Inspection on 10/04/07 for Broad Oak Manor Nursing Home

This inspection was carried out on 10th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Broad Oak Manor Nursing Home 27/10/05

Broad Oak Manor Nursing Home 30/06/05

Broad Oak Manor Nursing Home 28/02/05

Broad Oak Manor Nursing Home 29/09/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Broad Oak Manor Nursing Home Broad Oak Close Arnolds Lane Sutton At Hone Dartford Kent DA4 9HF Lead Inspector Eamonn Kelly Key Unannounced Inspection 10th April 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broad Oak Manor Nursing Home Address Broad Oak Close Arnolds Lane Sutton At Hone Dartford Kent DA4 9HF 01322 223591 01322 288345 nevards@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sandra Nevard Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (5) of places Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of six service users may be from the age of 55 years. Date of last inspection 27th October 2005 Brief Description of the Service: Broad Oak Manor, owned by BUPA, provides personal care and accommodation for people aged 55 and over. All bedrooms are en-suite and for single use. The home has a range of specialist equipment to meet the support needs and nursing requirements of residents. The premises are surrounded by gardens and open countryside. Fees are as follows: 1. Local Authority funded residents: £532 per week (assuming a medium band RNCC of £87, the weekly rate is £445). 2. Privately funded residents: £850-£950 per week. 3. Depending on the outcome of PCT (primary care trust) assessments of the level of nursing care, a refund (registered nurse care contribution) to meet the nursing care proportion of weekly fees may be applicable. These levels of refund are: £43 per week (low), £87 per week (medium) or £139 per week (high). Additional charges are made for the following: • • • • • • Newspapers (cost of papers nominal delivery charge). Hairdressing (£4 to £22). Chiropody (£14), Private phones and associated costs, Escort charges to hospital where family members are unable to assist [approx £5.50 per hour), TV licence (£7.50 but free for over 75’s). Prospective residents and their representatives receive a copy of the Resident’s Guide. This guide contains information about services and facilities including fees, additional charges and RNCC refunds. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 10th April 2007 (10am-4pm). It consisted of meeting with residents, manager, deputy manager, members of staff and visitors. A tour of the premises was made. Care practices were observed and discussed with members of staff, residents and visitors. A variety of records were seen principally those that are important for the safety and welfare of residents. Residents and their representatives completed and returned 6 CSCI surveys to the commission. Residents and visitors met indicated that they are satisfied with the care and attention given to residents. What the service does well: What has improved since the last inspection? What they could do better: Residents continue to receive excellent care and attention. The manager, with the assistance of BUPA’s quality monitoring and external operational support, Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 6 is continuing to identify and carry out improvements that benefit the interests of residents and their representatives. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6. Quality in this outcome area is good. This judgement was made using available evidence including a visit to the service. Prospective residents and their supporters have the benefit of receiving good information and support to enable a decision about taking up residence to be made with confidence. EVIDENCE: Following a pre-admission assessment, a letter is sent to the prospective resident stating that the home is suitable to meet his/her needs. Both respite and intermediate care are offered in addition to a permanent stay. Information recorded about the prospective resident’s state of health and levels of support needed and expected forms part of the subsequent care plan record for that resident. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 9 Prospective residents and their representatives are able to see if the home is suitable before they move in. They are able to visit for a day and have a meal. Written information about the home’s facilities and services is also given to prospective residents and their supporter(s). Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is excellent. This judgement was made using available evidence including a visit to the service. Residents receive very good support for their health and personal care needs. EVIDENCE: A written plan of care is prepared from the pre-admission assessment drawn up with each resident. This gives staff guidance about action to be taken to meet the health and welfare needs of residents. Individual goals and preferences are included. Care plans records include health and personal care, nutrition, skin integrity, mobility, social, recreational and spiritual interests. They are reviewed and updated regularly. Resident’s are protected by the use of risk assessments. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 11 The promotion of residents’ health care needs is maintained. Their access to social and health care professionals is recorded. GP’s visits the home once a week or when requested. Resident’s nutrition is assessed and their weight is monitored. Good written information about nutrition is available to residents. Specialist equipment is used for the treatment of pressure sores. Risk assessments are recorded and advice sought from a tissue viability nurse. Residents are provided with continuity of care by a ‘named nurse’ system. Residents are protected by the arrangements in place for the storage and administration of medication. Nurses check and sign for the receipt and return of medication to and from the pharmacy. Residents who wish to self-medicate are assessed and homely remedies are approved by a GP. The premises, procedures and all arrangements observed are such that residents’ privacy and dignity is maintained as an important factor in providing suitable support for residents. Residents met referred to the good care and support they feel they invariably receive. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is excellent. This judgement was made using available evidence including a visit to the service. Residents are able to make choices about their lives and enjoy a range of activities that suit their expectations, preferences and capacities. EVIDENCE: The routines of daily living and activities made available are flexible and varied to suit residents’ expectations, preferences and capacities. Two activities coordinators assist in helping residents. The activities co-ordinators and other members of staff speak with residents to tell them about activities available on that day. Written information about activities is also displayed. The home has it’s own hair dressing salon and a hairdresser is available for residents on a weekly basis. Ministers of religion visit the home on a regular basis and Communion is held every Sunday for those who wish to attend. If it is agreed at admission stage, residents might be able to bring small pets into the home. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 13 A mini-bus is available to the home. Occasional trips to places of interest are organised. Residents enjoy outings to the coast and to gardens. Throughout the year, themed activities are organised for the benefit of residents. Some residents say they are happy not to join in organised activities and prefer to watch television, relax or listen to music/TV in their bedroom. Residents are encouraged to keep contact with their relatives and friends if they wish. Visitors can be met in private and in comfortable surroundings. Relatives are invited to attend the events and entertainment organised by the home. The chef outlined how residents are asked every morning for their choice of food for that day. The home provides an excellent meal service for residents. Appropriately detailed records are kept which are of benefit to residents. The chef showed how particular emphasis is placed on knowing resident’s preferences, possible allergies and on providing special diets for low fat, gluten free and diabetic conditions. Residents and visitors met spoke in very positive terms about the support given to maintain good lifestyles and quality of life. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is excellent. This judgement was made using available evidence including a visit to the service. Residents can feel confidant that their concerns receive proper consideration and that procedures protect them at all times. EVIDENCE: The home gives guidance to staff on adult protection. All members of staff receive initial information on expected standards relating to protection of vulnerable adults (pova). Updates are provided when the manager and deputy manager feel that this is necessary. Residents are encouraged to provide their views via a BUPA questionnaire. The manager follows up all information given so that proper attention is given to resident’s expressed views or concerns. Although only a small number of residents or their supporters returned completed CSCI surveys, the information given was very positive. Residents and their representatives feel their views are listened to and receive proper consideration. BUPA provides a leaflet to all residents that contains a copy of the complaints procedure. Six expressions of concern were received in Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 15 the last 12 months. There was evidence that they were properly investigated and complainants received suitable information on the outcomes (one complaint substantiated, three partly substantiated and two not substantiated). Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25, 26. Quality in this outcome area is excellent. This judgement was made using available evidence including a visit to the service. Residents have the benefit of living in premises that are suitable for their support needs. EVIDENCE: The premises are surrounded by open countryside. Internal and external facilities are suitable for use by residents and visitors. The premises are well decorated, furnished and equipped. There are four communal areas available and residents have a good choice of where to spend their time. As well as high-back chairs, there are some easy chairs and settees for residents and visitors. All bedrooms are single and enBroad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 17 suite. In addition there are six communal toilets, three bathrooms, two shower facilities and well-equipped laundry. The home has a range of specialist equipment to meet the care and support needs of residents. Residents’ accommodation is on two floors, accessed by stair, platform and passenger lifts. The premises are suitable for wheel-chair users. Hoists and a staff call system are available. All external doors are alarmed. Continuous improvements are made to the premises. This currently includes improvements to some bathrooms (eg. to achieve “wet room” advantage), painting of corridor areas and new floor covering in some communal areas. The premises are kept clean and pleasant smelling throughout and procedures are in place to control the spread of infection. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is excellent. This judgement was made using available evidence including a visit to the service. Residents can be confidant that they are in the care of nurses and care assistants who receive good levels of support and on-going training. EVIDENCE: Eight members of staff that includes three nurses are on duty in the morning. This is reduced to five (including one nurse) in the afternoon. The number is further reduced (4 staff including a nurse) at night. The pressures on staff particularly in the afternoons and evening are considerable given the high dependency needs of residents. The manager feels that the current staffing levels are appropriate and that the allocated hours are within the parameters set by BUPA. There is relatively little dependence on agency staff as the home uses its “bank staff” to cover absences. Residents benefit from the presence of staff for management, administration, organising activities, catering, maintenance, laundry, housekeeping and domestic duties. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 19 Staff files indicated that appropriate pre-employment checks are made. These include detailed application forms, proof of identity, validation of nurses NMC registration, two references, CRB /POVA checks and, where necessary, work permits. Members of nursing staff are registered with the NMC (Nursing & Midwifery Council). All members of staff receive induction and foundation training. BUPA care Homes use a system of staff induction that incorporates “Skills for Care” induction standards. NVQ level training and other training is provided via BUPA procedures and training materials that have been accredited by “Skills for Care”. Manual handling training is provided for all staff prior to the commencement of their duties. CSCI provider relationship managers have validated the recruitment and training procedures in BUPA care homes. The evidence during this inspection visit was that members of staff receive proper support that enables good standards of care to be given to residents. This includes upkeep of BUPA requirements that all staff receive formal supervision about every six weeks. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is excellent. This judgement was made using available evidence including a visit to the service. Residents can be confident that management and administration procedures protect their interests and promote their health and welfare. EVIDENCE: The manager and deputy manager have the qualifications and experience necessary to enable the support needs and nursing requirements of residents to be addressed appropriately. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 21 The home has a calm and positive atmosphere generated by a combination of management and administrative staff, nurses and care assistants, activities organisers and others. There was evidence that the staffing structure and staff support systems, health and welfare support in place for residents, quality monitoring by visiting BUPA specialists and BUPA demands on high management standards and associated performance measurement enable a conclusion to be made that the home promotes resident’s interests and welfare. Most residents and their representatives deal with their own finances. It is understood that the CSCI has accepted via provider relationship managers that the methods of holding monies on resident’s behalf is appropriate. The process involves resident’s personal money being kept in a designated bank account and individually receiving any interest accruing. Residents are protected by the arrangements in place for the formal supervision of staff. There are good recruitment procedures and all members of staff receive induction and on-going training. A high priority is placed on safe moving and handling of frail older people. BUPA managers operate NVQ training and schemes of “mandatory” training the outcome of which is monitored by BUPA quality and performance managers. The views of residents are sought and these are given proper consideration. Quality assurance procedures are in place that requires the manager to assess areas of practice and safety of systems and equipment. The manager reports back on the improvements that are necessary for the continuing comfort and safety of residents. Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 4 4 4 4 x 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 4 Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Broad Oak Manor Nursing Home DS0000026154.V334513.R01.S.doc Version 5.2 Page 25 - 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. 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