20 February 2023
During an inspection looking at part of the service
Broadland View is a residential care home providing accommodation and personal care to up to 26 people in one adapted building. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 24 people using the service and 1 person was in hospital.
People’s experience of using this service and what we found
People using the service and relatives gave us positive feedback about the service and told us they felt the care was good. However, our inspection identified some concerns relating to the management of risk and safeguarding. This led us to question the quality of the leadership of the service and provider oversight.
Safeguarding concerns had not always been referred to the local authority for investigation or reported to CQC. Where safeguarding concerns had been identified by the provider, they did not always take prompt and effective action to protect people. Staff had not always been appropriately referred to the Disclosure and Barring Service (DBS) to review their safety and suitability to work with vulnerable people. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.
Risks relating to choking, falls management for people taking blood thinning medicines and some environmental risks were not robustly managed and fully understood by staff. Some environmental risks had been identified but not addressed which placed people at risk of harm.
Records were person centred and had recently been reviewed. However, further work was needed to make sure all records were accurate, and information recorded in the correct place to ensure effective oversight of people’s health and welfare.
Medicines were well managed, and people received their medicines as prescribed. Some recent medicines administration errors had not been fully investigated at the time they occurred. The registered manager assured us better medicines management systems had been put in place following this and records confirmed this.
There were enough staff and staff knew people’s preferences well. They were very kind and relationships were good. The service had a ‘homely’ feel which relatives commented on. One relative stated, ‘I find the service responsive to people’s needs’.
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.
This inspection reflected a mixed picture. Feedback about the service was positive and people who used the service were happy. However, poor management of safeguarding and risk led us to question the quality of leadership and provider oversight.
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 2 December 2017).
Why we inspected
We received information in relation to a historic incident which occurred before the current registered manager and deputy were in post. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of 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 provider took action to begin addressing our concerns relating to oversight of risk and the management of safeguarding. They introduced new systems of checking daily records, begun a complete review of all care plans and held a staff meeting to remind staff about some key issues raised during the inspection process. They have also begun an action plan which they will share with us.
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 Broadland View Care Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches of regulation in relation to the management of risk, safeguarding and overall leadership. 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
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.