The Care Quality Commission
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Archived: Brooklands Residential Home

Overall: Inadequate read more about inspection ratings

16 Harper Lane, Yeadon, Leeds, West Yorkshire, LS19 7RR (0113) 250 8677

Provided and run by:
Mr & Mrs P C Jowett

All Inspections

09 & 29 June 2015

During a routine inspection

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.

8 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2012 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 2012, and to pilot a new process being introduced by CQC which looks at the overall quality of the service.

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. At the time of our visit nobody was sharing a room.

The inspection was unannounced. During the visit, we spoke with 19 people who lived at the service, two relatives, four support staff and the registered manager.

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 and shares the legal responsibility for meeting the requirements of the law with the provider. The registered manager was also the provider of the service.

At our visit we raised concerns about the policy and procedures in place to evacuate people in the event of a fire. The provider had a policy where people were left in their rooms behind a closed fire door rather than attempting evacuation in the event of a fire. This was different to current guidance for care homes to take in the event of a fire. We shared our concerns with the fire service who undertook a full fire audit.

We noted areas of malodour within the service. The deputy manager told us this was due to carpeting in bedrooms and some bathroom areas that remained malodorous despite regular cleaning. Baths were used for the soaking of commode pots and toilet brushes were worn and soiled. This increased the chance of cross infection.

People told us they felt safe. Staff were able to recognise and report abuse. There was a low number of safeguarding incidents in the service. Staff told us they thought this was due to effective assessment and review of people’s needs. Staff and people who used the service told us there were always enough staff to support people safely.

Where the provider had concerns the support they provided might have deprived somebody of their liberty they had contacted the local authority for advice. We found the provider to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). One person who used the service had their care plan agreed as a best interest decision. This meant the service was able to support the person in accordance with the requirements of ther Mental Capacity Act 2005 (MCA). However, there was a lack of general information about people’s ability to make decisions. This meant best interest decisions might not have been recorded where people lacked capacity to make decisions regarding their care and support.

Staff had received training and had the knowledge and skills required to meet people’s needs.

People’s nutritional needs were met. People were supported to maintain a balanced diet. Everybody we spoke with told us they were satisfied with the quality of the food though some people told us they would have welcomed greater choice at lunchtime.

Where people needed support from external health professionals they were referred appropriately. People living at the service had support from clinicians including GPs, district nurses, dieticians and mental health professionals.

21 February 2014

During an inspection looking at part of the service

We spoke with six people who used the service. They told us they were satisfied with the care and support provided. One person told us, 'It's a lovely place' and 'If you don't want Weetabix you can have cornflakes for breakfast.'

We observed staff assisting people who used the service and noted staff were friendly, patient, polite and treated people in a respectful way. There was evidence people made choices in areas that related to their care. The provider had changed the breakfast time routine so people where always offered choice at meal times.

25 October 2013

During an inspection looking at part of the service

We spoke with four people who used the service, one relative and one visitor. They told us they were satisfied with the care and support provided. One person told us, 'I am happy as I can be.' Another person told us, 'You have got all you want and I am happy enough in my own way.'

We observed staff assisting people who used the service and noted staff were friendly, patient, polite and treated people in a respectful way. The provider had changed some routines so staffing arrangements were more effective. Although there was evidence people made choices in some areas that related to their care people where not always offered choice at meal times or with daily living activities. For example, help to set tables and putting their clothes away.

The care plans had been reviewed and some sections contained a good level of information setting out how each person should be supported to help ensure that their needs were met. However, some areas of the care plans still needed to be developed to make them person centred, accurate and relevant.

Although people told us they were satisfied with the service, we found the Provider still needed to make further improvements in some aspects of the service.

31 May 2013

During a routine inspection

People's views and experiences were not taken into account in the way the service was provided and delivered in relation to their care. However, people's families had signed their relatives care plan. People were not always offered choice or had sufficient daily stimulation. The provider followed a daily routine that meant activities were task based. One person told us, 'Everything is timed, but you are not rushed.'

People we spoke with told us they were happy with the treatment and support they received. However, people did not have thorough, detailed care plans relating to all aspects of their care needs. People did not always experience care, treatment and support that met their needs and protected their rights.

The food we saw served looked and smelt appetising, well presented and people had good portions. People said they were more than happy and they had a good varied diet and it's was well cooked.

People who used the service were protected against the risk of abuse. All staff had received training in abuse awareness and protecting vulnerable adults. Safeguarding policies and procedures were available and accessible to all staff.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work. This included carrying out a Criminal Records Bureau check.

There were quality monitoring programmes in place, which included people giving feedback about their care, support and treatment. This provided an overview of some areas that the service provided.

4 January 2013

During an inspection looking at part of the service

We have not spoken directly to people who used the service in assessing this essential standard but we found that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

18 June 2012

During a routine inspection

People told us that staff explained all procedures and treatment to them and respected their decisions about care. We saw evidence of their choices and decisions recorded in their care plans.

We spoke with one relative who told us they had been involved in the development of their relative's care and care plan. They also told us they were able to make changes and contribute to their relative's care if they wished. They said that they were contacted by the home straight away if their family member required any treatment.

People who used the service told us they were happy living at the home and they were well looked after.

We spoke with one relative who told us they were happy with the care and their family member was well looked after. They told us that the staff understood the care needs of their family member.

People we spoke with said they preferred the staff to give them their medication and that they usually received this on time and when they needed it.

6 March 2012

During a routine inspection

People we spoke with said that they were happy with the care they received. One person told us "I would not want to live anywhere else now, I have everything I need here".

People told us they liked being able to have their own belongings in their room as it "made it feel like home".

People we spoke with said they felt able to approach staff and were involved in deciding the care they received, "if we want something, we just have to ask".

People who use the service said they were treated well. One person said "The staff really are kind and helpful, they have been good to me".

People who use the service were complimentary about the staff. One person summed up the views of people by saying, "The staff here are lovely, we can have a laugh with them".

One person told us that "I tend to worry about things, but staff are patient with me and tell me things are ok".

People who use the service told us they could make decisions about what they did. One person we spoke with told us "I like to know I can go out whenever I want, and I can here, I feel I still live my life".

Staff told us that "people get up and go to bed when they want to, it is their choice".

While the people we spoke with were complimentary about the care provided at the home, we noted some concerns regarding the care and welfare arrangements that could affect people at the home.