Background to this inspection
Updated
10 September 2015
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 over two days on 09 and 29 June 2015. Both days were unannounced.
The inspection team consisted of three adult social care inspectors, a specialist advisor in governance and an expert by experience in people living with dementia and older people. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. On the second day the inspection team consisted of two adult social care inspectors.
On day one of our inspection there were 19 people living at the home. On day two of our inspection there were 18 people living at the home. During our visit we spoke with five people who lived at Brooklands Residential Home, two relatives, four members of staff, the matron, deputy manager and registered manager. We observed how care and support was provided to people throughout the inspection and we observed breakfast and lunch on all the floors of the home. We looked at documents and records that related to people’s care, and the management of the home such as staff recruitment and training records and quality audits. We looked at seven people’s care plans and six people’s medication records.
Before our inspection, we reviewed all the information we held about the home. We contacted the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
Updated
10 September 2015
This inspection took place over two days on 09 and 29 June 2015. Both days were unannounced.
At the last comprehensive inspection in July 2014 we rated the service as inadequate. We found the provider had breached three regulations associated with the Health and Social Care Act 2008. We found people who used services and others were not protected against risks associated with infections as standards of cleanliness and hygiene had not always been maintained. The registered person did not ensure people were protected against the risks of unsafe or inappropriate care due to the lack of an accurate record in respect of each person including appropriate information and documents in relation to the care and treatment provided to them. The provider had failed to monitor the quality of the service to identify issues. We told the provider they needed to take action; we did receive information about the actions that had been completed within the factual accuracy letter dated 29 December 2014. At this inspection we found the home was still breaching one of the three regulations and we also found additional areas of concern.
Brooklands Residential Home is registered to provide accommodation for up to 27 people who require support with their personal care. The service is situated in the Yeadon area of Leeds. Accommodation is provided in 19 single rooms and four double rooms on two floors. A stair lift was used by people with mobility difficulties to access the first floor.
The service had a registered manager who had been registered since 2010. 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.
Staff training and support did not always provide staff with the knowledge and skills to support people safely. Mental capacity assessments had not been completed and the service had made Deprivation of Liberty Safeguards applications inappropriately.
Staff were aware and knew how to respect people’s privacy and dignity; however, this was not always carried out. People were not always protected against risks and individual risks had not always been assessed and identified. There were not always effective systems in place to reduce the risk and spread of infection. People were not protected against the risks associated with medicines because the provider did not have suitable arrangements in place to manage medicines safely.
People’s care plans contained sufficient and relevant information to provide consistent care and support. People were happy living at the home and felt well cared for. There was opportunity for people to be involved in a range of activities within the home and the local community; however, there was not always varied social stimulation and meaningful activity provided.
There were enough staff to keep people safe. The recruitment process was robust which helped make sure staff were safe to work with vulnerable people.
People had good experiences at mealtimes. People received good support that ensured their health care needs were met. Appropriate arrangements were in place to manage infection control.
People got opportunity to comment on the quality of service and influence service delivery. Complaints were investigated and responded to appropriately.
There were not always effective systems in place to manage, monitor and improve the quality of the service provided. We saw staff, relatives and residents meetings were held.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special Measures’ by CQC. The purpose of special measures is to:
• Ensure that providers found to be providing inadequate care significantly improve.
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.
Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action.
Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.