CARE HOMES FOR OLDER PEOPLE
Broadpark House Belmont Road Ilfracombe Devon EX34 8DR Lead Inspector
Jo Walsh Unannounced Inspection 18th January 2007 14:00p 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 Broadpark House DS0000022141.V327820.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. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Broadpark House Address Belmont Road Ilfracombe Devon EX34 8DR 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) 01271 864752 NO FAX Mrs Elizabeth Emery Mrs Elizabeth Emery Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (4), Old age, not falling within any other category (3) Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. To accommodate one person (named elsewhere) outside the categories of registration The maximum number of placements including that named individual will be 4 On the termination of the placement of the named person, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert back to the original categories of registration and number of service users Date of last inspection Brief Description of the Service: Broadpark House is a large, detached, Georgian House, standing in its’ own grounds, in a residential area on the outskirts of Ilfracombe. Broadpark House is away from the road and is approached by its own level driveway, parking for visitors and staff is provided to the front of the home. The service provides twenty-four hour care and support for two older people and one younger adult - all with a history of learning disability and / or mental health problems. Although the home is registered for 4, the owners do not intend taking on another resident. Sympathetic refurbishment work has been ongoing and continues, restoring the house in keeping with its’ original style, the rooms that have been completed are of a high quality. Local facilities and amenities are within walking distance of the home and are used by the ladies at Broadpark House. The fee range from £250 to £363. A copy of this report will be placed on the residents’ notice board in the kitchen. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was completed on a weekday afternoon in January. The main focus of the inspection was to seek the views of the three residents and assess key standards. The registered provider was not available on the day, but her husband and the one member of staff they employ did spend time discussing how residents have been and how they access the necessary health and safety training needed. Some key documents were looked at as part of the inspection process, these included care plans and records of fire safety checks. Most parts of the home were seen including two of the residents’ bedrooms. As this is such a small home, and this is the second key inspection, no surveys were sent to the residents. Two comment cards were sent to the local GP practice, but none were returned. What the service does well:
The three residents who live at Broadpark House have been there for a long time and regard it as their home. Residents’ personal and health care needs are well met by a small core of people who know their needs well and have developed good relationships with all the individuals. Plans of care are in place to identify what individuals needs are and this helps to provide care in a consistent way. A good range and choice of meals is offered. All three residents said that they really enjoyed all their meals and their likes and dislikes were taken into consideration. One resident said ‘the food is lovely, I have not had better, I love it here.’ The home provides a warm, clean and homely environment for residents to enjoy and all said they felt like they were part of the family. Residents are treated with respect and dignity. One resident commented ‘we are treated very well here, everyone is very kind and we all get on well together.’ Residents are enabled to access both specialist and non-specialist activities within the local community and contact with friends and family is facilitated and encouraged where appropriate. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Broadpark House DS0000022141.V327820.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 Broadpark House DS0000022141.V327820.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current residents can be assured that their needs have been assessed and reviewed to ensure the home can meet their needs EVIDENCE: The home has not had any new residents for over 11 years, so it is difficult to fully assess whether a full assessment was completed prior to admission. The care plans are reviewed on a regular basis and these identify assessed needs. Two of the residents have been in the home for over 20 years and their changing needs have been documented in the care plans. A previous recommendation was made in respect of ensuring that residents had all the information to know understand their rights and responsibilities. This relates to the statement of purpose and was not checked on this occasion as the registered provider was not available. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care are well met. Residents can be assured they will be treated with respect and dignity. EVIDENCE: Care plans detail individuals’ personal and health care needs and state what social activities each individual enjoys. The health care needs of each individual is clearly set out and details any appointment to see GP’S or other health care professions. All three residents spoken to felt that their health care needs were always met in a timely fashion, that they were well cared for and saw their GP when needed. One resident commented ‘I have never been treated better.’ The plans are reviewed monthly and daily records are kept of any significant event for each individual. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 10 Residents confirmed that they are treated with respect and their rights to privacy were upheld. Examples given to evidence this were that people knock on their bedroom door before entering, residents are referred to by their preferred name and care and support is always provided in private. The staff member on duty on the day of the inspection was observed to be kind and respectful towards residents. Only one resident currently takes medication and they do this independently. The home has a written statement signed by this individual to say they consent to self medicating and they have now completed a risk assessment to ensure that all risks are identified and steps are taken to minimise those risks. The home does not currently handle anyone’s medication but has appropriate lockable storage for this and a policy and procedure they would follow to ensure safe administering and recording of medications. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that that they will be able to maintain contact with family and friends, access the local community and helped to exercise choice and control over their lives. EVIDENCE: Residents confirmed that the routines of the home are flexible to suit their preferences. They choose when to get up, go to bed and where they spend their days. One resident said that help is given to assist getting washed and dressed at a time that suited her. Care plans detail what activities each individual enjoys participating in and residents confirmed that they are enabled to take part in activities both in and outside the home. One resident said ‘I can’t get out as much as I used to but I still enjoy going to the tea dance.’ Another said they continued to enjoy going to a local day centre and meeting different people. One resident is still able to access the community independently and enjoys doing shopping for the house or other residents. The residents who need help to access the local community are provided with transport via the owners’ car or by taxi.
Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 12 All three residents expressed a high level of satisfaction with the meals provided. They all said they had a good choice and their likes and dislikes were taken into consideration. Residents can choose where to have their meals, two usually choose to have them together in one of their bedrooms, but they can eat in the kitchen with the family and staff if they wish to. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 13 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): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can be confident that complaints and concerns will be taken seriously and dealt with. Some improvements are needed in respect of recording of residents’ finances in order to ensure they are fully protected. EVIDENCE: The home has a written complaints procedure and all three residents said they would be able to talk to the registered provider or her husband about anything that concerned them. Since the last key inspection the person employed by the provider has obtained a CRB check. This helps to ensure residents are protected. One of the requirements made during the last inspection related to residents’ finances and ensuring that there was robust recording and an audit trail. The registered provider was not available for this inspection so the inspector was unable to check this. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 14 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a clean, warm and comfortable environment that is well maintained. EVIDENCE: During this inspection the main lounge, kitchen/diner and all residents’ bedrooms were viewed. All areas of the home looked at were very clean, furnished and decorated to a high standard and provide a pleasant homely environment. The residents spoken to say they liked their rooms, which they had personalised and decorated to their own tastes. The owner and her husband live in the home and it is very much a family based home. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by a small core of staff but their safety could be compromised due to lack of training in key areas of health and safety. EVIDENCE: The home is run mainly by the owner and her husband who provide much of the 24-hour care and support. At present all three residents are fairly independent and having one person available is appropriate to their needs. The home does not provide waking night cover and this is not currently needed for the resident group living at the home. The owner has not completed NVQ training or any of the core areas that would ensure residents’ safety. These include basic food hygiene, first aid, moving and handling, fire training and infection control. The one member of staff employed also needs to complete this training, to ensure they can complete their role in a safe manner that ensures the safety of the residents. The registered provider was not available during this inspection but the staff member asked for guidance on how they could get the necessary training. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are no formal systems in place to ensure that the views of the residents are used to improve the quality of care. Accounting procedures need improvements to ensure resident’s monies are safeguarded. Some improvements are needed to ensure that residents and staff are fully protected in all aspects of health and safety. EVIDENCE: Although the owner Mrs Emery has no formal training in management or care, she has been offering care and support to the resident group for 30 years. She does not intend to offer care to any other group of residents, but feels she would like to continue with her three remaining ladies for as long as she can.
Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 17 She will need to look at training for herself and staff in all aspects of health and safety including first aid, basic food hygiene, fire training, moving and handling and infection control. There has been no formal training in these areas for any of the core people who provide care and support to the residents. The home does not have a written annual development plan or quality assurance system in place that seeks the views of residents to help improve the quality of care provided. As the registered provider was not available, the inspector was not able to check how they are ensuring that there is a clear audit trail for residents’ finances, as only she handles these. As there were no satisfactory arrangements and a requirement was made during the last inspection, it has been repeated again this time. The pre inspection questionnaire submitted prior to the inspection highlights that the home ensures a safe environment by having the central heating and electrical systems checked, risk assessing for hot water and possible risk of burns from hot surfaces. The home keeps records of any accidents and has a procedure for reporting any significant incidents or accidents and the safe storage and disposal of any hazardous substances. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 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 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 3 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 2 X X 2 Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 19 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 OP18 Regulation 17(2) Requirement The registered person shall maintain in the care home the records specified in schedule 4. This relates to ensuring that all financial transactions made on behalf of residents is recorded. (previous date set for compliance 30/06/06) If the registered provider is an individual, he shall undertake; from time to time such training as is appropriate to ensure that he has the experience and skills necessary for carrying on the care home. The registered person shall ensure that the care home is conducted so as (a) to promote and make proper provision for the health and welfare of service users This relates to undertaking necessary health and safety training. (previous date set for compliance 31/08/06) Timescale for action 30/03/07 2. OP38 Reg 10 (2) (b)Reg 12 (1) 30/06/07 Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 20 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. Refer to Standard OP1 OP33 Good Practice Recommendations The Statement of Purpose and Service User Guide must contain all of the information in the standard. The registered person should have an effective quality assurance and quality monitoring system in place. Broadpark House DS0000022141.V327820.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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
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