Inspection on 15/06/07 for Broadview

This inspection was carried out on 15th June 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Broadview 30/10/06

Broadview 23/01/06

Broadview 04/11/05

Broadview 14/09/04

Broadview 08/06/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Broadview 8 Great North Road Welwyn Hertfordshire AL6 0PL Lead Inspector Yoke-Lan Jackson Unannounced Inspection 15th June 2007 15:00 Broadview DS0000019299.V344142.R01.S.doc Version 5.2 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 Broadview DS0000019299.V344142.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 Adults 18-65. 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. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadview Address 8 Great North Road Welwyn Hertfordshire AL6 0PL 01438 712572 01727 842904 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) Candour Care Services (Broadview Limited) Mr Rosario Fernandes Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Physical disability (6) of places Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th October 2006 Brief Description of the Service: Broadview, provided by Candour Services Limited, is a residential care home for six residents with learning and physical disabilities. Five of the residents were transferred from Harperbury Hospital following its closure. The registered manager is also the proprietor of the home. The building is situated in Welwyn, a short distance away from the A1(M) motorway. There is a large front drive with spacious parking facilities. The extended bungalow has been refurbished to provide specialist accommodation for service users with high needs. There are three large bedrooms in the extended part and three in the original section of the building. The bedrooms are of single occupancy. Other facilities include the administrative office, dining room, kitchen, lounge and a laundry room. The back garden is extensive and arranged in two sections divided by a wooden fence. The second section is mainly laid to lawn with mature plants and apple trees. The first section has a patio and seating areas that are accessible to wheelchairs. In addition there is a separate building comprising a sensory room, a staff training room and an office. The home charges £1302 - £1804 per week. Further information can be obtained from the Statement of Purpose and the Service User Guide. A copy of the CSCI inspection report should be available in the care home. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on 15/06/2007. The registered manager, who is also the proprietor, was present. The home has six residents. The inspection began with a tour of the premises. The inspector met with all the residents who have profound learning disabilities such that verbal communication is very limited. Staff were interviewed. Documents were examined. (See below for details of the inspection findings). What the service does well: This is an excellent service. The residents appeared very well cared for. They live in pleasant and homely surroundings. The environment is set up to provide the highest levels of comfort and stimulation to enhance the total development potential of the residents, despite their profound level of disability. Each resident’s room is personalised to meet their individual needs and match their personal tastes. The sensory equipment in the bedroom is customised for each resident’s personal developmental needs. Staff, individually and collectively, have the skills and experience to care for the residents. There is a continuous programme of staff development and training. The care model is fully person-centred with a comprehensive assessment of each resident’s needs. The presence of a qualified in-house staff/service development facilitator and trainer, who is responsible for the activity and sensory stimulation programme, further enhanced the care and service delivered. Broadview is one of very few homes in its sector accredited for ISO 90002001. It has been one of the accredited units for student placement by the University of Hertfordshire since 1999. It has maintained a very good record with the university. The home has not received any complaints since 1998. The provider, who is also the registered manager, knows all the residents clinically and has funded sensory equipment for each resident as well as a state of the art sensory room. He supported all his staff in a generous and caring way. Staff turnover has been negligible since the home opened. All members of staff have continued to support residents to help maintain their quality of life. This is demonstrated by the universal progress made by individual residents in independent living and their enhanced lifestyle and Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 6 improved behaviour. All these have been achieved despite the residents’ profound learning and physical disabilities, which would be a great challenge to the residents, were the service and care of a lesser standard. 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. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have the information they need to make an informed choice. A full assessment is carried out before a resident is admitted. A trial period is arranged. EVIDENCE: The home has a Statement of Purpose that is available in an alternative format on request. A Service User Guide is given to each resident. Five of the residents were transferred from Harperbury Hospital following its closure. Another resident was transferred to Broadview by Westminster Social Services. Since then there have been no further admissions. The registered manager will carry out a full assessment before a prospective resident is admitted. The home will only admit a service user whose care needs can be met. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 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. Residents are assisted to make informed choices and they are well supported in all aspects of life in the home. Their care needs are reflected by their written care plans. Confidentiality is maintained in accordance with legislation. EVIDENCE: Residents are well supported in all aspects of personal, health and social care needs. Each resident has a written care plan which is comprehensive. The care model is fully person-centred. Once a care need has been identified, there is an action plan to ensure that the care need is met. This is followed by regular evaluation and documentation of progress. The care plans examined reflect the health, personal and social needs of the residents. All care plans are regularly audited to monitor progress and to facilitate improvements in the care planning process. This is reflected in the written care plans. There is continuous progress documentation and evaluation. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 10 All confidential information about service users are handled in accordance with the Data Protection Act 1998. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are engaged in activities that enhanced their quality of life. Their rights are respected. They are encouraged to maintain contact with their families and to integrate into the community through outdoor activities. The meals provided are nutritious and balanced. EVIDENCE: The central focus of the care service is the enhancement of a better lifestyle for the residents, who have profound learning and physical disabilities. There is a planned activity programme. The activities include leisure outings and seasonal holidays arranged to meet all residents’ needs. Transport is provided, using a fully adapted minibus. In addition, residents attend the day care facilities provided by the local social services. On the day of the inspection, all the residents appeared relaxed and well cared for. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 12 Residents have the opportunity to use the outlying building, known as the activity building, which is situated in the back garden. There are art and craft sessions, known as the therapeutic expressive process, using art materials ranging from paint to clay. Staff initiate and demonstrate how to use the materials, promoting interaction. The session is adapted to suit individual’s abilities, preferences and strengths. Within the activity building is a sensory room, well equipped with different sensory stimulation equipment, such as light and music equipment, tactile panels, vibrating cushions and mattresses. The individual is encouraged to touch different kinds of equipment and explore different textures and stimuli. There are visual projectors with different picture wheels with changing random moving shapes. Colour changing wheels and bubble tubes create a visual and aural experience. The sensory room provides a safe, secure and relaxed environment to enable the individual to have different sensory perceptions and experiences. Residents are supervised by a member of staff trained in the use of the sensory room and its equipment. Relatives are invited to use the room with the resident. There are music sessions, aim to help the individual explore the way in which the instrument works and how a sound can be produced. The experience of making a sound is both tactile and aural. Softer sounds can produce a calming effect and can be used in conjunction with the sensory room. A member of staff prepares the meal. For some residents the meal has to be in purée form. The menu is planned with dietician input to ensure that the food provided is nutritious and balanced. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and dignity and they receive excellent health and personal care and support. They are protected by the home’s policies and procedures on medication. EVIDENCE: All the residents have profound learning and physical disabilities and therefore require care in all aspects of their lives. Staff assist the residents to lead an independent lifestyle as far as possible. There is no simple communication method except through long term observation and care by members of staff. The majority of the staff have cared for five of the residents when they were in Harperbury Hospital and therefore understand their gestures and sounds. Staff are deployed daily to meet residents’ care needs. Staff ensure that the care practice enhances the independent living, better lifestyle and improved behaviour of the residents. The home operates a key working system. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 14 Any health and behavioural concerns are referred to the appropriate healthcare team for immediate assessment. Each resident has a whole life review periodically that involves the resident, their relatives and members of the multi-disciplinary and multi-agency teams. There were no hospital admissions or any form of incident in the home since the last inspection. All the residents appeared content, relaxed and well cared for A trained member of staff administers the medication. Proper records are kept in accordance with legislation and guidelines from the Royal Pharmaceutical Society. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust Complaints Policy and Procedure. Service users are protected from harm. EVIDENCE: The home has not received any complaints since 1998. Staff have training on abuse issues and they follow the Hertfordshire Social Service Adult Protection Procedure. A detailed policy is in place for dealing with residents’ finances. Proper records are kept. The registered manager is the appointee for four of the residents. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and homely environment that is spacious, clean and tidy. They have the specialist equipment they require to maximise their independence. There is considerable investment in the home. EVIDENCE: The home is fully equipped with the latest high-tech equipment to assist residents in their day-to-day care requirements. This includes an electronically operated hi-lo bath with side access, a hi-lo shower trolley, a hoist and specially designed toilet seats. Each resident’s room is personalised to meet their individual needs and match their personal tastes. The sensory equipment in the bedroom is customised for each resident’s personal developmental needs. An interactive soundboard was installed in one bedroom. In another was a floor mat with soft sensory lighting, which creates a calming environment. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 17 The building is well maintained throughout. The interior of the building is neat and clean. There are large healthy looking potted plants in the communal rooms. This is a homely place with a serene atmosphere, which benefits the residents and those who work in it. There is ample communal space for all the residents’ communal interaction and exploration. The surrounding ground is extensive and secure. There is a purpose built outbuilding behind the main house, which has a sensory room and an activity room for arts and craft and music sessions. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well supported by a team of dedicated and experienced staff. All the staff have a good knowledge of the residents’ care needs. The staff have regular training to enable them to carry out their work efficiently. EVIDENCE: Staff have defined roles and responsibilities. They are well supported by the home manager and provider. The majority of the staff have been working in the home since it was established over ten years ago. Staff who have worked in the home for five years are given an additional bonus which is doubled after a further five years. Team working was evident on the day of the inspection. There is a continuous staff development programme, organised by the service development facilitator, who is an assessor and trainer herself. Therefore staff have regular in-house training and any issue raised is addressed immediately. Therefore staff have regular updates on information that is relevant to ensure residents are cared for appropriately. Each member of staff has a training and development record, which is kept updated. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The administration and management of the care and service are excellent. Residents benefited as a result. Their health, safety and welfare are promoted and protected. Their rights and best interests are safeguarded by the home’s policies and procedures. EVIDENCE: The registered manager, who is also the provider, is very well qualified and experienced in the field of learning disabilities. He is well supported by a team of highly committed staff. Most of the staff have been working in the home for over ten years. The management style is open and transparent. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 20 The quality assurance and monitoring system is linked strategically to the organisation’s management and development process, with a commitment to continuous service improvement through regular audits. The audit is carried out by an independent organisation. The home is IS0 9000-2001 compliant. In addition, the home has been one of the accredited units for student placement by the University of Hertfordshire since 1999. The home has maintained a very good record with the university. The Registration Certificate and the home’s Liability Insurance Certificate were on display on the wall. All policies and procedures have been updated. Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 4 3 3 3 3 3 3 Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 22 No 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. Standard Regulation 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. Refer to Standard Good Practice Recommendations Broadview DS0000019299.V344142.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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