Broomhills

We found the following examples of good practice.

The service had coped well with a recent outbreak of COVID-19. Contingency plans had been effective and staff absences had been managed well.

The service was clean. There were robust cleaning schedules in place and infection prevention and control measures were being followed to minimise risk.

Staff had regular infection control and COVID-19 training including the correct use of personal protective equipment [PPE].

The registered manager had carried out risk assessments for staff in higher risk groups and actions had been taken to minimise risk for these staff members.

There were risk assessments for all people living at the service however, these needed to include more detail about people’s individual risks. The registered manager took action to address this straight away.

The service had in place effective isolation, zoning and cohorting and people were admitted to the service safely.

The registered manager was very proud of how well the staff team had worked together to keep people safe.

We found the following examples of good practice.

Weekly Infection, Prevention and Control (IPC) steering groups were held at the providers head office. Minutes and actions were disseminated to all of the services straight after highlighting any new requirements, for example changes to procedures.

The provider's IPC policies and procedures were up to date and they were audited regularly.

There was a clear procedure for staff and people in the home to be tested for COVID-19 and clear guidelines as to what action should be taken if a positive test was received.

The service provided tests for staff to keep at home for their use if they displayed any COVID-19 symptoms. This meant that they did not have to enter the service to be tested, thus reducing the risk of infection to staff and residents.

IPC procedures were clear and followed by staff. All staff were trained in safe IPC practices. During our visit we observed staff wearing appropriate PPE and the home had plentiful supplies.

People were supported to maintain contact with their relatives in a number of ways, including a visitor pod, window visits, technology and by telephone.

Broomhills is a ‘care home without nursing’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to provide care and accommodation for up to 47 older people some of whom may be living with dementia and/or a physical disability and/or a sensory impairment. Although the service is registered to care for 47 people, the registered manager has reduced the number of rooms in use and there were 42 people living in the service during our inspection visits. They told us the service was full and that they had a waiting list.

At the last inspection, the service was rated good. We recently received some anonymous concerns that the service was not reporting incidents appropriately and we also had concerns about the number of un-witnessed falls that had taken place during the night. At this inspection, we did not find any evidence to support the allegation that incidents were not reported appropriately. The registered manager had put in place a system to minimise the risk of falls at night. Therefore, we found the service remains good.

There was a registered manager in post. 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.

People received their care and support safely. Staff knew how to support people and protect them from the risk of harm. Risks to people’s health and welfare were well managed. The service recruited staff safely and employed sufficient numbers of staff to meet people’s assessed needs.

People received their medication safely and as prescribed and the records were of a good standard. Staff had received regular updates in training and checks to ensure that they were competent to administer medication safely. The service was well maintained, clean and hygienic. Staff had been trained in infection control and had a good knowledge of infection control procedures.

People’s needs had been fully assessed and care plans had been regularly reviewed and updated to ensure they continued to meet their needs. Staff were well trained, supported and supervised and knew how to care for people effectively. People were offered a choice of fresh home cooked meals in sufficient quantities to meet their nutritional needs. The fruit and sweet stalls offered them additional snacks and there were cup drinks available 24 hours a day. Staff worked with health and social care professionals to ensure that people’s healthcare needs were fully met.

The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible. Appropriate assessments had been carried out in line with legislation. The service had made appropriate requests for authorisation when people were deprived of their liberty, People’s independence was encouraged while minimising any risks to help keep them safe.

People were cared for by kind, caring and compassionate staff who listened to them and made them feel that they mattered. Staff treated people with dignity and respect and ensured they had the privacy they needed. People and their relatives were fully involved in making decisions. Advocacy services were available if people needed them. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.

People received personalised care that was responsive to their needs. Care plans and daily notes were very detailed and informative and were kept up to date. People had good community links and were kept occupied with a range of indoor and outdoor activities and events. The complaints procedure was good and complaints had been fully investigated and addressed.

People and their relatives had confidence in the registered manager and knew them well. Relatives said they felt that the registered manager was very good at their job. Staff felt supported and shared the manager’s vision to provide people with good quality care. There were effective quality assurance systems and processes in place that identified and actioned the improvements needed. Confidential information was stored safely in line with data security standards.

Further information is in the detailed findings below.

At the last inspection, the service was rated good and at this inspection we found the service remains good.

People received a consistently safe service and were protected from the risk of harm. There were enough staff that had been safely recruited to help keep people safe and meet their needs. Risks were well managed. Medication management was good and people received their medication as prescribed.

People were cared for by supported, experienced and well trained staff. The service ensured that people had the support they needed to have as much choice and control over their lives in the least restrictive way possible. People received plenty of good quality food and drink to meet their needs and preferences and their healthcare needs were met.

Staff knew the people they cared for very well and were consistently kind, caring and compassionate in their approach. People felt that all of the staff were ‘the tops’ ‘couldn’t be better’ and, ‘treated with dignity’. People said the staff were wonderful and treated them ‘perfectly’ always respecting their privacy and maintaining their dignity. People were encouraged and supported to remain as independent as was possible.

People and their relatives were fully involved in their assessment process and their care plans had been tailored to meet their needs and preferences. People participated in regular reviews to ensure their care plans reflected their changing needs. There were plenty of activities available to suit people’s individual needs and tastes. People told us they had regular trips out to local pubs for a meal and to family gatherings such as weddings. Staff encouraged and supported people to participate in activities that suited their interests. Complaints were dealt with appropriately, they were fully investigated and responded to in a timely way.

All of the people we spoke with were positive about the quality of the service. The registered manager and staff were committed to providing people with good quality person centred care that met their needs, wishes and preferences. There were good systems in place to monitor the quality of the service and to drive improvements. The service met all relevant fundamental standards.

Further information is in the detailed findings below.

We saw that people's care needs were assessed. Care plans were in place so that staff would know about their care needs. Risks associated with people's care was minimised as far as possible through risk assessments being undertaken to keep people safe. The service was caring and responsive to people's changing needs. Staff sought support from other professionals or agencies when needed. Staff had a good knowledge of people's individual needs and offered them appropriate support. People had opportunities for activity and occupation.

People told us that they enjoyed the food provided at Broomhills. We found that people's nutritional needs were assessed and monitored to ensure their on-going wellbeing.

People told us that they felt safe and secure living in Broomhills. We saw that staff had been trained to understand different types of abuse and to report act upon any concerns they had about people's care and welfare.

The service was kept clean and provided a hygienic and pleasant place for people to live.

Staff were supported to be effective in their role through good levels of training and on-going supervision.

People told us that any concerns they had were listened to and acted on by staff and/or management in the service. We found that any complaints made were properly investigated and responded to.

Overall we found Broomhills to be a caring, effective, responsive, safe and well led service.