Inspection on 19/07/07 for Broomhill
Also see our care home review for Broomhill for more information
This inspection was carried out on 19th July 2007.
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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
People living at the home benefit from having clear information about their rights and responsibilities and the amount of money they have to pay for living there. Assessments carried out by the local authority and staff at the home make sure individual peoples` needs can be met. Improvements to activities record keeping shows that peoples` needs for stimulating and enjoyable social and leisure pursuits are met where possible. Further, improved access to religious services helps people`s spiritual needs to be met. Satisfactory complaints management and recording ensures people who use services can feel confident in raising concerns about any aspect of their care. Improvements in handling of abuse issues keeps people protected from risk of harm or abuse happening to them. People living at the home benefit from having a comfortable, clean, safe standard of accommodation that is well decorated and maintained, physically accessible and meets their needs. Improved management particularly in staff training, supervision and health and safety, makes sure all aspects of running the home meets the needs of people living there and keeps them safe.
What has improved since the last inspection?
Nine requirements made had all recommendations had been adopted. been met. Further, good practiceThe registered provider had issued guidelines to all homes about referrals and new admissions following the last visit to Broomhill. The guidance makes clear what managers need to do if someone is placed at the home and they cannot meet that person`s needs. Whilst a number of admissions had been made since the last visit none of them raised any difficulties for staff and the manager said she now felt more supported by team managers. Members of the home`s management team now visit to assess potential new people to make sure the home is the right place for them. Care plans looked at were all signed by staff to show that the home can meet peoples` needs. Further, a number of individual risk assessments were in place for people who have a history of falls or are at risk. Risk assessments for other issues affecting individual people were in place that helps to keep them safe. The manager and staff had been attending training on safeguarding adults from abuse. The manager was able to show how incidents were picked up and properly managed to make sure people living at the home are protected from harm. Casual staff taken on before the last inspection had now had induction training and records were available to show this. Staff that had not done safeguarding adults training had dates booked to make sure everyone attended a session. Training in dementia awareness and mental health needs is being done as an ongoing programme by the In-reach team that supports homes to manage difficult issues. Three new staff had been taken on since the last inspection. Proper recruitment had been done including request of Criminal Records Bureau disclosures before the person started work, where this was necessary. Care staff supervision is better organised and newly appointed staff had all had supervision sessions recently. Work needed to make the staircases safe for people living at the home continues. Health and Safety officers had given advice about the matter. The City Council`s property services department are trying to find suitable ways of making sure people are kept safe from possible risk of harm when using them. Good practice recommendations that had been adopted included: Continuing work to try and make sure people with dementia are included in activities and outings. Reminiscence sessions are to start shortly. Further, short trips out with smaller groups makes sure people with dementia get the same opportunities for social stimulation as other people. Religious services are now offered regularly at the home again and attended by several people who live there. This means peoples` spiritual needs are recognised and met where possible. The manager and other staff showed good knowledge of individual people living at the home that was gained from discussions with them and from reading care records. Broomhill DS0000035843.V338192.R01.S.doc Version 5.2 Page 7
What the care home could do better:
The Statement of Purpose was out of date and needs changing to make clear the types of needs that can be met at the home. Care plans looked at didn`t include all identified health or personal care issues. Further, not all care plans had been put in place at the end of the four-week trial period. This means that staff might be unaware of peoples` individual needs that had changed since coming to the home. From those care plans looked at some had not been checked regularly since the beginning of the year although had been done so throughout last year. This means that peoples` changing needs may not be picked up and met. Our pharmacy inspector did an inspection of medications at this visit. Medication is generally stored and handled safely in this home. People using the service are supported to look after their own medicines. To further safeguard peoples` health, the home`s policy for self-administration needs to be followed and some records of medicines administration need to be improved. Permanent care staff are to be commended for their continuing commitment to meeting peoples` needs. However there are not enough of them to make sure people living at the home have a good quality of life that includes one to one time. Reliance on use of agency staff that don`t know the home or the people living there means that people may not get the standard of care they are entitled to expect. Four good practice recommendations were made: Neither the current Statement of Purpose nor the service user`s guide gives any information about equality and diversity (the needs of people from different groups in society that make up the population of the home). Therefore people from these groups won`t have the information they need to decide if they wish to move into the home, or that it will be welcoming to them. The documents should therefore include a clear statement to show how the needs of people from these groups will be catered for and met. Staff should record the actual reason for disposal of medication so that they can monitor this and prevent any unnecessary waste. Whilst individual peoples` dietary needs were met, it was disappointing to note that the menus remain largely organised for meat eaters. Clear vegetarian choices weren`t seen that could offer people a more varied menu. Further, although one person had an identified need for a cultural diet the menus didn`t show this was happening often enough.The environment within the home is of a good standard and individual rooms were nicely furnished and homely. However too many notices were pinned up on walls, giving an institutional feel to rooms and spoiling the décor. The use of these notices was more for staff benefit than people living there and should be avoided wherever possible.