Care Home: Broadlands Nursing Home

Similar services:

• Henry Nihill House
• Birchwood
• The Infirmary
• Townley Road, 2-3
• Orchard House Nursing Home
• St Josephs Rest Home
• Foxley Lane (121a)
• Tudor Lodge

What the care home does well Assessments are completed before people move in, ensuring the home is right for them. Good information is available to help people make the decision about moving in. One person said `my relative visited and thought it was a good place, I agree`. Another person said `I knew other people who lived here, it was the obvious place to come`. Care plans are completed for all people and are kept under review. We saw some good interactions between staff and people who use the service and saw staff offer appropriate care and support. Peoples made positive comments about the food, the staff and what they do at Broadlands, these included: `the girls are nice`; `staff help` and `the food is good`. What has improved since the last inspection? Medication procedures and recording have improved to allow an audit of medicines, showing that people receive the appropriate medication to meet their needs. Improvements have been made to the environment with new furniture provided in bedrooms and the hallway and office being redecorated, making the home nicer for people who live there. We saw people`s names have been put on their bedrooms doors. One person told us that they like the `memory boxes` which are being developed. Application forms been updated to include all the appropriate information. CARE HOMES FOR OLDER PEOPLE Broadlands Nursing Home 51 Burdon Lane Cheam Surrey SM2 7PP Lead Inspector Janet Pitt Key Unannounced Inspection 23rd June 2008 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadlands Nursing Home Address 51 Burdon Lane Cheam Surrey SM2 7PP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8661 1120 020 8661 1768 Mr N Baloo Mrs Anita-Marie Porter Care Home 25 Category(ies) of Dementia (25), Mental disorder, excluding registration, with number learning disability or dementia (25), Old age, of places not falling within any other category (25) Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2007 Brief Description of the Service: Broadlands is a pleasant home situated in a quiet residential area close to Cheam village. It is situated close to public transport links, including rail services and motorways. The home provides nursing care for elderly, mentally frail, residents. Twenty-two people are currently living there. There are nine double bedrooms and seven single rooms. The majority of the bedrooms are situated on the ground floor. There is a large, attractive and well-kept garden, overlooked by a spacious conservatory in which the residents take their meals. The home provides information about its services in a Service User Guide, which is made available to current and potential Service Users. Additional information can be found in the home’s Statement of Purpose. The current weekly fees range from £575 - £750 depending on peoples needs. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. This unannounced inspection took place over five and a half hours on the 23rd June 2008. Two regulation inspectors visited, looked at records, spoke with people who use the service, the manager and staff. The manager completed an Annual Quality Assurance Assessment AQAA in the given timescales, which included good information about the service. What the service does well: What has improved since the last inspection? What they could do better: Care plans could be more person centred, written individually rather than in a set format to ensure they include the individuals needs. Care plans could include more information on people’s social interests and information for staff on how to deal with inappropriate behaviours. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 6 Consideration could be given to providing ‘rummage boxes’ to give people who use the service different fabrics and items to feel and interact with. The menu could be provided in pictorial format, to ensure it is accessible to all people who use the service. Any worn and stained carpets should be cleaned or replaced and a redecoration schedule should be developed to include all communal areas and bedrooms to ensure that the environment is kept to a good standard for the people who live there. The manager confirmed that they have plans to clean carpets and redecorate some areas. All staff must receive regular refresher training in fire safety to ensure the health and safety of people who use the service and visitors is maintained. A separate fax line should be provided to the home, to ensure important faxes are received and to allow the telephone to be used at all times. A copy of the monthly visit report should be sent to the home with a copy to CSCI, to ensure that any issues raised can be actioned by the manager. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Assessments are completed before admission. People and their relatives and representatives are invited to visit to look around, meet people who live there and staff before they decide whether to move in. Intermediate care is not provided. EVIDENCE: A Statement of Purpose and Service Users Guide have been developed. These documents inform people about the services provided and other information to help them decide whether the home is ‘right’ for them. Two people told us that their relatives had visited and chosen the home for them and that it ‘suited’ them. One person told us that Broadlands was the ‘obvious choice’ due to their previous involvement with the home. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 9 We saw assessments completed before individuals moved into the home. These assessments detail people’s needs and are mainly around personal care tasks and support required. These documents would be enhanced if individual’s social needs were included. The manager told us that assessments completed by social workers are kept in a separate file, not with the care plan. The home does not provide intermediate care. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Personal support is responsive to individuals needs, although recording is to a set format. People have access to healthcare services within the home. People’s health needs are recorded with clear details of appointments and actions to be taken. Medication is well managed. EVIDENCE: We saw that care plans have been developed for all people who use the service. The plans are written on a pre-printed, set format, which means they are not particularly person centred but do contain details of the individuals care and support needs. More attention could be paid to include people’s different needs including leisure and social needs, hobbies and important relationships. We saw one case file contain detailed information about the persons life, with information confirming the individual was involved in passing the details to Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 11 staff. We saw another file contain information about the support the individual needed. The person confirmed that they receive the care and support they need. We saw people to be well dressed and look cared for. One person told us that their appearance is very important to them and said that staff support them to ‘look good’. There was good attention to detail with people wearing jewellery, make-up, shoes and the men were clean-shaven. We saw details of people’s medical and health needs, with a nutritional assessment completed and actions for staff to take in the event of weight loss. Daily records are very task focussed and could include more detail about how the individual experienced the care and support provided. Appropriate medication policies and procedures are in place. We saw staff follow the procedures when administering medications during our visit. We saw medication appropriately stored and records up to date and signed by staff. Appropriate records are kept of medications received at the home. The controlled drugs register was up to date and balances correct. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service have the opportunity to take part in a few activities within the home. People have the opportunity to maintain important family relationships. Mealtimes are generally well managed and a pleasant experience for people who use the service. EVIDENCE: We didn’t see a large amount of activities taking place during our visit. Most people who use the service were sat in the lounge with staff or in their bedrooms. After lunch a few people went to their rooms to watch television, listen to the radio or read the paper. A list of regular weekly activities was displayed in the lounge. The manager told us that the activities person is away from the home at the moment. People who use the service told us they have regular visitors. We saw visitors made welcome, offered drinks and given up to date information about their Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 13 friend or relative. Visitors can go to the persons bedroom for privacy or use the garden, lounge or dining area. We saw mealtimes to be a pleasant social occasion for most people, with tables laid with cloths, a vase of flowers, placemats and cruet. We saw that staff were seated and offered appropriate support and assistance to most people at the mealtime. People made positive comments about the food including ‘I enjoyed lunch’, ‘that was good’, ‘the food is usually good’ and ‘I enjoy the food’. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and made to the people who live there and their representatives. Appropriate polices and procedures are in place for safeguarding and staff complete training. EVIDENCE: Appropriate systems are in place for managing complaints. People who use the service and their representatives have access to the complaints procedure. One person told us they would speak to ‘the manager’. Another person said they have ‘no reason to complain’. The manager said that they have had no complaints since the last inspection. We have not received any complaints about the service in the last year. The manager told us that staff complete a distance learning course on protection. We suggest that senior staff complete the local authorities safeguarding training to ensure they are aware of local policies and practice and form links with the staff in the department. Staff demonstrated an understanding of their responsibility regarding safeguarding. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides an environment that has been developed over the years to meet the needs of the people who live there. It is a safe, well-maintained place for people to live. The home is well lit, clean and tidy. EVIDENCE: Broadlands is an old house with lots of character, that has been developed and extended over the years. It is accessible to the people who live there. Appropriate aids and adaptations are provided in bathrooms and bedrooms to ensure people are supported to move around the home appropriately. The carpets in the lounge were stained and in need of cleaning. The manager said they have a regular programme of carpet cleaning. We saw that the carpets on the stairs are in need of replacing. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 16 We noticed a smell of gas around the boiler during our visit, which the manager said she would report to be checked. We saw screening provided in the double bedrooms to afford some privacy for people who currently share a room. The manager told us that they are careful about how they allocate shared rooms and take into account the needs and wishes of both people. We saw that people have personalised their rooms with pictures, photographs, ornaments and small items of furniture. One person told us that having their things around them was important and made them feel ‘at home’. We saw one person have a calendar with dates and anniversaries, helping the individual remember important events and staff to keep things ‘live’ for the person. One person said they ‘enjoy walking and sitting in the garden’. We saw that the garden is looked after very well with a variety of plants and trees and wildlife for people to watch. Two other people told us that they get a lot of pleasure from the garden. All areas of the home were clean and smelt fresh. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. There are enough staff to meet people’s needs. Staff have access to relevant training. Staff recruitment is in line with regulations. EVIDENCE: We saw enough staff available to meet people’s needs. We saw staff speaking with people in a polite and respectful manner. People who use the service made positive comments about the staff including ‘she’s nice’, ‘they give me the help I need’, ‘they smile a lot’ and ‘they know what I need’. Recently a temporary administrator was at the home. The provision of this role on a permanent basis would free the manager to work with staff on improving the care practices and support given to people who use the service. The manager told us that all staff have completed NVQ with two domestic staff still completing this training. Records are kept of training courses staff have attended and these include a distance learning course on the care of people with dementia, infection control and nutrition. We saw that staff are overdue refresher training in fire safety and this must be completed to comply with regulations. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 18 Staff confirmed that they have access to relevant training to help them do their job. Staff said that they are supported by the manager and senior staff. Staff files contained written references and evidence that a Criminal Records Bureau check has been carried out. Staff confirmed that they had been interviewed and had checks carried out before they started work. Staff said they had enough information when they first started work at the home. Nursing staff demonstrated a good knowledge of working with people with dementia and how best to meet their needs. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager understands the principles of the service and is working to improve the care provided. Quality assurance systems are in place to seek relatives and other stakeholders views of the care and support provided. The company could do more work to ensure the quality of care provided is good. Appropriate health and safety policies and practices are in place. EVIDENCE: The manager has been at the home for nine years and has previous experience in similar services. The manager demonstrated knowledge of the needs of older people and the conditions related to old age. The manager is supported Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 20 by both qualified and specialist nursing staff to provide care and support to the people who use the service. The manager told us that the company has started to have regular managers meetings once every two months. These should offer support and provide a forum to discuss good practice issues within the services. We didn’t see evidence of monthly visits being carried out at the home as required by regulation. The manager said a visit had been carried out in May 2008 although no report had been sent to the home with the outcome of the visit. The manager told us that she sent out quality assurance questionnaires to relatives in May 2008 and is awaiting response before analysing and seeing if any changes are required to the service or support offered to people. We saw some responses to include positive comments including ‘staff help’, ‘my relatives needs are met’ and ‘my relative is happy and settled’. We also saw the tick boxes to have the ‘good’ and ‘excellent’ boxes ticked by relatives, indicating that they are satisfied with the staff, support offered to their relative, the meals provided and the level of activities. Health and safety is well managed with records in place and up to date. The Environmental Health Department awarded the home Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP28 Regulation 18 (1) c (i) & 23 (4) d 26 (1) and (2) Requirement All staff must receive regular refresher fire safety training, to ensure that the people who use the service and visitors are safe from harm. The company must arrange for a representative to visit the home every month to check on the service being provided, to comply with regulations and to ensure that good services are being provided. A report should be made after these visits with a copy sent to the home and the CSCI. Timescale for action 22/08/08 2. OP33 22/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care plans could be more person centred and written in for each person rather than using the set format. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 23 2. 3. 4. 5. OP8 OP12 OP15 OP13 It is recommended that photographs of wounds are taken at regular intervals to evidence progress. The provision of ‘rummage boxes’ would give people at the home the opportunity to experience something different. Consideration should be given to the menu being available in pictorial format, so it is accessible to all people. It is recommended that a dedicated fax line be provided to ensure the telephone is accessible all the time. Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: 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 © 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 Broadlands Nursing Home DS0000019080.V365983.R01.S.doc Version 5.2 Page 25 - 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!