Inspection on 15/08/07 for Broadhurst Residential Home

This inspection was carried out on 15th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Broadhurst Residential Home 01/03/10

Broadhurst Residential Home 09/02/09

Broadhurst Residential Home 14/08/08

Similar services:

Flint House

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

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

CARE HOMES FOR OLDER PEOPLE Broadhurst Residential Home 35 Broadway Sandown Isle Of Wight PO36 9BD Lead Inspector Neil Kingman Unannounced Inspection 15 August 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 Broadhurst Residential Home DS0000070157.V348884.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. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadhurst Residential Home Address 35 Broadway Sandown Isle Of Wight PO36 9BD 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) 01983 403686 01983 568705 PKC Holdings vacant post Care Home 25 Category(ies) of Dementia (0), Learning disability (0), Mental registration, with number disorder, excluding learning disability or of places dementia (0), Old age, not falling within any other category (0), Physical disability (0) Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) - maximum number of places 8 Learning disability (LD) - maximum number of places 2 Mental disorder, excluding learning disability or dementia (MD maximum number of places 3 Old age, not falling within any other category (OP) 2. Physical disability (PD) - maximum number of places 2 The maximum number of service users to be accommodated is 25. Date of last inspection N/A Brief Description of the Service: Broadhurst is a home providing care and accommodation for up to 25 older people, with some capacity for people with illness associated with mental health, learning disability and dementia. The home has been in existence for many years but was registered under the Company PKC Holdings in July 2007. The home is a three storey detached house located on a prominent site along Broadway, a main road through the coastal town of Sandown, about a quarter mile from the shops and amenities of the town. All rooms except two are for single occupancy and arranged over three floors, all but one having an en-suite toilet facility. Ten of the rooms include an ensuite shower. There is a passenger lift that affords access to all but two rooms on the upper Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 5 floors. People who have full mobility occupy these two rooms. Part of the home has been extended in recent years to provide bedrooms that open onto a well-tended garden area with a raised fishpond and bird aviary. There are attractive and beautifully tended gardens to the front and rear of the property that in a previous year were placed first in the Sandown in Bloom competition. Weekly fees range between £369.25 and £452.41. The deputy manager states that a copy of the home’s service user’s guide is provided to all residents or their representatives where applicable. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by Broadhurst and brings together accumulated evidence of activity in the home since it was registered under the Company name PKC Holdings in July of this year. The home has actually been in existence for many years and has previously been inspected on a yearly basis, the last time being in May 2006. Since the change of registration the home has continued to operate with the same providers and staff group as before. Therefore, reference has been made to some activity in the home since that last inspection. Part of the process has been to consult with people who use the service. To this end we have received written responses to several surveys, i.e., four from people who live in the home, two from visiting relatives, two from healthcare professionals and two from care staff working in the home. Included in this inspection was an unannounced site visit to Broadhurst by an inspector on 15 August 2007. The home does not currently have a registered manager, although the deputy was available throughout the day to assist with the inspection. At the visit we had an opportunity to speak with staff on duty, several residents who were able to give informed views about the service, and two sets of relatives who were visiting residents at the time. We also looked at a selection of records. Prior to the site visit the outgoing manager sent to the Commission a range of information about the service including an Annual Quality Assurance Assessment (referred to as the ‘assessment’ during the report). However, the assessment lacked essential detail in all areas, especially the key areas of what the service does well and what they could do better. What the service does well: An opportunity for the home to tell us how well it is delivering good outcomes for the people using the service was the annual quality assurance assessment forwarded to the Commission as part of the inspection process. Legislation has made it a legal requirement for all adult services to fill in an assessment. The assessment from Broadhurst lacked detail in all the outcome groups, e.g., in the area of health and personal care the evidence from the inspection is that the service delivers good care for people by meeting their individual needs, accessing a range of healthcare professionals, treating people with dignity and Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 7 respect and providing a safe and effective system of managing residents medication. There was no mention of any of these in the assessment. The same applies to staff training, where over 50 have achieved a National Vocational Award (NVQ). The home’s assessment made no mention of meals, which according to the evidence is one of the home’s strengths. There was agreement from everyone spoken with that the deputy manager and staff are kind, caring and provide the care and support that people need. The building offers a comfortable and homely environment for the people who use the service and attention is paid to peoples’ choices and preferences. The home offers a good range of communal space, which includes a separate dining room and two sitting rooms; one of these provides a “quiet area” for those residents who prefer this. What has improved since the last inspection? What they could do better: While the results of the inspection have seen all of the outstanding requirements addressed there were two requirements and a good practice recommendation identified: • • • New staff recruited to the home must go through a full induction programme, which meets the Common Induction Standards produced by ‘Skills for Care’. Effective quality assurance and monitoring systems, based on seeking the views of people who use the service must be developed and maintained. Information in individual care plans is basic and not person centred. People who use the service and staff would benefit from additional information being recorded in care plans and risk assessments, to better evidence the fact that personal support is responsive to peoples’ individual needs and preferences, and to support the decisions made on behalf of the people identified as being at risk. DS0000070157.V348884.R01.S.doc Version 5.2 Page 8 Broadhurst Residential Home 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. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 9 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 Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 10 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 and 6 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that peoples’ care needs will be met by undertaking a proper assessment prior to them moving in. Broadhurst does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. EVIDENCE: Pre-admission assessment – People should know that their needs will be met when they move into a home. An important part of ensuring this happens is the pre-admission assessment process. It had been noted at previous inspections of Broadhurst that this standard had been met. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 11 During this site visit the deputy manager explained that she had recently carried out a pre-admission assessment on a person who may wish to move in. She described the home’s admissions process in general, and specifically in relation to this individual: • • The deputy manager, together with a senior care assistant visits the person who may want to use the service either at their home address or hospital where applicable. The deputy had very recently visited a prospective resident at their home address and carried out a care needs assessment with the help of a Social Services Care Manager who was also present at the time. A preadmission assessment tool was used to record information that would be used to inform a more comprehensive assessment planned to take place after the individual had moved in. Prospective residents are encouraged to visit the home prior to admission, as was this individual, who was invited to take advantage of a two week period of respite care, during which time a comprehensive assessment of needs would be carried out. A range of information is sought from relatives; professionals and other interested parties to better ensure that the home will be able to meet an individual’s needs. In the most recent case information was sought from care workers employed by a domiciliary care agency providing a daily service at the individual’s home address. • • • Copies of pre-admission assessments together with Care Manager’s assessments were available on a number of sampled files viewed. Intermediate care People living at Broadhurst tend to be long term. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. However, respite care is provided in a room designated for the purpose. There was no evidence that this has a negative impact on the long-term resident group. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • We carry out full assessments on service users prior to admission, ensuring the home is a suitable placement for the individual concerned. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 12 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 and 10 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Care planning – The home has a system of care planning with an individual personal plan for each person who uses the service. At the last inspection a requirement was made for the manager to ensure that each person has a comprehensive care plan outlining all their identified care needs, and to include an individual risk-assessment. This requirement was of particular importance as in January of this year an incident involving a resident who went missing from the home resulted in a safeguarding referral to Social Services. No risk assessment had been in place in respect of this person. Since that time one of the providers wrote to the Commission confirming the implementation of a format for all care plans and staff re-training in that Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 13 format. The provider also confirmed that care plans have individual risk assessments according to each person’s needs. At this site visit we looked at a sample of three plans. The intention was to look at the outcomes for people who use the service in general by assessing all areas of care for those sampled. The sample included a recent admission to the home, this person having moved in during May 2007, a person with high physical care needs and a person with mental health needs. It was clear that improvements had been made to residents’ files since the last inspection as each of those viewed had a plan of care, which identified a full range of daily needs, with action to be taken and outcome. Records showed that plans are reviewed monthly and include residents’ views and those of their representatives where applicable, and agreed outcomes. Risk assessments and manual handling assessments were in place in those sampled and significant events were recorded on separate staff observation sheets. There were however, some areas for improvement, which could be addressed by including more information in the plans and also the risk assessments. In discussions with the deputy manager it was recognised that the information in the sampled plans was quite basic and not person centred. More information especially under the heading of ‘action to be taken’ and ‘outcome’ would give an overview of peoples’ health needs and indicate changes in health requirements. In summary residents’ personal plans had been improved since the last inspection. However, the inclusion of more detail in the areas mentioned above would better evidence the fact that personal support is responsive to peoples’ individual needs and preferences. In discussions with residents during the site visit there were mixed messages about individual care plans. Those spoken with in the main lounge appeared uncertain or confused about the existence of their plans while those in the quiet lounge were well aware of their care plans and what sort of care they expected the home to provide. Health and access to care services The deputy manager confirmed, and records evidenced the regular contact with GPs, optician, dentist, chiropodist and mental health specialists. During the site visit we had an opportunity to speak with residents in group situations and in private with visiting relatives. Comments were very positive, Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 14 especially regarding the care provided by staff. They felt confident that the home would always call the doctor if they needed one. One visiting family made special mention of the efforts made by the home to help minimise the chronic pain experienced by one resident. Records showed and discussions with the deputy manager and care staff confirmed that while one resident was currently vulnerable to pressure sores the risk was low. The manager and staff were very clear about what was required to ensure that pressure sores did not develop, i.e., suitable equipment, good liaison with the District Nurse and care practices. The manager said, that all those who use the service are registered with Sandown Medical Centre where a choice of several GPs is offered. Other healthcare professionals visit the home on a regular basis and more specialist ones e.g., Community Psychiatric Nurse and Psychiatrist are called upon as and when required. A discussion was held about the needs of a resident with mental health issues. It was clear that specialist health care professionals had been consulted and were involved in discussions around the ongoing and future needs of this person. The responses to the service user surveys indicated they always or usually receive the care and support they need. Of the four responses the carers/visiting relatives survey three indicated the home always meets peoples’ needs and one made no comment. Comments about this area of the service were: “Staff are friendly and willing to discuss my mothers’ symptoms.” “We are delighted with the home and staff and have every confidence in them.” “Staff are very caring and excellent in an emergency.” Medication Since the last inspection, and following an incident involving a medication error the home has reviewed its medicines procedures and changed its medicines supplier. Medication is dispensed by means of a monitored dosage (blister pack) system by senior staff who have completed the B/Tech advanced medication training, and been deemed competent by the manager/deputy. The deputy manager confirmed that other care staff are due to undertake basic medicines management later this year. The home has a policy and system to ensure residents’ medication is stored, administered and recorded safely. During the site visit we looked at the arrangements in place and noted medicines were stored under secure Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 15 conditions in a purpose built metal trolley and accurate records of receipt, administration and disposal of medicines maintained. During the site visit we had an opportunity to witness the collection of unused medicines to be returned to the pharmacy. Appropriate procedures were followed. Privacy, dignity and respect The deputy manager confirmed that treating people who use the service with dignity and respect is part of the ‘top-down’ guidance for staff and the ongoing staff supervision and training. On the day of the site visit we toured the building and spent time with residents in the communal areas and in the privacy of their own rooms with visiting relatives. There were opportunities throughout the visit to observe staff at work. Several examples were noted of care staff providing help and support for people in a kind and considerate way. They were seen to knock before entering rooms and addressed people by their preferred name. Those people able to give an opinion paid compliments to the staff and their approach to care and support. In discussions with two groups of visiting relatives they also praised the care staff and how they treat people. Residents can use the facility of the home’s portable telephone to make and receive calls, in private if they wish. They can also have their own installations in their rooms if they wish. During the tour of the building we noted telephones in individual rooms, some with large numbers to assist those with sight impairment. Comments in the visiting health professionals survey were: “Privacy is respected overall.” “Staff are friendly and responsive.” “Residents appear well cared for and happy.” Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • We monitor our service users health and personal care very closely. DS0000070157.V348884.R01.S.doc Version 5.2 Page 16 Broadhurst Residential Home • Care plans have been improved to include more detail on how to maintain service users health and personal care. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 17 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 and 15 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their life style according to their needs and abilities. Some activities are offered, and friends and family are made to feel welcome and can visit at any time. Residents’ nutritional needs are satisfied with a varied and balanced diet of good quality food. EVIDENCE: Routines and activities – A list of activities is posted on the notice board giving details of what is available on each day of the week: Monday – Films Tuesday – Outside entertainment, singer – independent arts Wednesday – Arts and crafts – shopping p.m. Thursday – Painting Friday – Hairdresser and exercises Saturday – Manicures and beauty Sunday – Bingo Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 18 In discussions with residents, visitors and staff it was clear that these planned activities have been met with varying amounts of enthusiasm, resulting in bingo and arts and crafts being discontinued due to lack of interest. Music and movement and outside entertainment still proved popular, as did the Wednesday afternoon shopping trip in the home’s people carrier. We had an opportunity to observe residents going out and then returning from the shopping trip. The experience appeared very sociable and jovial. A number of residents prefer the privacy of their own room and enjoy their own company but have the opportunity to join in with the leisure activities if they want to. The relatives of one resident were very clear that the person they visited, while generally sociable preferred not to take part in any of the organised activities. Residents spoken with in the quiet lounge said they were all friends who enjoyed each others company while watching TV, colouring, knitting or just chatting. Three responses to the service users survey indicated there are sometimes activities arranged by the home that they can take part in and one made no comment. Visiting arrangements – The deputy manager confirmed that people are encouraged to visit at anytime but advanced notice is helpful if they wish to take a meal with the residents. The home’s statement of purpose states that visitors are welcome at all reasonable times. People can receive visitors in their own rooms or any of the communal areas. The quiet lounge and the dining room afford peace and privacy if required. All visitors spoken with said they are always made welcome by staff when they arrive. Personal autonomy and choice – Residents spoken with individually or in groups in the lounges generally said they were given choices regarding routines in the home, e.g., times of rising, going to bed, activities, meals, personal care, going out etc. The deputy manager confirmed that most have either a family member or a power of attorney to support them independently of the home. She explained that the advocacy service has been brought in to help two people who have no family to represent them. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 19 People are encouraged to bring with them pictures, ornaments and personal items for their room. During the tour of the building it was noted that some rooms were very well personalised, and others less so, according to peoples’ individual tastes and preferences. One of the newer residents had a good deal of personal items and staff were involved in working out where it was all going to go. The management of residents’ finances is covered later in the report but in a general sense they are encouraged, with support from family or a representative, to handle their own financial affairs for as long as they are able. However, the home has a facility to safeguard peoples’ monies and valuables on request. Meals and mealtimes – We had an opportunity to join residents and observe them and staff at lunchtime. The atmosphere in the dining room was quite sociable and friendly. Staff were available to assist residents as and when required. Food served was appetising and well presented. Residents spoken with made very complimentary remarks about the lunch and indeed the food in general. Most ate together in the dining room. However, the home will support those who prefer to take their meals in their room. The main meal consisted of a roast with fresh vegetables. The cook confirmed that an alternative would be provided from a selection for those who do not want the main meal. Menus are arranged over a two-week cycle and show food to be varied, appealing and well balanced. The cook said that breakfasts and suppers are provided either hot or cold according to individual preferences. She showed a good understanding of their likes, dislikes and special dietary needs. Records are maintained of what residents are actually served on a daily basis. We noted that drinks and light snacks, including homemade cakes were offered through the day between meals. Three responses to the service users survey indicated they always like the food and two usually. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • We record visitors shopping trips and activities well. More service users now participate in the shopping trip on Wednesdays. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 20 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 and 18 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home treats residents’ complaints seriously and responds appropriately. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: Complaints – The home displays a notice in the entrance hall informing people how to complain. In addition, there is reference to the complaints procedure in the home’s statement of purpose. All residents and visiting relatives spoken with during the site visit said they knew how to complain and would speak to the deputy manager or staff. Care staff confirmed that any complaints made directly to them would be passed on to the deputy manager. The home maintains a complaints register, which was available for inspection. The home’s assessment indicated that three complaints had been made in the past year; all had been resolved within 28 days and one had been upheld. Five responses to the relatives and service users surveys indicated they always knew how to complain and who to. One indicated usually. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 21 Safeguarding adults – The home has a safeguarding adults policy and procedure in place and a summary of the ‘whistle blowing’ policy is prominently displayed in the office. As evidenced at previous inspections long standing care staff have received adult protection training. However, since the last inspection staff turnover has resulted in the recruitment of a dozen new staff. The Deputy manager confirmed that the home was exploring specific safeguarding training for new staff, to commence later this year. Those undertaking the National Vocational Award (NVQ) training have safeguarding as one of the training modules. In discussions with staff they showed an understanding of how to recognise abuse and were very clear about the importance of reporting issues of concern without delay. They also were aware of the home’s “ whistle-blowing” procedures. Since the last inspection there has been a safeguarding of adults referral to Social Services. The home took action to safeguard people who use the service and reported the matter in accordance with laid down procedures. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • We act on any complaints without delay and support people with their complaint as it is being dealt with. We have ensured that staff and service users are encouraged to complain and defend their rights. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 22 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 and 26 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. On the day of the site visit the home was clean, hygienic and generally free from unpleasant odours. EVIDENCE: Environment Broadhurst has been a residential care home for older people in Sandown for many years and while not purpose built has been adapted over the years to be suitable for its stated purpose of providing a safe, manageable and comfortable environment for the people who live there. The home is located along Broadway, a main road through the coastal town of Sandown, about a quarter mile from the shops and amenities of the town. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 23 People who live in the home have rooms on the ground, first and second floors. Those with higher care needs are generally accommodated on the ground floor. People who are fully mobile and generally self-caring occupy the two rooms on the second floor, which is accessed by a series of stairs. The home has a passenger lift, which affords access to all rooms on the first floor. There is level access into and around the home. The home is generally comfortable, well furnished and decorated, rooms being decorated as they become vacant. Since the last inspection the programme of fitting covers to all radiators (except those with cool touch surfaces) has been completed. During a tour of the building we noted bedrooms to be generally spacious, well furnished and decorated. All but one has an en-suite toilet facility and ten have en-suite showers. The home has two lounges decorated and furnished to a good standard, one being a quiet lounge, with sliding doors opening onto an enclosed garden with a raised fishpond and a bird aviary. The dining room is bright and airy, well decorated and comfortably furnished. The home has two bathrooms on the ground floor; one with a ‘Parker’ bath; the other with an assisted bath to help people with mobility difficulties. The front of the building has a large gravelled parking area, a lawn and welltended flowerbeds. People spoken with during the inspection made very positive comments about the environment, especially their own bedrooms. While the home employs a person to carry out ongoing maintenance tasks the provider said he was in the process of recruiting a new one since the last one had left. Cleanliness All areas of the home were found to be clean and generally free from unpleasant odours. There was however a smell of urine in one bedroom. In discussions with the deputy manager and the provider they recognised that it was something that needed addressing and agreed to look at alternative ways to deal with what is regarded as problem specific to the needs of an individual. As mentioned later in the report the home employs domestic staff to ensure the standard of hygiene is maintained. However, the deputy manager confirmed that there have been no domestic staff since earlier in the summer Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 24 and the position was currently being advertised. Meanwhile care staff are undertaking domestic tasks to maintain standards of cleanliness. There is a laundry sited on the ground floor with a machine capable of washing articles at appropriate temperatures. The home’s assessment confirms it has policies and procedures for the control of infection and safe handling and disposal of clinical waste. The deputy manager confirmed that staff were scheduled to received training in infection control procedures in September this year. During the tour it was noted that all bathrooms and WCs were equipped with liquid soap and disposable towels. All responses to the service user survey indicated the home was always fresh and clean. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • We employ a maintenance man who ensures the environment is maintained. Rooms have been decorated as new service users have been admitted. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 25 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 and 30 - People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are generally deployed in sufficient numbers, are trained and given the necessary skills and experience to meet the needs of the people who live there. However, turnover of staff and slippages in induction training have affected the smooth running of the service. EVIDENCE: Staffing levelsThere have been no changes to care staffing levels since the last inspection when this standard was judged to have been met. The home employs nineteen care staff. On the day of the site visit there were twenty-one people resident in the home. There are two main shifts throughout the day with two overlap shifts. A minimum of three care staff is deployed at all times during the day with a senior on duty between 08:00 and 20:00 and the deputy manager working flexibly throughout the week. Overnight there are two waking night staff. These are considered sufficient for the number and needs of the people who use the service. The home employs additional catering, domestic and maintenance staff. However, those employed to carry out the maintenance and cleaning tasks Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 26 have recently left the home. The provider and care staff have been filling the gaps while new staff are found and recruited. In discussions on the day of the site visit there were no concerns raised about staffing levels. The responses to the service user surveys indicated they always or usually receive the care and support they need. NVQ training – Records showed and the manager confirmed that currently ten of the nineteen care staff have achieved the National Vocational Qualification (NVQ) at levels 2 or 3. A further five care support workers are currently undertaking the training. The minimum standard of 50 NVQ trained staff is well met. Recruitment Individual staff recruitment files were available for inspection. The deputy manager confirmed that twelve new staff had been recruited since the last inspection when this standard was assessed. A sample of six randomly selected recruitment files was checked and found to be in order. Two written references and Criminal Record and Protection of Vulnerable Adults (POVA) checks are carried out on all staff before they commence working in the home. Staff training – At the time of the inspection the deputy manager was overseeing the induction of all new staff. However, she said that with so many new staff and the fact that the manager had left had meant that only a very basic induction, involving the shadowing of a senior, had been given to the newest recruits. Individual staff training files of long standing care staff showed that the home had provided an induction/foundation training programme for new staff, which followed the TOPSS England guidance. TOPSS England became ‘Skills for Care’ in April 2005 and produced a new set of Common Induction Standards (CIS) designed to be met within a twelve-week period. The home must ensure that in future all newly appointed staff are given a full induction in line with the Common Induction Standards. In terms of equipping staff with the skills to meet the needs of the residents the home provides ongoing training opportunities. Records show that that training in dementia awareness and infection control is scheduled for September this year. Staff training records with certificates were available to evidence training achievements. Staff training includes: Manual handling Broadhurst Residential Home Medication DS0000070157.V348884.R01.S.doc Version 5.2 Page 27 Food hygiene First aid Health and safety Dementia awareness Safeguarding vulnerable adults Fire training Infection control The deputy manager was very clear that training courses continued to be sourced from two well known training providers in the area. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • Staff feel appreciated and supported. Staff are offered more training and support. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 28 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, 36 and 38 - People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently without a registered manager and there are no formal quality assurance systems. There is however, an awareness of the need to promote safeguarding and health and safety procedures and practices meet the requirements and legislation. EVIDENCE: Management and staff supervision – At the time of the inspection the deputy manager was carrying out the day-today management of the home with support from the providers. This had been the case since the previous manager left in June 2007. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 29 It was understood in discussions with the deputy manager and the provider that a new manager had been appointed and was due to take up the post later in August 2007. The deputy said that meeting the needs of the residents and day-to-day management had been the main priorities and recognised that in the process there had been slippages in quality assurance surveys, staff induction and formal staff supervision, although since the last inspection a programme of formal staff supervision had been introduced. This was confirmed in discussions with staff on duty who felt the home was being well run and staff morale was currently good. Quality assurance – There was no evidence of an annual development plan or formal quality assurance systems at Broadhurst. The deputy manager said that in the absence of a manager, formal satisfaction surveys amongst the people who use the service, and those professionals who visit the home had not been undertaken this year. However, it was clear from the evidence that the deputy manager is in very close touch with the residents on a day-to–day basis, ensuring they have what they want and what they need. This was strongly supported by the residents and relatives spoken with. Residents’ monies – As outlined earlier in the report the home provides a facility to safeguard monies or valuables on request. Currently several residents use the facility, whereby they make incidental purchases, some with support from staff. The system was checked and found to be in good order, with receipts for purchases kept and all entries in records signed and witnessed. Health and safety – The home has policies and procedures in place to ensure safe working practices in the home. Since the last inspection generic risk assessments of the environment have been carried out and recorded. These were viewed during the site visit and checks made of accident records, public liability insurance, and gas and electrical certificates, all of which were up to date. It was noted that records of fire alarm tests had not been maintained since 30 June 2007. The deputy manager said that fire alarm tests are carried out and recorded by the maintenance person. However, since this person left the tests had continued to be carried out each week by the provider, but there had been slippage with the recording. It was confirmed that this would be addressed. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 30 Staff training records showed, and staff confirmed that statutory training is scheduled and updated in manual handling, first aid, fire training, infection control and food hygiene. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • Care plans and other paperwork in the home are up to date and monitored. New paperwork has been put into place, care plans, medication, staff files. Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 31 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 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 1 x 3 2 x 3 Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 32 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. 1 Standard OP30 Regulation 18 Requirement To ensure that all members of staff receive induction training, which meets the Common Induction Standards produced by ‘Skills for Care’. To establish and maintain effective quality assurance and monitoring systems, based on seeking the views of people who use the service. Timescale for action 30/09/07 1 OP33 24 31/10/07 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 Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Broadhurst Residential Home DS0000070157.V348884.R01.S.doc Version 5.2 Page 34 - 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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