CQC takes action to protect people at Liverpool care home

A Liverpool care home has been rated inadequate and placed into special measures after inspectors found people were at risk of avoidable harm, including one resident who went without prescribed medication for more than three weeks.

The Care Quality Commission (CQC) took action against Brushwood House following its first inspection in July, which was prompted by concerns about people’s safety and the management of the service. The residential home, which is run by Liverpool City Council, provides personal and nursing care.

Inspectors identified breaches of regulations covering safe care and treatment, medicines management, staffing, dignity and respect, consent, person-centred care, nutrition and hydration, safeguarding and the overall management of the service. Brushwood House has now been rated inadequate across all five areas assessed by the regulator – safe, effective, caring, responsive and well-led.

The home has also been placed into special measures, meaning the CQC will closely monitor the service while improvements are made. The regulator has begun the process of taking further regulatory action in response to its findings, which Brushwood House has the right to appeal.

Andrew Peck, CQC deputy director for adult social care in the North West, said inspectors had found leadership failures which were putting residents at risk and preventing them from receiving safe, person-centred care.

He said: “For example, we saw call bells ringing for up to 20 minutes without anyone answering, and we found people at risk of falls left alone in communal areas for long periods of time. One person’s care records said they’d eaten their breakfast, but our inspectors found the meal untouched at their bedside.”

Inspectors also identified serious concerns around medicines. One resident had gone without their prescribed medication for more than three weeks, while inspectors found examples of medicines being hidden in food and administered without the appropriate legal processes being followed. Another resident was offered fluids despite having been assessed as being at risk of choking.

Concerns about nutrition and hydration extended further, with staff failing to consistently provide food and drinks of the correct texture for residents with swallowing difficulties. Inspectors also found people were not always repositioned as required to prevent painful pressure sores, while incomplete care records made it difficult to establish whether appropriate repositioning had taken place.

Staffing was another significant concern. Residents told inspectors there were not always enough staff available and they sometimes had to wait a long time for assistance. Families also raised concerns about agency workers not knowing residents’ individual needs, with one relative telling inspectors some agency staff “didn’t have a clue what they were doing”.

The CQC found examples of residents not being treated with appropriate dignity and respect. Staff were heard referring to people by their care requirements, including describing residents as “a hoist” or “a pureed”, rather than as individuals. Personal and sensitive medical information was also displayed openly on bedroom doors and in communal areas.

Inspectors raised additional concerns about audio-enabled CCTV operating in communal areas without appropriate safeguards. Staff told the regulator the system made them reluctant to speak freely, raising concerns about both privacy and the culture within the home.

Residents were also found to have limited opportunities for meaningful activities and social interaction. The home had been without a dedicated activities coordinator for several months, while inspectors observed occasions where staff sat in communal areas without speaking to or engaging with residents.

Despite the concerns, some residents and relatives told inspectors that individual members of staff were kind and caring. The CQC said the problem was that weaknesses in the home’s systems and processes were repeatedly letting people down.

Peck said: “We’ve told leaders where it must improve, and we’ll continue to monitor the home closely to make sure people are kept safe while those changes happen.”

Liverpool City Council has told the CQC that improvements have already begun in response to the issues identified during the inspection.

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