Inspection on 29/06/05 for Broadview (Anchor House)

This inspection was carried out on 29th June 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 2 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) 15/11/05

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 Unannounced 29 June 2005 10:00 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 (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 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 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 Mrs Barbara Buxton Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 29 March 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) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors who were in the home between 10.00 and 14.00 on 29th June 2005. Anne Butts and Sue McGrath represented the commission and the registered manager, Barbara Buxton, represented the home. The inspectors spent time talking to two of the service users, staff and the manager. During the course of the inspection records and documentation were read including care plans and staff files. Many judgements about the quality of life for residents were taken from observations, speaking with staff, reviewing records and from direct discussion with service users. A tour of the premises was undertaken, which included all of the service users rooms. What the service does well: What has improved since the last inspection? This was the first visit to the home by the inspectors, so an informed judgment can only be made from action taken with regards to any recommendations or requirements from the previous inspection report. The complaints procedure has been reviewed and updated and sent to service users families – it is also available in a service users friendly format. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 6 The assessment process has also been reviewed and updated and has a comprehensive and holistic approach to meeting the needs of the service users and is in an appropriate format for service users. These will be used as the basis of the care plan reviews that are due in July. Contracts now comply with National Minimum Standards. 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 (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.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 (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.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) 1,5 The home’s Statement of Purpose and Service User Guide are comprehensive and provide prospective service users with the information they need to make an informed choice about moving into the home. A written statement of terms and conditions protects Resident’s legal rights to occupancy. EVIDENCE: The home had an up to date statement of purpose clearly setting out the aims, objectives and philosophy of the home and would provide any prospective service user with a guide to the home. The service user guide was also well presented and in a format that would assist service users to understand. Examples were seen on service user files of a written contract/statement of terms and conditions between the home and the service user. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.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) 6,7,8 and 9 Service users benefit from the home’s effective care planning procedures. Comprehensive risk assessments are in place so that as far as possible service users may enjoy independent lifestyles. EVIDENCE: The home has put into place a detailed ‘Life Book’, which is reflective of the care plan and risk assessments for each service user and these 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 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. Service user records are extensive and all information to support service users is available within these records but they would benefit from becoming more streamlined for ease of use. Throughout the course of the inspection service users were observed making their own decisions as to activities and accessing local shops as required. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 10 The home is part of a larger organisation, which also provides a supporting people service and there was evidence of joint meetings between the different accommodations and that the service users in Broadview actively participated in these meetings. Risks assessments are in place, which promote the independence and choice of the individual and support them in their daily lives, and during the course of the inspection service users were observed benefiting from these risk assessments. There were clear and recorded reasons for any limitations in the service users rights and choices. The service users spoken to confirmed that they were able to make many of their own decisions and that they liked living in the home. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.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) 11,12,13,14,15,16 and 17 Service users have opportunities for personal development through education and a range of community and recreational opportunities enabling the individual to benefit from appropriate and fulfilling lifestyles. Families are actively involved and the service users clearly benefit from this. EVIDENCE: Service users attend different college courses in accordance with their preferences including writing skills, french, music classes, painting and drawing. Service users had drawn up a plan with staff of their weekly activities and confirmed with inspectors what they enjoyed doing. One service user also works in the main office of the organisation helping out with general office duties e.g. answering the phone, photocopying, and shredding etc and was paid a small wage. They confirmed that they enjoyed this. The residents access the local community to do their shopping, and use pubs and restaurants. Service users go out to activities independently based on an individual risk assessment. One service user regularly uses the local buses into town to go shopping or attend college. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 12 Activities largely take place out of the home and these include going swimming, going to bingo, shopping, visit the cinema and also out with families. Two service users visit their families and stay over on a regular basis. Service users told the inspectors of different excursions they had gone on, both with staff and family. Service users are also supported in individual life skills and help in the home with cooking, shopping and cleaning on a rota basis. Observation during the inspection showed service users having their opinions listened to and their choices respected. Although meal times were not observed during the inspection, care plans had details of special diets and preferences of choice of food, and service users spoken to confirmed that they ‘liked the food’. A member of staff stated, “that as the service users are quite busy with their daily routines meal times are flexible to suit their needs”. Risk assessments are in place for service users to use kitchen facilities and make their own meals, snacks and drinks. One service user has a peg feed and staff have regular training and updates for this. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.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, 20 and 21 Care plans detailed service users’ personal care support needs and outcomes which ensured their privacy and dignity were maintained. The home’s practices and procedures for the handling of medicines were largely sound and service users were protected from harm as a consequence. EVIDENCE: The ‘Life Books’ detailed 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. Service users choose their own clothes, reflecting their individual personalities. Times of getting up and going to bed are flexible but are governed to some degree by daily activities. The administration of medication was inspected and was found in general terms to be following the Royal Pharmaceutical Society of Great Britain’s guidelines. The home did not have a current copy of the guidelines and it was advised that a copy should be obtained as soon as possible. It was also Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 14 advised that prescriptions are collected by the manager or designated person and signed for on behalf of the service user, if they are unable to do so themselves, before being submitted to the pharmacist as stated in section 4.7 of the above guidelines. Good examples of PRN protocols were seen which provided guidance to all staff. The home had recently written to families to obtain their wishes over terminal care and death. This had been dealt with in a sensitive and caring manner. The home was still waiting for one response. Responses were recorded in the service user care plans. The manager stated that with regards to terminal illness, the home would endeavour to keep a service user for as long as it was medically possible. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.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) 21,22 Service users and their families have access to a sound complaints policy and procedures which ensures that their complaints would dealt with effectively. Whilst the service users are protected by the home’s Adult Protection Policy in place the home needs to ensure that its policy reflects that of the local authority. 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. The policy also included a Whistle Blowing procedure which staff were fully aware of. The homes Adult Protection policy varied from the Kent and Medway’s recognised policy in that it stated that the home would carry out an initial investigation into any incident. It was advised that this was carefully considered as the Kent and Medway’s procedure advises homes to contact the Adult Protection Co-ordinator first. This is done to prevent any potential evidence being compromised. The manager was an Adult Protection trainer and was expecting to update staff awareness in the very near future. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,29 and 30 Service users benefit from living in a safe, largely well-maintained, clean and homely environment which offers privacy and comfort, reflecting individual tastes so enabling service users to live in a ‘homely’ environment. EVIDENCE: The home was clean, tidy and smelt fresh and is well maintained and suitable for its purpose. There is a spacious communal lounge and dining area which service users can access as they want. The kitchen was clean and tidy and service users were observed moving freely around the home. Although service users did not have keys to their individual rooms, one did have a front door key to enable her to maintain her independence. The inspectors were invited into two of the service users bedrooms and these were well furnished and individualised to suit personal tastes. Both bedrooms were personal to the service user and reflected their interests and lifestyles. The third bedroom contained a specialist bed with cot sides and bumpers and was decorated with the help of the service users family and was pleasant and well personalised. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 17 Evidence was of one specialist armchair in the lounge and suitable moving equipment was also observed. This equipment had been recently serviced. The bathroom was small but the manager stated that the service users coped well in the room. The laundry room was seen and although the floor had been recently replaced with a vinyl covering, it was badly puckered and was a danger to staff or service users using the room. It will be a requirement that the flooring is relaid in a safe manner. The laundry was sited so that soiled items were not carried through food preparation areas and did not intrude on service users Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 36 Service users benefit from receiving care from staff who are properly inducted and receive regular on-going training. However, the care of service users might be compromised because staff do not receive regular supervision. EVIDENCE: There was some evidence of a recent comprehensive induction process and training undertaken by members of staff, however the organisations policy appears to be not to keep full staff records on the premises, so therefore the inspectors were unable to make a fully informed judgement with regards to the extent of staff training and competencies. The home would benefit from improved staff records within the home. Supervision was sporadic and needed to be more regular. The NMS state that supervision should be regular, recorded and take place at least six times a year, in addition to regular contact on a day-to-day practise. A record should be kept to evidence that supervision is taking place. The manager stated that appraisals do take place but this could not be evidenced on the day of the inspection. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 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 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) 37,41 and 42 The service users benefit from a manager who is clearly committed to safeguarding and promoting individuals independence, rights and choices and is assisted by a stable staff team who offer a good quality of support to the service users. The well-being of service users is put at risk from the excessively hot water supplied by the home. EVIDENCE: The Manager has nearly completed the NVQ 4 in Management and is just about to start the NVQ 4 in care. It was evident through observation that the manager and staff are approachable, and service users were clearly at ease when approaching anyone for advice or assistance. There are structured weekly plans in place for Residents, which also allow for flexibility and reflect their personal choices and the manager and staff were observed working with service users in maintaining the smooth running of the home. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 20 It was also observed that although the office area is accessible for both staff and service users confidential records for both staff and service users were locked away. This maintains the privacy and dignity for all in the home. Not all of the areas of safe working practises were assessed but it was noted that the hot water was very hot. Evidence could not be found that regular regulation of water temperature was being recorded. This could put service users and staff at risks of scalding. It will be a requirement that water temperature are regularly recorded and monitored with appropriate action taken and recorded. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 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 3 x x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 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 (Anchor House) Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 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. 1. 2. Standard YA42 YA30 Regulation 13 13 Timescale for action Hot water temperatures must be August 31st regulated and recorded to reduce 2005 the risk of scalding The flooring in the laundry room August 31st must be relaid 2005 Requirement 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. 3. Refer to Standard YA23 YA34 YA6 Good Practice Recommendations It is recommended that consideration be given to adopting the Kent and Medways Adult Protection Policy It is recommended that staff records be maintained at the home It is recommended that service user files are more streamlined for ease of use. Broadview (Anchor House) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent 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) H56-H06 S29018 Broadview V234575 290605 Stage 43.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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