Inspection on 27/10/05 for Broad Oak Manor Nursing Home

This inspection was carried out on 27th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 10/04/07

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 Helen Martin Unannounced Inspection 27th October 2005 12:30 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.V260801.R01.S.doc Version 5.0 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.V260801.R01.S.doc Version 5.0 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 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) BUPA Care Homes Limited Mrs Sandra Ann 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.V260801.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care of One Service User whose date of birth is 31/03/1944 Date of last inspection 30th June 2005 Brief Description of the Service: Broad Oak Manor provides nursing, personal care and accommodation for up to forty-two older people. The home offers a service for frail residents including those needing palliative care. A respite care service is provided and, in some circumstances, intermediate care would be considered. BUPA owns the home, which is situated in a rural area close to Dartford and Swanley. The premises are detached, surrounded by gardens and open countryside. There are good car parking facilities. Bus connections are nearby. The nearest train station is Farningham Rd, approximately two miles away. Residents’ accommodation is on two floors, accessed by a stair lift, a platform lift and a passenger lift. All bedrooms are en-suite and for single use. There is a good choice of communal areas available to residents. The home has a range of specialist equipment to meet the various needs and nursing requirements of residents. The home employs nursing and care staff, working a roster, which gives 24hour cover. The home also employs staff for management, administration, organising residents’ activities, catering, maintenance, laundry, housekeeping and domestic duties. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken on 27th October 2005 between 12.30 and 17.30. The visit included talking with residents, staff, the administrator and the head of care. The manager was not present on this occasion. Some judgements about the quality of life within the home were taken from observations and conversation. Some records were looked at. In addition, a tour of the home and garden was undertaken. Verbal discussion with the manager took place on 3rd November 2005. Findings from both occasions are included within this report. The home currently has forty residents and two vacancies. Three residents are currently being provided with respite care. What the service does well: What has improved since the last inspection? The home continues to make good progress. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 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.V260801.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5 Prospective residents and their representatives are able to visit the home prior to admission, to ensure that it is suitable to meet their needs. Residents under the age of sixty-five would benefit from the process to vary the home’s registration category, as this would confirm that the appropriate care could be provided. EVIDENCE: Following the pre-admission assessment by the home, a letter is sent to the prospective resident, together with other information, stating that the home is suitable to meet their needs. Both respite and intermediate care are offered, in addition to a permanent stay. 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, or have overnight stays. One resident spoken with said that they were happy for their friends to choose the home for them. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 9 The manager demonstrated a clear understanding regarding the category and needs of residents that the home could meet. One individual, who recently has returned home, was accommodated for two weeks respite care. They were under the age of sixty-five. The manager explained that in the past application to vary the home’s registration category has been made to CSCI. They assured the inspector that this would be undertaken in future. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Residents are treated with respect. Their health and personal care needs are met, although minor amendment to records would better reflect this. EVIDENCE: A written plan of care is prepared from a 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 included a range of holistic issues, including health and personal care, nutrition, skin integrity, mobility, social, recreational and spiritual interests. Care plans are reviewed regularly. Risk assessments are undertaken and recorded. Residents’ activities are detailed in designated records, although information transferred to care plans needed updating. The head of care explained that one resident was checked regularly as they had been diagnosed in the past with ‘dormant’ breast cancer. These checks were not recorded. The promotion of residents’ health care needs is maintained. Their access to social and health care professionals is recorded. One resident said that they often went to the hospital. Both the head of care and residents explained that Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 11 a GP visits the home once a week. Residents are offered a keep fit session on a regular basis. Their nutrition is assessed and their weight is monitored. Good written information about nutrition is available to residents. The head of care said that currently six residents have pressure sores and specialist equipment is used. 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. Medication administration records are completed appropriately. Nurses check and sign for the receipt and return of medication to and from the pharmacy. The record of medication returned is not confirmed by a pharmacy signature. Residents who wish to self-medicate are assessed and homely remedies are approved by a GP. The manager stated that the pharmacy used is registered to dispose of returned medication. Staff were observed to speak with residents in a respectful and appropriate manner. Arrangements are in place to maintain residents’ privacy and dignity. Individuals are able to make telephone calls in private. One resident spoken with said that the laundry provided a good service and that their clothes were returned to them with no problems. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Residents are able to make choices about their lives and enjoy a range of activities, varied to 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. There are two activities co-ordinators employed by the home. On the day of inspection, musical entertainment was provided for residents as part of ‘Community Spirit Day’. Residents received many guests from local sheltered housing. The event was popular with individuals who enjoyed the singing and dancing. A special high tea was provided, the table was presented attractively and the food looked appetising. Entertainment is provided on a regular basis, the next events being Halloween and Bonfire Night. The activities co-ordinators speak with residents to tell them about activities available on that day. Written information about activities is also displayed. This week they include a quiz, art and craft, bingo, a PAT dog and reminiscence. The home provides 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 Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 13 attend. Residents enjoy the home’s pet cat. In addition, one resident has their own cat. A mini-bus is available to the home. Trips out to places of interest are organised. In the summer residents enjoyed outings to the coast and to gardens. One resident spoken with said that they were happy not to join in the organised activities and preferred to watch television and listen to music in their room. 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. One resident spoken with said that they enjoyed visits from their friends on a regular basis. A staff nurse stated that residents are asked every morning for their choice of food for that day. Records contain a good variety of choices. One resident said that they liked the food and always got a choice. A special two-week Christmas menu is available. Special diets are provided where necessary, such as low fat, gluten free and Diabetic. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Residents feel their views are listened to and will receive proper consideration. Procedures are in place, which protect residents from abuse. EVIDENCE: Residents and their representatives feel their views are listened to and will receive proper consideration. BUPA provides a leaflet containing the complaints procedure, which includes details about the CSCI. The head of care said that no complaints have been received recently. It was indicated that, should a complaint be received, this would be handled and recorded appropriately. All permanent residents are on the electoral role and are able to vote if they wish. The home has guidance for staff regarding adult protection. Written policies are available, including Whistle Blowing and the Protection of Vulnerable Adults. The head of care is aware of the procedures should the need arise. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 26, Residents enjoy living in a clean and pleasant environment. They benefit from a good standard of facilities. EVIDENCE: The home is a large detached house, situated in a rural area with a view to the front. The premises are surrounded by open countryside and have a tidy and attractive garden. The home is well decorated, furnished and equipped. Recreational and individual accommodation is provided. There are four communal areas available and residents have a good choice of where to spend their time. These are attractively decorated and different in character, some contain a television and some do not. As well as high-back chairs, there are some easy chairs and settees used by residents. All forty-two bedrooms are ensuite and for single use. In addition there are six communal toilets, three bathrooms and two shower facilities. Residents’ rooms seen were pleasant and personalised. One resident said that they liked their room and the lounge areas. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 16 The home has a range of specialist equipment to meet the various needs and nursing requirements 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. The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection. The laundry room contains appropriate equipment. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 Residents’ needs are met by appropriately trained staff in sufficient numbers. Suitable staff are employed, although minor amendment to the home’s recruitment procedure could enhance the protection of residents. EVIDENCE: Staffing numbers were appropriate to meet the needs of residents at the time of inspection. There are eight staff, including three nurses, provided in the morning, five, including one nurse, in the afternoon and four, including one nurse at night. The head of care stated that currently enough nurses are on duty to meet the current nursing needs of residents. Up to date and accurate staff rosters are maintained. One resident spoken with said that the staff were very nice and attended quickly if they used the staff call point. The head of care said that the home is fully staffed and that no agency workers are used. It was mentioned that the home has it’s own bank staff to cover absences. The home also employs staff for management, administration, organising residents’ activities, catering, maintenance, laundry, housekeeping and domestic duties. The recruitment procedure in place within the home ensures that suitable staff are appointed to meet the needs of residents. A record of questions and answers at interview is kept. Staff files seen evidenced the necessary preemployment checks including, the Protection of Vulnerable Adults list, PIN number, eligibility to work in the UK, proof of identity and training certificates. Residents could be better protected, by amendment to the BUPA application form, to include the provision of a full employment history. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 18 Members of nursing staff are registered with the NMC. All care staff receive appropriate induction and foundation training. BUPA Care Homes use a system of staff induction (incorporating TOPSS induction standards) and TOPSS foundation standards that lead on to NVQ qualifications. Manual handling training is provided for all staff prior to the commencement of their duties. Training and qualifications were looked at in some detail during the previous inspection where the relevant Standards were met. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36, 37 The home is well managed and run in the best interests of residents. Minor amendment to the financial procedures of the home could better protect residents. EVIDENCE: The home has an open and positive atmosphere generated by a combination of management and administrative staff, nurses and care assistants, activities organisers and others. An in date insurance certificate is displayed within the home. Business accounts were not inspected on this occasion. Most residents or their representatives deal with their own finances. The home holds cash on behalf of some residents. Detailed transaction records and receipts were seen. Residents’ personal money is kept in a designated bank Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 20 account. This is sub-divided and residents receive their own interest. Cash held by the home for residents is not kept individually but pooled within a small float. This is kept securely. Arrangements can be made for residents to access their cash whenever they wish. Residents are protected by the arrangements in place for the supervision of staff. Staff appointed, following the Protection of Vulnerable Adults list check, are appropriately supervised until the receipt of a full Criminal Records Bureau check. One nurse is designated on shift for the supervision of newly appointed staff. Records are stored in a manner that preserves confidentiality. Computer records are password protected. Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 21 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 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 4 4 4 4 X 4 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X 3 2 3 3 X Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 22 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 19(1)(a) (b) Requirement The registered person shall not employ a person to work at the care home unless the person is fit to work at the care home; subject to paragraphs (6), (8) and (9), they have obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. A full employment history, together with a satisfactory written explanation of any gaps in employment. In that, applicants for employment must provide a full employment history. Timescale for action 1 OP29 Schedule 2.6 05/12/05 Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 23 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 OP4 Good Practice Recommendations It is strongly recommended that the manager complete their stated intention to apply to CSCI to vary the home’s registration category, should an individual wish to be accommodated under the age of sixty-five. It is recommended that with regard to care plans: • 2 OP7 • Details regarding residents’ activities should be updated more regularly. Checks undertaken by staff regarding residents’ health care should be recorded. 1 3 OP9 It is recommended that the record of medication returned to the pharmacy should be confirmed by a pharmacy signature. It is recommended that cash held by the home on behalf of residents should be kept individually and not pooled. 4 OP35 Broad Oak Manor Nursing Home DS0000026154.V260801.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 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.V260801.R01.S.doc Version 5.0 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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