Inspection on 28/04/05 for Broadview

This inspection was carried out on 28th April 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 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 15/08/06

Broadview 06/12/05

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Hillview Farm

Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Broadview 22 Kiln Road Fareharm Hampshire PO16 7UB Lead Inspector Isolina Reilly Unannounced 28-4-05 09.45 am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Broadview Address 22 Kiln Road, Fareham, Hampshire, PO16 7UB 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) 01543 442500 Milbury Care Services Ltd CRH 5 Category(ies) of LD- Learning Disability registration, with number of places Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Broadview provides care for up to five young adults with learning disabilities and associated behaviour support needs. The home is owned and run by Milbury Care Services Limited a national organisation that employs a manager for the home. This service was first registered on 16th December 2004. The home is located on the outskirts of Fareham with easy access to local shops, other amenities and is on a main bus route. The service users have access to a house care. The building is a two-storey domestic detached house, comprising of four single bedrooms, one self contained flat and a staff sleeping room accessed through the office. There is restricted parking at the front and to the side of the house. The home’s communal space comprises of one large lounge, a separate dining room and kitchen. The self contained flat has its own front door but can be accessed from the main home via an internal door. The garden is lancaped with an ornate fish pond that has been made safe and areas of decking. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection at Broadview since the home was registered in December 2004 and took place over one day as part of the normal regulation and inspection programme. On the day of the inspection, the opportunity was taken to look around the home, view records and talk to service users and staff. Most of the service users were seen during the inspection and several were spoken with. Several staff were also spoken with. What the service does well: What has improved since the last inspection? This is the first inspection of this home that opened on the 16th December 2004. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The home’s procedures are very good for admitting service users on the basis of a full assessment. This makes the experience for individuals welcoming, informative and understandable. EVIDENCE: Three service users explained that they visited the home at various times and stayed for meals before they choose to come and live at the home. The service users were interviewed by the organisations’ psychologist and manager and had various discussions about what their needs and wants also involving their family and Social Services Care Manager. The home’s rules and service user guide were explained to each service user. The staff spoken with also confirmed this. The three service users files sampled and evidence of pre-admission assessments records undertaken by health, Social Services and the organisation. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The staff have a good understanding of service users’ support needs and aspirations that is backed up by a good system for recording information that fully involves the service user. There is an on going implementation the organisation’s system of risk assessment that encourages service user independence. EVIDENCE: The inspector was able to sample three files records with the individual service user. The service users were all familiar with the records and their signatures were seen throughout the records. One record was also discussed with the visiting Nurse from the local Community Mental Health Team who found the home’s procedures both informative and knowledgeable. The individual records were clear and the service users confirmed that they are regularly checked with their Key Worker to see how they are progressing. The service users explained that at present they are able to continue with some activities they were undertaking prior to moving in. The service user and staff spoken with stated that they looking at different things they could get involved in including education and potential work. The records sampled reflected choices and discussion held with the service users on their likes and dislikes. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 10 Two of the service users explained that they enjoyed going out for meals and often shared a take away together. The reading of individual care plans with two out of the three the service users they confirmed that they were correct and covering their main issues, desires and wishes. The files seen also held records of risk assessments and service users abilities. The staff spoken with confirmed that they had had instruction on how to write care plans and risk assessment putting the service user first. So that the service users can be supported to make their wishes, desires and ambitions become a reality in a safe and enjoyable way. One service user explained how the staff were helping him to manage his money by looking after the money and teaching him how to budget. The records in the service user file confirmed this. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 and 17 The home has a supportive and service user led ethos that develops and maintains daily living skills and appropriate relationships including social and leisure activities within the local community. The service users are fully involved in the provision of nutritious variable meals of their own choose that ensure integration in the day to run of the home. EVIDENCE: A service user described the home as flexible, nice place to live with great staff and generally very relaxed atmosphere. The service users spoken with explained that they each have a weekly programme of activities that the staff support them to plan. This plan was seen in the records. All the service users felt that the routine within the home is dictated by their only schedule and likes. They explained that the staff are very flexible about the daily routine and treat them with respect. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 12 The staff spoken with confirmed that the service users are encourages and supported to make new friends and join in the local events. These are discussed individually or at the regular ‘house meetings’ that are attended by the service users and records made. The staff in conjunction with both Social Services Care managers and families are appropriately supporting a relationship between two service users living at the home. This was confirmed in the records sampled. The types of activities being undertaken by the service users spoken with include attending day centres, clubs, Bingo and discos. The service user also attends the local church and bible studies. Most of the service users were aware of the up and coming national political elections although one was not sure who to vote for. The inspector observed that staff and service users interacting well to each other and the service users stated that they feel respected. However, there were concerns regarding one service user’s integration with other service users not feeling safe around this individual. The home has been proactive in seeking advice and support to manage the situation and various risk assessments have been undertaken. On the day of the visit the nurse from the local Community Mental Health Team confirmed that this was the first day of a two-week assessment of the service user with integration issues within the home setting. The Community Mental health Care Team are working closely with the staff at the home and the organisations psychotherapist. There was evidence within the records of family involvement with individuals that staff explained is encouraged by the home. However, there was recognition of the issues surrounding family’s support when a service user first goes into residential care. This was discussed with the deputy manager who suggested that an independent advocate maybe of benefit to the service user to express their views The service users spoken with explained that they plan their own meals with the support of staff and can go shopping for the food with staff and assist staff with the cooking. On the day of the visit the inspector observed two service users in the kitchen assisting a staff member making lunch. The staff confirmed that all service users within the home assist to choose and plan of meals. Records of food prepared are kept in a file kept in the kitchen. The records showed that the food was varied and nutritious. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18. 19 and 20 The personal and emotional support, and health care in the home is offered in such a way as to promote service user independence, privacy and dignity. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: The staff spoken with confirmed that some of the service users need to be prompted to get out of bed in the morning and to shower or bath regularly. This was seen in the records sampled. One of the service users spoken with stated that they look after themselves and do not need staff to help them to wash and dress. One service user described the staff as being very good and “they know what they are doing”. The service users spoken with confirmed that they are able to call their doctor at any time or if very unwell will ask staff to call them. One service user explained that he has to have regular blood tests. Another service user explained that his mother takes him to the dentist. The individual files seen held copies of ‘Care Plan Approach’ (CPA) and the service users confirmed that Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 14 they had been present. The records seen had information on individual medical visits and other appointment letters. The home is situated on a main bus route and the service users spoken with confirmed that they also have the use of the home’s car and staff will drive them. The staff spoken with confirmed that currently there are no service users who self-administer their own medication. This was reflected in the records sampled. The staff were observed and discussed with the inspector good medication administration practices that are reflected in the homes policy and procedures that were briefly sampled. The medication receipt, administration and disposal records were seen by the inspector and found to be satisfactory. However, there was a one off gap in the recording of one service user’s medication. The staff member responsible was asked why this gap had occurred and explained that the service user had not been give the medication that morning. The deputy manager confirmed with the staff member the importance of ensuring that this is correctly recorded at the time. The manager showed the inspector the home’s medication storage cupboard that was clean with medication stored correctly in date and in sufficient quantities. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has a satisfactory complaints procedure that service users are able to use. The staff have an excellent knowledge and understanding of Adult Protection issues that protects service users from abuse. The home has an open and positive approach listening to service users views and improving. EVIDENCE: All the service users were very clear how and to whom to complain to if they are not happy. One service user said that if he is not happy he goes to the person in charge and the matter is resolved. They all stated that the staff are very good and always listen to individuals concerns. The home’s complaint records were seen and corresponded with information from the service users. The staff spoken with confirmed that the complaints log is up to date. The inspector sampled the complaint’s log and found one complaint regarding parking of builder’s lorries during the refurbishment of the home had been correctly dealt with in accordance with the home’s complaint procedure. The staff had a very positive attitude towards complaints and stated that they see them as a way of improving things. The staff confirmed that they receive training in Abuse of vulnerable adults. There has been no allegation of abuse at this home. The home has a copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure that is available in the home’s office. The inspector was able to read the home’s policy and procedure on the ‘Protection for Vulnerable Adults’ and found that it informative and follows Hampshire County Council policy. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 16 Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home presents as a homely, comfortable and suitable environment for the service users. The standard of the décor within the home is good with systems in place for maintenance. However, the organisational response times to requests for repairs need to be improved. EVIDENCE: The service users stated that the home is clean and warm. They also confirmed that they like the fresh décor and furnishing within the home. All service users’ spoken with felt there were enough toilets and bathrooms or showers. The staff stated that the home was pleasant and bright. However, they had a concern on the delay in the organisation’s maintenance team coming to make repairs. A panel in the laundry door had been damaged a few weeks ago and the home is still waiting for the repair to be completed and the paper towel holder on the ground floor communal toilet has yet to be installed. Also the home’s emergency pager system has had several teething problems that are on going. On the day of the visit the emergency pager system was not working. This was discussed with the deputy manager and agreed that the system must be working as a matter of priority especially taking into account Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 18 the current behavioural and safety issued associated with one service user. The deputy manager agreed that an interim alert system could be put in place while the other system is being repair. The service users like the home and all were very happy with their rooms. One service user stated that they help with the cleaning of the home and have certain tasks they do weekly like polishing. They feel the home is always clean and tidy. The inspector was able to look around the home and viewed all the bedrooms. The Environmental Health Officer last visited the home last week but the inspector did not see the report on this occasion. However, the deputy manager confirmed that there were no issues raised. During the tour of the home the inspector noticed that all the communal hand sinks have liquid soap for washing hands and disposable paper towels. The staff spoken with confirmed that they have had recent training in ‘infection control’. They also have had training in the safe use of chemicals for cleaning and the importance of hand washing. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The staff at the home are trained, supported and employed in sufficient numbers to meet the service users needs. The organisation has an ethos of developing staff as individuals and this is reflected in the service users feeling comfortable at the home. There are good recruitment procedures that are fully implemented and ensure that the level staff on duty does not put the service users at risk. EVIDENCE: The service users spoken with described the staff as ‘friendly, helpful’ and make one service user laugh. All the service users spoken with said there was sufficient staff around and like their key worker. One service user explained that the staff know what they are doing. The rotas showed that a minimum of three care staff were on duty each day shift and one waking and one sleeping night staff each night. The staff undertakes the cooking and cleaning with the service users assisting. The staff spoken with felt that the recruitment process within the home is thorough. The inspector was able to sample three different staff records and found that they were detailed with the necessary checks had been taken to ensure staff are fit to work at the home. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 20 The home’s induction programme is run over a period of time and some staff are awaiting training course to attend. The files sampled held records of the individual staff home’s own induction’ training covering the key areas with the signatures of the staff member and trainer. The organisation’s induction process has been assessed and meets the Skills for Care standards. The staff spoken with confirmed that the home provides and support staff to achieve qualifications in promoting independence to National Vocational Qualification level 3 and the Learning Disabilities Awareness Framework training. One staff member is being supported to achieve a trainer’s qualification. Many of the staff are awaiting course to come up in some of the areas already mentioned. One staff member described the organisation as having good intentions but the availability of course often means that there delays in securing training. The home’s training records show that the home undertakes training regularly. The inspector was able to sample training certificates and other records of training undertaken by the staff as part of their induction as the home is new that including health and safety, food hygiene, non violent crisis intervention, fire safety, manual handling and medication. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The manager is supportive and provides a clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The staff spoken with stated that organisation’s attitude including area managers is supportive and approachable. However, the staff describe the manger of the home as ‘fantastic’ with emeses patients and always approachable. The inspector found evidence of regular supervision of staff and full job descriptions and personal specifications for the various roles with the home that were found to be detailed and informative. The staff spoken with confirmed that they received clear information regarding their role within the home. Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 22 Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Broadview Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x x x H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 24 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. 1. 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. 1. Refer to Standard Good Practice Recommendations Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 Page 25 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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 Broadview H54 S63312 Broadview V224099 280405.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!