Inspection on 15/11/05 for Broadview (Anchor House)

This inspection was carried out on 15th November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Broadview (Anchor House) 19/02/09

Broadview (Anchor House) 19/02/07

Broadview (Anchor House) 29/06/05

Broadview (Anchor House) 29/03/05

Broadview (Anchor House) 09/02/05

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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 (Anchor House) 245 Brompton Farm Road Frindsbury Extra Rochester Kent ME2 3NW Lead Inspector Anne Butts Announced Inspection 15th November 2005 09:30 Broadview (Anchor House) DS0000029018.V251514.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 (Anchor House) DS0000029018.V251514.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 (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Broadview (Anchor House) Address 245 Brompton Farm Road Frindsbury Extra Rochester Kent ME2 3NW 01634 717295 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) Mrs Marian Parkinson Mr George Patrick Parkinson Mrs Barbara Buxton Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Broadview is a care home providing care and accommodation for 3 younger adults who have a learning disability and some additional needs. The home is owned by Mr George and Mrs Marion Parkinson and Barbara Buxton is the registered manager. The home is situated in the outskirts of Frindsbury/Strood town centres. It is on a bus route and has access to local facilities; shops, a park and a pub are all within easy walking distance. The property is a small but spacious detached bungalow and all service users have their own bedroom and access to ample communal space. There is a well tended garden to rear of the property that is accessible to wheelchair users. Parking is to the rear of the home accessed via a private road. Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out by one inspector. The manager was present during the process and the inspection lasted approximately six hours. Time talking to service users, staff and the manager. During the course of the inspection records and documentation were read including care plans and staff files. What the service does well: What has improved since the last inspection? What they could do better: Service users records need to be stored more securely, so that they are not accessible to any unauthorised persons. Service users would also benefit from monthly reviews, as opposed to six monthly. Although there are policies and procedures in place many of these reflect the larger organisational setting and the home would benefit from these being Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 6 adapted to meet the needs of the service users and staff in the residential setting so further protecting them. The induction booklet would also benefit from being adapted to reflect the residential setting in more detail. 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 (Anchor House) DS0000029018.V251514.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 (Anchor House) DS0000029018.V251514.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): 2, 3 and 4. Prospective service users will only be admitted on the basis of a full assessment, so that the home can be confident that they will meet their needs. EVIDENCE: The files of service users were viewed and contained needs assessments, however there have been no new service users admitted into the home for the previous three years and the manager stated that the needs assessment will be updated as the need arises. The manager is aware of how to meet prospective service users needs and through discussion demonstrated that the home was aware of how they would meet any prospective service users needs. There are procedures in place for how the home would be able to address and meet the needs of any prospective service users. Broadview (Anchor House) DS0000029018.V251514.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, 7, 8, 9 and 10. Service users benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Comprehensive risk assessments are in place so that as far as possible service users may enjoy independent lifestyles. Service users confidentiality would be better protected by the home ensuring that their records are stored in a secure location. EVIDENCE: The home has comprehensive files, which contain full details of the needs of service users. Following the last inspection the home has further improved these files by streamlining the information and this has resulted in making them user friendlier without losing any of the key information. The care plans are set out in the form of a ‘life book’ and these are reflective of the care plan and risk assessments for each service user and contain information about the individual’s background, general capabilities, routines, skills, care, health and social needs. They also contain a personal profile and the likes and dislikes of the individual service user and identifies personal Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 10 goals. It is evident that service users are involved in these Life Books through service users input into these records. There were detailed descriptions of guidance on how to care for the service user, and clear evidence of making informed decisions. Care plans are reviewed and re-written every six months. It was recommended that care plans be reviewed on a monthly basis so that any issues, which arise with regards to service users and their changing needs, are monitored and addressed on a more regular basis. Daily notes are comprehensively completed, and there are systems in place that ensures any significant events relating to service users are noted onto a separate incident form, so the home can promote continuity with regards to service users needs. Service users are regularly consulted about the events of the home and a representative for the home attends meetings for the larger organisation. Service users spoken to confirmed that they are able to contribute to making decisions about their own daily living choices and one described as to how she had organised her Christmas shopping and participated in helping organise menus for the home. There are comprehensive risk assessments in place that identify hazards with actions to be taken to minimise the risks to the individual and also the results of any possible positive or negative outcomes. All the service users have access to their own records, and they are set out in a coloured format, with each service user choosing the colour scheme for their files so they know which is theirs. Service user information is currently kept in a open bookcase in the office, however some of the information is confidential and although the manager is confident that no unauthorised person would look at these records a requirement is being made so that the home ensures that confidential information relating to service users is stored securely in a locked cabinet. Service users have access to all their own records, and the manager will issue service users with a key to their own records if they wish. Broadview (Anchor House) DS0000029018.V251514.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): These were inspected at the last visit and found to meet the standards. EVIDENCE: Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 12 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 and 19 The personal and health care needs of service users are well met, promoting and protecting their privacy, dignity and independence EVIDENCE: The ‘Life Books’ detail personal care needs and this was supported by personal plans in the service users bedrooms. It was evident that service users are encouraged to be as independent as possible with their own personal care needs and two of the service users are very independent and only supported where guidance may be needed. The third service user is supported with full personal care needs and this is carried out in a sensitive and supportive manner. The ‘Life Books’ also evidence as to how the home aims to meet the needs of the service users with regards to their emotional well being, and supports them with any issues that arise. Records also evidenced that service users have full access to healthcare professionals, and that the home supports and monitors their ongoing healthcare needs. Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 13 The home does not operate a key worker system, as there is a small stable staff team who all support the service users with their ongoing needs. Interaction between service users and staff was observed during the course of the visit and it was evident that there was a good rapport with mutual respect. Broadview (Anchor House) DS0000029018.V251514.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 and 23. The home has a clear and effective complaints system in place and service users are protected by robust adult protection policies and procedures. EVIDENCE: The home had a detailed complaints procedure that was also available in a format appropriate to the client group. A copy of this procedure was seen to contain appropriate timescales for responses to complaints. Any complaints are recorded and then actioned, however it was noted that not all full details are recorded of outcomes – and a good practice recommendation was made that the home should ensure that this is the case. Feedback received prior to the inspection raised a concern from a relative. The home was able to evidence through their records that they were aware of this and were addressing the concerns and aiming to work with the service user and their family at resolving these issues. As identified previously - monthly reviews would assist the home in ensuring that any changing needs are met and managed appropriately. The home has updated their adult protection procedures and now follows the guidelines set out by Kent & Medway Social Services. The manager is qualified as a trainer in adult protection procedures and records viewed evidenced that staff have been trained in this area. Policies and procedures, and staff records also evidenced that the home ensures that all relevant checks are taken with regards to new staff so as to protect the well being of those living within the home. Service users manage their own money according to their needs and the home supports them with this, and has systems and structures in place to ensure that they are protected. Broadview (Anchor House) DS0000029018.V251514.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, 27 and 28. Service users benefit from living in a ‘homely’ environment, which is wellmaintained and reflects individuality. EVIDENCE: The environment was inspected fully at the previous visit, and a requirement, which has been made with regards to the flooring in the laundry room, was fully met. Water temperatures are also now monitored. The home has also recently purchased a sanitizer for a service user – which purifies the air and maintains a safe as environment as possible. This is particularly relevant to this service user, who suffers from health problems that need to be monitored and safeguarded. There is a large communal sitting / dining area that service users share. This reflected a homely and comfortable environment in which service users were observed to move freely around in. The kitchen is accessible to service users as they require and they are able to make themselves snacks or drinks and are supported by the staff. The home uses the ‘back door’ as their main entrance – as the front access leads onto a busy road via some steep stone steps. The manager stated that this has been assessed by and Occupational Therapist and they are currently Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 16 awaiting the outcome of the report. entrance into the home. Service users do not currently use this There is one main bathroom, and this was seen to be clean and adequate for service users needs. Personal care items are stored discreetly away from any communal areas. Broadview (Anchor House) DS0000029018.V251514.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, 32, 33, 34, 35 and 36 Service users benefit from receiving care from staff who are properly inducted and receive regular on-going training. There are robust procedures for the recruitment of staff and systems are in place to protect service users. EVIDENCE: Full staff details are held securely within the managers’ office, and a sample of records was viewed. These were seen to contain job descriptions and CRB disclosures. As previously stated there isn’t a key worker system in place, but the small stable staff team all work closely with the service users and support them in meeting their needs. The home does not use agency staff or volunteers. The service users are confident that they can approach any member of staff if they have any concerns. Staff were observed to interact well with service users, and were able to access care plans and risk assessments, which support them in ensuring that they can care for the service users. Two members of staff have completed their NVQ, with another starting her NVQ in the New Year. Two other members of staff who had change their training providers for their NVQ’s are now enrolled with another organisation and are about to re-commence their course. The home and organisation Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 18 support staff in accessing NVQ’s and other relevant qualifications. Staff are also supported with their ongoing training needs, and there is a budget in place to support staff in accessing this training. It was recommended that the manager use a training matrix that would evidence training which had been undertaken and identify any training needs that were due. There is a full induction process in place, which aims to train new members of staff in meeting the core needs of the service users and becoming aware of the principles of good practice. The induction process also contains key policies and procedures. There is a workbook that accompanies this programme – which is then signed to say that the new member of staff is competent. The induction process is quite thorough but it is a generic one that covers all the areas of the care and support that is provided by the organisation. It would benefit from being adapted so that it reflects the needs of the service users within this home – and it is being recommended that the induction booklet be updated to reflect the needs of service users within a residential setting. Supervisions are now taking place on a regular basis, and team meetings are held and the outcomes and objectives for the staff and home are recorded and were seen to be acted upon. There is a full recruitment policy and procedure in place. There is a comprehensive application form, two written references are obtained, and there is a set interview process, which is carried out by two people. The organisation operates an equal opportunities policy. Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 and 40 Service users benefit from a manager who is committed to ensuring that their needs are met. Polices and procedures are in place to protect service users and staff, but this would further be enhanced if they were developed to reflect the setting of this home. EVIDENCE: During the course of the inspection the manager demonstrated a commitment to ensuring that the home was run in the best interests of the service users. An ‘open door’ policy is in place that ensures that the manager is available to service users at all times. Interaction between the manager, staff and service users was observed to be good. The manager largely maintains the records and is aware of the importance of good care planning and risk assessments and continually aims to improve so that she can be positive that the individual service users needs are fully met. Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 20 The home is part of a larger organisation, which also provides supported living for people. They, therefore, benefit from the policies and procedures that are in place. However, as this home provides care as opposed to a supported living service – it was noted that some of the policies and procedures that are in place may not be appropriate for this setting. It is a good practice recommendation that the home develops the key policies and procedures to reflect the needs of their own service users and staff in accordance with the larger organisational guidelines. Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Broadview (Anchor House) Score 3 3 X x Standard No 37 38 39 40 41 42 43 Score X 3 X 2 X X X DS0000029018.V251514.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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 YA10 Regulation 17 Requirement The manager must ensure that service users confidential records are stored securely. Timescale for action 31/01/06 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 6 Good Practice Recommendations It is recommended that monthly reviews be carried out with service users, preferably using a set format that would enable the home to better monitor any changing needs of the service users. It is a good practice recommendation that the home fully records the outcome of any complaints. It is strongly recommended that the organisational policies and procedures are adapted to reflect the needs of the service users within this setting. It is strongly recommended that the induction booklet is adapted to reflect the needs of the service users within a residential setting. It is recommended that a training matrix is implemented for staff. 2 3 4 5 YA22 YA40 YA35 YA35 Broadview (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 (Anchor House) DS0000029018.V251514.R01.S.doc Version 5.0 Page 24 - 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!