Inspection on 06/11/07 for Broadlands Care Home

This inspection was carried out on 6th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Broadlands Care Home 02/05/08

Broadlands Care Home 27/06/07

Broadlands Care Home 07/10/05

Broadlands Care Home 12/07/05

Broadlands Care Home 05/03/05

Broadlands Care Home 02/09/04

Broadlands Care Home 27/02/04

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

CARE HOMES FOR OLDER PEOPLE Broadlands Care Home 28 Shelford Road Radcliffe on Trent Nottingham NG12 1AF Lead Inspector Stephen Benson Unannounced Inspection 6th November 2007 09:30 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 Broadlands Care Home DS0000050869.V354454.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. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadlands Care Home Address 28 Shelford Road Radcliffe on Trent Nottingham NG12 1AF 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) 0115 933 2727 0115 911 5027 Miss Soowantee Doma Mrs Premila Auchraje Miss Soowantee Doma Care Home 19 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (19) of places Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Miss Soowantee Doma and Mrs Premila Auchraje are registered to provide accommodation and personal care for persons of both sexes at Broadlands Care Home whose primary needs fall within the following categories:Old Age, not falling into any other category - OP (19) 2. 3. Dementia - DE (5) All service users within Broadlands Care Home must be over the age of 60 years The maximum number of persons to be accommodated at Broadlands Care Home is 19 27th June 2007 Date of last inspection Brief Description of the Service: Broadlands is a care home providing personal care and accommodation for 19 older people. It does not provide nursing care. It is owned by Miss Doma and Mrs Auchraje, with Miss Doma being the registered manager. The home is located in the village of Radcliffe on Trent and it is approximately a quarter of a mile from the village centre, which has shops, pubs, a library and all the amenities one would normally expect from a large village. The home was opened in 1970 and is an extended, detached property. Service users are accommodated on the ground and first floor, access to which is by 2 stair lifts. There is some seating outside and a small garden area. The manager said on 27/06/07 that the fees for the service range from £290 £354 per week depending on dependency needs. There are additional charges for hairdressing and chiropody. Further information about the home is available in the brochure and service user guide. The manager welcomes any telephone enquiries and a copy of the latest inspection report is available in the office Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second visit to the home since 1st April 2007 by The Commission for Social Care Inspection and concentrated on looking at the standards that were not met during the last visit. Prior to the visit an analysis of the home was undertaken from information gathered over the last year. The site visit lasted for 4 hours and the main method of inspection used was called case tracking which involved selecting 3 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with the deputy manager, staff on duty and care practices were observed. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. The registration certificate was checked and found to be correct. What the service does well: What has improved since the last inspection? There is a system for carrying out a risk assessment when a possible risk has been identified. Staff will contact healthcare professionals to see to the healthcare needs of residents and their health is monitored through observation and regular health checks. Measures have been put into place to ensure that residents are not able to give medication to other residents. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is not accurate information available to any prospective new resident about the services provided in the home. Staff are not being informed of residents changing needs. There is not an intermediate care service provided in the home. EVIDENCE: The Statement of Purpose was seen and this has not been updated to take into account changes that have taken place in the home, including a change in registration to include caring for people with dementia and changes in staffing. The date shown on the Statement of Purpose was July 2006. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 9 The deputy manager said he did not know what was happening with the Statement of Purpose and he had not been involved in any discussion about updating it. Pre admission assessments were seen on care files, including copies of Social Services assessments. There has not been any new admissions since the last visit, but the care file for one resident showed the resident had been admitted to hospital for a reassessment, and there was an entry stating the manager had gone to the hospital to assess the resident for returning to the home, but there was no information about this on the file apart from a discharge note. A member of staff did not know anything about the resident being reassessed as she had been off work at that time and had not seen any assessment carried out. The resident said the manager had visited him in hospital when asked. There have not been any further admissions to the home. There is no arrangement made for the home to provide an intermediate care service. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 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. Care plans do not have the required information in and are not used on a regular basis by staff, which means that residents needs are not being fully met and they are not receiving their care in the manner they prefer. Residents’ healthcare needs are being attended to. EVIDENCE: A sample of three care plans were looked at and these did not have sufficient information about residents’ needs and how these should be met. An assessment seen for one resident referred to personal hygiene, communication, having dementia and forgetfulness. There were not any care plans for these and the information in the care plan was about managing challenging behaviour. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 11 Another assessment referred to confusion, needing to be encouraged to eat, personal hygiene, incontinence, hearing difficulties and depression. There were two care plans in the care file, one for comfort and skin integrity and the other assisting with personal hygiene. Care plans were not being reviewed or updated and the sections for residents or relatives to comment were not completed. Staff were not able to describe what information was in a care plan and when asked to refer to it appeared not to know how they were organised. When asked if she ever uses the care plans a member of staff said that she looked at them when she first came to work at the home but hadn’t looked at them since, although she did write in the daily notes. There were risk assessments seen for various activities of daily living and environmental. One was seen for a resident who had a tendency to give away gifts. When asked if staff had discussed his care plan with him a resident replied, “Don’t really talk about it”. There is a form in the care plan to record any medical appointments on, and these showed that a resident had seen a doctor with a rash, having a swab taken, having a flu vaccination and having a dressing done by a district nurse. Staff were aware of health issues for a resident and said they ask residents how they are feeling. A resident said, “I am feeling fit, I don’t need to see a doctor”. The deputy manager said that one resident had self medicated part of her medication but that had ceased when the medication was stopped. There was reference to this in the care file. Staff said they were aware of the correct procedures for administering medication and showed the home’s safe handling and administration of medicines policy, which had been signed by staff who give out medication. A resident said, “I have my tablets when I am given them by staff”. Standard 10 was assessed as being met during the last visit on 27th June 2007. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 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. Activities are provided in the home, but these do not meet the expectations of the residents. Residents are helped to exercise choice and control over their lives and receive a wholesome and balanced diet. EVIDENCE: There was a notice board in the dining room, which displays forthcoming entertainment. There had been a firework party for residents and relatives the previous evening. The deputy manager said there had been a trip out to a local garden centre last month and this was seen recorded in a care file for 15/8/07, however the previous record of an activity prior to that was 12/09/06. There was not a sheet to record any activities on in another file and a third file had a sheet but there were no entries on this. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 13 Staff were seen asking residents if they want a game of dominoes and two residents were seen playing a game with each other. Staff said they play dominos, bingo and sometimes sing with residents. Staff said they write in a book when they do an activity but when looked at there were few entries made regarding activities, two within the last month. A resident said, “There isn’t enough to do and we don’t go out enough, we should definitely have more outings. Standards 14 and 15 were assessed as being met during the last visit on 27th June 2007. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is not being used properly and measures are not in place to protect residents from abuse. EVIDENCE: The home has a complaints procedure and a book to record any complaints in. There was one entry since the last visit on 21/06/07 which said, “Received a letter from CSCI regarding Mrs ‘X’ interim care” There were no details of any investigation or outcome and the deputy manager said he was not aware of the complaint. Two recent complaints have been received by The Commissions for Social Care Inspection and areas of these complaints were covered during the inspection. One issues raised concerned staff shouting at residents. The deputy manager said a social worker had raised about someone shouting at a resident and the resident concerned was asked if this had happened by the deputy manager and social worker concerned. The deputy manager said the resident said she had not been shouted at. There was no record of this made. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 15 Other matters raised in the complaints were not substantiated. The deputy manager showed the new adult protection procedures, which have been received, however there were no plans for sharing these with staff or reviewing and updating the home’s own policies. Staff said they have not had any training in safeguarding adults and do not know bout the adult protection procedures or whistle blowing policy. There was a care plan for one resident who has a history of giving gifts. This stated that the resident was not allowed to give gifts or money to anyone in the home. The resident said, “I don’t give money to other residents or staff”. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 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. Repairs are carried out to ensure the building is kept to a suitable standard for the residents. The home is kept clean EVIDENCE: The deputy manager said there has been problems with the heating and hot water supply and that a plumber has been carrying out repairs. The deputy manager did not know where the invoices were to show this had been done but was able to show where new pipes have been fitted. Staff said the hot water had not been working but was now. A resident said, ”The heating works in my room” Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 17 A new hoist was fitted in the downstairs bathroom about 8 weeks ago and this was seen to work. The deputy manager said 3 or 4 new mattresses had been purchased in the last few months. All mattresses were looked at and these appeared to be in reasonable condition. Three residents were asked if they were happy with the mattresses on their beds and they all said they were. The deputy manager said that all call bells were working, however there were no records of any tests to show that this was the case. Standard 26 was assessed as being met during the last visit on 27th June 2007. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 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. Night time staffing levels may result in residents having to wait to have their needs attended to. EVIDENCE: The deputy manager said the manager has assessed their minimum staffing levels to be 2 care staff during the day and 1 member of staff awake at night. The manager and deputy manager work day shifts during the week. In addition the home employs a cook and domestic. Currently there are 17 residents at the home and this means that there is one person to look after them from 9.00 pm until 7.30 am. The deputy manager agreed that there is the potential for a resident having to wait to be assisted due to lack of staff. A member of staff said that she has had to call on staff who live on the top floor of the building to help sometimes. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 19 The rota showed one member of staff on duty at night time and did not indicate another person as on call. Standards 28 and 29 were assessed as being met during the last visit on 27th June 2007. The deputy manager said that he did not have access to staff training records so Standard 30 could not be assessed. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 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. Information about the running of the home is not available in the absence of the manager. EVIDENCE: The manager, who is also one of the providers, has been registered since February 2004. The deputy manager was not aware of any visits to the home by the provider who is not the manager to carry out visits as determined by Regulation 26 Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 21 Care Homes Regulations 2002 and was not aware of any reports being prepared. The deputy manager said that he did not have any dealings with residents’ finances and that the manager deals with the fees and pays for things like the hairdresser. The deputy manager did not know where the residents’ financial records were. Staff said that they do not handle residents’ money. Standard 38 was assessed as being met during the last visit on 27th June 2007. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4(1) Requirement There must be an up to date Statement of Purpose that accurately reflects the services provided in the home so current and future residents know what they can expect. THIS IS A REPEATED REQUIREMENT THE PREVIOUS TIMESCALE OF 01/09/07 HAS NOT BEEN COMPLIED WITH. Details about the needs of any resident who is assessed must be written up as an assessment so that staff can make sure they are able to meet the person’s needs. Care plans must clearly describe how resident needs are to be met and where a need is identified a care plan must be written for this. This will ensure that staff know how to meet residents’ needs. THIS IS A REPEATED REQUIREMENT THE PREVIOUS TIMESCALE OF 01/09/07 HAS NOT BEEN COMPLIED WITH. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 24 Timescale for action 01/12/07 2. OP3 14(1)(a) 01/12/07 3. OP7 15(1) 01/02/08 4. OP7 15(1) 5. OP12 16(2)(n) 6. OP16 22(3) 7. OP18 12 (1)(a) 8. OP27 18 (1)(a) 9 OP30 18(1)(c) (i) 10 OP33 26(4) Staff must understand the care planning process and care plans must be kept under regular review and updated as needed so staff are aware of any changing needs. More frequent and varied activities must be provided so residents have opportunities to spend time doing things they find enjoyable and stimulating. A record must be made of all complaints made and the details of the investigation and outcome must be included in the complaints book, which will show that appropriate action is taken to resolve anything which residents may not be happy about. All staff must be familiar with the procedures to follow to safeguard residents if there is any suspicion of abuse. The manager must review the current night time staffing levels to ensure that there are sufficient staff available to meet the needs of residents. There must be an up to date record of staff training available at all times to show that staff have received the training they need to care for the residents. The provider who does not have day-to-day management responsibilities must visit the home and produce a report in accordance with Regulation 26 Care Homes Regulations 2002. 01/02/08 01/01/08 01/12/07 01/12/07 01/12/07 01/01/08 01/01/08 Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 25 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 OP19 Good Practice Recommendations Regular checks should be carried out on the call alarm system to ensure it is in working order. Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Broadlands Care Home DS0000050869.V354454.R01.S.doc Version 5.2 Page 27 - 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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