CARE HOMES FOR OLDER PEOPLE
Broadlands Borrow Road Oulton Broad Lowestoft NR32 3PW Lead Inspector
John Goodship Announced 8 June 2005 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. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Broadlands Address Borrow Road Oulton Broad Lowestoft Suffolk NR32 3PW 01502 512895 01502 517177 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) Greensleeves Homes Trust Mrs Ann Maas Care Home 41 Category(ies) of Old Age OP (41) registration, with number of places Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10/11/04 Brief Description of the Service: The stated aim of Broadlands is to provide comfort and companionship in a supportive environment to those older people who require a level of care that is unavailable to them in their own homes. The building comprises a large house, which has been extended, resting on the edge of Oulton Broad, thus offering service users wonderful views over the water. The Home’s attractive gardens lead down to the water where there is a jetty to moor boats. The Home offers accommodation for 41 older people, over three floors, all of which can be accessed by passenger lift and the standard of décor and maintenance at the Home was seen to be very good. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection was the first in the current inspection year. A second inspector was present as part of their induction programme. The visit lasted 6 hours and the inspectors spoke to many of the residents, either in their rooms or in the lounges. Some of their comments are included in the report. The manager and the deputy were available all day, and a trustee of Greensleeves Homes Trust also visited for part of the day and was able to update the inspectors on the planned developments to the cottage. What the service does well: What has improved since the last inspection?
There were no requirements from the previous inspection. The adult protection policy had been updated to include the contact information for Suffolk County Council. The care plans had all been transferred on to the new format, and showed good practice.
Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 6 The manager commented that the role and skills of keyworkers was improving to better meet the needs of residents. 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. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.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 Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.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) 1,3,4. Prospective residents had full and attractively presented information on the home to enable them to decide if they wished to live there. Pre-admission assessments ensured that their needs were identified and that the home was able to meet them. EVIDENCE: A suitable and appropriate Statement of Purpose and Service User Guide had been produced by the Home and were available to service users. The Home was careful to admit only service users for whom they were able to offer appropriate care. Each new applicant underwent a full assessment prior to admission to the Home. An existing resident had recently been diagnosed with dementia. An application was in the pipeline to the Commission to allow that person to remain in the home. The home believed it had the skills to care for this person, and the relatives were happy for the placement to continue. An example was given of a referral which on the information given to the home might have been inappropriate but after assessment it was clear that the person was within the home’s registered categories. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 9 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) 7,8,9,10. Residents contribute to the development and review of their care plans, with their views and needs taken into account, to ensure they receive the appropriate personal, health, and social care. EVIDENCE: The home had completely converted its care plans on to the Greensleeves house style. They were clearly laid out with key information highlighted. They were straightforward to complete and to read. There was a sheet for staff to sign that they had read the file. Plans were regularly reviewed, including risk assessments. Medication procedures for the ordering, storage and administration of drugs were followed. The supplier provided staff training and regular audits of practice. 6 residents administered their own medication. This was riskassessed and regularly reviewed. The deputy manager had seen one error on the MAR chart and had followed the procedure to correct it. A relative had commented that “I cannot speak highly enough of the care. It is first class.” 8 residents expressed satisfaction with all aspects of their care. 2 residents said how kind the staff had been in getting them to and from the hospital for appointments.
Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 10 Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 11 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) 12,13,15. The home makes every effort to meet the different preferences of each resident for stimulating as well as relaxing activities. The home has good links with the local community and has its own Friends group to provide extra activities and services. Meal choice is good, with a continually varied menu. EVIDENCE: The home produced a monthly newsletter listing all the various activities, including trips, events and visiting specialists eg chiropodist, mobile library, clothing service, manicurist and pedicurist. A volunteer from the “Friends of Broadlands” canvassed residents for their ideas on events and trips. The home owned a minibus which a volunteer driver took out either for group trips or for individual visits. 7 residents went to Gt Yarmouth Potteries on the afternoon of the inspection. One resident belonged to an external book club. It was their turn to host the meeting that week which took place in the recreation room. One resident was looking forward to a visit from 2 relatives. They were staying for lunch then taking this resident out for the afternoon. The lunch menu had 2 meat dishes and one vegetarian choice. Several residents commented that the food was very good. The last inspection by the EHO had not led to any recommendations. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 12 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) 18 There is a proper policy, procedure and training programme in place to give residents confidence that they are protected from abuse. EVIDENCE: The home included the topic of abuse reporting in its training programme. It was also included in induction and foundation courses. One member of staff was unsure of the procedure. The manager said they would be updated during supervision. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 13 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) 19,20,21,22,23,24,25,26. Residents live in comfortable and well maintained facilities. EVIDENCE: Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 14 The standard of the environment at the Home, including its decor and fabric, remained high. The grounds were well maintained and overlooked the Broad. Service user rooms were properly furnished. Many service users had brought in items of their own furniture, and had personalised their rooms in other ways. One resident stated that she was happy that she could bring in some her own furniture “as it’s more like home.” 6 rooms were to be refurbished, and the carpets in the hall and corridors were being replaced. Some new chairs were to be put in the conservatory. These would be similar to those in the lounges which were liked by the residents, and were better suited to the frailty of some residents. One resident who regularly used the conservatory found the cane chairs comfortable and some would be retained. The conservatory was very warm, and the manager opened some windows, without exposing frailer residents to a draught. The downstairs bathroom was to be upgraded and a new assisted bath fitted. There were plans to bring the cottage in the grounds into use by conversion to 7 residential rooms. The proposals would be presented to the Commission after planning approval had been granted. One resident asked if there could be a proper path right down to the end of the garden to the Broad. The manager said that this would be done during the conversion work on the cottage. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 15 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) 27,28,29,30. Residents are cared for by well trained staff, whose care and concern is appreciated by residents. EVIDENCE: Staffing levels had been maintained and there were no current vacancies. The home had a high level of staff who had achieved NVQ Level 2. There was an annual training schedule covering all staff, and providing a wide range of mandatory and specialist training. The Home’s recruitment procedures met the standards for the protection of the residents. Residents commented that “the staff are very good and courteous”, “staff are very kind”, “I am very well cared for”. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 16 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 The cheerful atmosphere in the home shows that the manager and staff are giving the right support to residents. This is backed up by formal ways of listening to residents’ views on how the home could be improved. EVIDENCE: The current manager had recently been appointed as one of the operations managers for the registered provider. She was still managing Broadlands for 3 days a week, with the deputy manager covering the other 2 days. The Commission would be informed as soon as a replacement manager had been appointed. The home was visited monthly by a senior manager who completed a comprehensive report on all aspects of the home. Regular staff meetings were held, as well as separate senior staff meetings. Residents meetings were held each quarter. The most recent had an attendance of 35 out of 40 residents. Topics on the agenda included developments planned, the last inspection
Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 17 report, events and comments. Most of the latter were about aspects of the catering. Staff received regular supervision and records of this were in personal files. Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 18 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 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 3 3 x x 3 x x Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 19 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 NONE 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 NONE Good Practice Recommendations Broadlands I54-I04 S24346 Broadlands V226486 050629 Stage4.doc Version 1.30 Page 20 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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