Inspection on 14/05/07 for Broadwaters

This inspection was carried out on 14th May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Broadwaters 23/01/07

Broadwaters 22/02/06

Broadwaters 02/08/05

Broadwaters 28/02/05

Broadwaters 09/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Broadwaters 55 Wick Lane Tuckton Bournemouth Dorset BH6 4LA Lead Inspector Martin Bayne Key Unannounced Inspection 14th May 2007 09:30 X10015.doc Version 1.40 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 Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadwaters Address 55 Wick Lane Tuckton Bournemouth Dorset BH6 4LA 01202 423709 01202 429923 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) Bournemouth Borough Council Vacant Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The registered persons must comply with any requirements of the building control officer concerning works undertaken to the premises. 16 of the 27 beds are for intermediate care and 11 are for respite care. 23rd January 2007 Date of last inspection Brief Description of the Service: Bournemouth Borough Council Social Services Directorate manages Broadwaters. Situated in the Tuckton area, local shops, cafe and a library are within half-mile level walking distance of the home. There are pleasant riverside walks with a ferry into Christchurch. The home provides respite/short stay, assessment and intermediate care/rehabilitation for 27 older people who live in the Borough of Bournemouth. The service enables individuals to remain living in the community for as long as possible by providing respite for carers and helping service users to regain or learn skills, and improve their health so they can return home after a hospital stay or alternatively prevent admission to long term care. The home is purpose built with a passenger lift to all three floors. Separate facilities are provided for the 16 service users receiving intermediate care on the first and second floors and the 10 respite care service users and one permanent service user accommodated on the ground floor. All bedrooms are for single occupancy and do not have en-suite facilities, but there are sufficient bathrooms and toilets available on each floor. Extensive grounds that are easily accessible surround the home and garden furniture is available. The staff group for the intermediate care service includes health care professionals either employed or contracted to work in the home and the establishment works closely with the local Primary Health Care Trust and the Community Assessment and Rehabilitation Team. Fee Range: - Full fee:- £431.00 per week, basic fee:- £89.45 per week, temporary fee-£94.45. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of the home and was carried out between 9:30am to 4:15pm. The aim of the inspection was to evaluate the home against the key standards for older people and to follow up on the eight requirements and recommendations made at the last inspection in January 2007. The inspectors were assisted throughout the inspection by the manager and several members of staff. Records providing evidence of the care provided in the home were seen and a tour of the premises was made. At the time of inspection there were 19 residents accommodated in the home, with six vacancies in the intermediate care section of the home and 2 in the respite/assessment area. About half of the residents were spoken with about their experience of living in the home and the feedback was very positive. What the service does well: What has improved since the last inspection? Care planning for the residents on the ground floor has been improved. Risk assessment processes are improving. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 6 Medication procedures are better recorded allowing for full auditing of medications brought into the home. An activities co-ordinator has been employed to better meet social and recreational needs of residents. A training plan has been put in place to ensure that staff receive mandatory training. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents benefit from being informed and involved in the assessment process when choosing a placement at Broadwaters and being helped to maximise their independence when placed for intermediate care. EVIDENCE: The ground floor of the home provides a service for people in need of respite care, a period of assessment or an emergency placement. There is also one person on a long-term placement who lives in the home. This person was able to make the choice of staying at the home long term at the time when the home made the change to providing intermediate care. The upper two floors are dedicated to the provision of intermediate care. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 9 Referrals for intermediate care in the majority of cases come through local hospital referrals but in some cases through GP or community referrals. With regards to the ground floor, referrals are made through care management arrangements. Since the last inspection the Service User Guide has been updated and now provides up to date information about the home and the services provided. A copy of the Guide is provided in each bedroom so that the residents are fully informed about the home. The manager informed that referrals are screened through the assessment process to ensure that the needs of people can be met at the home. A sample of three personal files of residents was used throughout the inspection to track the paperwork that the home must keep up to date, providing evidence of the care practices of the home. It was found in all three cases that an assessment of need had been carried out that was detailed and it was clear that the home only accommodates people whose needs they are able to meet. The residents spoken with all said that their needs had been met and they had been involved in the process of arranging their stay at the home. The home meets all requirements for intermediate care as set out in the National Minimum Standards. Intermediate care is provided in a dedicated area with equipment for therapies and treatment. Residents are supported by trained staff, including physiotherapists and occupational therapists. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being involved in planning their care; their health needs being met with privacy and dignity in a home with procedures for dealing safely with their medicines. EVIDENCE: The care plans of the three residents tracked through the inspection were seen and these were all found to be of a good standard, setting out clear expectations of the staff on how to meet people’s needs. The plans were signed by residents and were up to date with reviews regularly taking place. There were also systems in place for keeping staff up to date with changes of residents’ progress. At the last inspection a requirement was made concerning the care planning for people accommodated on the ground floor for short-term Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 11 care. It was found at that time that there was no evidence of consultation between the home and these residents, with no plan as to objectives the home was working towards. It was found at this inspection that care plans had been developed for these residents with objectives being set. The residents spoken with in this area of the home said that they were very happy with the care that they received and could find no fault with the home. At the last inspection a requirement was also made concerning risk assessments in that they did not inform of the level of risk and did not translate how residents were to be safeguarded. Since the last inspection a new form had been devised and was being piloted for each resident that covered all areas of risk. From the records seen concerning the residents tracked through the inspection, where risks had been identified, care plans informed of the actions to be taken to minimise risk of harm to residents. A discussion took place with the manager concerning risk assessments. It was recommended that the risk assessment framework continues to be developed. Where risks are identified, an assessment should inform of the actions that should be taken as far as possible to eliminate that risk, balanced in the context of the resident’s right to make informed choices. From speaking with the residents and staff and from viewing the records of the residents tracked through the inspection, there was evidence that the health needs of residents were being met at the home. The home contracts with a local GP and residents are temporarily registered with this practice for the duration of their stay at the home. Within the records was evidence of pressure sores being treated in the case of two people who came from hospital to the home in this condition. There were also records of visits from chiropody, dental and optician services. At the last inspection a requirement was made concerning medication procedures and practices. At that time it was found not all medications could be audited through the records. At this inspection the medication records were seen for the residents tracked through the inspection. It was found that there were no gaps within the records, medicines could be audited and where hand entries had to be made, a second member of staff was checking and signing the record. Controlled drugs were being stored correctly and signed for. The requirement was therefore being complied with. All of the feedback when speaking with residents was positive. They informed that they were being well looked after and that the staff were respectful and mindful of their dignity. One resident commented, ‘the accommodation is five star and the human kindness is wonderful’. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their social needs and right to choice being promoted in a home where they are supported to maintain links with friends and families. EVIDENCE: At the last inspection a requirement was made concerning the meeting of social and recreational needs of residents on the ground floor. Since that time the home has appointed an interim activities co-ordinator and activities are being developed that meet the assessed needs of the residents. Records are maintained of activities arranged with residents and who has taken part. For those residents who like to spend time in their rooms, individual time is spent with those people. On the day of inspection residents were seen taking part in a music quiz leading to discussions on different subjects. A member of staff spoken with said, ‘ this is a lovely home to work in. It is such a luxury to have Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 13 enough time to talk to residents. It is so much better than other places I have worked in’. With the exception of one person, the home only provides short-term care that has specific objectives. For people placed for intermediate care, there are specific programmes agreed with them that aim to increase their independence, thus allowing them to have more control over their lives. The home has an open visiting policy and family and friends of residents are made welcome at the home. The menu for the day was seen, offering a choice of meal. All of the residents spoken with made favourable comments about the food provided. ‘the staff are marvellous, they do whatever I need and the food is good.’ ‘A1, 100 , food excellent, staff excellent’. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having access to a complaints procedure and from complaints being fully investigated; together with the protection of staff being trained in adult protection. EVIDENCE: Residents, by virtue of being accommodated in a service run by the local council have access to the complaints procedure that covers the right to complain about any council service. The home is also developing an internal complaints information sheet that complies with the National Minimum Standards. The Service User Guide also informs of residents’ rights to complain. The home maintains a log of both complaints and compliments. There was evidence that complaints are investigated and actioned appropriately. At the last inspection a requirement was made concerning the training of staff in adult protection. Since that time a programme of training has been put in place and three staff received this training in March with a further ten to undertake training later in the week that the inspection took place. The Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 15 requirement will remain in place until all of the staff have received this training. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean, well-maintained environment. EVIDENCE: On the day of inspection the home was found to be clean, in reasonable decorative order and free from any odours. The manager informed that since the last inspection re-decoration of some of the ground floor, including the main lounge had been carried out. There are plans for the activities room to be re-furbished. It was noted that two chairs in the activities room needed to Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 17 be replaced, as they were difficult to get out of. It was agreed that these would be removed and replaced. The home has a very pleasing outlook with views across the river. There are also large grounds and the manager informed that there were plans to develop the gardens with more plants and areas to sit. The manager also informed that it was hoped that the grounds could be made more secure as the river is a potential hazard for some residents. The home has a dedicated laundry area with two commercial machines, although one was out of order on the day of inspection. All bed linen in sent out to external launderers. On the day of inspection an agency member of staff was working in the laundry room and they informed that they had not received training in infection control. It is recommended that the manager look into this matter and ensure that some level of infection control appropriate for the duties of this person are provided if appropriate. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being staffed sufficiently and the staff being suitably trained; however, residents would be better protected by the home ensuring that the agency supplies suitable staff through obtaining a letter from the agency to inform that staff have been appropriately recruited and have the skills and competencies to carry out the tasks expected of them. EVIDENCE: At the last inspection a requirement was made concerning the levels of staff being provided on the ground floor. The manager informed at this inspection that there were difficulties in recruitment and that there was a higher level of agency staff working in the home than he would like. There was however a recruitment campaign underway and satisfactory levels of staffing being maintained through the use of agency staff. A deputy manager post, four assistant day managers and three night managers currently support the manager of the home. Three care staff are rostered to work on the ground floor, and two on each floor for intermediate Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 19 care. In addition specialist staff are employed, such as physiotherapists and occupational therapists for intermediate care. The residents spoken with informed that their needs were being met and that there were sufficient staff on duty at all times. The home has met the target of 50 of staff being trained to NVQ level 2 or above. All new staff at the home receive induction training that is aligned to ‘Skills for Care’ induction standards. At the last inspection a requirement was made concerning staff training, as it could not be confirmed that all staff had received their mandatory training. Since that time a training audit has been carried out and staff have been enrolled or training planned to ensure that all staff are up to date with training needs. The recruitment records for two staff employed since the last inspection were seen. It was found that in general the required recruitment checks were being carried out such as two references being obtained and a Criminal Bureau Check (CRB) and a check against the register of adults deemed unsuitable to work with vulnerable adults. However, in the case of both staff, there were no photographs of these staff and one did not have a full employment history as required. It was also found that concerning agency staff, there were no letters obtained from the agency to inform that all of the recruitment checks, as detailed in Schedule 2 of the Regulations had been taken up. The Registered Providers should also ensure that where agency staff are used they have the competencies and skills to be able to carry out the tasks expected of them, (reference the agency staff working in the laundry area, who said they were not trained in infection control). Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, run in the interests of the residents with their financial interests safeguarded. EVIDENCE: The manager is currently being registered with the Commission. Since the last inspection, an improvement plan has been sent to the Commission and this, together with the reports made under Regulation 26 and the findings from this Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 21 inspection, have demonstrated a commitment from the management to remedy the shortfalls identified at the last inspection. At this inspection significant improvements were found. At the last inspection it was recommended that policies and procedures be reviewed annually. The improvement plan informed that the current review would be completed later in the year. Feedback is obtained from residents about the quality of service they receive through exit questionnaires and the conversations had with residents during the inspection, attested to the home running in the interests of the people living there. The home safe keeps small sums of money on behalf of residents if they wish. The records for one of the residents tracked through the inspection was seen and good records were being kept with withdrawals, entries and a balance of money being recorded together with receipts for money spent. The balance was checked and this tallied with the money held. Records were seen of formal supervision sessions with the staff. The fire log book was seen and it was found that tests and checks to the fire safety system were being carried out to the required timescale. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes 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 OP29 Regulation 19 (4) Requirement You are required to make sure that agency staff are fit to work in the home and that you obtain a letter in respect of these staff from the agency to confirm that all the requirements of Schedule 2 have been met. Timescale for action 01/06/07 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 OP7 OP27 OP18 Good Practice Recommendations It is recommended that you continue development of the risk assessment process and documentation. It is recommended the staff recruitment campaign continue so that the home is less reliant upon the use of agency staff. It is recommended that the planned training of staff in adult protection continues. Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Broadwaters DS0000032041.V339973.R01.S.doc Version 5.2 Page 25 - 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. 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