Background to this inspection
Updated
6 October 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.
This inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
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
The inspection was carried out by 1 inspector.
Service and service type
Broxbourne Nursing 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. Broxbourne Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 15 August 2023 and ended on 7 September 2023. We visited the service on 15 August 2023.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our 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.
During the inspection
We spoke with 5 people and received feedback from 5 relatives. We also spoke with 11 staff including the registered manager, regional manager, quality assurance manager, managing director and support workers. We received feedback from health and social care professionals. We reviewed a range of records. This included 4 people’s care records and medication records. A variety of records relating to the management of the service were also reviewed. These included training records, incident records and quality assurance processes.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Updated
6 October 2023
About the service
Broxbourne Nursing Home is a purpose-built residential care home providing personal and nursing care to up to 77 people. The service provides support to older people, some of whom live with dementia. At the time of our inspection there were 26 people using the service.
People’s experience of using this service and what we found
There had been improvements since the last inspection. Work had been completed to minimise risks and use governance systems more robustly. Good progress had been made with the action plan developed by the provider after the previous inspection. People, relatives and staff told us they felt there had been improvements.
We found that while risk management and safeguarding was more effective, there were still some areas of practice that needed to be embedded to ensure the improvements were sustainable. We found there had been an issue with a person’s ‘as needed’ medicines, ensuring a person ate foods that did not impact on their heath and whether pressure care mattresses were consistently checked appropriately. However, the management team’s response to these points assured us that robust systems were in place.
People and their relatives told us they were happy with the care provided and living at the service. They told us they felt safe. Infection control was promoted and medicines were managed well for the most part.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported to eat and drink well and choose how they spent their days. The building was decorated nicely and people had access to ample communal areas and a pleasant garden which was in use on the day of our visit.
Activities were available and people told us they enjoyed these. The provider had systems in place to aid communication between people and staff.
Complaints systems were used and people and their relatives told us they could speak up. There were meetings and contact with people, relatives and staff to get their views. Feedback was collated and shared.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was inadequate (published 12 January 2023) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 12 January 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from inadequate to good based on the findings of this inspection.
We have found evidence that the provider needs to make some further improvements. Please see the safe sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Broxbourne Nursing Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.