime experience and said improvements had been made. Another professional visitor said they had concerns regarding cleanliness, medicine management and leadership.

There were good, detailed assessments in care records to give information to healthcare professionals when moving between services. We saw referrals were made when required to promote safe care. Advice was sought and followed.

People felt safe living at the home. One person said, "I am reasonably happy here. I am not afraid, so feel safe here.” Relatives also felt assured their family members were safe and cared for at the home.

Staff understood safeguarding and were aware of the need to report. We saw posters displayed with information on how to report an allegation of abuse. Leaders understood their responsibilities and supported people in line with The Mental Capacity Act 2005 (MCA).

We observed staff interacting with people and found they were kind and caring. Staff knew people well and people responded to staff in a positive way. Throughout our observations, we did not identify any potential safeguarding concerns.

The provider had a safeguarding policy and procedure in place and actioned any concerns. The manager kept a record of safeguarding concerns and learnt lessons to improve the service. Staff received training in safeguarding and understood what actions to take to keep people safe. Systems were in place to ensure people were supported in line with the Mental Capacity Act 2005 (MCA). Where people lacked capacity, best interest decisions were made involving appropriate people.

People told us they felt safe living at the home. One person said, “Yes, I do feel safe her. I feel looked after.” Another person said, “I feel safe here, definitely.” Relatives also commented positively about safety. One relative said, “[Relative] is definitely safe here, [relative] is happy here.”

Staff and leaders knew people well and were aware of risks associated with people’s care.

We observed staff supporting people in a safe way, for example when being assisted to transfer from wheelchair to armchair. Staff offered reassurances to people and spoke with them, explaining what they were doing and seeking their approval.

Risks associated with people’s care were identified and managed to keep people safe. However, risk assessments and care plans in place did not always offer sufficient guidance for staff and were not always in line with people’s current needs. Staff were aware of people’s current needs and delivered care and support in line with them. Some care plans required updating to ensure they contained the correct information. This was a recording concern, and we found no harm to people. The management team were aware of this and were working to improve documentation.

People and relatives were happy with the environment and felt the home was safe and secure. One relative said, “Yes absolutely [relative] is safe here. It is very secure, and staff are lovely. {relative] is so much happier now." Where people used equipment, such as hoists, regular servicing and checks were in place to ensure they were safe for use.

Staff told us they worked in a safe environment and ensured the home was safe and secure. One staff member said, “Risk assessments are in residents care plans, any changes in circumstances are noted and handed over to the next shift. Keeping people safe: - to ensure staff levels are adequate, ensure doors are securely closed (key code to enter), doors are locked, and windows are closed.” The management team explained safety and security checks in place to ensure safety.

Although we identified concerns regarding infection control, the environment was otherwise safe. Although some equipment was being charged in communal areas. We spoke with the manager about this, and they took action to address the issue.

There were arrangements in place to monitor the safety and upkeep of the premises. Environmental safety checks were in place, ensuring the environment and equipment was safe for people to use. This included fire safety, legionnaires and lifting equipment precautions.

We received mixed comments regarding staffing. Some people told us there were enough staff and responded quickly to them when they needed their support. One person said, “The staff are ok. They usually come quickly enough when I need them. I think there are enough of them, and they seem to know what they are doing.” However, some people and relatives were less complimentary. One relative said, “Some staff are better than others. There are times when I see staff chatting together or on their phones. That’s not right. Most of the people just want to chat. They [staff] don’t engage enough with people.” Another relative said, “The staff are lovely. The staff levels should be higher though.” One relative commented that staffing levels were reduced at the weekend, saying, “There are only 3 staff on at the weekend. I don’t see why weekends are different. People still need the same amount of care.”

We spoke with staff regarding staffing levels and received mixed feedback. Some staff said there were sufficient staff to meet people’s needs. One staff member said, “Yes, we have enough time [to complete tasks], sometimes tasks take longer depending on who you are working with i.e. agency staff as they aren't familiar with the residents. There are enough staff members at the moment as there is a twilight member of staff, 5pm until 11pm, to assist where needed.” Another staff member said, “Some days are busier than others so it can take longer to get to residents, but we work as a team and ask for help off other staff when needed.” However, another staff member said, “We are understaffed and don't have enough time to carry out tasks.” Staff were concerned staffing levels were not always amended when people’s needs changed. The management team explained they used a dependency tool and staffing was allocated according to people’s current needs. Staff told us they received training and support to carry out their role effectively.

During our assessment we observed staff were visible and calls bells were answered in a timely way.

The provider used a dependency tool to identify the number of staff required to meet people’s needs. The provider's recruitment procedure assisted them in employing suitable staff. Records did not always evidence staff had received training. The provider explained they had changed online training companies, and the staff training had not migrated from one system to the other effectively. This meant the provider could not always demonstrate staff received appropriate training to carry out their role. We have reported more about this in the well led section of this report.

During our assessment we found areas of the home were not cleaned effectively. Sluices, bathrooms, toilets and bedrooms were not always kept clean. People were happy with the cleanliness of the home; however, this did not reflect our findings. One person said, "My room is always clean and tidy. They [staff] clean it every day."

Staff did not raise any concerns regarding infection control. Leaders told us they would review their procedures to improve infection control. The management team were in agreement that areas of the home were in need of cleaning and some items required replacement. The armchairs had already been highlighted for replacement and the home were awaiting their arrival.

We carried out a tour of the home with the deputy manager and found many areas in need of cleaning and some items which were worn and not easy to keep clean. These areas included storerooms required deep cleaning, some armchairs were stained and worn, kitchenettes were untidy and required cleaning, one fridge seal was broken, a better system was required for storing people’s laundry and some bath and shower chairs and toilet seat raisers were in need of a deep clean and some were beginning to rust. Following our site visit the management team took action to address these issues and replaced many items. However, the infection control processes had not identified these concerns and therefore require reviewing and embedding into practice.

Processes in place to monitor infection prevention and control, were not always robust enough to identify the concerns we found on our site visit. The infection control audit completed for July and August 2024 did not identify and concerns and a full score of 46/46 was given, showing no concerns were identified. However, on our inspection dated 29 August 2024 we identified several infection control concerns. This showed the audit was not effectively identifying and monitoring standards of cleanliness. A staff meeting dated 9 August 2024 identified that spot cleaning should take place and cleanliness improved, however, this was not detailed on the audit dated 2 August 2024. Also, a domestic meeting dated 23 August 2024, highlighted that cleanliness of the home had declined dramatically. This showed the systems in place were not effective in identifying and actioning concerns.

Although people responded positively and did not raise any concerns in respect of medicine management, we found some concerns regarding medicine management. People told us they received their medicines as prescribed. One person said, “I have to take medication, but staff look after all that for me.”

Staff informed us they received training in the safe handling of medicines and had their competencies checked on a regular basis. One staff member said, “Yes, we receive training in medicine management. Competencies are checked by [manager and deputy manager] during supervisions and appraisals.” However, we found some concerns in medicine management which raised issues about the training and support staff received.

Processes in place to ensure people received their medicines as prescribed, were not always effective. Some people required medicines on an as and when required basis often referred to as PRN. Some protocols were in place to ensure people received these medicines safely and as prescribed, others were not in place. However, protocols in place required more detailed information. Following our inspection, the registered manager confirmed these had been reviewed and updated. Some medication administration records were handwritten and had not been double signed in line with best practice. We found some discrepancies in regard to medicines in stock and covert medication instructions had not been signed by the pharmacist.