Inspection on 03/08/05 for Broadoaks

This inspection was carried out on 3rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Broadoaks 12/08/08

Broadoaks 17/09/07

Broadoaks 31/10/06

Broadoaks 16/01/06

Broadoaks 20/01/05

Broadoaks 20/09/04

Broadoaks 24/03/04

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

CARE HOMES FOR OLDER PEOPLE Broadoaks 2 Southend Road Rochford Essex SS4 1HA Lead Inspector Vicky Dutton Unannounced 3 August 2005 rd 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. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Broadoaks Address 2 Southend Road Rochford Essex SS4 1HA 01702 545888 01702 546442 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) Eastwood Hall Limited Mrs Agnes Stubbings Care Home 20 Category(ies) of OP Old Age (20) registration, with number of places Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2005 Brief Description of the Service: Broadoaks is a large detached 19th century Manor House situated close to Rochford town centre. Care and accommodation is provided for twenty residents. The home is not registered to admit service users who are diagnosed as suffering from dementia. Accommodation is provided on two floors with a shaft lift to enable access. Bedrooms are all single rooms with en suite facilities. The Home has two lounges, a pleasant dining room and a visitor’s room. There is parking to the front of the building and a secure garden with seating available to the side of the building. The Home shares a minibus with two sister homes, and this is available to provide transport and outings for service users. The registered providers have a website that can be accessed on www.crollgroup.co.uk Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of six hours. On the day of inspection eighteen residents were being accommodated at Broadoaks. The registered manager was available on the day of inspection, and assisted throughout. A partial tour of the premises was undertaken. Care, medication, staffing and other records were randomly selected and examined. A staff handover was observed. Many residents were spoken with. The inspector also spoke with staff and a visitor. A notice was displayed beside the homes signing in book advising any visitors that an inspection was taking place, with an open invitation to speak with the inspector. What the service does well: What has improved since the last inspection? The home have developed their admission procedures to show that they assess residents needs before they move into the home, and make sure that they can meet peoples needs. Residents and their families are given information more quickly to make sure that they know what services are offered and what fees are charged. An annual development plan has been written that shows the areas that the home hopes to improve on and develop over the coming year. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 6 More permanent staff have been recruited, reducing the homes reliance on agency staff. This means that residents can in the main be cared for by staff who they know. When new staff are recruited they now have a better introduction to the home and receive a fuller induction into residents needs and of the best ways to care for them. Two staff are now employed to undertake activities with residents. This is providing residents with more opportunities for activity and stimulation. 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. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 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 Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 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) 2, 3, 4. Prospective residents have their needs assessed before moving into the home. They and their families are given information to explain the terms of their stay. Staff at the home have received appropriate training to help them to meet residents needs. EVIDENCE: Since the previous inspection the home has worked on their admission procedures. Although they had previously carried out pre-admission visits these were not well evidenced. A format is now available that, in addition to the residents profile which is often completed by families, shows that staff from the home have assessed people’s needs to ensure that the home can meet these. Since the previous inspection there have only been two admissions to the home. Both of these residents were in hospital at the time of inspection. The inspector however saw that appropriate assessments had been carried out and that the home had confirmed in writing to residents/families that they had carried out an assessment and felt that Broadoaks were able to meet their needs. It was also seen that these residents had been given a contract of residence and a statement of terms and conditions to explain the nature and cost of the service offered. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 9 Records showed that staff at the home have received appropriate training to meet the needs of residents. Although the home is not registered to admit residents who suffer from dementia the home has a significant number of residents who show signs of dementia and confusion. All staff at the home have completed training in dementia awareness. Broadoaks do not provide intermediate care. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 Residents health and care needs are identified and planed for, but some development is needed to ensure that care plans are comprehensive, current and used by staff. Medication practices at the home were well managed and ensured that residents were kept safe. EVIDENCE: A care plan was in place for each service user. Those viewed identified resident’s needs and gave information to staff to assist them in meeting these needs. Care plans are reviewed on a monthly basis and any changes noted. However, the care plans themselves had not been updated to show the changes and give staff accurate information as to individual care needs. For example one resident had a catheter but this was not mentioned on the care plan. As residents needs become more complex the home will also need to monitor the format of the care plan. Currently there is limited space available to record complex or multiple needs, and the actions required to meet these needs. Residents current daily records are still kept in a separate folder from their individual care plans. Comments from care staff raise some concern that this practice leads to care plans not being used effectively or frequently. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 11 Records, observations and discussions with residents showed that the home monitor and meet their health care needs. One resident told the inspector of their recent trip to the dentist. A visitor said that the home were very good at keeping them informed of any changes or illness in their relative. A chiropodist visits the home on a regular basis. The home maintain a nutrition record and record in daily notes how well residents have eaten. Although residents are weighed as part of completing a moving and handling assessment, there is currently no systematic approach to monitoring residents weight. Pressure relieving equipment was noted to be available to help residents in maintaining healthy pressure areas, or assist healing. The home uses a monitored dosage system of medication administration. (Blister packs.) Medication systems and records were sampled and showed that residents are kept safe by good practices being maintained. Staff spoken with confirmed that they had received relevant training in this area. During the inspection staff were observed to treat residents with respect and uphold their privacy and dignity. Each room has a phone, to which incoming calls can be put through, and through which residents can contact the office. Residents can choose to have their own external line, or there is a pay phone available. There is a visitor’s room and a quiet lounge available where residents can meet with visitors. Residents preferred term of address is recorded in their care plan and in the activity record. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 Some activities are provided at the home to provide stimulation and occupation for residents. Visiting at the home is open. The food provided by the home is plentiful and residents are offered choice. EVIDENCE: The home employs two part time staff who provide activities with residents each afternoon. Each resident has a ‘Social Care Record’ completed. This records their preferred activities. The registered manager also reported that as well as group activities the home are trying to provide more in the way of one to one outings that reflect individual preferences such as attending a concert or theatre. Social events are held at the home such as a recent VE party and a planned barbeque. The group of three homes share a minibus. The registered manager said that when Broadoaks require the use of this it is brought over to them. Residents spoken with were generally happy with the level of activity provided. Some said that they preferred to spend time in their own rooms. Residents spoken with said that visiting at the home is very open and that their relatives can visit at any time. Visitors were observed to come and go during the inspection and have a good rapport with the manager and staff at the home. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 13 The dining room at Broadoaks is comfortable and airy. The tables were nicely laid and presented. The home has a three weekly menu plan, with a choice being offered at lunch and teatime. Residents spoken with mostly had no complaints about the menus or quality of food offered. One resident spoke highly of a recently appointed cook and said that she had been told that ‘She just needs to ask for anything she wants, and she will get it.’ Residents are served in their rooms if they do not wish to go to the dining room. The daily menu is written up on a whiteboard in the dining room. Lunch of the day of inspection looked appetising and was well presented. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 A complaints process is in place that is understood by residents and helps them to raise any concerns. Staff knowledge and training helps to protect residents from abuse. EVIDENCE: The home has a complaints procedure in place. Residents spoken with said that they would feel comfortable in raising any concerns with staff or the registered manager. The homes complaints record showed that no complaints have been received by the home. Previous inspections have shown that the home has suitable policies and procedures in place to protect residents from abuse. Staff spoken with confirmed that they had received training in this area and demonstrated a good understanding of the issues involved. This knowledge and understanding will help to ensure that residents are cared for safely. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26. Residents at Broadoaks live in a comfortable and homely environment. The home is kept clean and well maintained. Sufficient bathing facilities are provided to meet residents needs. All residents have their own rooms, which can be personalised to their own taste. EVIDENCE: Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 16 Broadoaks provides a comfortable and well maintained home for residents. The homes grounds are secure and provide a safe environment for residents. One resident spoke of how much they enjoyed the garden and of how they had their own chair to use. The home has sufficient communal space available. This includes two lounges, a visitor’s room and a dining room. All areas are pleasantly furnished and decorated. Lighting is domestic in character. There is ramped access to the garden area to assist residents with mobility difficulties to access this area. The Home has a level access shower, standard shower, 2 assisted baths and standard baths. It therefore provides a range of options to meet residents’ needs. In addition all rooms have an en-suite facility, five of which include a bath. Toilets are available close to living areas so that residents do not have far to go when using communal areas. Dependency levels in the home are currently low to medium. The home has a hoist available. Grab rails are available in toilets and bathrooms. However there are no grab rails in corridors or communal areas. The Home has adequate storage areas. There are call points available in each room to enable residents to call for assistance. All single rooms with en suite are provided. Bedrooms were all furnished to a good standard. All were carpeted. Most rooms had a lockable storage space. Not all bedroom doors are yet fitted with locks as standard. A previous inspection however noted that this choice is offered in the information provided in the Service Users Guide. Due to the shape and space in some rooms it was not possible to have a bedside table or other surface next to the bed. This may make it difficult if Service users wish to have a clock, drink or books etc. to hand when they are in bed. However many rooms contained over-bed style tables that could be positioned for this purpose. All residents spoken with during the inspection were happy with their rooms and accommodation provided by the home. Many had clearly brought in some of their own furniture and most rooms were personalised. All areas of the Home had plenty of natural light. There is emergency lighting throughout the Home. Most residents rooms had table lamps. Radiators were guarded and could be individually controlled. Water tested randomly during the inspection was at an acceptable temperature. At the previous inspection it was advised that a risk assessment in relation to the control of legionella should be in place. This to demonstrate that this area of resident/staff safety had been considered and relevant strategies put in place. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 17 The home employ housekeeping staff. On the day of inspection all areas of the Home were found to be cleaned to a high standard and were odour free. The laundry area was clean and tidy. The washing machine has a sluicing facility, and there is a large sink available for hand washing. No sluice is provided at the home. Housekeeping and other staff confirmed that they had received training in infection control. Staff were observed to use protective clothing when carrying out different tasks. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 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 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, 29, 30 Staff are offered induction and training opportunities to enhance their knowledge and enable them to care well for residents. Safe recruitment practices are followed. EVIDENCE: Broadoaks agreed minimum staffing levels are: • One in charge plus two care staff during the morning afternoon and evening. • One in charge plus one care staff at night. The registered manager felt that these levels were sufficient to meet the current needs of residents, but is aware that this needs to be monitored to ensure that all their needs can be safely met. The homes rota was viewed and showed that the minimum levels are being maintained, and that staff are not working excessive hours. The home does have quite a high turnover of staff. Since the previous inspection several new staff have been recruited. Housekeeping, kitchen and activity staff are employed. All residents spoken with during the inspection spoke very highly of the staff team at Broadoaks. One recognised that several new staff had recently started and said that they were still getting to know them. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 19 Recruitment is mainly managed centrally and checks for the protection of residents are carried out by the organisation. The files of two recently appointed staff were sampled at this inspection. Both showed that all appropriate checks and processes had been carried out to ensure that residents are cared for by suitable staff. The home has commenced a more comprehensive format than previously to make sure that staff have a good induction into the home. This programme is compliant with National Training Organisation standards and was undergoing completion on the care staff file sampled. A new member of staff spoken with confirmed that they had received a good induction into the home, and that they were undertaking NVQ level two. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 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 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, 33, 38 The registered manager at Broadoaks is experienced and able to manage the home in the best interests of residents. The home is generally managed to ensure the safety of residents. EVIDENCE: The registered manager has worked at Broadoaks for some years and has thirteen years experience in managing homes. She holds NVQ level three, and is aware of the further qualifications required of a registered manager. Since the previous inspection, and in accordance with previous requirements, the registered providers have developed an annual development plan for the home. It was also noted that periodic family meetings are held. Staff meetings are held but it was recognised that the frequency of these needs to be improved on. The registered provider arranges for regular visits to be carried out as required under Regulation 26 of the Care Homes Regulations. These visits check that the home is being run effectively and should seek Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 21 resident and staff views. Copies of these reports should be sent into CSCI on a regular basis. Discussions with staff and records viewed showed that all staff are trained in core areas such as moving and handling and first aid. In order for the recommendations of the fire department to be fully complied with a door guard needs to be fitted to the laundry door. This is outstanding from the previous inspection. On the day of inspection the laundry door was noted to be held open by a wedge. An accident book is maintained and the registered manager said that the level of accidents are monitored. Records sampled showed that equipment and services are regularly tested and maintained. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 x x 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 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 2 Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 23 Yes 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. 2. Standard 7 3, 8 Regulation 15 12 Requirement Residents care plans must be kept up to date and reflect their current needs. The registered person must make proper provision for the health and welfare of service users. This refers to the need for service users nutritional needs to be assessed before/on admission and for weight loss/gain to be monitored. Previous requirement date of 01/05/05 not met, although the home have gone some way towards meeting this requirement. Copies of registered persones visits undertaken as required must be sent into CSCI on a regular basis. The reccommendations of the fire service should be actioned by the fitting of a door guard to the laundry door. Timescale for action 01/10/05 01/10/05 3. 33 26 01/10/05 4. 38 12, 23 01/10/05 Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 24 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. 2. 3. Refer to Standard 7 7 26 Good Practice Recommendations The practice of keeping daily records separate from care plans should be kept under review to ensure that care staff make full use of residents care plans. The format of care plans must be kept under review to ensure that they are able to identify all residents needs and the actions needed to meet theses needs. A risk assessment in relation to the control of legionella should be completed. Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Broadoaks I56-I06 S18064 Broadoaks V242568 030805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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