Care Home: Broadland House

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What the care home does well The manager has worked at the home for several years although is still going through the registration process, she is supported by a loyal staff team, with the majority having worked at the home for some time. The proprietor also takes an active role within the home visiting staff and residents most days offering advice and support. The staff team demonstrated they know the residents needs and help them to remain as independent as possible, offering support when needed. Staff receive a general training to enable them to care for people with or without dementia. The residents are cared for in a homely environment within the village of Potter Heigham. There are sixteen single rooms and two shared rooms with the majority having their own personal possessions around them. Staff encourage residents to continue with their own hobbies and interests as far as possible, even though this can be challenging at times, they try to involve family and friends with some of the arranged outings and parties. The manager has developed a life history format where she obtains more detailed background information about the residents who have a memory impairment to help staff develop a better understanding of the whole person. This also helps with conversation and reminiscing about past events individual to them. What has improved since the last inspection? The home was issued with five requirements at the end of the last inspection undertaken on 27th October 2007. The manager has dealt with all of them. The health and safety of residents have now been identified and risk assessments have been introduced to enable staff to be aware of possible risks to reduce or eliminate these for the residents. The fire records including staff fire training is now being kept at the home. People living in shared rooms now have separate storage areas within their rooms and adequate screening so residents who share have privacy. The manager has changed the cleaning arrangements within the communal toilets by adding soap dispensers rather than loose soap which could harmful if eaten. The manager now sends all notifiable incidents to the Commission, including a record of deaths, accidents and other events that is governed by Regulation 37. Several of the bedrooms and the dining room have been recently redecorated taking into account the individual taste of the resident. There were also six recommendations resulting from the last inspection visit with the majority having been adapted by the manager to improve life within the home for the residents. What the care home could do better: There is very little that this home needs to improve. The residents appear to enjoy a good quality of life with the care and support given by the staff. The manager has improved several areas of the documentation so the required written details are in place and carried out. There were no requirements issued following this site visit. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Broadland House Bridge Road Potter Heigham Great Yarmouth Norfolk NR29 5JB 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 assessment of the service. We call this full assessment a ‘key’ inspection. Lead inspector: Hilda Stephenson Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 Copies of the National Minimum Standards – Care homes for older people 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 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 Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Broadland House Bridge Road Potter Heigham Great Yarmouth Norfolk NR29 5JB 01692670632 01692670632 susan.hollyman@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Raymond Hollyman,Mrs Susan Hollyman Miss Dawn Clarke Care home 20 Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): dementia 0 20 old age, not falling within any other category Additional conditions: Number of places (if applicable): Under 65 Over 65 20 20 Twenty (20) Older People who may have Dementia may be accommodated. Total number not to exceed 20. Date of last inspection: Brief description of the care home: Broadland House is a care home providing personal care and accommodation to 20 older people who may also have dementia. The home is privately owned. The owners are experienced providers having two other homes in the area. Broadland House is located in Potter Heigham and is within walking distance of shops and other facilities. The service has 16 single bedrooms and 2 double rooms. Eight of the single rooms have en-suite toilets. The home informed CSCI of its charges in October 2007 and charges from £333 - £367 per week for care provision. Residents are expected to pay extra for hairdressing and chiropody at a cost from £8 - £20. Care Homes for Older People Page 4 of 26 D D M M Y Y Y Y Care Homes for Older People Page 5 of 26 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 How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This visit to Broadlands House took place during the day on the 25th February 2009 as an unannounced inspection to check the outcomes of the key standards. These standards were inspected, although not all the elements have been examined at this time. The evidence gathered to publish this report was obtained by speaking to six of the twenty residents, three care staff, the manager, cook and the proprietor during the day and by checking care records, staff files, policies and procedures. The manager who is currently going through the registration process returned the Annual Quality Assurance Assessment (AQAA) which provided written information about the home since the last inspection. Care Homes for Older People Page 6 of 26 During this site visit a tour of the home and grounds took place which found the home clean, tidy and well decorated throughout. For approximately two hours of this visit the home experienced a power cut, so the staff followed their contingency plan by making sure all the residents were made aware of the power cut, adapting the lunch time meal and offering cold drinks in place of the usual tea and coffee. The fees charged at the time of writing this report is between £343.00 and £378.00 with extra costs for chiropody, hairdressing and purchasing personal items Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: There is very little that this home needs to improve. The residents appear to enjoy a good quality of life with the care and support given by the staff. The manager has improved several areas of the documentation so the required written details are in place and carried out. There were no requirements issued following this site visit. Care Homes for Older People Page 8 of 26 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 enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good clear written information is available for prospective new residents and their families to enable them to make up their own mind whether the home is right for them. All residents individual needs are assessed before moving into the home. Residents requiring intermediate care are not admitted to this home, although they occasionally admit residents who require short-term respite care. Evidence: The manager is currently going through the registration process so the statement of purpose is currently being reviewed to include her details of the service. The statement of purpose and service user guide is available to all prospective residents to read before making up their mind about moving into the home. A copy of each document is also available for visitors to read in the hallway. The manager explained the admission procedure that she follows after an inquiry for a room is made. This was verified after speaking with the latest resident to be admitted to the home who was satisfied with how the manager conducted her visit and how the information was gathered about their personal and social needs. Each resident is admitted on the understanding that the first four week period is for both resident, family and the home can meet their individual needs when a review meeting takes place with all of them involved to ensure the resident makes their decision whether to stay at Broadlands House. Care Homes for Older People Page 11 of 26 The pre-admission format which has been altered since the last inspection contained details about the level of care that the individual required and instructions for the care staff on how to attend to them until the care plan was written by the senior carer, usually within two weeks. Each resident is given a contract to explain the fees charged and payment for any extras that they may use while living at the home such as hairdressing, chiropody and personal toiletries and magazines. The home has a mixture of both privately and socially funded residents with many already within the local area to Potter Heigham. Care Homes for Older People Page 12 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health, social and personal care needs are generally being met. Residents or the next of kin are generally involved when their care plan is compiled and reviewed. Safe medication administration procedures are in place to ensure residents receive the correct prescribed medical treatment. Evidence: Two residents care plans were thoroughly examined and found to contain clear information regarding the physical, social and health care needs of each individual, this information was much more individually orientated than at previous inspections, the majority included residents life history to enable staff to look after the whole person. Each of the care plans contained risk assessments in relation to their moving and handling needs, nutritional needs, personal care to enable each resident to be able to live the lifestyle they preferred. Some of the residents spoken to confirmed that they were regularly kept up to date with their care needs and written aspects of their care, although due to several residents having some memory impairment this could not always be assessed. Evidence of specialist services such as chiropody, hearing, dental and psychiatric services were regularly sought for those who required these and the information was recorded within the care records. During the site visit district nurses were able to treat a resident in private, the manager explained that if they required any nursing equipment then this was obtained for the resident. Some of the residents could confirm that they were treated with respect from the staff Care Homes for Older People Page 13 of 26 and that if they wished to go to their rooms they were assisted in a manner befitting to them. Six of the residents were spoken to during this visit. Some preferred to stay in their own rooms, although they were encouraged to go to the dining room for their main meal. The home has two shared rooms with suitable screening in place to enable privacy for each resident. The manager has developed the care records of each resident which allows individuals to live the life they wish within a homely environment, with the necessary risks assessments in place. The senior carer is in charge of the medication system within the home and demonstrated how medicines are administered, checked in and returned. All the records seen were well documented. Several of the staff have received certificates which are displayed in the hall for the Advanced administration of medicines. The medication system was safe and deemed satisfactory within this environment. Care Homes for Older People Page 14 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are able to make choices in their daily lives. A range of activities are available and visitors are warmly welcomed to the home. Residents are generally content with the food offered. Evidence: Sociable activities tend to be arranged with the Activities Co-ordinator on a daily basis. The weekly list is displayed on the door of the lounge. Care staff organised games, cards, singing, parties and the occasional outing. In the past year since the last inspection their have been organised outings and parties including a Christmas party, an RSPB discussion, monthly Music for Health exercises, a summer fete, minibus trips within the local area, a trip on the Broads and several pub lunches at the local village pub. They also have close connections with the village school where the children visit to include the Nativity and concerts. The Activities Co-ordinator assists the care staff to include one to one activities with each resident to include some social stimulation especially for those residents who do not have regular visitors. Several residents go out to the local village shops. During this visit it was observed that care staff actually sat and talked with residents at various times during the day. Those residents who were too physically frail to take part in more organised activities it was noted that the staff provided music and some form of reminiscence discussion. Past comments received from relatives have always been that they feel included when they visit the home, with some becoming involved with several of the parties and outings. Care Homes for Older People Page 15 of 26 Visitors are asked to sign the visitors book when they enter the building as part of the fire regulations and this showed that the residents enjoy people who visit the home each day. Lunch time was observed, due to the home having a power cut, the meal time took place with a choice of food not being a problem for cook to adapt. The dining room is next to the kitchen so meals were served direct by the care staff. Residents are asked their preference from a varied menu. Some residents who required assistance had their food cut up with staff assisting them in a dignified manner. The lunch time was not rushed and residents developed their own pace, staff spent an adequate amount of time to enable each resident to enjoy their meal. The manager explained that the menu is rotated regularly to include seasonal fruit and vegetables. The kitchen was found to be clean, with the cook preparing salads and two desserts, with the majority of residents having fish and chips brought in due to the power cut. Care Homes for Older People Page 16 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives are confident that the manager would deal with their complaints satisfactorily. Residents are protected from abuse. Evidence: No complaints were received prior to this inspection. The home has a complaints procedure in place for residents and visitors to read and guide them on how to raise a concern and how it will be dealt with. The manager has a Grumbles book and any minor concerns are recorded, with the appropriate action that has taken place. This gave an overall picture of improvements that have taken place since the last inspection. A requirement from the previous inspection was for an improvement in notifying CSCI of recordable incidents that take place within the home. The manager explained about a notifiable incident that had recently taken place regarding a resident who had a fall resulting in a fracture and an admission to hospital. This incident is currently under investigation. A second notifiable incident which occured over the past few days was they had experienced an outbreak of the diarrhoea and vomitting virus and the staff had put the required infection control measures in place. On talking to residents it was clear that they were happy to discuss their concerns with the manager or senior carer. For those residents who were unable to express themselves it was observed that the staff dealt with the situation going through a variety of options to assist them to ensure they could make the resident comfortable again, showing that the staff could empathise with each resident. Staff records show that staff has attended adult protection training. This topic is included within the recommended NVQ training and induction programme of new staff. Staff spoken to during this visit confirmed that they felt confident in their knowledge of various forms of abuse and how they put this into action to protect their residents they care for. The staff feel able to report any concerns to the manager and that they would be dealt with. Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 of 26 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, 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. This is what people staying in this care home experience: Judgement: People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, well maintained comfortable home. Evidence: A tour of the building and grounds was undertaken which found the home to be clean and well maintained. Three of the requirements issued at the last inspection had been dealt with, health and safety records were being maintained by the maintenance man, residents in the shared rooms had their own individual area for there toiletries and soap dispensers were in place in the toilets. Several areas of the home had been decorated since the last inspection. There is a divider situated in the lounge to enable residents who wish to watch the television are separated from those wishing to be involved in the daily activities. The garden has been adapted for people to be able to walk around it safely with the addition of sensory raised flower beds. Access via a ramp from the conservatory is in place for wheelchair users. The garden is enclosed. The proprietors have replaced some carpets throughout the home, the dining room has been redecorated with several of the bedrooms having been given a new coat of paint. The two shared rooms have a screen between the beds to ensure the residents have privacy, although these have been used as single occupancy when a resident does not wish to share, the fees being changed appropriately. There has been an addition of two cats recently and several residents were seen to enjoy the comfort these pets bring. The manager explained that this information abouts the cats had been added to the statement of purpose so any new prospective resident that the home had pets. The building has a secure front entrance with every visitor greeted by a member of staff, they are asked to sign the visitors book in line with the fire regulations. Fire training for staff takes place at regular intervals, the manager has a clear and detailed fire risk assessment for the building with the records showing this vital training is carried out. Care Homes for Older People Page 19 of 26 All the residents laundry is carried out at the home by the staff. Care Homes for Older People Page 20 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are available in sufficient numbers to look after the people living at the home. The manager follows a clear recruitment procedure to ensure the protection of vulnerable adults. Evidence: Staff spoken to had been in post for a while and the rota showed that adequate amounts of staff were on duty. Extra staff are brought in if their are outings arranged and during periods of sickness the manager tends to use there own staff to cover rather than use agency staff. Staff training records were now kept at the home which was not the case at the last inspection. The training of staff is overseen by the Homes Trainer and manager and training tends to take place at one of the sister homes in a nearby village. Two staff files were checked with the manager following a good clear recruitment procedure, obtaining references and the relevant checks before staff commenced. It was noted that staff expressed their satisfaction of their job role and the amount of support they received from the manager. Staff meetings were held at regular intervals with the minutes taken so staff not attending could catch up. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is managed with their best interests at heart. Residents health, welfare and safety needs are promoted and protected. Evidence: The manager Dawn Clarke is currently going through the registration process having just recently undertaken the fit person interview. She has worked at the home since 2005 and has kept up to date with the required training. She is supported by regular visits by the proprietors. Six residents and three staff were spoken to during this visit to the home and the impression the Inspector was given was that the home is managed in a supportive and professional manner. The manager has since developed the quality assurance and now makes visitors and residents aware of the outcomes which is an improvement since the last inspection. The last regulatory 26 report was read and showed that the proprietor audits the home each month. Staff confirmed that the manager holds regular staff meetings for them to raise their issues and discuss ideas to plan events for the future. This information is gathered from residents through informal discussion and taken to these meetings. The manager also monitors staff through regular supervision and appraisal sessions. Residents finances are protected and any personal spending money is kept safe in individual wallets with records in place. Care Homes for Older People Page 22 of 26 Safe working practices were observed during the inspection. Hoists and other specialist equipment were being used, and records showed that they are regularly maintained. A sample of health and safety records were checked including the fire records, monitoring accidents, staff training and risk assessments. The registration and insurance certificates were displayed in the hall. Overall, the home is managed in a safe and satisfying manner putting residents and staff health and safety first. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes No 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 Older People Page 24 of 26 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 Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. ©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. 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