This is the latest available inspection report for this service, carried out on 24th February 2009.
CSCI found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Broomfield Nursing Home Yardley Road Olney Bucks MK46 5DX one star adequate service 02/09/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Chris Sidwell Date: 2 4 0 2 2 0 0 9 Information about the care home
Name of care home: Address: Broomfield Nursing Home Yardley Road Olney Bucks MK46 5DX 01234711619 01234717054 broomfield@atlantishealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Atlantis Healthcare Ltd The registered provider is responsible for running the service care home 49 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 49 dementia old age, not falling within any other category Conditions of registration: 49 0 The registered person may provide the following category of service: Care home with Nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Dementia (DE) The maximum number of service users to be accommodated is 49 Date of last inspection 0 2 0 9 2 0 0 8 Care Homes for Older People Page 2 of 10 Brief description of the care home Broomfield Nursing Home is situated in the town of Olney and is privately owned. Local amenities are within walking distance to the home. The home is registered for 49 residents, including 5 who have dementia. The home cares for people who need support with personal care only and those requiring nursing care. Care Homes for Older People Page 3 of 10 What we found:
The inspection was unannounced and was undertaken because we had received concerns about the care of some residents in the nursing wing of the home. A day was spent in the home speaking with staff, residents, families and reviewing records. The care of four residents on the nursing wing was looked at closely. The residential wing of the home was not inspected on this visit. The care plans of four residents were examined. All had had initial assessments although not all had been reassessed after a spell in hospital. The manager said that sometimes people were discharged at short notice and that it was not always possible for someone to go to the hospital to reassess the resident. The information in the care plans following residents discharge from hospital was very limited and a complete assessment of their needs on return from hospital was not evident. The care plans were not complete and had not been updated regularly. The home is introducing new care planning documentation and is in the process of updating all care plans. Residents risk of developing pressure damage, nutritional difficulties and of falling had been assessed. There were records to show that two of the four residents had been weighed regularly. One had maintained her weight since moving to the home. The other had lost weight although her medication had been reviewed and this may have contributed to the weight loss. She was also very ill and in the last stages of her life. Her family were with her on the day of the unannounced visit and they were very happy with the care given in the home. The records relating to pressure damage were poor. Two of the four residents whose care was looked at had pressure damage. In one an entry had been made on the 10/10/08 to say redness has occurred and a care plan dated 12/10/08 was written. An entry was made on 24/10/08, when the resident came back from hospital, to say that she had a grade 1 pressure sore. The care plan was not updated. There did not appear to be any further entries until 12/12/08 when the pressure damage had deteriorated to grade 4. A sheet labelled nursing intervention stated when dressings were changed but did not describe the dressings or whether the wound was improving or deteriorating. It was not possible therefore to determine whether the resident had received the appropriate care and treatment to prevent her pressure damage deteriorating to a serious level. On the day of the visit, she was being nursed on an appropriate pressure relieving mattress and a record of the times that staff repositioned her was being kept. She was sleeping, appeared comfortable and not in pain. She had been seen by the tissue viability specialist and the wound was improving slowly. For the second person the hospital discharge sheet showed that he had developed pressure damage to his heels whilst in hospital. The care plan and daily notes made no mention of this and the first entry regarding pressure damage was made seven days after discharge from hospital, when a care plan was written. There are medication policies and procedures in place. The medication was well organised and the nurse in charge was knowledgeable about residents medication. There is a need to ensure that there are photos on all medication administration records and to hold a record of the names and signatures of staff who are responsible Care Homes for Older People Page 4 of 10 for administering medication. The pharmacist should be asked to undertake pharmacy audits periodically to ensure that medication management is safe and well managed. The homes training records were not up to date and it appeared that not all staff had had moving and handling training. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must reflect the care needed by residents to meet their assessed needs To ensure that residents , their families and staff are clear about the care that residents should receive. 28/11/2008 2 9 13 Changes to variable dose medication regimes should be in writing and it must be clear which is the current regime being followed. To ensure residents recieve the correct medication. 31/10/2008 3 16 22 The updated complaints 28/11/2008 policy and procedures should be described in the homes Statement of Purpose and the service users guide. To ensure that residents and their families know how to raise concerns should they wish to do so 4 19 23 The proprietor must comply 28/11/2008 with the requirements of the fire safety authority To protect residents from harm should there be a fire. 5 26 13 The infection control procedures must be improved. Foot operated 28/11/2008 Care Homes for Older People Page 6 of 10 clinical waste bins with lids should be provided. The external clinical and general waste bins must be kept clean. To minimise the risk of acquired infection for residents. 6 29 19 The recruitment files must contain the documentation listed in Regulation 19 and schedules 2 and 4 of the Care Homes regulations 2001 In order to ensure that the correct checks as to the suitability of the care worker are made. 7 31 8 The proprietor must appoint a permanent manager who must register with the Commission for Social Care Inspection. To ensure continuity and safe care for residents 8 33 38 The proprietor must notify the Commission for Social Care Inspection of managerial changes and other significant issues affecting the home. To ensure that the information held about the service is accurate. 31/10/2008 28/11/2008 28/11/2008 Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 3 14 The home must ensure that 30/04/2009 they visit all residents who are admitted to hospital to reassess their needs before they move back to the home. To ensure that they can meet these needs 2 7 15 Care plans must be reviewed 30/04/2009 and updated as soon as a resident returns from hospital. Their new care needs must be described clearly and a care plan must be developed to meet these. To ensure that residents changing care needs are accurately described and are met. 3 7 15 All residents care plans must 30/04/2009 be reviewed and updated on a regular basis, when the residents condition changes or at least monthly. To ensure that carers have up to date information about the needs of residents. 4 8 13 The records relating to pressure damage must be 30/04/2009 Care Homes for Older People Page 8 of 10 improved. A care plan must be in place which shows the care that is required, the dressings to be used and the frequency of dressing changes. The wound must be evaluated when dressings are changed and the advice of the tissue viability nurse should be sought if the wound does not appear to be improving. To ensure that residents presure damage does not deteriorate and that they receive the correct treatment 5 38 13 All staff must have moving and handling training To ensure that residents and staff are protected from harm arising from their care Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 31/05/2009 1 30 The training records should be updated to show that all staff have had an induction and have had basic mandatory training in safe working practices. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
