Inspection on 27/04/05 for Broughton House and College

This inspection was carried out on 27th April 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 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

Broughton House and College 10/08/06

Broughton House and College 24/10/05

Broughton House and College 11/11/04

Broughton House and College 12/05/04

Broughton House and College 15/01/04

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Broughton House College Brant Broughton Lincolnshire LN5 0SL Lead Inspector Wendy Taylor Unannounced 27 April 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Broughton House College Address Brant Broughton Lincolnshire LN5 0SL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01400 272929 N/K N/K Phillip Champion, Hesley Care Services Limited Robert Noble Care Home (CRH) 23 Category(ies) of Learning Disability (LD) - 23 registration, with number of places Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 10 children (male and female) aged between 16 and 17 years of age on admission, may be accomodated. 2. A maximum of 13 adults (male and female) aged between 18 and 25 years of age on admission, may be accomodated. 3. 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. 4. 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. 5. The provision of care is for medium to long term placements. 6. Admissions are planned and emergency admissions are not accepted. Date of last inspection 11 November 2004 Brief Description of the Service: Broughton House College is registered as a residential care home and owned by the Hesley Group. 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 C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in April 2005. A tour of the building took place and student and staff records were looked at. The main method of inspection used was called case tracking which involved selecting five students and tracking the care they receive through the checking of their records, discussion with care staff and observation of care practices. General records including those relating to health and safety issues were also looked at. 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 C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 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 standard(s) 2,5 Students are admitted only after a full care and support assessment has been carried out. They benefit from a regular review of their assessments. The students and their families benefit from clear contracts and terms and condition for the service provided. EVIDENCE: Files contained thorough assessments that contained evidence of at least annual reviews. There was evidence that assessments were completed and reviewed with the student where they were able, their families and any involved professionals. Assessments addressed all of the students needs including communication, social activity, daily living programmes and individual learning plans. All files contained notifications of the offer of placements, terms and conditions and placing authority contracts. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 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 standard(s) 6,7,9,10 The student’s personal information is managed in a safe and secure way. The students’ benefit from being encouraged to develop their independence, including choice and decision making wherever they are able. There is a commitment to ensuring that this is done in a safe and supported way. EVIDENCE: Files are well organised and kept securely. There is evidence that the care and support plans reflect initial and on-going assessments, and that they are developed with the students where possible and their representatives. Their likes and dislikes were recorded clearly. Files contained specific and detailed management plans and risk assessments for areas of need such as behaviour, communication, restriction of liberty and health. There was also evidence that care and support plans and risk assessments were updated regularly. Independence curriculum’s were available on files and demonstrated that the promotion of choice and decision-making underpins support planning. Staff were observed to encourage students to make choices about their daily lives to whatever level they are able, for example choosing meals and activities. Daily notes recorded where the student had achieved goals for example direct communication with staff. Staff also demonstrated through practical support that they were aware individual care plans and risk assessments. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 9 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 standard(s) 12,14,15,17 The students benefit from individually designed activity programmes but staffing levels may impact on their opportunity to engage fully in them. They enjoy a varied and balanced menu with the opportunity to make their own choices. EVIDENCE: The likes and dislikes for the individual student are clearly recorded in files. There are individual activity schedules on files, which are based on likes and dislikes, and demonstrate that activities are age appropriate and include community presence. There is demonstration in daily notes of a wide range of activities being offered and undertaken. The daily notes also demonstrate that family involvement is promoted. The home provides an activity room and a sensory room, both of which were being used by students on the day of the inspection. Several students were out on trips on the day of the inspection. Some staff said that there is not always enough staff to provide meaningful activity in one particular area of the home (see Staffing section of this report). Menus were displayed outside the kitchen in pictorial format, and staff were observed to encourage the students to make a choice of meals. Kitchen staff Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 10 are aware of individual likes, dislikes and needs and they keep a record of what students have eaten. The atmosphere in dinning rooms relaxed and students took their meals at the time and place that was suitable to their needs. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 11 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 standard(s) 18,19 Student’s benefit from detailed record keeping and access to a range of healthcare provisions. They benefit from a well-informed staff team who provide support in a respectful and consistent way. EVIDENCE: Files contained evidence of health needs assessment including medical history, allergies and epilepsy. Records demonstrate support from GP’s, Consultant Psychiatrists, Psychologists, dentists and opticians. There are personal care guidelines that include the student’s preferences for routines such as bathing, continence support and nutrition. Staff were observed to provide care and support in a respectful and encouraging way. They demonstrated a detailed knowledge of individual needs and care plans, and a commitment to promoting dignity and privacy for example, when supporting students to use toilets and when they were dressing and bathing. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 12 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 standard(s) 22,23 The home takes complaints seriously and deals with them appropriately. They respond in a timely and appropriate way to the outcome of investigations. EVIDENCE: Two separate complaints have been received by CSCI since the last inspection, both were in regard to the management of an individuals needs and the impact on staff. Two issues raised were upheld, one was unresolved and five were not upheld. Requirements and recommendations were made as a result of the investigations and are recorded in the relevant sections of this report. The home has provided action plans to demonstrate their compliance with the requirements made. The home has received one complaint regarding vehicle access to the site. The complaint was managed in accordance with home’s complaints policy and satisfactorily resolved. There has been one adult protection issue raised within the home. The allegations were not upheld but recommendations were made, which the home has complied with. ‘Cause for Concern’ logs were seen and there was evidence of the responses and actions taken, attached to each log. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 13 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 standard(s) 24,25,26,28,30 Students’ benefit from a well maintained environment. They also benefit from the home’s appropriate responses to the safety issues arising from extensive refurbishment to some parts of the home. The home needs to address the storage issues in one area of the home. EVIDENCE: Décor and furniture was in good order and suitable to the needs of the students. Bedrooms were personalised to the needs and wishes of the students. Some parts of the home, including three bedrooms are being refurbished as a result of recent fire damage and students do not have access to those parts of the home. Environmental risk assessments were in place. Alternative accommodation has been found for the students whose bedrooms are affected. The environment was generally clean and tidy and free from offensive odours however in one area cleaning equipment and waste disposal bags were found outside a student’s bedroom. The home responded to an immediate requirement to remove the items. In the same area of the home clean bedding was found on a windowsill and the vacuum cleaner was being stored in the lounge area. At the last inspection a requirement was made in respect of a control of Legionella policy. There was evidence of the day of this inspection Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 14 that water temperatures are monitored and that there is a programme of showerhead disinfection and replacement. As a result of the home carrying out these measures the requirement has been changed to a recommendation. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 35 Students benefit from robust recruitment processes and an appropriately trained and supervised staff team, although the home need to provide more specialised training for their individual needs. The home maintains at least minimum staffing levels. EVIDENCE: Staff files contained the required recruitment information for example evidence of CRB checks, two references and identification. Job descriptions are kept on each file and staff demonstrated that they are aware of their roles and responsibilities within the home. During discussions, staff said that they receive training in mandatory subjects such as fire safety, moving and handling and vulnerable adult training; and service specific training such as epilepsy, behaviour management and autism. Staff said that they had a thorough induction process and received good support from their colleagues throughout the process. They said that they receive support through supervision and appraisal processes. Evidence of appraisals were seen on files. As an outcome of complaints investigations (see Concerns, Complaints and Protection section of this report) it was identified that staff should have access to more specialised training in relation to autism. Some staff said that there is not always enough staff to provide meaningful activity in one particular area of the home. This issue was discussed with Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 16 managers on the day of inspection. Managers explained that there is impact on staffing numbers within the home due to having to supply staff support to students who are temporarily placed at another Hesley Group establishment; this being because of recent fire damage. Duty rotas demonstrate that minimum staffing levels are met, and managers said that the situation would be resolved in the near future when refurbishment work has been completed. Staff demonstrated throughout the inspection that they had a detailed knowledge of the students needs and they were aware of adult protection procedures. Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,40,41,42 Records are well maintained and the home ensures that student’s health and safety needs are met, whilst promoting their independence. Students and staff would benefit from a review of the communication processes within the home. EVIDENCE: Fire records were found to be satisfactorily completed; alarm, detection and lighting systems were serviced in February 2005. The fire risk assessment was reviewed in December 2004 and again in January 2005. Since the last inspection the home has experienced a fire requiring full evacuation of the home. Evacuation procedures proved to be effective and efficient, and the staff on duty demonstrated their knowledge and understanding of the procedures. Portable appliance testing was carried out in March 2005. Staff said that there is generally a good team spirit but they felt that communication between managers and the care teams could be improved. This issue was also raised as an outcome of complaints investigations. Complaints investigations raised a further issue regarding the home’s responsibility in relation to protective equipment (see recommendations). Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 18 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 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Broughton House College Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 3 3 x C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA 24 Regulation 13(4)(a) (b) Requirement The responsible person must ensure that all parts of the home to which students have access are so far as is reasonable practicable free from hazards to their safety and unneccesary risks to health and safety are identified and so far as possible eliminated. The registered person must provide evidence that staff have access to specific training relating to the individual needs of the students; for example autism and sexuality awareness and management. Timescale for action Immediate 2. YA 35 18(1)(c) (i) 31 August 2005 3. 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. Refer to Standard YA 24 YA 30 Good Practice Recommendations It is strongly recommended that the home identifies suitable storage space for laundry and cleaning equipmenti. It is recommended that the home develops a policy in C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 20 Broughton House College 3. 4. YA 38 YA 42 respect of Legionella. It is recommended that the responsible person review the communication processes within the home, with staff to ensure that the processes are robust and effective. It is recommended that the responsible person liaise with the Health and Safety Executive in regard to ensuring compliance with legislation highlighted in Standard 42.4 Broughton House College C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 C53 C04 2334 Broughton House College 223874 270405 stage 4.doc Version 1.30 Page 22 - 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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