Archived: Browns Field House

Updated 9 March 2024

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.

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

Two inspectors carried out this inspection.

Service and service type

Browns Field House 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. Browns Field House is a care home without 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 not a registered manager in post. The provider had employed a consultant to manage the service through the consultation period about the future of the service. During the inspection the provider employed a second consultant to work in the service to provide management cover.

Notice of inspection

This inspection was unannounced.

What we did before the 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people who lived at Browns Field House, we also observed the care and support people received in communal areas of the service. We also spoke with one relative of a person who lives in the service. We spoke with the nominated individual, the director of care operations, the providers consultant who was managing the service, the head of care, one team leader, one senior carer, two care assistants and a member of the housekeeping team and the care service administrator.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 9 March 2024

About the service

Browns Field House is a residential care home providing personal care to 15 adults at the time of the inspection. The service can support up to 29 people. Browns Field House accommodates people in one building over two floors. The provider was in a consultation period to close the service.

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

Risks to people were not always identified, managed or reviewed to ensure people were safe and

protected from harm. We could not be confident that staff always took the necessary action to ensure people received the care and support they required. People were not always protected from the risk of cross infection due to some poor infection prevention and control practices. Incidents and accidents were not always reported in a timely way to the manager. Analysis of incidents to identify patterns to learn lessons and prevent reoccurrence had not always taken place at a service level.

Staff had not always received the support they needed to carry out their role effectively. Not all staff had received/ completed inductions, supervisions and appraisals as expected. Senior staff told us they had not completed training to write and review care plans out their role. There was a high dependency on agency staff however where possible the same agency staff were used.

Oversight and audits had not been effective in identifying some areas for improvement and ensuring they were completed in a timely manner. Processes to monitor people's standards of care were not clear and we found gaps in recording and/or monitoring that had not been addressed. Lack of provider oversight had meant that it had not been identified that their policies and procedures were not always being followed.

Information about people was not always up to date and did not reflect their current needs. Care plans had not been regularly reviewed and updated as people’s needs changed. Information about how people wanted to be supported at the end of their life was not always in place in a timely manner.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence had good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and/or who are autistic.

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 (report published 06 August 2021).

Why we inspected

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

We inspected and found there was a concern with reducing risks to people’s safety and identifying areas for improvement and taking prompt action, so we widened the scope of the inspection to become a comprehensive inspection which included all of the key questions of safe, effective, caring, responsive and well-led.

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 see what action we have asked the provider to take at the end of this full report.

The provider has taken action to mitigate the immediate risks to people’s health and safety.

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

Enforcement and Recommendations

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 will take further action if needed.

We have identified breaches in relation to reducing risks to people, identifying areas for improvement and taking action in a timely manner, ensuring people records are reviewed and updated and that staff receive the support they need to carry out their roles effectively

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.