Inspection on 30/08/07 for Broomy Hill Nursing Home

This inspection was carried out on 30th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Broomy Hill Nursing Home 06/01/10

Broomy Hill Nursing Home 05/02/07

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOMES FOR OLDER PEOPLE Broomy Hill Nursing Home 43 Breinton Road Hereford Herefordshire HR4 0JY Lead Inspector Wendy Barrett Draft: Key Unannounced Inspection 30th August 2007 09:00 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 Broomy Hill Nursing Home DS0000067471.V343659.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. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broomy Hill Nursing Home Address 43 Breinton Road Hereford Herefordshire HR4 0JY 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) 01432 274474 lwilliams@ashberry.net Ashberry Healthcare Limited Lorraine Theresa Williams Care Home 40 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (40), Mental disorder, excluding learning of places disability or dementia (5), Mental Disorder, excluding learning disability or dementia - over 65 years of age (40) Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Room 17 is occupied only if the service user or his/her representative has first seen it and documented his/her agreement. The registered person may provide personal care, with nursing, and accommodation for service users whose primary care needs on admission to the home are within the following categories: Dementia over 65 (DE)(E) 40 Mental disorder over 65 (MD)(E) 40 Dementia (DE) 5 Mental disorder (MD) 5 The maximum number of services users to be accommodated is 40. 3. Date of last inspection Brief Description of the Service: Ashberry Healthcare Limited was registered as the Provider at Broomy Hill in July 2006. Since the last inspection the Care Manager has been approved for registration by the Commission. The home is situated in a residential area close to the centre of Hereford city. It provides 40 places for older people who have nursing care needs arising from mental health or dementia related conditions. One of the places is registered to accommodate a named resident who is between 55 and 64 years of age. Five places are registered for residents who are under 65 years of age and who have the type of needs falling within the home’s Statement of Purpose. There is information literature describing the service and copies of this are displayed at the home. Potential residents, or their representatives, are given an information ‘welcome pack’ when they come to view the accommodation. In December 2006, the fees ranged from £495-80p. per week to £650-00p. per week. There are additional charges made for hairdressing, chiropody and toiletries. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written with reference to information about the service and held by the Commission since the registration of the new provider in July 2006. Residents, relatives and professionals have been invited to complete survey forms and the Care manager completed an annual quality assurance assessment report that was submitted to the Commission prior to an unannounced inspection visit to the home. What the service does well: What has improved since the last inspection? The Care Manager has formally demonstrated her fitness to carry out her responsibilities as a registered person. The number of complaints and concerns has significantly reduced since the arrival of the new management. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 6 The staff have received more training to help them work well with the residents. The quality of the accommodation has continued to improve. There has also been additional attention to infection control measures e.g. more staff 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. Broomy Hill Nursing Home DS0000067471.V343659.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 Broomy Hill Nursing Home DS0000067471.V343659.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): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and/or their representatives are given written information that describes the service. There needs to be more thought about presenting the information in a variety of ways that may help more residents make use of it. Admissions are carefully planned so that there is the best chance of a successful introduction to the home. EVIDENCE: Prospective residents or their relative are given a welcome pack of information so they know what to expect from the service. A relative recalled receiving the pack and described it as ‘comprehensive’. Given the dependency of residents Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 9 admitted to Broomy Hill it would be advisable to consider if presenting information in alternative formats would make it more accessible. There is also information displayed in the entrance area of the home e.g. a copy of the last inspection report, a newsletter produced by the Commission for Social Care Inspection (CSCI). When referrals for admission are received the Care Manager goes out to meet the prospective resident and their relatives in order to gather information that will help her assess whether the home will be suitable. There is also consultation with other care professionals who have been working with the potential resident and they often give the home copies of their own assessment records. Records seen at the home reflect a thorough pre-admission assessment that addresses physical care needs and also social and emotional needs of the individual. When potential risks are identified e.g. a tendency to fall, a need to be moved and handled by staff, the degree of risk is calculated with the use of specific formulas. Then guidance is written so staff know what they need to do to reduce the risk as far as possible. The managers are currently working to improve their pre-admission assessment work to be sure it meets nationally recognised standards. If it seems that Broomy Hill will be suitable, an initial care plan is written – based on the pre-admission assessment information. A resident’s care record referred to consultation with the resident (or their relative) when this plan is written. There are 3 places at the home for people who need respite care. The Care Manager still makes sure she has a chance to assess the person’s needs because an inappropriate placement is unsettling for the individual and often for the other residents. Because respite residents usually can’t recognise their own clothes it has been a problem for staff to make sure things don’t get lost in the laundry. A new inventory form has been introduced to try and reduce this problem. Broomy Hill Nursing Home DS0000067471.V343659.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care for each individual is set out in a written plan and this is regularly reviewed to make sure it is always up to date. Relatives and other professionals are consulted as part of this work. There is confidence in the way staff deal with residents’ health care needs. Medication is generally handled safely and in the best interests of the residents. There are a few measures that would further strengthen the way this work is managed. EVIDENCE: Each resident has a written care plan that describes how staff should provide everyday care. A sample of these records contained reference to consultation with relatives and social workers when the plans were written or revised. The plan is designed to take into account the whole person and not just to address Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 11 the physical care needs. In order to support this work staff have received more training on dementia care and Person Centred Approach. When residents are reaching the end of their lives the staff follow a specific plan that has been designed for people who are dying. A G.P. commented about a relative who was ‘very happy with the way his mother was looked after during her final illness’. A relative stated -‘so far my aunt has been cared for very well’. There were no instances of pressure sores at the time of this inspection. A specialist hospital nurse recently praised the nursing staff at the home for managing to heal a nasty pressure sore through good care and attention. There are differing views expressed by visiting professional workers regarding the availability of trained nurses. The Care Manager is aware of the need for a clinical nurse who can support her, and recruitment was underway so the situation should improve in the near future. For instance, she was planning to introduce ‘dressings files’ where applications of topical medications could be recorded. The work had not yet been completed due to lack of time. Medication is generally managed safely but there are a few areas that need further attention. Staff are not always signing to confirm double-checking of handwritten entries on administration records. Mistakes can be made when transcribing information by hand and so it is very important that a second staff member checks the accuracy of a colleague’s work when this is done. Dating medication bottles when the stock is first used should be extended to medication supplied in boxes as well. This will strengthen the audit trail. The home already follows good practice in writing care plans for any medication that is prescribed to be given ‘as required’. It is good to see that staff are encouraged to try other methods before resorting to medication. However, the plans still tend to be rather generalised and should better describe the individual resident’s situation. This was recommended at the last inspection and the Care Manager has now agreed that the work will be addressed within three months of this inspection. Broomy Hill Nursing Home DS0000067471.V343659.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff give residents choice and variety in the way they spend their days. The Care Manager recognises that there is more work to be done to improve the quality of everyday life for each resident, and plans are already in place to achieve this. The records of social care need to be more fully maintained now that a new activities organiser has been appointed. Residents enjoy their meals and the kitchen is managed by staff who understand how to provide a varied but healthy dietary balance. The records of actual food provided to each resident need to be more carefully maintained. EVIDENCE: Residents at Broomy Hill need a great deal of one to one support to pursue their preferred lifestyle. Many have a limited ability to make informed choices and rely heavily on their relatives or the staff in this. A previous activities organiser used to work five days a week but had recently left the home. A new activities organiser has subsequently been appointed Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 13 and was being supported to obtain appropriate skills. He had just completed a training day on music therapy and another course on ‘therapeutic activities for people with dementia’ was being organised. This recent absence of an activities organiser may explain why the activity records in care plans did not always contain many recent entries. A visiting professional commented – ‘need more person centred care and more activity assistants. Provide better social interaction areas e.g. placing chairs to look out into garden areas’. A relative felt that there was a need for more mental stimulation and said the resident ‘often says she is fed up with sitting and doing nothing and would like to go outside sometimes’. The Care Manager was already considering ways to re-arrange the communal areas so that residents would have more choice about the way they spend their days e.g. creating a dedicated television lounge where a small group of interested residents could watch from sensibly positioned armchairs. Residents were being supported in enjoying a variety of activities during the inspection visit e.g. two residents were playing dominoes with a member of staff, some residents had books or magazines to read, relaxing music was playing in one communal area. A care assistant described how she had enjoyed taking some residents to the local park (although this had been done in her own time). A resident survey form referred to pleasure gained from a visit to church. Residents who were able to comment were complimentary about the meals‘better than I thought they would be’, ‘they are very satisfactory’. One resident felt the meals could be a bit more punctual. Breakfast was observed and it was clear that residents have considerable choice and flexibility over what they eat, when they eat and where they eat e.g. some residents were being served with a variety of cereals and hot dishes at the dining tables. Another resident was later observed eating a breakfast of scrambled egg and bacon at her chair in a lounge. Care plans include assessments of each resident’s nutritional needs. The nursing staff have received training in the use of an improved tool for assessing risk of malnutrition (MUST tool) so this can now be used as part of the care planning. The cook had received training and guidance literature to help her manage the kitchen and menus. She gave examples of changes to improve the quality of the service e.g. more fresh vegetables, pomegranate juice served in the afternoons, more varied menu dishes. The records of actual food provided need to be more detailed so that they show any variations from the standard menu-either for all residents or for specific individuals. An Environmental Health Officer recently inspected the kitchen and was satisfied. The only recommendation had already been complied with-the purchase of new chopping boards. Broomy Hill Nursing Home DS0000067471.V343659.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives have information to help them raise concerns about the service, and, when reported, these are taken seriously and investigated in an open way. Many residents are unable to use a formal procedure so further thought should be given to alternative ways of ensuring their concerns are recognised and addressed. The service isn’t generating any concerns about resident safety and staff have awareness and written guidance to help them recognise and report potential abuse. However, training should be more regular and cover all staff in recognition of the particular vulnerability of the residents. EVIDENCE: There is a complaints procedure at the home. All new residents or their relatives received a copy and it is displayed in the home. Relatives’ survey responses confirmed their awareness of this procedure. Comments from residents indicate they have confidence in the staff and feel able to approach them –‘I will speak to anyone really, a nurse or the lady that walks around in charge’, ‘would speak to staff. I’m happy. I have no complaints’. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 15 When the home receives any complaints or concerns a record is kept for future reference. The complaints register was being maintained and there were records of the complaints and action taken in response to them. There have been 3 complaints/concerns raised at the home since the last inspection. The Commission has received one complaint. The care manager and a social work manager investigated this jointly. The outcome indicates a communication problem between a visiting health care professional and staff at the home and there was no indication that residents’ care had been compromised. The home’s response to the complaint confirms a commitment to be open and co-operative in working with other professionals in protecting residents. Records of staff training suggest that there should be more attention to abuse awareness and adult protection training. Only 10 out of 42 staff had received training during the past two years. The Care Manager anticipated that this training would be provided on an annual basis. Although staff gain some knowledge through their induction programme and as part of work on national vocational qualifications, the resident group at Broomy Hill are highly vulnerable because most are unable to speak up for themselves. It is, therefore, particularly important for all staff to understand how to recognise potential abuse and how to report any concerns. Staff also need to be particularly skilled at recognising when a resident’s behaviour may be indicating their dissatisfaction with something. Many residents do not have the ability to follow a formal complaints procedure and depend on staff to help them report concerns. A relative supported this view with the comment ‘my mother is rather paranoid on occasions. It would help if they listened to her worries a little more’. Having said this, a care assistant was aware of a number of ways she could protect the residents e.g. reporting unexplained bruising, filling in accident/incident report forms, availability of written guidance in the home’s policies and procedures e.g. whistle blowing. Broomy Hill Nursing Home DS0000067471.V343659.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The cleanliness and general standard of residents’ accommodation is continuing to improve as the result of an ongoing programme of refurbishment. There are plans to continue this work – particularly in making sure the layout of the accommodation helps residents make best use of it. EVIDENCE: The premises have been subject to an ongoing programme of refurbishment since the current Provider took over the service last year. This is still underway and is being done with the needs of the residents in mind e.g. a new wet room has been introduced since the last inspection, there has been additional attention to infection control measures e.g. more staff training, more hand wash facilities throughout the home. Ancillary support staff are Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 17 being offered relevant training in recognition of the important role they play e.g. national vocational qualification in housekeeping. The Provider is ensuring that routine maintenance and servicing is being arranged to make sure the premises are kept safe. There are continuing problems with delays in answering the front door bell. Two visiting health care professionals expressed some frustration over this situation. There has been action to try and reduce the difficulty-the administrator’s office has been moved downstairs and is now right next to the entrance, advice notices have been put up near the door bells. It is necessary to keep the door locked so that residents, and the premises, are protected. Broomy Hill Nursing Home DS0000067471.V343659.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are enough care staff to respond to the residents’ needs but there needs to be more nursing time for managing clinical practices. New staff are carefully selected to be sure they will be safe to work with vulnerable adults. Once employed, all staff are encouraged to undertake training that is relevant to their work at the home. Statutory health and safety training has been extended but this will need careful targeting in future programmes to fill gaps in some staff records. EVIDENCE: The observations of care assistants serving breakfast indicated that there were enough of them on duty to offer residents personal, unhurried support. One qualified nurse was at work and she spent a considerable amount of her time completing the medication rounds. The Care manager agreed that the home needed a clinical nurse who could support her in managing nursing practices. Recruitment was underway. A G.P. commented that there may be insufficient trained staff as there was sometimes a delay before someone could be found to deal with a visiting doctor. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 19 Staff are receiving a good variety of training opportunities so that support staff can develop relevant skills as well as the staff involved in direct care e.g. 3 staff working towards a national vocational qualification (NVQ) in catering and hospitality, another staff member undertaking an NVQ in hospitality. A newly appointed activities organiser was also being offered relevant training. More care staff are being encouraged to obtain a national vocational qualification in care although the current level has not yet reached the recommended 50 of care staff. A training matrix was submitted in compliance with a previous inspection requirement. This shows that there has been a considerable amount of statutory health and safety training provided to all staff since the new Provider took over the home. There are still gaps in essential instruction e.g. moving and handling and the future programme will need to be carefully targeted with reference to individual staff roles and agreed refresher timescales. A recent recruitment record confirmed a generally satisfactory process for checking the suitability of potential new staff. Broomy Hill Nursing Home DS0000067471.V343659.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, 33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The new provider and Care Manager have demonstrated their ability to develop the service in the best interests of the residents. There has been considerable improvement in all aspects of the service and this has led to increased confidence in residents, relatives and visiting health care professionals. EVIDENCE: The service required considerable improvement when the new management arrived. A lot of work has been completed and this confirms that the provider and Care Manager are fit to run the type of service offered at Broomy Hill. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 21 Involved parties are noting the improvements – a visiting G.P. comments ‘there has been a vast improvement in the last few months as far as I can tell’. The outcomes of this and the last inspection support this view although it is recognised that there is still more work to do. The Care Manager has been approved for registration with the Commission since the last inspection. She was expecting to complete work on a Registered Manager’s Award qualifying course during the next year. The manager already has considerable relevant experience and a nurse qualification. She has already been able to improve many aspects of the everyday service at the home and has clear plans for future developments. The appointment of a clinical nurse should support the manager in this work although it may be that experienced and competent care assistants are able to undertake a useful role. In early 2007 there was a formal consultation exercise to obtain the views of residents and/or their families about the service. The comments were generally positive with a few suggestions for improvements e.g. more care of personal items/aids. The willingness of the Care Manager to respond to suggestions is demonstrated in her introduction of a new inventory form following loss of respite residents’ clothing. There were reports seen at the home to confirm that the Provider’s representative is complying with a requirement to visit the home at least once a month to monitor the service. The Care Manager feels well supported by her employer. The Provider and Care Manager have demonstrated their willingness to work openly with the Commission and other professionals and this co-operative attitude will strengthen the safety of the residents. The administrator at the home explained how residents’ personal money and valuables are cared for when held in the safekeeping. The arrangements and associated records were satisfactory to ensure the protection of the residents’ property. There is still work to be done to establish a structured programme of staff support and supervision. The Care Manager has implemented some new systems but these had not been fully actioned at the time of this inspection. She did, however, have timescales for the work e.g. one to one supervision meetings to be introduced by October of this year. The Provider understands what is required to comply with health and safety legislation e.g. work completed to comply with new fire regulations. The staff have up to date policies and procedures to guide them in working safely around the home. The recent training provision indicates a commitment to provide essential health and safety training although this has not yet been fully achieved. Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 22 Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 23 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 2 Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no 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. Standard Regulation Requirement Timescale for action 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 4 Refer to Standard OP1 OP15 Good Practice Recommendations There should be more thought given to alternative ways to help residents make use of information about the service. Records of food provided should be more detailed so that they demonstrate the flexibility of the service in accommodating special dietary needs or preferences. Staff training in adult protection should receive greater priority given the high vulnerability of the residents group. There should be more consideration to providing the Care Manager with the senior support she needs to monitor and develop all aspects of the service. The appointment of a clinical nurse will go some way to achieving this end but it may be that competent and experienced care assistants can play a part in this work. Essential health and safety training should be more carefully monitored and targeted to ensure each staff member receives relevant training at the recommended intervals. DS0000067471.V343659.R01.S.doc Version 5.2 Page 25 OP18 OP27 5 OP30 Broomy Hill Nursing Home Broomy Hill Nursing Home DS0000067471.V343659.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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