Inspection on 28/07/06 for The Broughtons Care Home

This inspection was carried out on 28th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

The Broughtons Care Home 16/10/07

The Broughtons Care Home 17/02/06

The Broughtons Care Home 10/10/05

The Broughtons Care Home 14/01/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Broughtons Care Home 2 Moss Street Great Clowes Street Salford Manchester M7 1NF Lead Inspector Adele Berriman Unannounced Inspection 28th July 2006 10:15 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 The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Broughtons Care Home Address 2 Moss Street Great Clowes Street Salford Manchester M7 1NF 0161 708 9033 0161 792 8144 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) Broughton Care Limited Mrs Doris Nordskog Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home provides accommodation for a maximum of 37 service users, who require care by reason of old age (OP) One named service user who is under 65, and requires care by reason of physical disability (PD) is accommodated. Should this be no longer required, this place will revert to the service user category (OP). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The staffing arrangements at the home must be maintained inline with the minimum staffing levels set out in the guidance published by the Residential Forum `Care Staffing in Care Homes for Older People` 17th February 2006 Date of last inspection Brief Description of the Service: The Broughton’s provides residential accommodation with personal care for up to thirty-seven (37) service users within the category of old age (OP). Accommodation is offered in 36 rooms, 35 single and one double, 31 of which have en-suite facilities. Lounge and dining facilities are located on the ground and first floors. These are arranged in group-living situations accommodating 8 or 9 people. The home is situated in a residential area of Salford close to local amenities and transport systems. Fees for the home range between £310.17 and £355.52. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on 28th July 06. Time was spent talking to residents, the manager and staff members. Assessment of documents and a tour of some areas of the building also took place. Five service users surveys were completed by residents and their family members and returned to the Commission. Not all of the key standards were assessed during this inspection of the service and therefore it is highly recommended that this report is read in conjunction with the previous report dated 17th February 06. What the service does well: What has improved since the last inspection? An activities co-ordinator was in place to assess and meet the recreational needs of residents. The content of residents care plans continued to be developed and contain the relevant risk assessments for individuals. Several staff had received training in subjects including adult protection. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. People’s needs are assessed to ensure that the home can meet their needs and wishes. EVIDENCE: Prior to a resident being admitted to The Broughtons a senior member of staff carries out an assessment of need to ensure that the home is able to meet the persons care requirements. Copies of these assessments were present on residents’ files. Information gained from this assessment informed the individuals’ care plan. The Broughtons does not offer intermediate care facilities. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 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 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to the service. Care plans contained good information to inform staff on how to meet individuals’ needs. Failure to improve on the recording processes for the administration of medication may result in people being put at unnecessary risk. EVIDENCE: Each resident had a care plan. The contents of four care plans were assessed. The information contained in these documents was informative and gave guidance for staff to follow when delivering care and support to the individual. The contents included a needs assessment, service user plan, personal history and biography, evidence that care plans are reviewed on a regular basis. However, following a requirement from the previous inspection report not all care plans contained information relating to how, when and why ‘when required medication should be administered. At the time of this visit the manager of the service was in the process of reviewing the storage arrangements for residents files to ensure that people needing access to the information were able to at all times. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 10 Individual risk assessments formed part of residents care plans. Following a requirement in the previous inspection report falls risk assessments had been added to individuals’ files. Several residents spoke English as a second language. The family of one resident supports the staff occasionally with the Polish language. One resident speaks Spanish as his first language. A member of staff employed at the home speaks Spanish and staff also have access to a Spanish phrase book. Daily records of what care and support had been offered/delivered to individuals were maintained by staff. Some of the entries on these records were detailed and informative. However, some entries were brief and contained little information and on occasions some information was inappropriately documented, for example, one entry stated ‘refused to go to bed.’ Care notes demonstrated that residents had access to their GP when required. There was evidence that some residents were receiving support from local community psychiatric services and on the day of the inspection a physiotherapist was visiting a resident to provide support. Medication was stored appropriately in a locked room. A fridge was also available for the storage of some medication, the temperature of which was monitored on a regular basis. The home had a procedure for the management of medication stock and controlled drugs balances and records were accurate. However, some areas of practice in the administration of medication were could potentially put people at risk. The Medication Administration Records (MAR) were not completed appropriately. For example, they did not record when and by whom medication had been stopped. Hand written entries onto the MAR sheets did not contain the full name, amount of medication received or the dosage to be given. Not all medication that had been administered had been signed for at the appropriate time. Discussion took place between the inspector and a senior member of staff about the needs to ensure that all medication is recorded and administered as prescribed. Requirements relating to the recording and administration of medication were made following the previous inspection. Residents said that staff were polite and respectful. However, during the inspection the inspector observed a member of staff entering a resident’s bedroom without knocking on the door. This matter was addressed with the member of staff after the inspection. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Once the activities co-ordinator role is established residents’ recreational needs should be met. EVIDENCE: Since the previous inspection the service had member of staff in post as an activities co-ordinator to work 5 hours a day Monday to Friday. No formal activities programme was available at the time of the inspection as the coordinator was still in the process of assessing what activities people wished to participate in. The manager stated that one resident had expressed a wish to plant some hanging baskets in the garden and arrangements were being made for them to go out and purchase the plants for the baskets. Another resident continues his hobby of fishing locally with friends and makes regular evening visits to the fishing club. The residents showed his fishing equipments and trophies that he had won to the inspector. Visitors were observed entering and leaving the home throughout the visit. Residents confirmed to the inspector that they were able to receive visitors at all times and that it was their choice as to where they met with them. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 12 Information about local advocacy services was clearly displayed in the foyer area of the home. Residents said they were given a choice of how they managed their affairs. An example of this was that some people did and participated in the management of their finances. There was evidence around the home that people had an opportunity to bring to the home personal effects and treasured items and one resident of the home was in the process of purchasing some furniture for their bedroom. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their families are confident to raise any concerns or complaints with the service. EVIDENCE: The home had a complaints procedure that was readily available within the communal areas of the home and in people’s bedrooms. Within the previous 12 months the home had received 6 complaints, one of which was substantiated and one that was partially substantiated. Complaints were recorded on individual forms which detailed the investigation and its outcome, any action to be taken following the outcome and the date of the response to the complaint. However, the documents did not contain the name of the person who had investigated the complaint. Five residents’ survey forms had been completed and returned to the Commission and all stated that people knew how to make a complaint if they needed to. On the day of the visit several residents confirmed to the inspector that if they had a concern or a complaint they would be happy to speak to the manager. A copy of Salford Social Services joint agency adult protection procedure was readily available for staff to access. A requirement was made following the last inspection that the manager and staff must have training in adult protection awareness. Since this requirement was made several staff had attended adult The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 14 protection awareness training in May 06. The manager stated that further training was planned to ensure that all staff received awareness in the subject. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home provides a pleasant environment in which to live. EVIDENCE: The home is set within its own maintained grounds with an accessible garden area to the rear of the property. The home employed a ‘handy person’ to assist with day to day maintenance of the home. The home was comfortably furnished with furniture to meet the needs of the residents. Several bedrooms had recently been decorated and the manager stated that this was part of an on-going redecoration programme. The home was clean, tidy and hygienic. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 16 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team were able to meet the needs of service users. EVIDENCE: At the time of the inspection the manager, a senior carer, carers, cook and ancillary support staff were on duty to meet the needs of the residents. Staff demonstrated a good awareness of residents needs and wishes. A total of 20 care staff and 7 ancillary staff are employed at the home. A total of 63 of care staff have completed their National Vocational Qualification (NVQ) level 2 or above. All 5 people who completed the service user survey said that staff listen and act on what you say. One resident wrote, “we get well looked after” and “they have plenty of time to listen to you.” One resident wrote in relation to the care and support they received from the staff team ‘they are all very good, always at hand when they are needed’. The homes training plan demonstrated that on-going training for staff was scheduled in fire safety, first aid, moving and handling, COSHH, adult protection, infection control, medication and NVQ. The manager stated that health and safety training for all staff was in the process of being organised as she was aware that all staff needed update training in this area. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 17 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, 38 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of the residents. EVIDENCE: The manager of the home had been in post for some time and has extensive experience of working in social care. The manager stated that she was in the process of completing her National Vocation Qualification level 4. Both residents and staff spoke positively about the manager of the home. One resident wrote, ‘The management are very good, always at hand when needed’. The home has a process for assessing the quality assurance of the service delivered. People’s views are gained by written surveys. At the time of the inspection the manager stated that she was in the process of starting to do a quality audit of the service as only some surveys had been completed. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 18 All monetary transactions on behalf of service users are recorded on individual account balance sheets. Several of these sheets were assessed and were balanced. The home had a procedure for the storage of all receipts. The majority of residents have individual savings accounts managed by Salford Social Services. Two residents were supported to maintained their own finances. The home had appropriate storage facilities for the safe keeping items of value. However, the facility contained monies belonging to residents that should be placed in the individuals’ bank account to ensure safe keeping. Discussion took place between the manager and the inspector regarding the management of people’s finances. Further discussion took place regarding the safe storage of keys to safe keeping facilities as during the inspection the assistant manager was seen to hand a member of staff a set of keys that would access all storage facilities in the home. Policies and procedures relating to the health, safety and wellbeing of all were in the process of being amended and updated. The manager demonstrated several policies and procedures that had been amended that were awaiting typing. Documentation assessed demonstrated that the home had regular maintenance contract for utilities and equipment. The environmental health office has inspected the home on 20.06.06. The home fire equipment testing records demonstrated that weekly fire bell tests were carried out. At the time of the inspection a bell test was being carried out. Some residents and all staff were seen to respond appropriately to the fire bell test. Several internal doors were seen to wedged open. The safety issues of this practice were discussed with the manager of the home who removed the wedges immediately. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 19 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 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 2 The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 Requirement Daily notes that form part of the care plan for an individual need to detail all care and support that has been delivered/offered and be written in an appropriate manner. Timescale for action 15/09/06 2. OP9 13 07/09/06 The home must ensure that the management for the recording and administration of medication are carried out safely to maintain the safety of residents. This includes:Ensuring all medication is signed for at the time of administration. Ensuring that all MAR sheets contain full details of the prescribed medication. The care plan for the administration of ‘when required’ medication must confirm why the medication is prescribed and in what circumstances should it be given. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 21 3. OP35 16 Arrangements for managing the money of residents must be reviewed so that sums of money held at the home are deposited in residents’ bank accounts. The practice of passing bunches of keys that would access sensitive information and monies must cease. The practice of ‘wedging’ doors needs to cease. 15/09/06 4. OP38 13 05/09/06 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. Refer to Standard OP16 Good Practice Recommendations It is strongly recommended that all records and completed investigations of complaints contain the name and signature of the person who carried out the investigation. The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 The Broughtons Care Home DS0000062302.V297942.R01.S.doc Version 5.2 Page 23 - 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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