Care Home: Broadway Lodge

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What the care home does well Broadway Lodge continued to provide a person centred approach to the rehabilitation programme based on the 12 step model. The programme was also supported by alternative therapies and educational groups. People indicated in their surveys that they were more than happy with the service provided at Broadway Lodge. Their comments included, `They provide an excellent programme of recovery, the counsellors and nursing staff provide support emotional and physical.` `They care for all my needs, good structure and discipline, good food and washing facilities the home is always clean and I know there is always a counsellor, nurse or member of staff available to talk to.` Staff also indicated in their surveys that they felt the home provided a high level of care and support for people following the programme, they also felt they received appropriate support and training from the manager. The expert by experience spoke to people about the service provided, they said they felt well supported in a structured programme, with help to move on when they completed. People said, ` I can deal with things better now with what I learnt here.` `Staff are considerate and patient.` and `It`s possible to survive with a little love but when lots is given the possibilities are endless.` We noted that people felt at ease approaching any member of staff either for a chat a laugh or medication. There was a friendly and cheerful atmosphere in the home. What has improved since the last inspection? Staff and management at Broadway Lodge had put a lot of time and effort into the changes they had introduced since the last inspection. Tia Chi had been introduced four mornings a week, this had been very well received. Staff leading the Tia Chi group recorded a DVD for people in secondary care so they could take part in their own time. People were being offered the chance to talk to people in the home following the programme during their initial assessment. Although this practice had been in place for a while staff had structured it into the assessment. People were no longer asked to write their life stories on their first day as they had indicated that it was a bit overwhelming. This showed us that the staff and manager listened to the concerns and opinions of people in their care. The admissions department had been redecorated making it a comfortable yet professional area to carry out interviews. A display of feedback from previous people to follow the programme was available. They had refurbished the dining room following training and consultation about best practice to help people with eating disorders. The dining room was laid out more like a restaurant with round tables and was less institutional. Staff had received training in specific areas to meet peoples assessed needs including eating disorders, care planning in a person centred way, carrying out risk assessments and complimentary therapies this would ensure continuity throughout the 24 hour staff cover. A member of the nursing staff had trained as an extended nurse prescriber, she had used the knowledge gained to improve the documentation and records associated with the handling of medication in the home. What the care home could do better: No requirements or recommendations were made following this inspection Key inspection report Care homes for adults (18-65 years) Name: Address: Broadway Lodge Totterdown Lane, Off Oldmixon Road Weston Super Mare North Somerset BS24 9NN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Juanita Glass     Date: 0 6 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Broadway Lodge Totterdown Lane, Off Oldmixon Road Weston Super Mare North Somerset BS24 9NN 01934812319 01934815381 briandudley@broadwaylodge.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Broadway Lodge Limited care home 55 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: The maximum number of service users who can be accommodated is 55. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Past or present drug dependence (Code D) Past or present alcohol dependence (Code A) Date of last inspection Brief description of the care home Broadway Lodge is a charity set up to provide treatment for individuals suffering from alcoholism, chemical dependency, eating disorders, gambling and gaming and codependency. The home provides detoxification services, and primary and secondary care within the framework of the 12 Step Recovery Programme. The primary care is sited in the main building and is also able to offer nursing care support. The secondary care is within a domestic type house and bungalows situated within the grounds of the property. The mission statement for the home is: To provide the highest quality of care and treatment for people suffering from an addiction. To treat everyone with respect, taking into account individual needs, offering hope and freedom. Broadway Care Homes for Adults (18-65 years) Page 4 of 29 55 55 Over 65 0 0 Brief description of the care home Lodge is situated on the outskirts of Weston-super-Mare and can be easily accessed by public transport. There are nearby shops, which people are able to visit and people can use the local primary care health centre services. The home has established strong links with the local AA and NA groups, which people attend at appropriate times in the programme. Care Homes for Adults (18-65 years) Page 5 of 29 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over two days and a total of 9 hours were spent in the home. To gather enough evidence to support our judgements for this inspection, We The Commission asked the service provider to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gives us some numerical information about the service, and how they intend to maintain or improve outcomes for people using their service. We also looked at surveys returned to us by people living in the home and people with an interest such as relatives, social workers and GPs. We received 10 surveys from people following the treatment programme and 4 from staff working there. Care Homes for Adults (18-65 years) Page 6 of 29 Once we had received this information we carried out a visit to the home. We requested the assistance of an Expert by Experience who is someone who has experienced the type of care and support provided by a Rehabilitation Centre. The Expert spoke to people living there and asked for their opinions of the way the service was provided. Whilst in the home we also looked at documents maintained for the dayto-day running of the service. These included care plans, staff recruitment, training and supervision, service records and health and safety. The Expert by Experience introduced himself to people at Broadway Lodge and joined us for a tour of the premises. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? Staff and management at Broadway Lodge had put a lot of time and effort into the changes they had introduced since the last inspection. Tia Chi had been introduced four mornings a week, this had been very well received. Staff leading the Tia Chi group recorded a DVD for people in secondary care so they could take part in their own time. People were being offered the chance to talk to people in the home following the programme during their initial assessment. Although this practice had been in place for a while staff had structured it into the assessment. People were no longer asked to write their life stories on their first day as they had indicated that it was a bit overwhelming. This showed us that the staff and manager listened to the concerns and opinions of people in their care. The admissions department had been redecorated making it a comfortable yet professional area to carry out interviews. A display of feedback from previous people to follow the programme was available. They had refurbished the dining room following training and consultation about best practice to help people with eating disorders. The dining room was laid out more like a restaurant with round tables and was less institutional. Staff had received training in specific areas to meet peoples assessed needs including eating disorders, care planning in a person centred way, carrying out risk assessments and complimentary therapies this would ensure continuity throughout the 24 hour staff Care Homes for Adults (18-65 years) Page 8 of 29 cover. A member of the nursing staff had trained as an extended nurse prescriber, she had used the knowledge gained to improve the documentation and records associated with the handling of medication in the home. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from very clear and concise information provided in an appropriate format, helping them make an informed choice of their preferred treatment centre. People can visit to see how the centre is run when a full assessment can be carried out. People also benefit from a full assessment of their needs. Evidence: We asked for a copy of the current Statement of Purpose and Service User Guide, they were readily available and easy to read. This meant that people could see how the service was run. People were clearly informed of the house rules and what could be expected whilst following the treatment programme. The brochure included the views and opinions of people who had completed the programme at Broadway Lodge. People attending for an assessment were offered the chance to talk to people experiencing the programme. The manager stated that they were in the process of developing a DVD that would give people a visual overview of the home. A diversity statement said that Broadway Lodge would endeavour to meet the diverse needs of people in their care. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The manager confirmed that their dedicated admissions department handled the process from initial enquiry to the day of admission. The assessment consisted of an in depth assessment finding out peoples addiction, health and emotional needs. The expert by experience spoke to people about their experiences, they confirmed that they had received appropriate support and information enabling them to make an informed choice. People indicated in their surveys that they had received plenty of information and support from staff prior to moving into the home. One person did state that they would have liked more information about the 12 step treatment programme, however they were happy with all the information specific to Broadway Lodge. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from clear personal care plans based on a full up to date holistic assessment of their needs, which have been discussed and agreed with them. They also benefit from clear risk assessments that identify areas that they may need assistance with including, relapse and moving on following completion of the programme. Evidence: We looked at care plans for people working their way through the treatment programme both in the primary and secondary stages. These showed us that personal needs had been discussed and therapeutic interventions agreed with them. We saw that the plans were personal to the individual, despite the need for some generic decisions made on admission. People had signed their care plans and also signed to agree to the restrictions that needed to be in place in a rehabilitation centre. We saw that the restrictions and house rules were were discussed and signed on admission. Each individual had a named counsellor and named nurse enabling staff to develope a relationship with the person promoting a clear continuity in their support to achieve Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: their goals. We saw that the care plans were reviewed regularly and that people continued to be involved in any reviews and changes made. The home uses an internal computer system which appeared to work well. The expert by experience spoke to people about their care plans and the way they were enabled to make decisions about the programme they followed, they stated Residents have input to their care which is reviewed on a regular basis. A user involvement group is held every 8 weeks so residents can offer ideas and input to their care. People indicated in their surveys that they were happy with the level of decision making they were involved in and that they understood the need for restrictions within the programme. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from appropriate leisure and social activities within the constraints of the therapeutic programme. They are assisted to maintain contact with families and are assisted to build relationships with their children. People are encouraged to be as independent as possible within the programme and are involved in areas of daily living in the home. People also benefit from a healthy and nutritious diet suitable to their cultural or medical needs. Evidence: Broadway Lodge continued to offer a holistic programme of treatment, which included individual and group therapy, peer support and education. The aim being to support people in making essential lifestyle changes and decisions without depending on mood altering chemicals. There were a range of alternative therapies available to people in the home, a recent Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: addition was Tia Chi, which had been eagerly supported. A buddy system was in place providing peer support especially for the first few days when a person was becoming accustomed to the house rules and living in a close community. People were also supported to go into the community in safe groups when they could join in AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) meetings, they also enabled access to other fellowship meetings. This enabled people to to feel confident in using these groups following discharge. In secondary care people also had access to educational courses and a local sports centre. Whilst people were also encouraged to to be involved in a schools educational programme. One person said to the expert by experience, I really enjoyed talking at the school as it made me feel I was giving something back to the local community. Structured visiting times were arranged on Sundays, however the home had a flexible approach to people with children who are unable to visit on a Sunday and alternative days could be agreed. A programme of educational lectures were provided for families helping them to understand addiction and associated behaviours. People in secondary care were encouraged to spend time out or weekends with their children to rebuild and strengthen relationships. Staff at Broadway Lodge also supported people to maintain their chosen religion either by attending their place of worship or enabling religious representatives to visit the home. Weekly mens and womens groups ensured that both genders had the opportunity to explore issues specific to them. The expert by experience spoke to people about their leisure activities. People said that they respected the restrictions in place and understood the reasons why they went into town in peer groups or out with staff. They confirmed that they were, encouraged to build social networks in the community and to maintain relationships with families and friends. Relationships between residents were not permitted. Residents days are more structured in Primary care and activities assist residents in preparing to move on to secondary care. Residents are responsible for keeping their own rooms tidy whilst those in secondary care were responsible for the cleaning duties and cooking in their house. There were outings into Weston-super-Mare for residents both primary and secondary and peer support was widely promoted. People were observed to be offered well balanced and nutritious options at meal times. People told the expert by experience that the food in primary care was prepared by a cook and was of a very good standard with a wide variety, they said the Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: menu changed weekly and all dietary needs were catered for. People in secondary care said that they each received a budget to spend on food so each house organised their own menu with asssitance from a member of staff trained as a dietician. Care Homes for Adults (18-65 years) Page 17 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People staying at Broadway Lodge benefit from personal and specialist healthcare support that is provided In a person centred way, respecting their rights within the constraints of the therapeutic programme. They are also protected by the handling and management of medication in the home. Evidence: Broadway Lodge does not provide personal care to people in the home all support was provided through the therapeutic programme. People were encouraged to take personal pride in their appearance developing personal daily living skills. We looked at the care plans for people following the treatment programme at Broadway Lodge. They showed us that peoples health care and physical needs were considered on a personal basis and individual to the persons needs. As well as receiving the medical support to successfully complete a detox programme and the counselling support that followed they were also assisted to register with a GP, local dentist and any other health care specialist that may be identified. Additional groups such as stress management could be accessed by people in the home to promote good health. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The expert by experience spoke to people about the treatment programme at Broadway Lodge, they said the programme was very structured with support provided through counselling on a one to one basis and in group therapy. Support was also provided for people in Primary Care by the in house Medical team, whilst people in secondary care would visit the local health centre. People said in their surveys, The home provides a structured programme with plenty of support, The staff are excellent they are always ready to listen and help. Medicines are supplied by a local pharmacy, some medication is on prescription whilst Broadway Lodge also holds a stock. People in secondary care order their own prescriptions preparing them for discharge. We looked at the way medication was stored and recorded we saw that a homely remedy policy was in place and that all staff were trained to handle medication. We looked at the records kept by the home and the manager told us that they had recently re-written the medication record sheets. All staff were observed to follow the correct procedures and we did noticed that people visited the office to receive their medication rather than staff taking a trolley around the home. All records were up to date and we noted no inconsistencies or omissions. Due to the nature of the treatment programme available at Broadway Lodge end of life plans are not agreed as part of the care package provided. Care Homes for Adults (18-65 years) Page 19 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from and are protected by the homes complaints and safeguarding policies and procedures. Staff are fully aware through training of the procedures to follow to protect people from abuse. Evidence: A copy of the complaints policy and procedure was included in the initial contract given to people on admission. People were made aware of their freedom to raise concerns and issues with the support staff or the manager. People told the expert by experience that the complaints procedure was clearly explained to them right from the start. A weekly house meeting was also held where people could raise concerns or put forward ideas or suggestions. We saw evidence that complaints were dealt with appropriately with the managers response and the outcome for the complainant clearly recorded. Every eight weeks and on completion people are asked to comment on the programme and home in general, we saw returned surveys that indicated people were happy with the programme. We saw that the home had clear copies of the safeguarding procedures to follow to protect vulnerable people from harm. Staff indicated that they were aware of the homes policies on safeguarding people and also knew they could use the organisations whistle blowing policy to raise concerns. All staff had received training in safeguarding vulnerable adults. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People staying at Broadway Lodge benefit from a comfortable, well equipped and homely environment, which is well maintained and decorated with access to garden areas. People are protected by staff awareness of appropriate infection control guidelines. Evidence: Broadway Lodge is a Victorian building which was converted for use and provides services for the detoxification and primary care. People in secondary care are housed in five modern houses attached to the grounds. The expert by experience visited the secondary care houses and a short tour of the home was carried out. The expert by experience said,The main house is an impressive building with a friendly atmosphere residents rooms are situated over two floors. There is a healthcare unit on the first floor where GP appointments are held, and complimentary therapies and medication administered. At the time of the inspection a new purpose built detox unit was under construction in the grounds to the rear of the main house. All the rooms were of a good size and good standard. All residents have the use of a laundry. Both the main house and the secondary houses were bright and clean and had a friendly atmosphere. A designated smoking area has been provided just outside the front door of the main house or in a smoking shelter at the secondary care Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: houses. The main house has a TV room with an assortment of books and board games. There is a communal telephone in the main house that residents can use. Records showed that staff were kept up to date with infection control guidelines and appropriate protective clothing was available to use if necessary. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a staff team who are competent, qualified and trained to meet the diverse needs of the people following the rehabilitation programme from detox to discharge. They are also protected by clear policies and procedures for the recruitment of new staff and volunteers and their ongoing supervision. Evidence: The staff team at Broadway Lodge continued to be a multidisciplinary team providing comprehensive support for people to successfully complete the agreed therapeutic programme. We looked at files for people working at Broadway Lodge, they showed us that all staff had a job description, which clearly stated what their roles and responsibilities were within the team. Staff spoken to said they had clear lines of responsibility and that people in the treatment programme understood each staff role and what support they would provide. We looked at the training records, the manager provided us with a matrix of planned and completed training for the last twelve months. The matrix showed us that all mandatory training was up to date and that staff had also attended training about the specific needs of people in their care. Staff spoken to could discuss the identified Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: needs of people in the home and understood the plans of care in place for individuals. Staff surveys indicated that they felt well supported and received appropriate training. One person said, multi disciplinary teams bring vast knowledge and experience as staff tend to stay in post for exceptionally lengthy periods of time. Another person said, an experienced staff team work closely to achieve the overall goal of the clients. The expert by experience spoke to people about staffing in the home they said there was always enough staff about to talk to and they would always make time to listen. We looked at the records kept by the manager following the recruitment process. We saw that Broadway Lodge followed strict recruitment policies and procedures ensuring people in their care were protected from harm. This meant that they obtained all the required documentation to prove the person was fit to work in the home, including a full employment history, references and a Criminal Record Bureau check. We also saw records that showed us all staff received regular supervision when they could discuss working patterns, training needs and any concerns they may have. Counsellors also attended supervision provided by an outside agency. People spoken to confirmed that they were well supported and supervised. As well as regular supervisions staff attended regular meetings such as the morning significant events discussion, and feedback sessions following therapy groups. The manager confirmed that each team was also being consulted about the way the new detox unit would be run. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a home that is well managed, the manager communicates a clear sense of direction and is able to evidence a sound understanding of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction and quality assurance. Evidence: The registered manager has many years experience in the field of addiction and rehabilitation she had undertaken training to keep her professional knowledge up to date so that the home continued to provide care and support that was in line with current practices and guidelines. She oversees the general day to day running of the home but was also available for people to speak to, we observed people approaching the manager at ease. The manager completed the Annual Quality Assurance process and this showed us that the processes they used to gather peoples opinions and ideas had underpinned changes through the year. An annual questionnaire was sent to people as well as 8 weekly user involvement groups, covering all aspects of the programme and the ancillary services provided. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: People also completed a survey when leaving the home whether they had successfully completed or not. The manager confirmed that the opinions expressed in the surveys underpinned any decisions made about changes and plans for development. As well as assessing customer satisfaction regular monitoring was carried out to demonstrate the success of the service. Implementation of health and safety within the home was satisfactory. All residents had personal risk assessments and generic risk assessments were in place. People staying in the home were also involved in fire drills, and fire training ensured staff were up to date with emergency procedures. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 20 13.2 All medicines must be kept securely. This refers to: All medicine cupboards and the medicine fridge need to be locked. The Controlled Drugs cupboard needs to be attached using the correct bolts. 01/12/2007 Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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