Latest Inspection
This is the latest available inspection report for this service, carried out on 29th June 2010. CQC found this care home to be providing an Good service.
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.
For extracts, read the latest CQC inspection for Broad Oaks.
What the care home does well Broad Oaks is a service which provides accommodation and support for people with a physical, and, or learning disability and. or mental health issue. Accommodation is provided in a number of different bungalows and flats, which accommodate no more than six people. We looked around one home and it was very homely and well decorated. Bedrooms were personalized and staff told us that residents helped in the garden. Residents have the opportunity to socialize with residents they share with or residents from other bungalows. Staffturn over is fairly low and staff told us that the service had improved. They said there was better training, supervision and support. The home exceeds the national minimum standards for the percentage of staff employed with a National Vocational Qualification (NVQ). The home were able to demonstrate that they have good links with other health and social care professionals and meet a wide range of needs, through staffs expertise and gaining support through other agencies where necessary. What has improved since the last inspection? The last key inspection to the service was undertaken in November 2009. The service was rated as adequate. We made 10 requirements over two visits to the service and had sufficient concerns to make a referral under the safeguarding of vulnerable adults protocals. As part of this inspection we were provided with clear evidence of how the home had met those requirements in their evidence file. The home hold regular health and safety meetings which follow a due process, maintenance, health and safety and refurbishment issues are raised and actions are agreed . Minutes were seen for each month and outstanding requirements had been met. Staff training and development is recorded on staffs` individual training folders and on a staffs` training and development matrix. This was largely up to date and staff spoken to stated that the service had improved over the last six months. examples given were greater cohesiveness, better team work, training and regular support and supervision. Staff felt that senior staff were approachable and the appointment of a senior staff member who works across shifts was seen as advantageous because they were able to pass information from one shift to the other to ensure a seamless service. The home has appointed a manager, who was previously employed as the deputy manager. She is enthusiastic and well organized. She has been supported by another manager employed by Southern Cross and an area manager who completes monthly internal audits. The home has improved its documentation. We looked at the statement of purpose, service user guide, pre-admission documentation and revised care plans. These were much improved. The home has also introduced a health action plan and a hospital passport What the care home could do better: The home has improved substantially but needs to demonstrate that they are able to sustain improvements. The manager is in the process of making an application to the Care Quality Commission. Key inspection report
Care homes for adults (18-65 years)
Name: Address: Broad Oaks 30 Gaul Road March Cambridgeshire PE15 9RQ The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Shirley Christopher
Date: 2 9 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years)
Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home
Name of care home: Address: Broad Oaks 30 Gaul Road March Cambridgeshire PE15 9RQ 01354656202 01354656934 broadoaks@schealthcare.co.uk Notavailable Active Care Partnerships Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability Additional conditions: The maximum number of services users who can be accomodated is: 38 The registered person may provide the following category/ies of service only: Care Home only - Code PC, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD, Dementia - Code DE Date of last inspection Brief description of the care home Broad Oaks is a care service for people with learning disabilities. The service consists of four bungalows, two blocks of four flats, and a resource centre. The home has accepted groups of people with a wide range of needs, and covering a great age range: two of the bungalows have groups of much older residents, several of whom are over 65 years of age and one bungalow offers a home to young adults who are between 19 and 25 years of age. Built around a central courtyard, and backing onto a small estate Care Homes for Adults (18-65 years)
Page 4 of 24 Over 65 0 15 1 38 1 6 1 1 2 0 0 9 Brief description of the care home of new houses in a residential area of March, the bungalows and flats blend in well with neighbouring properties. Each bungalow consists of single bedrooms all with ensuite toilet and washbasin, a kitchen/dining room, lounge, laundry, bathroom, shower room and cloakroom. The flats are in blocks of four, each for two people, with two bedrooms, bathroom, living room and kitchen. An additional building on the site, the leisure and education centre, contains offices and rooms where a range of activities can take place, both during the day, during the evening and at weekends. There is an art room, a sensory room and a large room which houses a piano and an organ. This room can be divided into two. There is also a kitchen, and toilet facilities. Adjacent to a public recreation park, Broad oaks is situated about five minutes walk from the centre of the busy market town of March, which offers a range of shops and leisure facilities. The home is within easy driving distance of Peterborough which has additional leisure facilities such as bowling and ice-skating. All of the people who live at Broadoaks are funded by local authorities/care trusts. The average fee £1,041.00 per week, based on the amount of care and support needed by each person. A copy of the inspection report is available in each bungalow and each block of flats, and in the reception area of the resource centre. Care Homes for Adults (18-65 years) Page 5 of 24 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home
peterchart Poor Adequate Good Excellent How we did our inspection: We carried out a key inspection on the 28 June 2010 to this service. We met with the manager and the operations manager and a manager from another service who had been supporting the manager. We met and spoke to at least twelve staff. The home was holding a barbeque over lunch and early afternoon, which gave us the opportunity to speak to most of the residents. We looked at records including a revised care plan, staff records, maintenance and servicing records. We looked at medication in respect of one person, and we looked around one of the bungalows. Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 7 of 24 The home has improved substantially but needs to demonstrate that they are able to sustain improvements. The manager is in the process of making an application to the Care Quality Commission. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 24 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users can expect the home to assess their needs and to give them opportunities to visit the home to familiarize themselves with the service and to ensure the service can meet their needs. Evidence: We looked at the homes statement of purpose and service user guide which had been updated. The home has amended its admission form and this is more in depth. The home has not had a new admission since the last key inspection in November 2009. The admissions form is in more depth but tends to focus on medical rather than social issues. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are well written and help staff to assist residents with their needs. Evidence: We looked at one care plan and were assured by the manager that all the care plans would be updated using the same format by the 1st August 2010. The staff have done a considerable amount of work to make the care plan, user friendly and information easily accessible. Staff spoken to stated this was the third change to the care plan, but staff felt care plans had improved significantly. The care plans look at peoples future dreams and aspirations. We spoke to a bank member of staff and they felt they were able to find current information easily. Care plans gave detailed information about service users needs and included health care records, and risk assessments. Care Homes for Adults (18-65 years) Page 11 of 24 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can expect to be offered a range of social activities and take part in the community. Evidence: We saw a big improvement in the number and variety of social activities being provided. We spoke to staff and they told us there is a budget for activities and there is more scope for staff to take residents further afield and to go to local events. Examples given of recent or planned visits were Hunstanton, East of England show and Friday Bridge Farm. On the day of inspection there was a barbecue taking place and most of the residents were involved. Several residents were at day centres or colleges. We spoke to residents about what they liked to do. A few residents had been watching the football. Another resident was planning to see his girlfriend and go to a disco which is a regular event. There is a gardening club and one of the residents has a green house.
Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: On site the home has facilities such as a multi sensory area which is used for residents. There are activity folders which record what activities people have done. The home have secured one to one funding for some residents and for another resident who we case tracked, the home are trying hard to secure funding. There is a clear audit trail of what actions the home have taken to try and secure funding. The home has its own transport. One of the larger vehicles can only be driven by a small percentage of staff, but there are alternative vehicles. The home stated they make good use of local facilities and can easily walk into town. We saw evidence that the home encourage residents to see their friends and families. The home had recently completed an internal quality audit. As part of this survey, families had commented that they always receive a warm greeting from staff at the home. We did not look at meals specifically as all residents were outside enjoying a barbecue. The individual dwelling we visited provided comfortable arrangements for meal times. We looked at records which included a nutritional assessment and weight records. We pointed out that the record showed us that the person had put on a significant amount of weight and the nutritional assessment only identified if a person was at a nutritional risk from weight loss, not weight gain. Care Homes for Adults (18-65 years) Page 13 of 24 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect the home to meet their health care needs and meet their needs in a sensitive, professional way. Evidence: We saw a clear audit trail relating to one person and the efforts the home had made to get their health care needs properly assessed. Residents have a health check which is a comprehensive, person centred document. We saw evidence that residents health care needs are regularly reviewed by a range of general and specialist health care professionals. The staff are sufficiently trained to meet the specialist health care needs of residents such as administering medication when needed to stop seizures. Staff are trained in administering rectal diazepam and using an epi-pen, (also for epilepsy.) Staff are trained in tube feeding in one dwelling. We spoke to staff who showed a good understanding of residents needs and looked at training records. The manager told us that support was provided by the learning disability partnership and other agencies who provided training and workshops. Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: We looked at accidents and incidents, trips and slips. These are closely audited and there has been a general reduction in recorded/reported accidents. We looked at medication records for the person we case tracked. Records were satisfactory. The home has controlled drugs and these were properly recorded and the number in stock tallied with the number recorded. We looked at staff training records and medication audits and these were in place and sufficiently robust. The last medication audit took place in April 2010 and there was evidence of recent medication training by external providers. The home have introduced a new local policy after meeting with the pharmacists. Care Homes for Adults (18-65 years) Page 15 of 24 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promote residents welfare and have internal systems in place to keep people safe, such as good staff selection and recruitment procedures, staff induction and training and clear complaints procedures. Evidence: The home has a complaints procedure which is easily accessible and any complaint recorded detailed clearly what actions the home had taken. Actions taken were appropriate. The home are forthcoming in reporting concerns or safeguarding issues to the Local Authority and the Care Quality Commission. The home are proactive in reporting any event which affects the safety and or well being of people using the service. The home has robust staff recruitment and selection processes. Staff are adequately inducted and receive mandatory training including safeguarding. Care Homes for Adults (18-65 years) Page 16 of 24 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes are appropriate to the needs of the people living there. Evidence: We did not go round all the individual dwellings as everyone was outside on the day of inspection. The grounds were maintained well and we did visit one house. The home was well furnished and was homely. Residents had individualized bedrooms which reflected their personalities and their physical needs. We did not identify any hazards to their safety or maintenance issues. The home seen was maintained to a high standard of cleanliness and this was something identified in the recent homes internal audit of what the home does well. The home has a health and safety representative who meets monthly to discuss any concerns or maintenance issues. We were concerned that issues raised relating to manual handling equipment could be putting staff and residents at risk. Actions had been identified and met, but some of the issues took quite a time to resolve. We did speak to one resident who said that they would rather live with younger people, as they were the youngest by far in their house. Social and age compatibility should be considered as part of the admission process.
Care Homes for Adults (18-65 years) Page 17 of 24 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good staff recruitment and selection procedures and the workforce are sufficiently trained and supported to ensure residents needs are understood and met. Evidence: We looked at three staff files. These were satisfactory and demonstrated that the home has robust staff recruitment and selection procedures. A number of staff had references which were not dated, which made it difficult to establish if these had been received before staff were employed. We spoke to staff about their experiences of working at Broad Oaks. Staff stated they were well supported by senior management and felt that the training and the support provided to them was good. No concerns were raised and staff commented that the service has significantly improved, which was consistent with our findings. We looked at the staff training and development plan, which showed almost all mandatory training was up to date. This was confirmed by staff. A very high percentage 80 and more of staff had a national vocational qualification at levels 2, 3, or 4. We looked at more specialist training and saw that staff were being supported by the Learning Disability Partnership, (LDP) and psychiatrist, who were teaching strategies to be used for clients who have difficult behaviours. Staff are trained in a non physical intervention for people with challenging behaviour. We spoke to staff about residents
Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: they supported with additional and complex needs and staff showed a good understanding of clients needs and how to meet them. We looked at supervision schedules and staff were receiving regular supervision. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and there are good self-monitoring tools in place to ensure the service provided is of a high standard and provides good outcomes for people. Evidence: The home has a manager who was officially appointed to the role on the day of the inspection. They are very competent and were able to demonstrate how they have moved the service forward, by meeting all the requirements made at the time of the last key inspection in November 2009. They have worked hard to improve the lives of residents living at the home through improved access to the community and increased social activities. The staff said they were happier because they were able to get out more with residents. They said they had received good training and support from the senior staff and the manager. The staff felt there was greater accountability through the appointment of a senior member of staff working across the shifts and being aware of issues affecting residents across the day. We looked at the support in place for the manager which was good. The operations manager regularly supports the manager and a monthly internal audit is completed. A
Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: registered manager from another service is also on hand to offer support and advice and work on improvements. The home has regular meeting to discuss service deficiencies and actions are put in place to address these. We saw evidence of effective quality assurance which included feedback from residents and their families, staff and volunteers. Results showed a high level of satisfaction with the home. We looked at a sample of maintenance and servicing records and these were in order. They included fire records, including testing of equipment, alarms, and lighting. We looked at the latest fire report. We looked at water temperatures, a persons finance and general maintenance. They were fine Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 24 of 24 - 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!