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Inspection on 24/10/05 for Broughton House and College

Also see our care home review for Broughton House and College for more information

This inspection was carried out on 24th October 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Service users were observed to be settled within their environment and discussion with staff showed that they were aware of, and responsive to, service user needs. The medication systems ensured that medication was stored and administered safely. The records were checked regularly to ensure that processes were being followed correctly. The home had good quality assurance systems in place to ensure the ongoing development of the service.

What has improved since the last inspection?

The home has met two requirements from the last inspection in regard to health and safety and staff training. The staff training had been specific to the needs of the service users and had enabled staff to address individual needs.

What the care home could do better:

The content of care plans varied greatly and some of the information within them was over 18 months old. More input was required on meeting service user communication needs: including specific communication profiles and staff training.

CARE HOME ADULTS 18-65 Broughton House College Brant Broughton Lincolnshire LN5 0SL Lead Inspector Alison Marshall Unannounced Inspection 24th October 2005 02:15 Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 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 Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 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 Adults 18-65. 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. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Broughton House College Address Brant Broughton Lincolnshire LN5 0SL 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) 01400 272929 Hesley Care Services Limited Mr Robert Noble Care Home 23 Category(ies) of Learning disability (23) registration, with number of places Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 10 children (male and female) aged between 16 and 17 years of age on admission, may be accomodated. A maximum of 13 adults (male and female) aged between 18 and 25 years of age on admission, may be accomodated. Young adults, who are aged beyond 25 years of age, due to placing authorities not having identified and obtained appropriate move on placements, may only be accomodated at the home on an Application for Variation. Adults who are over the age of 25 years of age, and have been given dispensation by the Commission for Social Care Inspection may not be accomodated in an area of the home where children aged 16 and 17 years of age are living. The provision of care is for medium to long term placements. Admissions are planned and emergency admissions are not accepted. 4. 5. 6. Date of last inspection 27 April 2005 Brief Description of the Service: Broughton House College is registered as a residential care home and owned by Cambian Education Services Ltd. The home is situated in the village of Brant Broughton and provides a 52 week placement for up to 23 young people between the ages of 16 and 25, who have special educational and social care needs resulting from severe learning disabilities and autism coupled with challenging behaviour. The home, set in landscaped grounds, provides accommodation, education and therapeutic services. Accommodation consists of single bedrooms and a variety of communal areas located in five areas of the property; the main part of the home – York and Lincoln house, the coach house, the flat and the bungalow. The Statement of Purpose promotes an approach based on non-aversive positive intervention and the purpose is to develop each student’s independence through education in an environment that offers warmth, security, consistency and understanding.The extensive staff team receives training and development opportunities relevant to the educational and social needs of the service users. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out between 2:15 pm and 6:45 pm. Time was spent talking with the care manager, the on site manager and the staff on duty. Medication was inspected as were a number of other records. What the service does well: What has improved since the last inspection? 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. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 All service users had care plans, however, they did not all contain up to date information and some contained more information than others. EVIDENCE: A number of care plans were looked at. There was an index at the front of each care plan file but not all of the information listed was contained in each file. Hence the contents across the files varied. For example, not every file contained a support plan for care or communication. All files did contain a student profile but some were dated February 2004 meaning that the information was 18 months old and not necessarily current. One file contained an agreement for medication to be administered covertly. This had been agreed in April 2004 but had not been signed to say that it had been reviewed since. It was clear that service user reviews were held every six months. Most service users had specific communication needs and further work was required to meet these needs. Staff said that service users did not have an individual communication profile and that similar ways of communicating were used with all service users. Besides signing, staff had not received other communication training. Staff said that a new speech and language therapist had been appointed and would be addressing these issues. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 9 Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 16 and 17 EVIDENCE: The care manager and staff said that it was an aim to involve service users in the community as much as possible. Given that the college was situated within a village they made good use of the wider community in terms of visiting Newark and Lincoln. Most of the learning was carried out in the community in terms of shopping, going to the gym, swimming, going to college and, where appropriate, using public transport. The college also had its own transport to enable service users to access the community. Service users were enabled to take as much responsibility for their life as possible. However, care plans had statements saying that there were restrictions on service user choices and daily routines due to the nature of their disability. For example, staff opened service user post and, where appropriate, read the contents to them. Choices around such things as bed times and getting up times were normally decided by the service users but in some cases it was agreed as part of the care plan that times would be set. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 11 Although meal times were not observed discussion did take place with staff around the benefits of staff sitting and eating meals with service users. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Medication was stored correctly and administered safely to service users. EVIDENCE: The medication cupboards were in a locked room. The cupboards were also locked. Senior staff administered medication and had all received training. Support staff that witnessed the administration of medication had received basic training to ensure they understood the process. The home had an arrangement with an external pharmacist who visited four times a year to check that medication systems were safe and that staff were following procedures correctly. In addition a senior member of staff carried out monthly audits to ensure that all medication administration record sheets had been filled out correctly and that the correct amount of medication had been ordered and given. Controlled drugs were stored and recorded correctly. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 There were good systems in place to ensure the safety of service users. EVIDENCE: Adult protection was covered within staff induction training and staff spoken with were aware of the policy and procedures. Since the last inspection staff had raised concerns appropriately and the senior management team had responded in line with the procedures. The senior management team were very clear about their responsibilities with regards to adult protection and followed up all concerns. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected. EVIDENCE: Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Good quality assurance systems were in place. This ensured that the service continued to develop and improve. EVIDENCE: There were a number of systems in place to review the service provided. The company carried out monthly visits as required by regulation 26 of the Care Home Regulations 2001. An education inspector, employed by the company, visited several times a year to review the education provision. The inspector produced a report following each visit with recommendations for improvements. The company had obtained Investors in People status. There was a development plan for the home for the next 5 years. This had been drawn up with staff input and was reviewed annually to assess what progress had been made. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Broughton House College Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000002334.V257151.R01.S.doc Version 5.0 Page 18 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. 1 Standard YA6 Regulation 15(1) Requirement The registered person must ensure that care plans contain up to date information and sufficient information for staff to meet identified needs of the service users. Timescale for action 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA6 YA6 YA17 Good Practice Recommendations The registered person should ensure that service users have detailed individual plans in place with regards to their communication needs. The registered person should ensure that staff receive training in the specific communication needs of the service users. The registered person should consider the benefits of staff sitting and eating main meals with service users. Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Broughton House College DS0000002334.V257151.R01.S.doc Version 5.0 Page 20 - 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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