20 April 2023
During an inspection looking at part of the service
Brushwood is a purpose-built care home which can support up to 60 people over three floors. One of the units specialises in caring for people who are living with dementia. At the time of the inspection 56 people were living at the home.
People’s experience of using this service and what we found
Management and oversight of the service had failed to identify improvements needed to the management of people’s medicines; minimising known risks to people and the cleanliness of some areas of the environment. Concerns were not always managed in a timely manner.
Care records did not always contain the most relevant information or guidance that staff needed to follow in relation to minimising risk to people and keeping them safe. Quality performance measures were not effectively in place, areas of risk were not always safely managed.
People’s food choices and mealtime experiences varied around the service.
We were unable to confirm that people were always 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; policies and systems in the service were in place to support this practice. A review of Deprivation of Liberty safeguarding was in progress at the time of this inspection.
Family members had mixed views on the service their relatives received. Some were happy and other felt that improvements were needed.
Suitably qualified, competent, skilled or experienced staff were not always effectively deployed in some areas of the service. In other areas, people were seen to receive care and support from staff that knew them well and were caring.
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 requires improvement (published 26 July 2022) and there were breaches of regulation. At this inspection not enough improvement had been made and the service is rated inadequate.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
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.
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Enforcement and Recommendations
We have identified breaches in relation to medicines management; risk management; infection prevention and control and management and governance at this inspection.
We have made three recommendations in this report in relation to managing safeguarding concerns, numbers and deployment of staff and people’s mealtime experience.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.