CARE HOMES FOR OLDER PEOPLE
Broadwaters 55 Wick Lane Tuckton Bournemouth Dorset BH6 4LA Lead Inspector
Marjorie Richards Unannounced 2 August 2005 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 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 D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 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 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 Rita Fisher CRH PC - Care Home Only 27 Category(ies) of OP Old Age (27) registration, with number of places Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered persons must comply with any requirements of the building control officer concerning works undertaken to the premises. 2. 16 of the 27 beds are for intermediate care and 11 are for respite care. Date of last inspection 28 February 2005 Brief Description of the Service: Broadwaters is managed by Bournemouth Borough Council Social Services Directorate. 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 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, 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 9 respite care service users and two permanent service users 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. The home is surrounded by extensive grounds that are easily accessible 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.
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours on the 2nd August 2005 and was one of the two statutory inspections carried out each year. The main purpose of the inspection was to check that service users were safe and properly cared for and to check if progress had been made in meeting the two requirements and two recommendations from the previous inspection. A tour of the premises took place and the interaction between management, staff, service users and visitors was observed. A variety of records and related documentation were examined including the care records for four service users. Time was spent talking with ten service users, as well as Mrs Fisher (Manager), the Deputy Manager, the staff on duty and two visitors to the home, in order to get a real feel about life at Broadwaters. What the service does well:
Information about the services provided at Broadwaters is available for prospective service users, including large print and audio versions. Preadmission assessments are carried out and service users and their relatives are encouraged to contribute to assessments and care plans. For those receiving intermediate care (rehabilitation) a self-contained unit within the home is provided and a multi-disciplinary team is available to ensure service users are helped to maximise their independence before returning home. Service users speak highly of the service provided, I have found everyone here to be very helpful and supportive. They want you to succeed. The health and personal care needs of service users are well provided for. Service users confirm they are well cared for and treated with respect and dignity. Staff were observed throughout the inspection to be treating service users with courtesy, patience and kindness. The need for privacy is respected. The majority of service users are only in the home for a short time, but a range of activities is available. Well balanced and nutritious meals are provided and specialist diets are catered for. Service users speak highly of the meals provided, e.g. The food is very good. I havent eaten so well in ages. Broadwaters is well maintained and equipment is regularly serviced to ensure that service users live in safe and comfortable surroundings. The home offers
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 6 a range of communal space, including lounges, a smoking room, hairdressing room and spacious dining room. Broadwaters is set in very attractive, spacious, well-kept grounds and the front of the home boasts spectacular views across the River Avon towards Christchurch. Seating is provided and service users also have access to patio areas and a summerhouse. The Manager is assisted by a team of experienced care, catering, cleaning, laundry, clerical and administrative staff. In the rehabilitation unit, service users have access to a multi-disciplinary team, including Occupational Therapists and Physiotherapists. Service users commented favourably about staff, “They are always there when you want them.” Nothing is too much trouble for the staff, they are very supportive.” A visitor said, The staff do a marvellous job. They show endless patience and understanding.” Working relationships between the management, staff, service users and visitors are friendly, yet professional, contributing to a happy, relaxed atmosphere where service users feel at ease. A member of staff said, I enjoy my job and I enjoy coming to work. The views of service users are actively sought and the results of Quality Assurance questionnaires are collated. This ensures that Broadwaters listens to what people say and offers the best possible provision to service users. What has improved since the last inspection?
Continuous investment in the upkeep of the home ensures that standards of constantly improving. Since the last inspection, new carpets have been fitted in three bedrooms and the lighting in lounges has been improved. Work has been progressing to replace windows throughout the building. New windows have now been completed in all bedrooms and lounges, with further work on kitchen and dining room windows now being planned. The Day Centre, which used to operate from two large lounges on the ground floor, has now closed leaving additional space available to service users. Plans are in hand to create a Medical/Treatment room within the next month. Following the previous inspection, there were two requirements and two recommendations made. For those Standards not examined in full during this inspection, sufficient time was allowed to assess whether or not progress had been made in meeting these requirements. Both requirements and one of the recommendations have been met. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 7 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.
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 6 Information provided about Broadwaters and a thorough admissions procedure allows prospective service users to make informed decisions about admission to the home and ensures that only those who would benefit from the service are offered places there. Those admitted solely for intermediate care (rehabilitation) are helped to maximise their independence before returning home. EVIDENCE: Broadwaters has a range of printed information about the services provided for intermediate (rehabilitation) care and short-term (respite) care, which includes large print and audio versions. The home’s Service User Guide (Information Pack) gives a good indication of what a service user can expect from the home and is available in each bedroom. Broadwaters has a written admissions policy which, for example, requires that rooms are fully prepared prior to admission and staff explain the home’s routines and facilities to new service users on arrival. One service user commented: Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 10 “I was anxious about coming here, but the staff soon helped me to settle in.” Two new admissions took place during the afternoon of the inspection and staff were observed providing a warm welcome and putting people at their ease. All service users are admitted to the home through Local Authority care management arrangements and consequently they all receive community care assessments. Individual care records are kept for each service user and four of these were examined. All showed that, prior to moving to the home, care needs had been fully assessed by Social Services Care Managers. Service users and their relatives are encouraged to contribute to assessments and care plans. Accommodation on the first and second floors at Broadwaters is dedicated specifically to an intermediate care service, providing rehabilitation to help people live independently in their own homes. This unit is self-contained and includes rehabilitation kitchens where service users may relearn, adapt and/or acquire skills needed for daily living. The kitchens are fitted with domestic appliances of the sort to be found in service users own homes. Service users are admitted for rehabilitation from hospital or the community and staff at Broadwaters are supported by members of the Community Assessment Rehabilitation Team. (CART). This means that service users have access to Physiotherapists and Occupational Therapists who are responsible for devising rehabilitation programmes. Access to medical advice is also available whenever necessary. Care records show that each discipline has a section of care notes to complete and these are well detailed and informative. Wherever possible, service users are encouraged to take responsibility for their own medication. Arrangements can be made for service users to visit their own homes with a Care Manager and Occupational Therapist prior to discharge to ensure that any necessary equipment etc is in place. Care plans are reviewed at least weekly in addition to a daily ‘case conference’ to discuss each service users progress. A final case conference takes place shortly before discharge and an Assistant Care Manager based at Broadwaters follows up with a multi-disciplinary review in the service users own home two weeks after discharge. Service users commented, They (staff) dont let you sit still for long, they keep you on your toes. They are determined to get you as fit as possible. I have found everyone here to be very helpful and supportive. They want you to succeed. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Broadwaters has a detailed care planning system in place, which ensures that staff have the information they need to meet the needs of service users. Excellent support from Broadwaters staff and community health professionals helps to ensure that the health needs of service users are well met. The home encourages service users to be responsible for their own medicines where appropriate. Although improvements have taken place, some staff do not follow correct procedures when administering medicines and this has the potential to put service users at risk. Service users are treated with respect and their privacy and dignity is promoted at all times. EVIDENCE: Broadwaters is in a unique situation in that the Local Authority’s Care Managers carry the out pre-admission assessments. For those receiving respite care, the home draws up its own Programme of Care, based on these assessments. The home reviews care plans as necessary but with the exception of two, the service users are only in the home for very short periods of time.
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 12 When a service user is admitted to for rehabilitation, the multi-disciplinary team carries out an assessment and devises a detailed day and night care plan, which is reviewed at least weekly. Discussion with service users and staff, evidence from records and attendance at the afternoon handover session on the Rehabilitation Unit shows that the health/care needs of service users are promoted and well maintained. For instance, the care plan shows one service user to be an insulin controlled diabetic. Staff demonstrated their awareness of this, including the provision of a suitable and varied diet. Care notes show attention to the needs of the individual, for example, Usually wakes during the night to have a drink. Needs assistance with this and then help to resettle. Staff discussion at handover sessions shows a regular updating of information and an opportunity for all to express their views. The manager and staff confirm that a chiropodist regularly visits the home and service users have access to the ‘flying dentist’ and a visiting optician service, when necessary. Risk assessments are in place and appropriate steps are taken to minimise any risks identified. The Commission for Social Care Inspection Pharmacist Inspector visited Broadwaters on 18/7/05 to inspect the medication arrangements. Two requirements and three recommendations were made as the result of this inspection. One requirement has now been met but examination of the Medicine Administration Records (MAR) showed there were still a few gaps, where staff had not signed when medicines had been given or used a code letter to indicate the reason for non-administration. This requirement is therefore carried forward. The Manager is currently planning implementation of the three recommendations. Staff were observed throughout the inspection to be treating service users with courtesy, kindness and respect. Service users have their own single bedrooms, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. Service users commented, The staff here are excellent. They are always polite and always knock on your door before coming in. The staff make us work hard but we can share a laugh and joke. They are always polite and respectful. One of the first things they asked me when I arrived was what did I want to be called. I can be on my own if I choose to. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 A range of activities and events provide variation and interest for service users and satisfies their social, religious and recreational needs. Broadwaters serves a balanced and varied selection of food that meets service users’ tastes, choices and special dietary needs within pleasant surroundings. EVIDENCE: The majority of service users are only in the home for a short time, but some information is recorded about social and recreational care needs. Service users have access to televisions, music, a selection of books, (including large print) board games, cards, dominoes, jigsaw puzzles etc. Armchair ball games and exercises to music are arranged and some service users like to participate in painting or quizzes. A monthly inter-denominational communion service is held within the home and arrangements are made for clergy to visit individual service users if required. Service users commented, I like to watch Songs of Praise on television on Sundays. I can see it better here as the television has a large screen. (Service user, respite.) There is not a lot in the way of activities but that suits me quite well as I can entertain myself. (Service user, rehabilitation.) I enjoy a good quiz and wish we had them more often. They are good fun. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 14 Lunch on the day of inspection started with a choice of fruit juice, then roast chicken with bread sauce, roast and boiled potatoes, cauliflower, runner beans and gravy, OR sweet and sour pork with rice. This was followed by jam tart with custard, milk jelly or a variety of fresh fruit and tea/coffee. Special diets are catered for, as necessary. It is expected that service users will usually eat together in the dining room, unless they are unwell or have individual care needs. Meals take place in a relaxed, unhurried atmosphere with discreet staff assistance and support provided wherever necessary. The timing of meals can be flexible to fit in with care needs, appointments etc. It was good to see some service users lingering in the ground floor (Respite) dining room for a chat long after lunch was finished. The menu shows that service users enjoy a healthy, well-balanced diet with plenty of fresh produce. Special diets can be provided. Service users said they appreciated the way in which individual preferences were catered for. Service users commented, The food is very good. I havent eaten so well in ages. Since coming here for my holiday, Ive had huge breakfasts, a threecourse dinner and then we can have a cooked tea as well. It is like a first-class hotel here. If you cant eat what is on the menu, they provide you with something else. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 A system is in place for dealing with complaints. Service users are confident that any complaints would be listened to and dealt with appropriately. EVIDENCE: The home has a complaints policy and procedure that is included in the information provided to service users or their representatives. A copy is provided in the home’s information pack, which is available in every bedroom. No complaints have been received by the home or the Commission since the last inspection. Service users spoken to said they had no concerns, I have absolutely no complaints about anything here. I have no concerns about this place, it is very well run. No one could find anything to complain about here Im sure. One service user said, “ If I was worried about anything, I would tell the staff or the person in charge. I feel sure they would put it right straight away.” Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 26 Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for service users, where standards are constantly improving. The home provides a variety of communal areas, including attractive grounds that are easily accessible to service users. Broadwaters is clean with no unpleasant smells, making daily life more pleasant for all in the home. EVIDENCE: Maintenance records show that continual work is carried out to keep the home and grounds in good condition and to ensure a safe environment for service users and staff. Equipment, such as hoists, portable electrical appliances and the passenger lift are routinely serviced at the recommended intervals. Records demonstrate that appropriate maintenance and checks of the fire warning system, emergency lighting and fire fighting equipment are taking place to ensure service user safety. Staff confirm that fire training and drills
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 17 are also taking place at the required intervals, so they are fully aware of what to do in the event of fire. Since the last inspection, work has been progressing to replace windows throughout the building. New windows have been fitted in all bedrooms and lounges with further work on kitchen and dining room windows now being planned. New carpets have been fitted in three bedrooms and the lighting in lounges has been improved. All radiators throughout the home are guarded to ensure service users are protected from the risk of suffering burns. Hot water temperatures were tested at baths and found to be close to the recommended temperature of 43C, to prevent any risk of scalding. Broadwaters offers a variety of communal space to service users. There are small lounges and dining rooms in the Rehabilitation Unit. The day centre, which used to operate from two large lounges on the ground floor, has recently closed. These rooms are now accessible to service users and, in addition to existing communal space, have allowed the home to provide a choice of sitting areas, a smoking lounge, hairdressing room and a spacious dining room. There are extensive grounds that are easily accessible to service users, with plenty of seating for those who wish to sit outside. At the front of the home there are spectacular views across the river Avon to Christchurch. Service users commented, I love sitting outside. How can anyone feel downhearted when sitting here looking at such a wonderful view? Why go abroad for a holiday when you can come and stay here? A number of service users were sitting outside with their visitors, enjoying the summer sunshine. One visitor commented, The view is a tonic in itself. My relative has made so much progress since coming here. One service user, a keen gardener, has a small patch of garden to look after. It would be helpful if some assistance could be given to prune back the shrubs etc in this area to make the gardening experience more pleasurable. The home is clean throughout and there are no unpleasant smells. Suitable facilities and procedures are in place in respect of laundry and the disposal of clinical waste. A service user commented, They work very hard to keep everything clean and tidy here. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The numbers and skill mix of staff are sufficient to meet the needs of service users. EVIDENCE: The staff • 1 • 6 • 26 • 7 • 3 • 1 team for the home, excluding the registered manager, comprises: Deputy Manager Assistant Managers (plus 2 relief assistant managers) Care Assistants Ancillary staff (3 catering staff, 3 domestic and 1 laundry assistant.) Clerical and administrative staff Assistant Care Manager The Manager is assisted in the running of the home by a Deputy Manager and a team of experienced care, catering, cleaning, laundry, clerical and administrative staff. The weekly staffing roster shows sufficient staff on duty throughout the day, including wakeful staff at night. The Manager is still using Agency staff from time to time, although always seeking to achieve continuity from the Agency, with the same members of Agency staff being sent to Broadwaters. There are some staff vacancies at the moment and the home is actively trying to recruit new members of staff. In addition to the home’s care staff the Community Assessment and Rehabilitation Term (CART) and Primary Care Trust (PCT) provide 1.25 whole time equivalents of Occupational Therapy staff and 0.75 Physiotherapy staff
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 19 and dedicated time from district nursing staff. Service users commented about staff, “They are always there when you want them.” Nothing is too much trouble for the staff, they are very supportive.” A visitor said, The staff do a marvellous job. They show endless patience and understanding.” Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 33 The Manager is qualified and experienced in care and management. Clear leadership is provided throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The home regularly reviews its performance and actively seeks the views of service users to ensure the home is run in their best interests. EVIDENCE: The registered Manager is not only experienced, with some 13 years in post at Broadwaters, but she also has previous experience in management posts in other care homes. She holds a Diploma in Social Work, a Certificate in Management and has just completed the first part of a course in care management. The Deputy Manager has recently completed a National Vocational Qualification (NVQ) level 4 in care and holds a certificate in Social Care. She is hoping to commence a degree course shortly. Both the Manager and her Deputy keep themselves updated by regular attendance on training
Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 21 courses, seminars etc. There is a clear management structure in place within the home and this is set out in the information available in each service users bedroom. Working relationships between the management, staff and service users and relatives/visitors were directly and indirectly observed throughout the course of the inspection. They were amicable, yet professional, contributing to a welcoming and relaxed atmosphere, which was beneficial to all in the home. Discussions with staff show that they are clear about their roles and responsibilities within the home and feel they are an important part of the multi-disciplinary team. They speak positively about Mrs Fisher and her management approach. Mrs Fisher is supportive and helpful. You can always talk to her. If I had a problem, I know I could talk to the Manager and she would listen. One service user commented, This place is so much better than hospital. I can relax here, I am in safe hands. A member of staff said, I enjoy my job and I enjoy coming to work. We all work together here, we are all part of the same team. The views of service users are sought informally throughout their stay in the home. They are also asked to complete a Quality Assurance questionnaire before they return to their own homes. The Manager looks at all completed questionnaires to pick up on any feedback and take appropriate action wherever needed. (She is currently looking at providing similar questionnaires for other visitors to the home.) Information from questionnaires is collated annually and used to ensure the best possible service is offered. Most of the comments received are very positive, for example: • • • • • The staff were very cheerful, especially when I was low. I was very pleased with the hairdresser service. My stay has been very pleasant. I can find no fault. Patience is a virtue they say; there is plenty of it here. ”There is ample choice of diet and the food is well cooked. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 4 x x x x x 3 STAFFING Standard No Score 27 4 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 x x x x x Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Timescale for action It is a requirement that staff sign 30/08/05 the MAR chart to record when medicines are given or the reason for non-administration. The Manager must introduce a system for regularly monitoring MAR charts with the audit trail to confirm that medicines are given as prescribed and recorded. 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. Refer to Standard 9 Good Practice Recommendations It is recommended that the home should follow guidance from the Royal Pharmaceutical Society: 1. Staff should administer medicines from the labelled container in which the pharmacy supplied them. They should not be re-dispensed by one member of staff for others to administer. 2. The medicines policy should be updated to include the recommended additions. 3. When staff handwrite the details of prescribed medicines onto the medicine chart a second competent person should countersign to confirm that all the details are correct.
D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 24 Broadwaters 2. 3. 9 9 4. 20 5. 25 4. The home should have a clear audit trail for medicines not in MDS blister packs, e.g. by recording when a new container is started or entering a carry forward balance on the MAR chart. 5. If the service user has no known medicine allergies this should be recorded on the MAR chart. It is recommended that the Controlled Drugs cupboard be fixed to a solid wall with rag or rawl bolts to comply with the Misuse of Drugs (Safe Custody) Regulations 1973. It is recommended that all staff who administer medicines should have accredited training on medicines, how they are used and how to recognise and deal with problems in use. It is recommended that occasional assistance should be offered to the service user with their own patch of garden to prune back shrubs etc and make the garden more easily accessible. It is recommended the registered person should install some means of enabling service uses to control the level of heating in their bedrooms. Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF 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 Broadwaters D55 S32041 Broadwaters V242419 020805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
