CARE HOMES FOR OLDER PEOPLE
Broxbourne House 57 Barnsley Road Wakefield West Yorks WF1 5LE Lead Inspector
Tony Railton Unannounced Inspection 30th November 2005 12:00 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 Broxbourne House DS0000006169.V259028.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 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. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Broxbourne House Address 57 Barnsley Road Wakefield West Yorks WF1 5LE 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) 01924 370004 01924 384650 Mr M Seeratun Mrs Ursula Owen Care Home 21 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (21), Old age, of places not falling within any other category (21) Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Broxbourne House provides residential care for 21 older people who may also suffer with mental health problems. The home is situated just outside the centre of Wakefield on the main Barnsley Road. Set in its own grounds there is a garden area to the front and side and car parking to the rear. The main entrance is to the rear of the home where there is an office and corridors leading to the lounges, dining room and bedrooms. A passenger lift is provided for those who require it and there are assisted bathing and showering facilities. Shared and single accommodation is provided and bedrooms are personalised and comfortable. The home is on a main bus route and is only a few minutes from the centre of Wakefield and all services and amenities. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection commenced at 12.00 and there was the opportunity to observe the lunchtime routines of the home. There was the opportunity to speak to nearly all residents, care staff, kitchen and domestic staff, the manager and visiting relatives and district nurse. There was also the opportunity to examine residents’ case files, staff personal and training records and observe the administration of medicines. This was a particularly enjoyable if not busy unannounced inspection and a number of improvements were noted since the last inspection. The home continues to meet all statutory requirements and most minimum standards. The inspector would like to take the opportunity to thank residents, the manager her staff team for their warm welcome, hospitality and patience throughout the inspection. What the service does well:
All residents continue to have their personal and healthcare needs assessed before they are admitted so they know that the home can meet their needs. The manager said that Broxbourne continues to have a waiting list of people wanting to come and live in the home. Residents and their relatives said that they are happy with the standard of care provided by the home. The District Nurse commented that there have been no major issues with the home and residents appear to be well looked after. On the day of the inspection another District Nurse was also visiting to monitor and assess the healthcare needs of residents. The manager and District Nurse said that the home has a good relationship with local healthcare professionals who support and visit the home on a regular basis. All residents have care plans which are implemented and reviewed on a regular basis. Upon inspection bedrooms were found to be homely, comfortable and clean. One resident said that she likes her own room, another said that he has everything he needs and is “ very comfortable”. The staff team and in particular domestics are to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home. One resident said that the food is very good and that they have a choice of menu. The cook said that everyone has their “likes and dislikes” and that she try’s to be as “creative” as possible with the menus to give a “varied and wholesome diet”. On the day of the inspection residents were observed enjoying their lunch in relaxed and homely surroundings. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 6 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. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 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 Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Each resident has there personal and healthcare needs assessed before they are admitted to the home. EVIDENCE: Residents case files showed that their personal and healthcare needs are assessed before they are admitted to the home. Some records show that residents may also have an Integrated Care Management Assessment completed by the local authority. On the day of the inspection it was noted that assessments and in particular risk assessments are reviewed and updated on a regular basis. It was also noted that on the day of the inspection a visiting District Nurse was also reviewing residents’ healthcare needs. The home does not provide intensive rehabilitation. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 On the day of the inspection it was found that residents were treated with dignity and respect at all times and that their health, personal and social care needs are set out in their individual plan of care. EVIDENCE: Observation of care staff and residents showed that there are positive relationships fostered between staff and residents. A visiting District Nurse said that there have never been any problems with the home. She said that there is a good relationship with healthcare professionals visiting the home. Observation of the administration of medicines showed that residents are safeguarded and protected by the medicine ordering, storage, and ministration and recording systems adopted by the home. Examination of residents care plans show that they are based on residents assessed needs are implemented and reviewed on a regular basis. Medical records indicate that residents have access to and benefit from the support of other community based healthcare professionals such as Chiropodist, District Nurses, Continence Advisors and General Practitioners. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Residents do have opportunities to exercise choice and control over their own lives and their lifestyle experienced in the home matches their expectations. EVIDENCE: Discussion with nearly all residents indicates that they are happy with the care provided by the home. Discussion with two relatives and a visiting District Nurse supported this view. Staff spoken to said that with the exception of a few who are confused and have particular problems of their own others are generally happy and content. The manager said that the home never has any empty rooms and there is a waiting list so they “must be doing something right.” One relative said that she always made to feel welcome. On the day of the inspection one resident was going out with relatives for a game of snooker at the local club. All residents were observed having and enjoying lunch which had a wonderful smell and looked good. Residents said that they had enjoyed their lunch. The cook said that residents have their likes and dislikes and are given an alternative choice of menu which is recorded. The chalkboard on the dining room wall showed the menus for the day. The daily records do have descriptive words to reflect and show residents choices, preferences likes and dislikes. This good practice is to be commended.
Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents, their relatives and others visiting the home are confident that their complaints will be listened to and acted upon. Residents are also safeguarded and protected from abuse. EVIDENCE: Discussion with residents, some relatives and visiting District Nurse showed that their views regarding the quality of care provided by the home are listened to and acted upon. The manager said that the home has not received any complaints since the last inspection. It was noted that the home has a copy of Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure. Staff training records show that abuse forms part of the induction training for all new staff. Staff records show that the staff selection and recruitment process ensures that residents are protected from abuse. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Residents live in comfortable and homely surroundings which are safe and clean. EVIDENCE: Inspection of the home and discussion with residents showed that they are comfortable and have their space as they want. The communal areas are homely and comfortable, clean and free from any unpleasant odours. The staff team and in particular domestic staff are to be commended for their efforts in maintaining such a good standard of cleanliness throughout the home. It was noted that a number of bedrooms have been re-decorated and that the lounge/dining room has a new carpet. The manager said that the owner of the home is committed to raising standards and that he intends to make improvements throughout the home. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Residents are cared for by an effective staff team who appear to be confident and happy in their work. EVIDENCE: Examination of staff training records and discussion with the manager showed that over half of the care staff have a National Vocational Qualification at Level 4, 3 or 2 and others are registered on NVQ training. The manager also said that ancillary staff have also undertaken NVQ foundation training. The certificates on the kitchen wall show that the cook has an Intermediate Certificate in Food Hygiene and Risk Analysis which is to be commended. The manager said that the home is committed to staff training and there is a senior carer also with NVQ Level 4. This standard is to be commended. Examination of staff personal records show that all relevant checks including CRB and POVA (Protection of Vulnerable Adults List) are taken up before new staff are employed. Through observation and examination of the staff rotas and discussion with the manager show that there are enough staff available in sufficient numbers to meet residents care needs in a relaxed and unhurried manner. A visiting District Nurse said that she has always found the care staff to be most helpful and obliging. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 & 38 Residents live in a well run home by a manager who is qualified and is fit to be in charge is of good character and able to discharge her responsibilities fully. EVIDENCE: The manager as well as been a Registered Nurse has successfully completed the Registered Managers Award, NVQ Level 4. Through observation and discussion with residents, relatives, care staff and visiting District Nurse it was established that the atmosphere created in the home is open and inclusive. Residents and their relatives are asked their views on the quality of care provided by the home annually. The manager said that quality assurance questionnaires are due to be given out again and this time they plan on seeking the views of visiting healthcare professionals. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 15 The manager said that the home does not administer any residents’ monies and that this is done by their relatives. Each resident has a record of who is responsible for administering their monies in their case files. Staff supervision records show that staff do receive planned line management supervision sessions. Examination of staff training records also show that they receive training and update training in First Aid, Moving and Handling ad Basic Food Hygiene The training files also show that staff have to read and sign health and safety policies and procedures as part of induction training. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 2 X 3 Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? N/A 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 OP38 Regulation 23 (4) Requirement The responsible individual will inform the CSCI in writing of how the home plans to meet the recommendations made by the Fire Safety Officers report following his visit on 28th November 2005 Timescale for action 01/01/06 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 4 Refer to Standard OP12 OP14 OP19 OP33 Good Practice Recommendations The daily records would benefit from an increase in the use of descriptive words to reflect residents daily choices and preferences. Descriptive words should be used to reflect when residents make decisions about how they live their lives. A programme of routine maintenance and renewal of the fabric and decoration of the premises should be produced and implemented with records kept. Along with the views of residents and their relatives the views of other stakeholders, such as visiting healthcare professionals for example District Nurses should also be sought.
DS0000006169.V259028.R01.S.doc Version 5.0 Page 18 Broxbourne House 5 6 OP33 OP36 The information gathered as part of quality assurance survey questionnaires should be collated and a report published which reflects the outcomes for service users. The manager should ensure that all care staff receive a minimum of six line management supervision sessions per year. Broxbourne House DS0000006169.V259028.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Broxbourne House DS0000006169.V259028.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
