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Inspection on 30/06/05 for Broad Oak Manor Nursing Home

Also see our care home review for Broad Oak Manor Nursing Home for more information

This inspection was carried out on 30th June 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users and their supporters are encouraged to speak for themselves and make their aspirations or concerns known to the manager and members of staff. The home enables privately funded service users to receive services as well as local authority funded service users receiving nursing and terminal care.

What has improved since the last inspection?

New furniture suites were being fitted in some 13 bedrooms. A new summerhouse was built. New curtains were fitted to 12 bedrooms and some other areas. A new arrangement has been introduced to enable members of staff to deal more effectively with visitors ("hostess" initiative). The Bupa "personal best" initiative (to improve customer care) has been extended. The "chefs best" notice board has been further developed.

What the care home could do better:

The continuous progress made by the home as outlined above is commendable. No requirements were identified nor have recommendations been made on this occasion.

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 Announced 30 June 2005 11:00a.m. 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 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 H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 Telephone number Fax number Email 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 Nevard Care Home 42 Category(ies) of Old Age (42) registration, with number of places Physical disability (5) Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Care of one service user whose date of birth is 31/03/1944 Date of last inspection 28 February 2005 Brief Description of the Service: Broad Oak Manor provides care and accommodation for up to 42 older people. The home is registered for the care of frail people including those needing palliative care. A respite care service is offered and, in some circumstances, intermediate care would be considered. Broad Oak Manor has a range of modern specialist equipment to meet the needs of people who have diverse physical and mental health challenges and nursing requirements. The home has a combination of management and administrative staff, registered general nurses, care staff, chef and kitchen assistants, laundry staff, maintenance manager, activities organisers and housekeeping staff. The premises are situated in a rural area near Dartford and Swanley. It is surrounded by extensive gardens and open countryside. There are good car parking facilities. Bus connections are nearby. The nearest train station is Farningham Rd, about two miles away. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit consisted of meeting with the manager, members of staff, visitors and service users. Some records relating to the care of service users were viewed. Use was made of a pre-inspection questionnaire submitted by the manager. “Comment” cards (as part of quality assurance measures) submitted to the Commission by service users and their friends were also used as well as aspects of the home’s own quality assurance process. What the service does well: What has improved since the last inspection? What they could do better: Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 6 The continuous progress made by the home as outlined above is commendable. No requirements were identified nor have recommendations been made on this occasion. 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 H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 & 6 Prospective service users and their supporters provided with sufficient assistance and information for them to make a judgement about whether the home can provide effectively for their care and accommodation needs. EVIDENCE: Prospective service users and their supporters are provided with adequate information to enable them to decide if care and accommodation requirements can be met. Each service user has an information folder in his/her bedroom and this (with other information folders) is available to prospective service users and their advocates. Each is provided with a personal contract. Detailed pre-admission assessments are carried out (supported by appropriate records which are used as the basis for subsequent individual care plan records). This issue was discussed in some depth during the inspection visit and in particular the trend towards the need for sufficient staffing and infrastructure to meet the needs of people with increasingly high care needs (including terminal care) at admission stage. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 9 A respite care service and intermediate care is offered. Where service users are admitted for intermediate care, dedicated accommodation is provided together with specialised facilities, equipment and staff, to deliver short-term intensive rehabilitation and enable service users to return home. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10 and 11 Service user’s health and personal needs are met by the home. EVIDENCE: Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 11 A written plan of care is prepared from a pre-admission assessment drawn up with each service user (this provides the basis for the care to be delivered). There was evidence that care plans are updated regularly. Care plan information, in the examples seen, included details of service user’s disabilities and assessed needs, goals of care allocated to each need and progress or otherwise on how care needs are being met. Records of written risk assessments were seen [examples included moving and handling requirements and the use of hoists, bedsides etc (a member of staff provides moving & handling training and updates)]. Records (seen as part of case tracking) indicated that service users have access to relevant social and healthcare services (the services normally provided in care homes by district nurses are provided by registered nurses). Policies and procedures indicated that service users rights to respect and privacy are observed. Members of staff have wide experience (supported by staff training and support) of working with people who are seriously ill or dying and of helping them and their friends and families. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 Service users are able to exercise control over their lives and they avail of a commendable range of activities and opportunities for physical and mental stimulation. They benefit from the availability of meals that offer choice and variety and cater for special diets. EVIDENCE: The routines of daily living and activities made available are flexible and varied to suit service users’ expectations, preferences and capacities. They are able to have visitors at any reasonable time and a new “hostess” scheme has been set up to contribute to customer care. Activities organisers provide services on all weekdays and they have produced a template to be followed by staff members on weekends. There is a comprehensive programme arranged for service users [examples were regular outings for one or two service users and a special taxi (which accommodates wheelchair users) which a member of staff accompanies (in a private vehicle)]. A range of other activities was outlined and dates and times were displayed. Examples of associated risk assessment records were seen. A collection of oldtime kitchen and household aids and equipment and magazines is kept as part Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 13 of reminiscence therapy. BUPA inter-house sports days are held each year. Other examples discussed with the activities organiser included the production of a home calendar for 2005 featuring patients and members of staff. The home tries to obtain at least one externally provided entertainment each week. Service users are encouraged to keep contact with relatives and friends. Visitors can be met in private and in comfortable surroundings. The chef manager has obtained BUPA’s Chef award for 4 consecutive years and an Environmental Health award. Most service users were encouraged to have their dinner in the dining room whilst only “bedfast” service users (or those who really wanted this) generally have their meals in their bedroom. The chef manager maintains an information board relating to meals and other information for service users and their families. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 standard(s) 16 Service users and their families/friends are encouraged to express their views in the knowledge that their comments will receive proper consideration. EVIDENCE: A number of CSCI “comment” cards were returned to the Commission by service users and their supporters. These and meetings with service users and their visitors indicated that their comments were taken into consideration by the manager and members of staff. A case tracking exercise relating to several service users also confirmed this. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Service users and their families/friends have the benefit of excellent indoor and external facilities. EVIDENCE: Broad Oak Manor has residential accommodation on 2 floors served by a stair lift, a platform lift and a passenger lift. There are extensive grounds surrounding the premises and a sensory garden. A copy of a programme of routine maintenance was seen (a number of bedrooms were in the process of being re-equipped and other improvements were taking place). The premises are floodlit at night. There are 4 communal areas available to service users. As well as high-back chairs, there are some easy chairs and settees used by service users. The premises are suitable for wheel-chair users. It has 42 (single) en-suite units, 6 communal toilets, 3 communal bathrooms and 2 shower facilities. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 16 There are extensive external facilities for residents, staff and visitors. Broad Oak Manor has a range of modern specialist equipment to meet the needs of people who have diverse physical and mental health challenges and nursing needs. The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 Service users are in the care and supervision of staff who receive appropriate training and personal development. EVIDENCE: Members of nursing staff are registered with the NMC. Healthcare assistants receive training through the BUPA programme and 55 either have or are completing NVQ Level 2/3 in Care. BUPA Care Homes use a system of staff induction (incorporating TOPSS induction standards) and TOPSS foundation standards that lead on to NVQ Levels 2 & 3. This pathway leads on to NVQ Level 4 in Care for registered managers. Copies of in-house booklets entitled “Introduction to Health & Safety”, “Introduction to Food Hygiene” and “Safe Moving & Handling of Residents” were seen. These include a questionnaire to enable the user to self-check understanding and evaluate progress. Aspects of the programme were discussed with members of staff and positive feedback was received. The home has a self-learning manual (“Basic Health & Safety: a BUPA Distance Learning Course”). There is a moving & handling trainer on site. Examples of training provided over the past 6 months included: Fire safety awareness, Concepts of abuse, Principles of infection control, Care of clients with dementia, Handling dysphasia, Working with people who have dementia, Customer Care (“Personal Care”). In addition there are training sessions for new staff and updates for current staff on TOPSS Induction and Foundation, moving & handling, COSHH, medication handling, food hygiene and health & safety. [There are a number of Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 18 BUPA produced manuals with self-tests available to underpin these courses]. Again, aspects of this training was discussed with members of staff and records were seen including references to training through the home’s staff supervision process. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 & 38. Service users benefit from a well managed home where their personal interests, health and safety are safeguarded. EVIDENCE: The manager is a registered general nurse and has completed the Registered Manager’s Award. The range of policies and procedure statements were seen and these are used as necessary for staff training and development and staff supervision. 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 and new customer care initiatives. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 20 BUPA uses an independent organisation to obtain feedback from residents, visitors and others. Information from relatives, visitors and service users is used to help them adjust the home’s approach and services. Examples of how services have been improved were discussed. “Comment” cards were also returned to the Commission by service users and their relatives. The service manager carries out detailed performance reviews every 1-2 months. This includes an evaluation of how procedures continue to meet corporate operational requirements. The results are outlined to the Commission through monthly reports. There are a number of self-audits (eg. effectiveness of bedsides, dealing with behavioural difficulties, quality assurance outcomes, maintenance standards) carried out by the manager. The pre-inspection questionnaire listed the maintenance checks carried out and all certificates and records checked during the inspection visit were up-to-date. Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x 3 x 3 Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? 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. 1. 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. 1. Refer to Standard Good Practice Recommendations Broad Oak Manor Nursing Home H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent 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 H56-H06 S26154 Broad Oak Manor V230786 290605 Stage 4.doc Version 1.30 Page 24 - 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!