Brabourne Care Centre

Updated 12 January 2022

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 Care Act 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 three inspectors.

Service and service type

Brabourne Care Centre is a ‘care home’. 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.

Notice of inspection

This inspection was unannounced.

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 the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and four relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, clinical lead, deputy manager, dementia lead, nurses, senior care workers and care workers.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 12 January 2022

About the service

Brabourne Care Centre is a residential care home providing personal and nursing care to 58 people older people, some of whom are living with dementia. The service can support up to 82 people. The service is purpose built with three separate wings over three floors each of which has separate adapted facilities. One of the wings provides care to people living with dementia.

People’s experience of using this service and what we found

People told us they were happy and felt safe living at Brabourne Care Centre. However, we found that medicines management was not always safe. Staff did not document where pain patches were applied, creams had not been dated on opening and medicines stock numbers did not match those on the medicines administration records. Guidance was not always in place for staff to follow to inform them of how best to support people with risks to health, such as skin breakdown. This was implemented on the day of the inspection.

Audits and checks were completed regularly however, they failed to identify issues with medicines and care plans. The quality lead was in the process of reviewing and updating all care plans and risk assessments, however there was no priority to review the highest risks to people. Following the inspection, the registered manager sent us an improvement plan detailing how they planned to review all risk assessments, alongside a full audit of medicines and improvements to implement.

When accidents and incidents occurred, these were analysed by staff and action taken to mitigate risks to people. People were safeguarded from the risk of abuse. Staff had received training in safeguarding people. People were supported by enough staff and were supported by regular agency staff when needed. The service was clean and well maintained.

There was a positive culture within the service. We observed positive, kind interactions between people and staff. Staff worked with external healthcare professionals to ensure people received joined up care. People’s opinions on the service were sought and staff shared information with people and relatives.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 29 August 2018).

Why we inspected

We received concerns in relation to the quality of care and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. The registered manager took action to address the shortfalls we identified and has implemented improvements. We will check this on our next 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Brabourne Care Centre on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to medicines management at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.