Inspection on 04/11/05 for Broadview

This inspection was carried out on 4th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Broadview 15/06/07

Broadview 30/10/06

Broadview 23/01/06

Broadview 14/09/04

Broadview 08/06/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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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 OPL Lead Inspector Julia Bradshaw Unannounced Inspection 10:00 4 November 2005 th Broadview DS0000019299.V259321.R01.S.doc Version 5.0 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.V259321.R01.S.doc Version 5.0 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.V259321.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Broadview Address 8 Great North Road Welwyn Hertfordshire AL6 OPL 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.V259321.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2004 Brief Description of the Service: Broadview is a home for six service users who have a learning disability, some of whom have additional physical disabilities. The building is a bungalow, which has been refurbished to provide specialist accommodation for service users with high needs and there is a separate building in the grounds providing a sensory room, a staff training room and an office. There is a large garden, although this does have a fairly steep slope towards the orchard, where staff take service users in the autumn to collect up the apples. The six bedrooms are all single occupancy and there is a large front drive with spacious parking facilities. The home is situated on the main road, within a residential area and close to Welwyn Garden City and Hatfield. The registered manager is also the proprietor of the home. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one day. The majority of time was spent talking to members of staff on duty and service users. Some time was also spent looking at Service user Plans, risk assessments, complaints, and staff training. The Inspector also explained the new inspection style, format and report. Staff and service users were very welcoming This was a very positive inspection and only three requirements were made in relation to the risk assessments and staff training. What the service does well: What has improved since the last inspection? There is very little that the manager and staff need to do in order to improve the current service provided. A new minibus was purchased in May 2005, which has enhanced the service users lives and given more opportunities to embark on outside activities and events. The manager will be purchasing some new furniture for the lounge before Christmas and the outside of the home has been re-painted Broadview DS0000019299.V259321.R01.S.doc Version 5.0 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 DS0000019299.V259321.R01.S.doc Version 5.0 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.V259321.R01.S.doc Version 5.0 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 the following standard(s): 1-4 Prospective service users individual aspirations and needs are assessed and reviewed, enabling the service user and staff to continuously review the individuals care package provided. Information provided to the service user about the home and its terms is suitable to meet their needs except that it should be provided in a format that is understood by all service users who may access the service. EVIDENCE: A comprehensive Statement of Purpose is held in the home. The Statement contains information for the service user to make an informed choice about where to live. The content is suitable to meet individual needs. However all these documents could benefit from being adapted into a more “user friendly format” Full assessments of each service users needs and aspiration are made before the service user moves into the home. The assessments carried out within the home are continuously taking place supporting and monitoring individual progress and needs identified. Experienced and competent people complete the assessments. Staff also seek and obtain external specialist support to meet the individual service users needs. Reviews support the service users in achieving and reviewing individual needs, goals and aspirations. The home is in the process of implementing Person Centred Planning. Service user contracts should be maintained on each service users file and in a format that is understood by the individual. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 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 the following standard(s): 6-9 Individual needs and choices within the home are being promoted to encourage and empower user self-determination. Service user consent must be obtained. EVIDENCE: All service users have an individual care plan and an allocated key worker to support them. Individual daily guidelines/diary notes for service users where observed. All service users will be supported within the Person Centred Planning programme once completed and regular reviews of changing needs are continuously assessed. The ethos of the home is that the care plans of each individual are owned by the individual; those service users spoken to during the inspection were aware of their individual care plans. However the manager must obtain individual service users consent and GP support before using bed rails. Each service user is encouraged to take part in daily living tasks, where appropriate, for example help with washing up, laying the table and shopping. Staff can sometimes find this challenging with the service users who have been living in institutions for many years and can be reluctant to join in self-help Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 10 programmes. The home is nicely decorated and the service users are involved with the choices for decoration collectively. All information within the home is handled with care and respect. All personal notes and files detailing information on the service user are locked away. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 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 the following standard(s): 12 - 17 Personal development opportunities are encouraged for all service users ensuring interactions within the local community and that individual rights and responsibilities are recognised and supported. EVIDENCE: Four of the Service users attend Hornbeams day centre. The remaining two service users have chosen to stay at home during the day and are supported by the home’s Activity co-ordinators who are shared with the ‘sister’ home next door. There was adequate evidence seen on the day of the inspection to confirm that service users are consulted and involved in the planning of these activities. Access to transport occurs with the use of the home’s onsite transport, with staff support. Staff support and encourage all service users to maintain and develop social, emotional, communication and independent living skills. The involvement of the service users, where possible, in a variety of tasks was observed throughout the inspection. All service users have one day off per week in order to attend to their personal tasks including washing, cleaning their rooms and personal clothes shopping, this is usually combined with a trip out for lunch. The home provides holidays for its service users and Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 12 recent trips include Skegness for four nights with three service users and three staff. All service users are encouraged and supported to maintain links to the local community. The home is close to Welwyn Garden City and is within a residential area of the Town. During the inspection staff and service users were observed to interact equally with one another. Routines within the home promote and encourage service user independence. Service uses are unrestricted in movement around the home, (except the kitchen) Menus are offered on a flexible basis, with service users making choices over the meals daily. All service users are provided with external nutritional advice and assessments and monthly weights are recorded. The lunchtime meals were unrushed and relaxed. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 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 the following standard(s): 18,19,20. All personal and health care support is well maintained ensuring individual needs, choices and preferences are met at all times. EVIDENCE: All care provided is individual and tailored to each person needs with service users choices and preferences being promoted. Assessments and reviews are continuously completed ensuring that the approach adopted by the home is person centred and holistic to each service users needs. Service users needs and are supported with all aspects of their physical and emotional health and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Information and advice is provided to all services users regarding general health issues. There is a robust policy and procedure in place to support the safe administration, storage and receipt of medicines. All staff receive training prior to being deemed competent to administer medication. The home uses the Blister pack medication for two service users and Lloyd’s chemist supplies these. Currently, there are no service users who require controlled medication. Service users access the local chiropodist and a dentist visits the home, when required. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 22 & 23 Service users live in a safe and protected environment. EVIDENCE: The home has a written policy which complies with the requirements of this standard and which staff said they were aware of. A record is maintained of complaints made detailing actions and outcomes as necessary. There is a written procedure in relation to Adult Protection which is used in conjunction with the Hertfordshire Adult Protection policy, which was on display within the main office. The home also has a written whistle blowing policy. There is a clear and detailed policy in relation to service users monies which includes regular audits and the maintenance of receipts for all purchases. Each service user has a bank account. None of the service users are able to manager their own money therefore the manager is appointee for four service users and two have Power of Attorney arrangements through their respective solicitors. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24 - 25, 27 & 30 The home and its surroundings offer a pleasant, comfortable and safe environment to its service users. The home is extremely clean and well maintained. All bedrooms are personalised offering a homely, lived in feel. The bathrooms could benefit from being redecorated. EVIDENCE: Service users are encouraged to bring personal items such as furniture and pictures into their room when they move in. Service users spoken to were happy with their rooms. The home is very clean and attention to detail is given. The cleaning of the home is carried out by the care staff and with service users assisting where possible. The manager monitors this closely to ensure that standards of cleanliness remain high. Hygiene and infection controls are good and gloves and are always readily available. The kitchen and laundry rooms are domestic in style and appear to manage their current workload effectively. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 16 The home provides sufficient lighting, heating and ventilation. A maintenance and renewal and redecoration plan is in place. Each service user has a single bedroom. The communal areas of the home are decorated and furnished to a good standard and there is a range of home entertainment equipment for service user to access. There is also a piano in the main lounge/conservatory for service users to enjoy. Both the bathrooms could benefit from being re-decorated the paintwork is worn and water damaged. The home has been re-painted externally and there will be new furniture purchased for the lounge before Christmas. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 35 The home is suitably staffed with well-trained and experienced individuals ensuring that at all times service users changing needs can be met. The staff team are enthusiastic and appear to take great pride in the service. Training records were not up to date. EVIDENCE: Staff spoken with during the inspection appeared very clear of their individual roles and responsibilities. Staff were seen to support the main aims and values of the home. The home has clearly defined job descriptions and person specifications in place. All staff have received a series of mandatory training courses in order for them to meet the needs of the service users. Training includes, Care Planning, Challenging Behaviour, and communication. However training records were not up to date on the day of the inspection. The manager carries out regular supervisions. Staff files were not inspected on this occasion but there is a clearly defined recruitment policy within the main home’s policies and procedures file. Staff meetings need to be held more regularly and minutes of the meeting recorded and maintained. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 43 The management within the home is secure and effective ensuring that changing needs of service users are met and that the home is running meeting its aims and objectives are being met. Quality assurance systems are in place but require updating. Service user meetings need to be documented. Fire risk assessments require updating EVIDENCE: Service users appear to be very happy with the home and seem to be relaxed in their environment. The relationship between the service users and the staff is well balanced with interactions observed being appropriate and supportive. The ethos and management approach of the home creates an open, positive and inclusive atmosphere. Staff spoken to commented that they feel supported and valued and that they feel the home is well managed. A clear commitment is made to equal opportunities within the home, with staff and service users expressing positive views with regards to this. The service users appeared to Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 19 benefit from this well structured and well run home. The staff and manager are suitably trained to meet the complex changing needs of the service users. Quality assurance systems are in place and the home conducts an annual audit. However the manager must ensure that both service user meetings and staff meetings are held more regularly as on the day of the inspection there were inconsistent records maintained to support this. Although the manager has daily contact with each service user and therefore the service users have the opportunity to raise issues or concerns informally. The service users spoken to felt that their views were listened to and considered. All records are secure within the home and were up to date and held in accordance with the Data Protection act 1998 ensuring that service users rights and best interests are safe guarded by the homes polices and procedures. Individual risk assessments were in place, with all external required safety checks occurring. All fire records were up to date with the exception of a fire risk assessment and individual risk assessments on the use of bedrails. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 20 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 3 3 3 4 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 2 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score 3 x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 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 x x x x x 2 DS0000019299.V259321.R01.S.doc Version 5.0 Page 21 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 YA24 YA9 Regulation 13 (4) (c) 13 (4) (c) Requirement The manager must complete a fire risk assessment. The manager must obtain written consent when using bedrails for individual service users. The manager must ensure all training records are maintained and update to reflect and demonstrate that all staff are receiving the necessary training to carry out their role effectively. Timescale for action 05/11/05 05/11/05 3 YA35 18 (1) (c) (i) 05/11/05 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 YA1 YA24 Good Practice Recommendations All information provided to service users should be produced in a format that is understood by everyone who may use this service. Both bathrooms could benefit from being re-decorated. Broadview DS0000019299.V259321.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 DS0000019299.V259321.R01.S.doc Version 5.0 Page 23 - 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. 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