Care Home: Broadoaks

What the care home does well Broadoaks provides people with well maintained, clean and safe place to live where they can have personal possessions around them to make it feel more homely. Residents told us they are satisfied with the care provided and that their dignity and privacy is respected. Discussion with residents and observation of every day life in the home demonstrated that people can choose how to spend their time and have opportunity to join in social activities if they choose to. Some of the staff have worked in the home for a long time and so are able to provide continuity of care and familiar faces to the residents living there. Resident spoke warmly about staff and complimented them. Staff took time to talk with residents and so build relationships. Residents told us that they would feel able to tell the staff or the manager if they were unhappy about anything.BroadoaksDS0000018064.V376692.R01.S.docVersion 5.2The management team undertake robust recruitment practices to ensure that staff employed a suitable people to care for the residents at Broadoaks. They also provide staff with all the basic training to enable them to meet residents` needs safely and appropriately. What has improved since the last inspection? The registered provider and registered manager responded positively and effectively to the requirements identified in the last inspection report. Evidence of the actions taken was seen at this inspection and the homes rating has improved to a 1 star service. People are told in writing if, based on the home`s assessment of their needs, they can be met at Broadoaks, so that people can be sure the home is suitable for them before making a decision to live there. A care plan was available on all resident files sampled including the recently admitted resident. Individual care needs are better identified in those care plans that have been completed using the new format. This provides more information and guidance to help them meet people`s needs. Photographs were available of each resident with their care plan and medication records. This would support staff to ensure that the care and medication was given to the person it was intended for. Sampled records of medication administered to residents were accurate to the medication available indicating that people received their medication in the way it is prescribed for them. Robust recruitment procedures were evidenced to safeguard residents. Staff have been provided with training and updates on basic relevant topics to help them support the needs of people using the service. Health and safety has improved. A current certificate of inspection relating to the electrical fixed wiring was available. Records demonstrated that staff have been involved in fire drills and practices so that they know the procedure to be followed in case of fire. What the care home could do better: The temperature of the room where medication is stored must be monitored and recorded, and maintained at a suitable recommended temperature to ensure that the medication remains effective. Care plans should be extended for all residents and should be updated where reviews show that changes in the person`s needs have taken place. This will ensure that staff have the most up-to-date information on how to deliver care to residents. Risk assessments need to be individual to each person.BroadoaksDS0000018064.V376692.R01.S.doc Version 5.2 Key inspection report CARE HOMES FOR OLDER PEOPLE Broadoaks 2 Southend Road Rochford Essex SS4 1HA Lead Inspector Mrs Bernadette Little Key Unannounced Inspection 23rd July 2009 09:45 DS0000018064.V376692.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadoaks Address 2 Southend Road Rochford Essex SS4 1HA 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) 01702 545888 01702 546442 Eastwood Hall Limited Sally Ann Clark Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th August 2008 Brief Description of the Service: Broadoaks is a large detached 19th century Manor House situated close to Rochford town centre. Care and accommodation is provided for twenty residents. The home is not registered to admit service users who are diagnosed as suffering from dementia. Accommodation is provided on two floors with a shaft lift to enable access. Bedrooms are all single rooms with en suite facilities. The Home has two lounges, a pleasant dining room and a visitors room. There is parking to the front of the building and a secure garden with seating available to the side of the building. The Home shares a minibus with three sister homes, and this is available to provide transport and outings for service users. The registered providers have a website that can be accessed on www.crollgroup.co.uk The home has a statement of purpose and service users guide available. Information about the home and most recent inspection report are available to residents/visitors in the lobby area of the home and copies. An information pack including a copy of the most recent inspection report is provided to each new resident. It was confirmed by the manager at the site visit that the current fees at the home are £535.00 to £685.00per week. There are additional charges for chiropody, hairdressing, personal items, newspapers/magazines, some transport costs and any privately arranged therapies. Broadoaks DS0000018064.V376692.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 that people who use this service experience good quality outcomes. The last key inspection of this service was undertaken on 12th August 2008. This site visit was undertaken over a seven and a half hour period on one day as part of the key inspection. Time was spent with residents, visitors and staff and information gathered from these conversations as well as from observations of daily life and practices at the home have been taken into account in the writing of this report The manager submitted an Annual Quality Assurance Assessment (AQAA) as required prior to the site visit. This is to detail their assessment of what they do well, what has improved and what they plan to do better. The AQAA contained an adequate level of information that was considered as part of the inspection process. A tour of the premises was undertaken and records, policies and procedures were sampled. The manager was present during the site visit and assisted with the inspection process. The outcomes of the site visit were fed back and discussed with the manager and opportunity was given for clarification were necessary. The assistance provided by all those involved in this inspection process is appreciated. What the service does well: Broadoaks provides people with well maintained, clean and safe place to live where they can have personal possessions around them to make it feel more homely. Residents told us they are satisfied with the care provided and that their dignity and privacy is respected. Discussion with residents and observation of every day life in the home demonstrated that people can choose how to spend their time and have opportunity to join in social activities if they choose to. Some of the staff have worked in the home for a long time and so are able to provide continuity of care and familiar faces to the residents living there. Resident spoke warmly about staff and complimented them. Staff took time to talk with residents and so build relationships. Residents told us that they would feel able to tell the staff or the manager if they were unhappy about anything. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 6 The management team undertake robust recruitment practices to ensure that staff employed a suitable people to care for the residents at Broadoaks. They also provide staff with all the basic training to enable them to meet residents needs safely and appropriately. What has improved since the last inspection? What they could do better: The temperature of the room where medication is stored must be monitored and recorded, and maintained at a suitable recommended temperature to ensure that the medication remains effective. Care plans should be extended for all residents and should be updated where reviews show that changes in the persons needs have taken place. This will ensure that staff have the most up-to-date information on how to deliver care to residents. Risk assessments need to be individual to each person. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 8 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 Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5. Standard it is does not apply to this service. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents will have their needs assessed, be informed that these can be met by Broadoaks, and will have enough information about the home on which to base a decision to live there. EVIDENCE: Broadoaks have recently produced a new brochure designed along with a new website that mirrors it and allows it to be downloaded from the Internet. The brochure provided relevant information about living at Broadoaks and is supported by a service user guide and statement of purpose. Additionally, prospective residents are provided with a copy of the most recent inspection report. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 10 The file for a person more recently admitted to the home was reviewed to consider the managers admission process. Thorough pre-admission assessment would ensure that the home had obtained all the information necessary so they could be sure they would be able to meet the persons individual needs. The file sampled showed good detail in the pre-admission assessment. While the manager had not referred to it in their AQAA, there was a letter on the file confirming to the person that, based on the homes assessment of the persons needs, Broadoaks could meet these. This lets people that know the home is a suitable place for them. It was a requirement from the last inspection and is a noted improvement. The homes brochure encourages people to come and visit to see if they like what they find. Evidence was seen on the assessment file reviewed that the person had come for a trial day visit, and this was also confirmed with residents spoken with. The managers AQAA confirmed that intermediate care is not offered at Broadoaks. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. While some further development of the care planning system is needed, people living at Broadoaks can expect to have their care needs met. EVIDENCE: A care plan was in place on each of the two resident files randomly sampled. This is an improvement from the last inspection. In addition, assessments relating to moving and handling and pressure area care were in place. Nutritional assessment has been introduced for each person, providing useful information as to the persons level of risk. Where indicated, weight recording and food intake charts were in place and monitored to support good nutritional intake and identify issues for referral to the dietician or GP as necessary. The manager has extended the previously very limited care plan format. This allows more information to be included on the persons assessed needs and preferences so that staff have more information to help them to meet peoples Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 12 needs. The manager was recommended to continue with this positive development to ensure that full information was available for each residents assessed needs and how these were to be met by staff in daily practice. The care plan inspected for a person who has lived at the home for some time had not been changed to the new format, however the manager advised they are working through these and all the care plans will be written in this way. There was evidence on the care plans seen that the resident or their relative had been included as required so that the persons wishes and preferences are respected and taken into account. Appropriate equipment such as pressure relieving mattress and cushion was available in practice to residents where this was identified as necessary as part of preventative pressure area care. Regular review of the care plans had been undertaken but was recorded separately, rather than the care plan itself being revised to ensure that it was meaningful and accurate. While information was then available on the persons current care needs, it was in different sections and took time to find. In discussion, the manager agreed that the plan of care itself was not clear using this method and that they would improve this. Records showed that residents were supported to access relevant healthcare services to meet their healthcare needs. Discussions with residents at the site visit indicated that they were satisfied with the care received, that staff listen to them and respect their privacy and dignity. A visiting health professional confirmed that residents are always taken to a private area for treatment, that staff speak to residents with respect and that they are going to book in here. The managers AQAA tells us that all senior staff completed training on safe handling and management of medication since the last inspection. Evidence of this was seen on three staff files reviewed. A sample of medication administration records reviewed showed no omissions and had a photograph of each resident to support identification, which is good practice. Tablets remaining in the blister packs tallied with the records, an improvement from the last inspection. No resident is currently prescribed controlled drugs. The temperature in the drug storage room was noted as 26°. No records of the temperature of the room were being maintained. The failure to store medicines at the correct temperature could result in people receiving medicines that are ineffective. The managers AQAA tells us that two residents are self-medicating, risk assessment is undertaken, medication and records are checked in with the resident each month so that residents who are capable have appropriate support to maintain their independence. For remaining residents, a pre-printed risk assessment was in place on all files sampled that states they are unable to self-medicate due to confusion associated with dementia. One of these for a male resident identifies a female name and staff confirmed that the person is not confused due to dementia. Risk assessments need to be individual to each person and be accurate. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to have their social care needs met, their choices respected and to receive a satisfactory diet according to their individual needs. EVIDENCE: The resident profile on each persons care file sampled identifies likes and dislikes, hobbies, food or religious preferences and relevant information on history and family and this is included in the lifestyle section of the care plan. Since the last inspection, the hours worked by the activities coordinator have increased, so providing more opportunities for residents. An activity programme was displayed in the lounge and shows that planned activities are available four afternoons each week. This includes one-to-one sessions and also a weekly outing in the homes minibus. On the afternoon of the site visit, four residents and two staff went to the reservoir at Hanningfield and had tea. Records are kept for each resident of activities undertaken or declined and included gardening, dominoes, individual chats with residents, musical movement, church service painting and Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 14 reminiscence. A visiting sweetshop has also been introduced and the manager advised of plans to introduce the pat a dog service to begin to bring the community into the home. Residents we spoke to told us they enjoyed the activities but could also choose not to join in and some preferred to listen to music, watch television or read in their own room. They also confirmed that their visitors were welcomed and visitors were noted to come and go at the time the site visit. Residents also told us they could choose whether or not to go downstairs for meals and what time to go to bed and get up. A resident also told us that they are asked each time by the activities coordinator if they would like to join in with the activities and that their preferences are always respected. At times throughout the inspection day, staff were noted to chat to and interact with residents. This included the housekeeper chatting to residents in their room as they undertook their tasks. A four-week menu that showed choices at each meal was operating and the menu for the current week was displayed in the dining room. The cook told us that this had been devised with the input of residents and can continue to change with resident suggestions. Residents can choose to come down for breakfast, and breakfast for one person was being provided at 10am. The cook was preparing poached eggs as this was the persons choice that day. Residents spoken with said that the food was lovely or not bad at all. The cook was seen to visit people individually to tell them what was for tea and to ask what they would like. Ample food stocks of quality brands were available and a local butcher, fishmonger and greengrocer are used to provide fresh produce. The dining room provides residents with a pleasant and sociable table arrangement. Tables were set with cloths, condiments and, as a noted positive development from the last inspection, each table had a gravy boat and a vegetable tureen so that people who are able could help themselves. Where a person needed assistance, they were provided with appropriate equipment and the staff member who supported them did so with sensitivity and patience. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be expect to be listened to and to be safeguarded by staff knowledge and competence. EVIDENCE: The homes brochure tells people that the home has a complaints policy and procedure in place to ensure that any complaint is investigated properly, promptly and fairly. A copy of the complaints procedure is attached to the service user guide and tells people that the home looks at complaints positively as an opportunity to learn and provide better services. It is written in larger size front to make it easier for people to read and had been updated to reflect the new contact information for the Commission. The complaints information tells people what they can expect if they make a complaint and the timescales within which they can expect a response. The manager told us that no complaints have been received since the last inspection. The Commission has not received any complaints about this service. Residents spoken with told us they would feel able to say if they were not happy with something and would expect to be listened to. Residents also told us that their relatives feel able to raise issues on their behalf. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 16 A number of letters of thanks and compliment had been received by the home and included comments such as the love, kindness and attention you gave (resident) was absolutely fantastic, thanks so very much for the high standard of care given and staff were supportive and responsive. The manager told us that there had been no safeguarding incidents or referrals since the last inspection. A current information poster was displayed in the entrance hall near the visitors signing in book telling people about types of abuse and with contact information on reporting it to Social Care Direct. The manager advised that following the last inspection, she had requested the current guidance and protocols on safeguarding vulnerable people, but had only received the poster. The manager was able to demonstrate appropriate responses and knowledge of reporting any suspected incident of abuse. A number of staff are currently updating their safeguarding training through distance learning, which is good practice. The whistleblowing procedure has been updated since the last inspection. Staff spoken with were aware of how people can be abused, what actions they should take and confirmed clearly that they would report it immediately and appropriately. The manager advised that they have undertaken two seminars on Deprivation of Liberty Safeguards and that Rochford council sent a member of staff to visit the home to discuss the issue and raise staff awareness. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents of Broadoaks can expect to find a pleasant, clean and well maintained environment that meets their needs. EVIDENCE: The managers AQAA tells us that since the last inspection, or communal areas have had new carpets and new furniture. This was seen at the time of the site visit and overall the home is well maintained. . Improvements to the secure garden area have been completed and include improved access and raised flower beds. Externally the driveway and paths surrounding the home have been resurfaced. No health and safety hazards were observed at the time of the site visit. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 18 Residents have a large lounge and a separate dining room that maintain a homely feel. Since the last inspection the second lounge has been refurbished and is available to residents for social activities and also for residents to use to invite their family or friends to have a meal with them in private. An additional small lounge is available as a visitors or quiet room giving residents a change of scenery and a choice of places to sit. Residents spoken with told us that the facilities and equipment offered by the home met their needs. The manager advised that a new seated scale had been obtained to enable residents to be weighed monthly to support healthcare monitoring. The homes brochure tells people that individuality is important and that they are welcome to bring as many personal possessions as can be accommodated, including furniture and ornaments to make their room their own. Residents spoken with confirmed that they had been able to bring lots of their own things including pictures, ornaments and pieces of furniture and some rooms were particularly personalised and homely. All bedrooms are for single occupancy and are ensuite. People spoken with also confirmed that they can choose whether to spend time in their own room or in the communal areas as they please. All parts of the home were clean and there were no unpleasant odours. The kitchen and laundry were clean and well organised and staff were seen to wear appropriate protective clothing to promote effective management of the risk of cross infection. All residents spoken with were satisfied with their rooms and said that the home is always kept clean and pleasant. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the 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 living at Broadoaks can expect to be supported by adequate numbers of competent and safely recruited staff. EVIDENCE: There were seventeen people resident at Broadoaks at the time of this site visit and the manager said all were assessed as having low to medium dependency needs. The manager advised that minimum staffing levels to meet the needs of the residents were maintained at one senior and two carers during the day and one senior and one carer at night. This concurred with the staff on duty at the inspection and those recorded on the rota. Staff and residents spoken with confirm this was adequate to meet peoples needs. One resident said of staff the girls are very good generally, I have my buzzer and they do come. The manager advised that one senior care staff has recently achieved NVQ 4, four staff have achieved NVQ 3, four staff have achieved NVQ 2, and one staff member is currently undertaking each of NVQ 2 and NVQ 3 in Care. This indicates that the home have met the national minimum standard of 50 of care staff in achieving at least NVQ level 2 and demonstrates a positive approach to training and development by both the provider and the staff. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 20 Files were reviewed for two staff recently recruited to assess if appropriate references and checks had been undertaken to ensure that prospective staff are suitable people to care for the residents at Broadoaks. Both contained evidence of required information, checks and identity being undertaken prior to implement commencing to evidence robust recruitment procedures. This is a noted improvement from the last inspection. Initial records of induction were available for both staff along with evidence of ongoing or completed induction training to Skills for Care standards. Induction training ensures that staff are aware of the needs of the residents they are to care for and how to meet these. There was also evidence that staff had been provided with moving and handling training soon after implement commencing. This is a noted improvement from the last inspection. Each staff member had an individual training record and training evidence file and these were seen to be well organised. Outside companies provide training to staff on basic topics such as on first aid, infection control and food hygiene. The registered provider has an internal training officer who provide staff at Broadoaks with training and updates on basic areas such as fire awareness, health and safety, dementia and safeguarding vulnerable people using DVD training tools The manager is qualified to and provides staff with moving and handling training. Two staff files sampled demonstrated that staff had up-todate training on all the basic relevant topics with additional training on issues such as Parkinsons awareness and supervisory skills in care. This is a noted improvement from the last inspection. Staff spoken with confirmed that they are provided with appropriate induction, training and information on service users that is relevant to their role and helps them to understand and meet the individuals needs. They also confirmed that it is a happy friendly place, there is a good teamwork and an approachable and supportive manager and staff group. The cook confirmed that they undertake regular training with the other staff in the home including in relation to health and safety, moving and handling and fire. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents of Broadoaks can expect to live in a safe, well-managed home that is run in their best interests. EVIDENCE: The manager has been in post for over a year having previously worked at the home is the deputy manager. The manager has achieved NVQ 4 registered managers award and completed the application process and been registered with the Commission since the last inspection. Evidence was available to show that the manager had recent or current training in first aid, moving and handling - train the trainer, fire awareness, health and safety, safe handling of Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 22 medication, infection control, dementia awareness, food hygiene and safeguarding vulnerable people to keep their practice up-to-date. It was positive to note that issues highlighted in the last inspection report have in the main been addressed and this is reflected in the homes improved quality rating. Staff and residents spoken with were complimentary regarding the day to day running of the home and of the homes management. There has been a recent meeting for residents and residents. The registered provider sends surveys to residents and relatives each year and some completed surveys were available. This means that residents and their families have the opportunity to be open about their views of the home and help shape and influence future changes and developments. An annual development planned that considered the findings of the surveys and other quality assurance aspects was available to demonstrate the actions taken/planned. Reports were available that demonstrate that the owners representative visits monthly as required to ensure that the home is operating properly. The manager looks after small amounts of money for some residents. The record of monies looked after for two residents were sampled and the system found to be satisfactory. Safe storage was available and records of money paid out was supported by two signatures and individual receipts. Records are also regularly checked as part of the monthly registered providers visit to the home under Regulation 26. Aspects of health and safety reviewed were found to be well managed, with improvements from the last inspection. A random selection of service and maintenance records were sampled and assessed to be in good order. Current safety inspection certificates were available on request for the gas, portable appliances, electrical fixed wiring, lift and the fire alarm. Records show that fire drills are undertaken at different times and record of staff to evidence they have attended. Records demonstrate that the fire fighting equipment, emergency lighting and fire alarms are checked regularly to ensure they are in good working order. The managers AQAA advises that all staff receive health and safety at work literature and are given training in order for them to undertake their duties safely. Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 23 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 Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 24 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 3 n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement Medication must be stored under suitable environmental conditions. This will ensure people receive medication of suitable quality. Timescale for action 18/08/09 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 Continue to develop and extend the care plan for all residents to ensure that it includes all areas of their assessed needs and incorporates the information from reviews so that it is up-to-date and accurate. Undertake individual assessment of risks relating to selfmedication that is relevant and accurate to each person. 2. OP9 Broadoaks DS0000018064.V376692.R01.S.doc Version 5.2 Page 26 Care Quality Commission Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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