Brooklands Homecare Ltd (Edenbridge) was rated Requires Improvement overall following a July 2018 inspection, with a breach of Regulation 19 identified due to inadequate recruitment practices including missing references and expired vehicle documentation in staff files. The service performed well in the effective, caring and responsive domains, with safe medication management, good person-centred care and positive feedback from people and healthcare professionals, but governance systems failed to rectify known recruitment shortfalls.
Concerns (4)
criticalStaffing levels: “Two references had not been received before staff started work. One out of the four recruitment files we looked at had no references on file and staff had started to support people without any references.”
moderateGovernance: “Audits of staff files had also identified that there had been difficulties in obtaining staff references in some cases when they were requested, but staff had commenced work without all their references being obtained.”
moderateRecord keeping: “We found no current record of car insurance they had expired in 2016...two out of the staff files we looked at had no MOT certificate and one had expired in 2015 and the other in 2016.”
moderateLeadership: “The registered manager had processes in place to monitor the delivery of the service. However, this had not been effective in rectifying the shortfall we found in recruitment.”
Strengths
· Medicines were managed safely with no gaps or omissions in MAR records and staff adequately trained in medication administration.
· People felt safe with carers and staff demonstrated good knowledge of safeguarding policies and whistleblowing procedures.
· Sufficient staffing levels deployed to meet people's needs with flexible adjustment as required.
· Staff received infection control training and had access to personal protective equipment.
· People were treated with dignity and respect, and their privacy was maintained.
Quality-Statement breakdown (18)
safe: Recruitment practicesRequires improvement
safe: SafeguardingGood
safe: Medication managementGood
safe: Staffing levelsGood
safe: Infection controlGood
effective: Assessment and care planningGood
effective: Mental Capacity Act complianceGood
effective: Staff training and supervisionGood
effective: Working with external professionalsGood
caring: Dignity and respectGood
caring: Involvement in care planningGood
caring: ConfidentialityGood
responsive: Person-centred careGood
responsive: Complaints handlingGood
responsive: End of life careNot rated
well-led: Governance and audit systemsRequires improvement
well-led: Leadership and managementGood
well-led: Regulatory compliance and notificationsGood
Brooklands Homecare (Edenbridge) was rated Good overall at its first CQC inspection in November 2015, demonstrating safe care, positive staff culture, and person-centred practice. The single area requiring improvement was a regulatory breach under Regulation 11, as neither staff nor management had completed essential Mental Capacity Act 2005 training.
Concerns (2)
criticalConsent / capacity: “Staff and management had not completed essential training in the principles of the Mental Capacity Act 2005 (MCA) and the requirements of the relevant legislation. This is a breach of Regulation 11”
criticalStaff training: “The registered manager and staff had not completed essential training in the principles of the Mental Capacity Act 2005 (MCA) and the requirements of the relevant legislation.”
Strengths
· Staff were trained in safeguarding of vulnerable adults and knowledgeable about recognising signs of abuse
· Risk assessments were centred on individual needs with clear measures to reduce identified risks
· Thorough staff recruitment procedures including DBS checks and employment reference verification
· Medicines administered safely with competency checks every four months and regular audits
· Staff sought and obtained people's consent before providing support
Quality-Statement breakdown (17)
safe: Safeguarding and protection from abuseGood
safe: Risk assessment and managementGood
safe: Staffing levels and recruitmentGood
safe: Medicines managementGood
effective: Mental Capacity Act training and complianceRequires improvement
effective: Staff training and competency (general)Good
Brooklands Homecare Ltd - Edenbridge remains Requires Improvement for the second consecutive inspection, with a safeguarding concern identified pre-inspection relating to unsafe medicines management and inadequate infection control by one care staff member. Governance systems were insufficiently robust, with infrequent auditing of care records and inconsistent spot checks, though caring and responsive practice was consistently strong and recruitment failings from the previous inspection had been remedied.
Concerns (5)
criticalMedication management: “A member of care staff had not followed the service's guidance...and had left medicines out for the person to take after their care call had been completed.”
moderateGovernance: “Some records were only taken to the office infrequently. In addition, once received in the office only a sample of the records were audited.”
moderateInfection control: “The same member of care staff had not informed the registered provider that sufficient time had not been allocated to enable them to complete the cleaning tasks.”
moderateSupervision / appraisal: “Spot checks were completed by a senior member of staff...however, this process not well organised as the checks were not comprehensive and were not completed on a regular basis.”
moderateIncident learning: “Care staff had not been fully supported to understand their responsibilities to meet regulatory requirements...one member of care staff had not fully complied with some of this guidance.”
Strengths
· Sufficient staffing levels with care calls completed reliably and on time
· Safe recruitment practices improved since last inspection, no longer in breach of Regulation 19
· Care staff demonstrated compassion, courtesy and promoted people's independence and dignity
· People supported to pursue interests and hobbies, including community activities
· Effective multi-agency working including liaison with healthcare professionals and commissioners
Quality-Statement breakdown (22)
safe: Staffing and recruitmentGood
safe: Medicines managementRequires improvement
safe: Infection prevention and controlRequires improvement
safe: Assessing risk, safety monitoring and managementGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choicesGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enoughGood
This focused inspection of Brooklands Homecare Ltd (Edenbridge), covering effective, caring and well-led domains only, found the service to be Good across all three areas inspected. A previous breach regarding mental capacity training had been fully remediated, and the service demonstrated strong staff support, person-centred care, and effective governance.
Strengths
· Provider met Mental Capacity Act 2005 requirements; staff trained in MCA principles and appropriate capacity assessments carried out.
· All staff had completed essential training relevant to their role with an effective system to monitor and schedule refresher courses.
· Staff received regular one-to-one supervision with additional support or training provided when necessary.
· People and relatives consistently described staff as kind, caring and professional, with positive relationships developed.
· Registered manager conducted unannounced spot checks, acted on complaints, sought feedback via satisfaction surveys, and fostered an open, person-centred culture.
caring: Kindness, respect and dignityGood
caring: Involvement in care planningGood
caring: Information provision and communicationGood
responsive: Person-centred care planning and reviewGood
responsive: Complaints handlingGood
responsive: Acting on feedback and people's viewsGood
well-led: Culture, values and leadershipGood
well-led: Quality assurance and governanceGood
well-led: Record keeping and information governanceGood
effective: Staff working with other agenciesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported: respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to follow interests and avoid social isolationGood
responsive: Improving the quality of care in response to complaintsGood
responsive: End of life care and supportGood
well-led: Continuous learning and improving careRequires improvement
well-led: Managers and staff being clear about their roles and understanding quality performanceRequires improvement
well-led: Engaging and involving people using the serviceGood
well-led: Planning and promoting person-centred, high-quality careGood