Care Home: Broadlands Care Home

What the care home does well Comprehensive assessments are carried out so that people are assured their needs can be met in their preferred way. Full care plans are prepared within two days of people moving into the home and these are reviewed at least once a month so that staff have updated information to meet people`s needs. Care staff demonstrate good practice when they give medication to people and we saw that the current records were completed in full. People told us that they were treated with respect when receiving help with washing and dressing. One of the senior staff had undertaken further training and become registered with the local authority as the Dignity Champion. It was her role to investigate any concerns about people`s dignity and to challenge people if dignity was not upheld. One of the staff was responsible for co-ordinating activities and had compiled ideas and materials for other staff to use. People were keen to join in activities and told us that they play something different each day including dominoes card games, quizzes and bingo. There were also visits from outside entertainers including an accordion player, singer and three artists. On Saturday evenings they had a film night and took turns in choosing which film to watch. Most people were complimentary about the meals and said, "The dinners are all very good here" "She`s a very good cook". "They know what food we like." People know how to make complaints if they need to and any concerns are taken seriously and dealt with appropriately. The premises are clean and comfortable for people. One relative who was a regular visitor commented, "Always fresh and clean". There are sufficient staff available and they are supervised and trained. People said that there was always someone to give some help when they needed it. The quality of the home is monitored by another person that owns it and also through meetings with people living there and regular contact with relatives. Surveys had been carried out and there was a suggestions box in the entrance hall. What has improved since the last inspection? Pre-admission assessments have been improved so that they now contain more clear information about the person`s history, social interests, hobbies, religious and cultural needs and actions relating to these are set out in care plans to enable people living at the home to maintain interests in the way they prefer. The ground floor bathroom has been cleared, to enable the bath to be used safely and to give people choice of a bath or shower.Work has been carried out to tidy and improve the garden and maintenance within the home is ongoing to improve the premises overall in order to provide a comfortable home for people living there. What the care home could do better: They could offer to arrange social outings and give assistance for people to visit the local library and attend church as appropriate. They should install paper towel dispensers in the first floor bathroom and toilet. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Broadlands Care Home 28 Shelford Road Radcliffe on Trent Nottingham NG12 1AF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme 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 a ‘key’ inspection. Lead inspector: Meryl Bailey     Date: 1 5 0 4 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. 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. 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) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Broadlands Care Home 28 Shelford Road Radcliffe on Trent Nottingham NG12 1AF 01159332727 01159115027 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Premila Auchraje,Miss Soowantee Doma care home 19 Number of places (if applicable): Under 65 Over 65 0 19 dementia old age, not falling within any other category Additional conditions: 5 0 All service users within Broadlands Care Home must be over the age of 60 years Miss Soowantee Doma and Mrs Premila Auchraje are registered to provide accommodation and personal care for persons of both sexes at Broadlands Care Home whose primary needs fall within the following categories:- Old Age, not falling into any other category - OP (19) Dementia - DE (5) The maximum number of persons to be accommodated at Broadlands Care Home is 19 Date of last inspection Brief description of the care home Broadlands is a care home providing personal care and accommodation for 19 older people. It does not provide nursing care. It is owned by Miss Doma and Mrs Auchraje, with Miss Doma being the registered manager. The home is located in the village of Radcliffe on Trent and it is approximately a quarter of a mile from the village centre, which has shops, pubs, library and church. Care Homes for Older People Page 4 of 26 Brief description of the care home The home was opened in 1970 and is an extended, detached property. People are accommodated on the ground and first floor, access to which is by 2 stair lifts. There is some seating outside and a small garden area. Current fees for the service range from £297 - £355 per week depending on dependency needs. There are additional charges for hairdressing and chiropody. Further information about the home is available in the brochure and service user guide and a copy of the latest report is also available for viewing. The Certificate of Registration is displayed in the entrance area and is up to date. 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 Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people using the service and their views on the service provided. This process considers the providers capacity to meet regulatory requirements and minimum standards of practice and it focuses on aspects of service provision that need further development. Prior to the inspection visit we sent out survey forms to a sample of people currently living at the home and we have used their comments for planning and to inform our judgments. We reviewed all of the information we have received about the home since the last report of our key inspection, which took place on 2 May 2008. Services are now required to fill in a document called an Annual Quality Assurance Assessment (AQAA), Care Homes for Older People Page 6 of 26 in which the registered manager identifies from their own quality monitoring what the service does well and what they need to improve. We received a completed AQAA form in March 2009. We considered this in planning the visit and deciding what areas to look at and the information has been taken into consideration within this report. We carried out the inspection visit with one inspector. It was unannounced and took place on one day in the daytime, including lunchtime. The main method of inspection we used during this visit is called case tracking which involved us choosing a sample of people who live at the home and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We looked at staffing records and other records connected with the running of the home. A partial tour of the premises included all shared areas and a sample of bedrooms. What the care home does well: What has improved since the last inspection? Pre-admission assessments have been improved so that they now contain more clear information about the persons history, social interests, hobbies, religious and cultural needs and actions relating to these are set out in care plans to enable people living at the home to maintain interests in the way they prefer. The ground floor bathroom has been cleared, to enable the bath to be used safely and to give people choice of a bath or shower. Care Homes for Older People Page 8 of 26 Work has been carried out to tidy and improve the garden and maintenance within the home is ongoing to improve the premises overall in order to provide a comfortable home for people living there. What they could do better: 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 set out 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 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 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. Comprehensive assessments are carried out so that people are assured their needs can be met in their preferred way. Evidence: We looked at a sample of files and found that the needs of each person had been assessed prior to moving into the home. Further assessments had then been carried out in order to plan the care required. Assessments were comprehensive and some areas had been added to these since the last inspection. People had signed the assessments. Care Homes for Older People Page 11 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 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 care planning and reviewing process ensures staff have updated information to meet peoples needs. People have clear access to health professionals and the handling and recording of medication promotes and safeguards peoples health. Dignity is maintained and staff offer respectful care to people. Evidence: We found full care plans had been prepared within two days of people moving into the home. These plans clarified action to be taken in relation to each identified need. Risk assessments had been carried out as part of the care planning and these had been reviewed each month. Clear assessment tools were used, for example, with regard to the risk of people developing pressure sores and the way they needed to be moved and handled. Weights were monitored and recorded on charts in peoples files. There were daily records and further records of contact with health professionals. Some people had nursing files in their rooms where district nurses were involved. One person was recovering from an operation and was cared for in her bedroom. She told us she was very satisfied with the care at the home and had plenty of attention from Care Homes for Older People Page 12 of 26 Evidence: staff popping in to see her. Medication was stored in a locked trolley. The majority of medication was prepared by the pharmacist using a dosage system. Care staff recorded when they had given medication to people and we saw that the current records were completed in full. A Boots pharmacist visited regularly to ensure staff were following good practise and there were records of these visits. We observed staff speaking with people respectfully. People told us that they were treated with respect when receiving help with washing and dressing. There were two double rooms and we saw that these had screens in place to give some privacy. One of the senior staff had undertaken further training and become registered with the local authority as the Dignity Champion. It was her role to investigate any concerns about peoples dignity and to challenge people if dignity was not upheld. Care Homes for Older People Page 13 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 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. People enjoy a varied lifestyle with choices and varied meals that suit their dietary needs and preferences Evidence: Peoples likes and dislikes, social and leisure interests were included in the assessments. One of the staff was responsible for co-ordinating activities and had compiled ideas and materials for other staff to use. During the morning of this visit people were enjoying singing along to music. After lunch staff encouraged people with activities. One person was doing some art work, a group of people were playing giant snakes and ladders and another group played dominoes. People were keen to join in and told us that they play something different each day including card games, quizzes and bingo. There were also visits from outside entertainers including an accordion player, singer and three artists. On Saturday evenings they had a film night and took turns in choosing which film to watch. There were regular Residents Meetings to discuss entertainment as well as meals and improvements in the home (see the management section of this report). A hairdresser came to the home each week and some people had been out for pub Care Homes for Older People Page 14 of 26 Evidence: lunches in the local community. There had not been any other contact with the local community or outings and one person suggested anonymously that trips to the local library and church would improve the service further. There were three visitors to the home during the inspection. Visitors told us they were always made welcome and offered drinks. Lunch was served in the dining room and individually to those who wished to stay in the lounge or their own rooms. The menu for the day was on a chalk board and there was a four week menu in the kitchen. This showed a variety of meals were served with options given each day. The meal on the menu for the day was roast turkey, new and roast potatoes, peas, broccoli and carrots, followed by Jam Tart and custard or icecream. A roast was served on Sundays and mid week and although no option was written on the board the staff said that occasionally someone asks for something different and it is provided. On other days there was always a choice given on the days menu. For the following day this was Lasagne or Cornish Pastie and for Friday it would be Fish or Vegetable slice. Two people we spoke with said they didnt like the meals. However, these people were had specific needs related to food intake. We saw later that they were given food they would eat. All others that we spoke with were very complimentary about the meals and said, The dinners are all very good here Shes a very good cook. They know what food we like. Care Homes for Older People Page 15 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 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. Any concerns are taken seriously and dealt with appropriately and people are safeguarded from abuse. Evidence: The complaints procedure and was included in the Service User Guide and on the wall in the entrance hall. There was a confidential management file of complaints records and this contained full clear details of investigations and responses. There had been one complaint in the last twelve months. It was partly upheld and the complainant was satisfied with the response given and subsequent action taken. People told us they would speak to the manager if they were unhappy about anything. The relatives said they knew they could make a complaint if necessary. The manager told us in the Annual Quality Assurance Assessment that all staff are provided with training in Safeguarding people and that they are reminded to be vigilant in reporting any malpractice and concerns. We saw records of the training the local Safeguarding Adults Procedures booklet was available for reference on the managers desk. We also saw evidence that action is taken when recruiting staff, by checking people through the Criminal Records Bureau as well as two written references. There had not been any allegations or investigations under the Safeguarding procedures during the last 12 months. Care Homes for Older People Page 16 of 26 Evidence: Care Homes for Older People Page 17 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 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. People live in a comfortable environment that is kept clean. Evidence: One relative said about the environment Always fresh and clean. We saw all communal areas, bathrooms and a sample of bedrooms. All areas we saw were clean. The dining room looked homely and tablecloths were used at lunchtime. Later they were removed when the tables were used for activities. The small lounge and conservatory were both well furnished. Some bedrooms we saw had flaking wallpaper and staff said that the manager was gradually having rooms redecorated. There was a written maintenance plan for this to commence from April 2009. There were records of maintenance work that had been carried out each month. People who had lived at the home for a few years said that they were very happy with their home and enjoyed sitting in the conservatory. A new blind had been requested when they asked for it. They said they liked going into the garden when the weather was warm and described it as beautiful. At the last inspection we noticed that hand towels were shared and the ground floor bath was not available. Since then the manager had arranged for paper towels in the ground floor toilets and bathroom. We saw the dispensers in place, but on the first floor there was a toilet and bathroom without paper towels. Staff told us these facilities Care Homes for Older People Page 18 of 26 Evidence: were not used as often. The ground floor bath was fully equipped and back in use giving people a choice of bath or shower. The laundry room had all working washing and drying equipment in place. The laundry work was carried out by care staff after they had completed personal care tasks and one of them said it works very well. The night staff did the ironing and people told us they always get their clothes returned to them when they needed them. Care Homes for Older People Page 19 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 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. People are cared for by a sufficient number of competent staff, who are supervised and trained to meet their needs. Evidence: There were photographs of the staff in the entrance hall. Two carers were on duty during the day shifts and then from 9.00pm until 7.30am one night carer was awake and one asleep, on call on the premises. There was also a cook and a domestic worker and the manager was available on the premises on most days. In addition to this extra staff were employed to accompany people to hospital appointments. We saw one of the staff performing this duty during the inspection. People said that there was always someone to give some help when they needed it. We looked at a sample of staffing records and found all appropriate recruitment checks were carried out. There were separate records showing that staff had one to one supervision meetings with the manager every 6 to 8 weeks. Staff told us that they were able to discuss training needs with the manager and training was arranged regularly. We saw records of training in all the safe working topics (see next section) and there was also evidence of specific training in Medication, Dementia Care, Managing Challenging Behaviour, Equality and Diversity, and Visual Impairment Awareness. Care Homes for Older People Page 20 of 26 Evidence: The manager told us in the Annual Quality Assurance Assessment that seven of the nine permanent staff had achieved a National Vocational Qualification at level 2 or above in Care. We saw some copies of certificates relating to this on peoples files.. 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 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 run in the interests of people living there and health and safety are promoted. Evidence: The home is managed by one of the registered providers. She is referred to as the manager throughout this report and has been assessed as fit to manage the care home. The other provider does not live locally, but has visited on a monthly basis and completed reports of her visit. We looked at the last three reports and found they provided clear monitoring of the service. The manager had completed the Annual Quality Assurance Assessment and sent it to us when we asked for it in March 2009. It was completed comprehensively , giving us information needed to plan and carry out this inspection. The quality of the home was also monitored by meetings with people living there every two months and contact with relatives. The manager told us that there had been a meeting with relatives Care Homes for Older People Page 22 of 26 Evidence: during the year and also a survey had been carried out with people living in the home to look at food menus. There was also a suggestions box in the entrance hall. Most people were responsible for their own money, but there was a safe for any valuables and pocket money if needed. Each person had a lockable area in their own room to keep their personal possessions. There were records of staff training in health and safety, infection control, basic food hygiene, First Aid and fire safety. Some people had received the training more than once to ensure they had been refreshed. There were health and safety records of regular checks and other records showing that all equipment had been serviced within the last year. For example the emergency lighting was serviced in January 2009 and the fire alarm system was serviced in February 2009. We also saw maintenance record that attention was given to repairing the stair lift in February 2009. Care Homes for Older People Page 23 of 26 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 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 1 2 12 25 Offer social outings and arrange assistance for people to visit the local library and attend church as appropriate. Install paper towel dispensers in the first floor bathroom and toilet. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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