Inspection on 22/02/06 for Broadwaters

This inspection was carried out on 22nd February 2006.

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

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

Other inspections for this house

Broadwaters 14/05/07

Broadwaters 23/01/07

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 Debra Jones Unannounced Inspection 22nd February 2006 09:40 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.V284706.R01.S.doc Version 5.1 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.V284706.R01.S.doc Version 5.1 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 Rita Fisher Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 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. 2nd August 2005 Date of last inspection Brief Description of the Service: Broadwaters is manages 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 included health care professionals wither 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 DS0000032041.V284706.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 2 hours on 22 February 2006 and was the second of the two anticipated inspections of the year. The purpose of the inspection was to assess the home against core national minimum standards not assessed at the last inspection and to follow up on the 1 requirement and 5 recommendations made at the previous inspection to see if they had been addressed. The inspectors looked around the home and a number of records and related documentation were inspected. Gail Hurst – the acting manager assisted the inspectors. Inspectors would have wished to have met and chatted with some residents in order to get a feel for what it is like to stay at Broadwaters but as a number of people at the home were unwell this was not possible. Prior to the inspection comment cards were sent out by the home on behalf of the Commission. Of those returned 8 were from residents, 3 from GP surgeries, 5 from care managers, 1 from a social care professional and 4 from relatives / visitors. Most comment cards returned were very positive about the staff and service provided at the home. ‘I wish to thank everybody here for all their kindness and help’ (a resident) ‘A happy and caring home’ (another resident) ‘Very well run and organised’ (another resident) ‘This was my mothers’ fist visit for respite to Broadwaters and she was (in her own way) very positive and complimentary about the staff.’ (a relative) ‘I have been visiting patients at Broadwaters since 1979! Excellent.’ (a GP) ‘Staff have a very positive caring attitude and provide an excellent level of care.’ (another GP) ‘I have worked with Broadwaters respite facility and staff for two years. I have always found them to offer a professional and supportive service.’ (a care manager) Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Residents, relatives, friends and staff need to be clear about visiting arrangements and these should be as they would be for anyone living in the community. In order that residents are fully protected from abuse staff need to have training in this area. It would be helpful if occasional assistance could be offered to the service user who looks after a small patch of garden. Pruning back the shrubs etc in this area would help make the garden more easily accessible and provide greater pleasure for the service user. The recommendation made at previous inspections regarding control over the level of heating in bedrooms, is carried forward as no resolution has been achieved. Identified gaps in staff pre employment checks have to be addressed. These are important as they help ensure that only the right people look after residents at the home. It will be good for the home to have a permanent manager in post. Policies and procedures that underpin the practice at the home and the care of residents should be regularly reviewed, and updated where needed. The home must stay on top of all matters relating to health and safety to ensure the safety of residents, staff and visitors to the home. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 7 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 DS0000032041.V284706.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 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 the following standard(s): (Standards 1 and 3 were met at the last inspection. Standard 6 was exceeded) EVIDENCE: None of these standards were assessed on this occasion. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 10 (Standards 7 and 8 were met at the last inspection) The home is making progress towards managing medication more effectively in order to promote and evidence the good health and well being of residents but short falls in practice have a potential to place residents at risk. Service users are treated with respect and their privacy and dignity are promoted. EVIDENCE: The Commission Pharmacy Inspector visited the home on 16 December 2005. The judgement above was made at this visit. Since this time Broadwaters have arranged to get support from the Community Pharmacist in respect of people self-medicating and to do an audit of medicines. Due to this currently being incomplete this standard was not assessed. However the requirements and recommendations made by the Commission Pharmacist are repeated in this report and will be followed up at the next inspection. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 11 Staff are introduced to the importance of treating people with respect and to respecting their dignity in their induction. Information to service users further confirms this commitment. Eight comment cards were returned to the Commission from service users. All 8 said that they felt well cared for, were treated well and that their privacy was respected. 7 of the 8 said that they liked living there. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14 (Standards 12 and 15 were met at the last inspection) Information provided encourages visitors at any time but recently the home has been trying to restrict visiting hours. Residents are helped and encouraged to exercise choice in their daily lives at the home. EVIDENCE: Information provided to residents and their supporters encourages visitors to come to the home at any time. Due to the nature of the service and the perceived need for residents to have uninterrupted rehabilitation sessions the home has had a trial period where they have been trying to restrict visiting times. Signs were posted around the home and were in residents’ bedrooms to this effect. The acting manager said that this was not going to continue and that visiting hours would be unrestricted but this message had not been absorbed by all staff. Four relatives returned comment cards to the Commission prior to the inspection. All said that they felt welcome in the home at any time and that they could visit their relative / friend in private. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 13 Residents and their supporters are made aware of the choices that will be available to them in the information that the home provides. Residents undergoing rehabilitation are given choices as to what they do with their time outside of the programmes they are on and where they spend their days. Most other residents are at the home on a respite basis and can do as they wish. Residents were seen being offered choice in where to spend their time and what to do. A variety of communal areas are available or residents can relax in their rooms. One resident talked of how she chose when she got out of bed and went to bed and of how she was asked about what she wanted to eat daily. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 (Standard 16 was met at the last inspection) Bournemouth Borough Council’s adult protection policy demonstrates their commitment to understanding abuse and of protecting residents in their care. However not all staff have been trained in this subject. EVIDENCE: The adult protection policy made available at the inspection was dated May 2001 and there was no evidence to show that it had been reviewed since that date. The policy did not make reference to the Protection of Vulnerable Adults list, which was introduced in July 2004. It was not clear from records which staff had been trained in this subject. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 15 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 the following standard(s): (19, 20 and 26 were met at the last inspection. Standard 20 was exceeded) EVIDENCE: None of these standards were assessed on this occasion. However it was noted at the last inspection that ‘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.’ It was also noted that ‘all radiators throughout the home are guarded to ensure service users are protected from the risk of suffering burns’. But the residents were not able to control the temperatures in their rooms. Neither issue has been addressed and so the recommendations made at the last inspection are repeated. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 (Standard 27 was exceeded at the last inspection) Sufficient well-qualified care staff are employed and deployed to endeavour to meet the care needs of residents, however training could not be evidenced. Recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home but gaps in essential pre employment checks leave residents at risk of having unsuitable people working at the home. EVIDENCE: Information provided showed that the home has achieved the Department of Health target of having 50 of care staff with the NVQ level 2 in care qualification. Inspectors were told that since the last inspection only one new member of staff had begun working at Broadwaters. Their file was inspected. Most necessary documentation that should have been in place was in place with the following exceptions:• The required check against the Protection of Vulnerable Adults (POVA) list was missing – the returned certificate stated that this check had not been requested. • The person’s full employment history was not documented. • There were no statements as to the person’s mental and physical health or about any criminal offences. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 17 Agency care workers supplement employed staff. A policy governing how the home ensures that these staff have the appropriate pre employment checks and suitable and up to date training was not available. Staff were unclear about how these matters were checked and where evidence of these checks would be held. Whilst there was nothing to indicate during the inspection that staff had not been appropriately trained to do their jobs, no recent records could be found to demonstrate that this was the case or that staff were receiving the regular updates to their training as required. Staff attend corporate inductions but there was no evidence that inductions specific to the very specialised service that Broadwaters provides take place. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 (Standards 32 was met at the last inspection) Residents will benefit from a permanent manager being in post. Policies and procedures are not sufficiently up to date to properly underpin the practice at the home and the care of residents. Residents can have confidence in the manner in which their money is being handled at the home. Insufficient records were available to confirm the health and safety of all in the home. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 19 EVIDENCE: Since the last inspection the registered manager has left the home. An acting manager is in place while the recruitment takes place. The policies seen at the home were in the main corporate i.e. covering all Bournemouth Borough Council employees. None were seen that were specific to Broadwaters aside from the statement of purpose / service user guide. Policies and procedures available had not been reviewed / updated in the last 12 months. The following policies / documentation were identified as needing updating:• Statement of purpose (with management arrangements and shift towards more rehabilitation and respite) • Adult protection (to include information about the Protection of Vulnerable Adults list (POVA)) • The recruitment and disciplinary procedures (again in respect of the POVA list) • Managing residents’ finances. The home holds a small amount of cash for residents who wish them to. Balances are kept and transactions signed appropriately. The member of staff who has delegated responsibility in respect of health and safety was not available at the inspection. Fire records were examined. Not all internal checks of fire equipment were up to date and records to evidence the regular required staff fire training could not be found. A risk assessment was seen for the building that was due for review in January 2006. Accident records were seen and these were well completed. Risk assessments are completed for residents. One was sampled for a resident, recently admitted to the home for respite. Aside from his respite need his primary need is his dementia. The home is not registered for this resident group and the risk assessment seen did not outline how the home was to ensure his safety given the level of his confusion and the nature of the home e.g. how they were to ensure that he remains in the home and safe from the road and river - both just outside, very close to the home. Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 20 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 2 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 21 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 OP9 Regulation 13(2) Requirement Timescale for action 28/02/06 2. OP18 13 (6) The registered person must make arrangements for the recording, handling, safekeeping and safe administration of medicines: • The current procedure for re-dispensing medicines must be reviewed. • Medicines dispensed for one resident must not be kept as stock to use for others. • 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. Risk assessments for selfmedication must be regularly reviewed. The registered person shall make 01/04/06 arrangements, by training staff or by other measures, to prevent residents being harmed or suffering abuse or being place at risk of harm or abuse. DS0000032041.V284706.R01.S.doc Version 5.1 Broadwaters Page 22 3. OP29 19 and sch 2 4. OP30 18 (1) 5. OP38 23 (4) 6. OP38 13 (4) It is required that pre employment checks be made and records kept of these for all staff working at the home according to the Care Home Regulations - Regulations 10 and schedule 2 (as amended through statutory instrument 2004 no 1770 - which came into force on 26 July 2004). The registered person must ensure that staff receive training appropriate to the work they are to perform, including structured induction training. The registered person shall after consultation with the fire authority make adequate arrangements for the testing of fire equipment at suitable intervals and make arrangements for persons working at the home to receive suitable training in fire prevention. The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 01/04/06 01/04/06 01/04/06 01/03/06 Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 23 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 OP9 Good Practice Recommendations The home should follow guidance from the Royal Pharmaceutical society in The Administration of medicines in Care Homes and Children’s Services: • 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. If they are there should be a record of accountability, including if changes are made. • When staff handwrite the details of prescribed medicines on to the medicine chart a second competent person should countersign to confirm that all the details are correct. • 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. • Staff should sign the MAR chart immediately after the medicine has been given not before. Residents should be able to receive visitors at any reasonable time. It is recommended that occasional assistance 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 install some means of enabling service uses to control the level of heating in their bedrooms. Policies and procedures should be updated / reviewed annually. Where needed, new policies / procedures should be developed. 2. 3. OP13 OP20 4. 5. OP25 OP30 Broadwaters DS0000032041.V284706.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole 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 DS0000032041.V284706.R01.S.doc Version 5.1 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. 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