Inspection on 23/06/05 for High Broom Care Home

This inspection was carried out on 23rd June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

High Broom Care Home 20/06/06

High Broom Care Home 18/10/05

High Broom Care Home 28/01/05

High Broom Care Home 08/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE High Broom High Broom Road Crowborough East Sussex TN6 3SL Lead Inspector Elaine Green Unannounced 23rd June 05 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 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. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service High Broom Address High Broom Road Crowborough East Sussex TN6 3SL 01892 654027 01892 665713 None The Royal Surgical Aid Society Age Care 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) Mrs Anita Louise Clarke Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (OP), 42. of places High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That a maximum of forty two (42) older people be accommodated. 2. A maximum of thirteen (13) older people are accommodated in the close care cottages. 3. That the service users are aged 65 years or over on admission. 4. That one (1) service user can be accommodated aged between 60 and 65 years on admission as long as their individual needs can be met. Date of last inspection 28 January 2005 Brief Description of the Service: High Broom is a large detached house set in extensive grounds in a quiet country lane on the outskirts of Crowborough. The home is one of a group of four homes run by Age Care, a charity that was formed in 1863 under the Royal Surgical Aid Society. Crowborough town is approximately one mile from the home, with access to local shops, banks and other services. There are rail services to London and bus services to Tonbridge Wells and Brighton. The home is currently registered for 42 older people that includes accomodating a maximum of 13 users in semi- independant cottages located within close proximity to the main house. The service users of the cottages choose how much contact they have with the other service users and staff, with meals and help with bathing in main house. Staff check on service users in the cottages in the morning and there is a call system. If the needs of the service users change over time, they can be admitted to the main house as vacancies occur. High Broom provides a comfortable home for service users. Independance and activities are promoted. A new extension to the lounge, new conservatory and front office was completed last year. A lift is available in the main house. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 24th June 2005 from 10am to 5pm by two inspectors. Not all standards were inspected on this occasion and requirements from the last inspection were followed up. Inspectors talk to a total of 6 service users over the lunch time period and many more during a tour that included all areas of the house and grounds. It was noted that friends and relatives visited service users throughout the day. The homes’ communal areas were bright and clean and service users were making use of these areas on the day of the visit. Information about activities and events were displayed in the home along with other relevant information such Service Users Guide/Statement of Purpose. What the service does well: What has improved since the last inspection? What they could do better: They could involve service users or their representative in the Care Planning process and request that they sign and date the Care Plan when they have done so. All Care Plans to follow the same format and be reviewed monthly. Policies and procedures to be reviewed on a regular basis to ensure they are still in line with legislation and local guidelines in particular with respect to adult Protection and the Complaints procedure both of which are in need of updating. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 6 Procedure for obtaining two references for all new employees, including one from the previous employer before deployment, must be followed. It would be beneficial for service users if an Occupational Therapist risk assessed the building to advise on how best to support them to access all areas of the building. 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. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4&5. Standard 6 does not apply. The home needs to develop further its’ pre admission assessment of prospective service users. Adequate information is provided to prospective service users to enable them to make an informed choice about the home including the opportunity to assess the home for themselves through visits. EVIDENCE: The combined Statement of Purpose and Service User Guide needs slight amendment to include room sizes and the reviewed complaints procedure but was on the whole well presented and informative. Additional information about the organisation is on display in the home. The quality and content of pre admission assessments is varied, of those seen, only one was signed by the service user. All service users are given the opportunity to visit the home, look round the building and grounds, meet service users and staff, have a meal and ask any questions before deciding if they would like to come for a months trial stay. The inspectors witnessed this when a prospective service users relative came to make enquiries and was given information. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9&10. Service user’s health, personal and social care needs are not adequately set out in an in individual plan of care. Care Plans need to be developed and reviewed monthly. Service users health care needs are met and those who self medicate are adequately protected. Service users are treated with respect. EVIDENCE: The Care Plans inspected varied in content and quality. Albeit the home is introducing a new system for assessing and reviewing the needs of service users that incorporates support notes for staff to follow. Providing a suitably qualified and experienced person completes these appropriately they should meet the required standards. As they are, they are failing to do so. It is evident that service users health needs are monitored daily and any changes or concerns are recorded in their daily notes, records of visits made by GP and other health care professionals are kept but in some cases it was not apparent why the visits had been made. Treatments are given in service users own rooms. When shown around the house staff knocked on service users doors before entering and spoke to them in a dignified and respectful manner. Service users open their own mail unless they request otherwise, most have a postal vote but those who don’t are supported to access a polling station if required. Each service users laundry is washed separately. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 standard(s) 12&13 The lifestyle experienced by service users in the home matches with their expectations and they maintain contact with family, friends and the community. EVIDENCE: Service users and staff stated that the majority of the service users came from the local area or their family did and consequently relationships are easily maintained. Visitors are welcomed into the home and are able to join service users for meals and can stay overnight if there is a room available. Most service entertain visitors in their own rooms or in the conservatory but there is also a large lounge area and extensive grounds that can also be used. Service users from the bungalows also have a large room that they can use through a booking system should they wish to hold a function or party, this is within the bungalow complex. The Friends of High Broom are involved with organising shopping trips out for service users as well as a range of other activities. Meal times are reasonable, choice is available and lunch, can if required, be kept for the evening. There are various activities offered in the home and the times and dates for these are displayed on a notice board. Service users stated that the home met with their expectations. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 standard(s) 16,18 The Complaints and Adult Protection Policy and Procedures are adequate but require minor adjustments. EVIDENCE: The records examined did not clearly show when a complaint had been made, how it had been investigated and the outcome of the complaint auditing was therefore not possible. There were leaflets available to service users explaining how to make a complaint including where they should go if they were not satisfied with the outcome. Though some of this information was out of date and did not include the name and address of the regulatory body Commission of Social Care Inspectorate (CSCI). Staff stated that they respond in writing when they receive a complaint and then again to inform the complainant of the outcome once the investigation is complete. Service users stated they would feel confident in telling staff if they weren’t happy about something and that they felt that something would be done to rectify it, feeling confident that their complaints are listened to. A copy of the local guidance - East Sussex Brighton and Hove Multi Agency Guidelines for the Protection of vulnerable Adults is available for staff but needs adjustment in regard to reporting a suspected incident of abuse to the local Social Services, and the need to inform CSCI. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25 The environment is clean, safe, well maintained, and provides ample comfortable communal facilities. Specialist equipment is available, service users rooms suit their needs and are personalised. Occupational Therapist input is required to maximise independence for service users with mobility problems who do not have level access to their rooms. EVIDENCE: The homes communal areas were clean, free of odours, fresh looking and well maintained. An extensive extension to the building has recently been completed and decorated and the home is regularly risk assessed by a qualified Health and Safety Officer. There are ramps in place in the house and garden to allow wheelchair access and a call system in operation throughout the building. Wheelchairs etc were stored out of the way so not to obstruct fire escapes or thorough ways. There are sufficient and suitable lavatories and washing facilities throughout the home with many rooms benefiting from en-suite facilities. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 13 All rooms meet the minimum standard sizes but specialist O.T assessments would benefit service users especially in respect of those rooms which do not have level access and where a ramp would be impractical. Service users personalise their rooms with their own belongings and furniture. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29&30 Service users are in safe hands at all times and are protected by the homes recruitment procedures in respect of care staff. Staff are trained and competent to do their jobs. EVIDENCE: The home provides statutory training in house and supports all staff through the NVQ awards. It currently exceeds the percentage of staff required to possess NVQ Level 2 in Care or above. The home employs dedicated domestic staff as well as care staff. Staff induction is thorough and completed within the required timescales but would benefit from the inclusion of the homes Adult Protection policy and the Alerting of Suspected Abuse Procedure. The home has improved its recruitment procedures and the care staff files examined contained everything required and the correct procedures had been followed. However, it was noted that a domestic had been employed after only one reference had been obtained when two are required. High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed. EVIDENCE: High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 4 3 2 3 3 3 x STAFFING Standard No Score 27 x 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x x High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 17 YES 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 OP7 Regulation 15(1) Requirement All Care Plans to be rewritten. Service users or representatives to be involved in process. Care plans to be reviewed monthly. CSCI to be informed of number updated as part of monthly monitoring (Schedule 26). This requirement is outstanding from the last 4 inspections. Recruitment procedures to be followed. Two references to be obtained before deployment, one from previous employer. All areas of the home and grounds to be assessed by a qualified Occupational Therapist. Adult Protection Alert Proccedures to be updated to include informing Assessment Team and CSCI. Complaints Policy and Procedures to be updated to include CSCI contact details. Records of all complaints to be kept. Comprehensive pre admission assessments are undertaken by suitably qualified individuals with service user involvment. Timescale for action 30.10.05 2. OP29(2) 19(1c) Schedule 2(5) 16(1) 23(2a,f,n, o) 12(1a) 30.06.05 3. 4. OP22(1) OP18(2) 30.10.05 30.06.05 5. OP16 (2,3,4) 22(7) Schedule 4(11) 17(2) 14 all 30.07.05 6. OP3 30.06.05 High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 18 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. Refer to Standard Good Practice Recommendations High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 High Broom H59-H10 S21134 High Broom V229495 230605 Stage 4.doc Version 1.30 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. 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