Care Home: Broadwindsor House

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What the care home does well Broadwindsor House provides a comfortable home for the residents, with provision of good care by cheerful, kind and considerate staff. Residents are encouraged and supported to maintain as much independence as possible, and to spend time according to their individual preferences. Visits from their friends and relatives are welcomed. There are regular and varied recreational and social activities. The standard of meal provision is very good and residents like the food provided. Staff receive training in essential aspects of their work and are properly supervised. What has improved since the last inspection? The premises is subject to a programme of ongoing improvement, recently including the replacement of carpets and curtains in the main lounge and some corridors, the redecoration and refurbishment of some bedrooms. What the care home could do better: This report contains no requirements for improvement; the National Minimum Standards are met. Key inspection report Care homes for older people Name: Address: Broadwindsor House Broadwindsor Beaminster Dorset DT8 3PX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Gloria Ashwell     Date: 2 3 0 4 2 0 1 0 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 Older People Page 2 of 22 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Broadwindsor House Broadwindsor Beaminster Dorset DT8 3PX 01308868353 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): info@broadwindsorhouse.co.uk Florence Lodge Healthcare Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Any service users accommodated on the second floor must be fully ambulant and able to self-rescue to the first floor on fire alarm actuating. The maximum number of service users who can be accommodated is: 21. The registered person may provide the following category of service only: Care Home only: Code PC, to service users of the following gender: Either, whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category- Code OP - maximum number of places: 21. The schedule of requirements is completed within the agreed timescales. Date of last inspection Brief description of the care home Broadwindsor House is a care home providing personal care and accommodation for up to twenty-one older people. The registered provider is Florence Lodge Healthcare Ltd. At present there is no registered manager. The provider also employs the services of a Care Homes for Older People Page 4 of 22 Over 65 21 0 Brief description of the care home management company to provide additional support to the home. Broadwindsor House is a large detached house originally built as a rectory during the early 1830s. The home is set in extensive grounds on the edge of Broadwindsor village and is approached by a private driveway leading to the home and a spacious parking area for the use of visitors. Broadwindsor House provides care and accommodation in a total of 20 bedrooms, including one shared room. Details of fees can be obtained from the home. Additional charges include hairdressing, chiropody, dry cleaning, toiletries and newspapers. Care Homes for Older People Page 5 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. This inspection was unannounced; the inspector arrived at 11.00 on 19 April 2010, toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with senior staff discussed and examined documents regarding care provision and management of the home. Care Homes for Older People Page 6 of 22 During the inspection, particular residents were case tracked; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. During this inspection compliance with all key standards of the National Minimum Standards was assessed. An Immediate Requirement relating to window safety was issued during the first day of this inspection. The inspection was concluded by a return visit on 23 April 2010 and we then found the Immediate Requirement had been properly met. Care Homes for Older People Page 7 of 22 What the care home does well: What has improved since the last inspection? 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 Older People Page 8 of 22 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. Evidence: The records of two residents admitted since the last inspection included details of preadmission assessments carried out by senior staff of the home while visiting the prospective residents at their previous addresses. In advance of making the decision to enter the home the prospective residents or their representatives visited the home to view the premises and meet residents and staff. Following pre-admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Care Homes for Older People Page 10 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and social care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. Evidence: We combined the information we obtained from the documents we read, with the things we saw taking place in the home during our inspection, and what we were told by residents and staff. We examined the care records of 5 residents found to be of very good standard, based on up to date and relevant risk assessments, and reflective of the changing conditions of residents. For medicine handling the home uses a monitored dosage system, whereby most of the medications are stored in blister packs, to simplify the process of administration. Staff trained in this work carry out all medicine handling; residents who wish to can manage their own medicines in accordance with the findings of risk assessment. Care Homes for Older People Page 11 of 22 Evidence: Records of medicine administration were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. An audit of medicines is periodically carried out, with records kept to show that the home is carefully monitoring all aspects of medicine handling. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and polite manner and the atmosphere throughout the home was calm and unhurried. Residents are treated with respect and those we spoke to felt that staff are always kind and considerate of their needs. Care Homes for Older People Page 12 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetising. Evidence: There is a weekly programme of recreational and social activities including handicrafts, exercises to music, one to one and small group activities in addition to seasonal events and celebrations. Occasional visiting entertainers attend the home to provide musical sessions. Visitors are welcome at any time and residents spoken to during the inspection said their visitors are always made to feel welcome and placed at ease by the staff. Most residents take meals in the dining room on the ground floor while those who wish to receive them in their bedrooms. Residents receive a choice for all main meals and those spoken with said the food is well presented, plentiful and appetizing and was seen to be enjoyed by the residents. Care Homes for Older People Page 13 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and are confident their complaints would be listened to. Residents are safeguarded against risks of abuse in its various forms. Evidence: The home has a complaints policy and procedure. From discussion with staff and examination of records there was evidence that there is a reliable process ensuring that any complaints received would be competently managed to ensure that if weaknesses in service were identified they would be unlikely to recur. All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults. Care Homes for Older People Page 14 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean, and suited to the needs of residents. Evidence: The home is well maintained both inside and out. The extensive well maintained traditional gardens are a particular feature of this home and are accessible to residents. There is a continuous programme of repair, renewal and refurbishment to ensure the premises and furnishings remain comfortable, well maintained and safe. The bedrooms we saw had been personalised with pictures, furniture and photographs to reflect the taste of the particular residents currently accommodated in these rooms. All areas of the home were clean and in good decorative order. There are bathrooms equipped for the use of residents who need assistance. During the first visit of this inspection it was noted that some upper floor windows had unrestricted opening capacity and thereby presented a risk of accidental falling. An Immediate Requirement was issued and when we returned to the home to conclude Care Homes for Older People Page 15 of 22 Evidence: the inspection we found the Immediate Requirement had been properly met. Care Homes for Older People Page 16 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Staff receive training for their work and are properly supervised. Evidence: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The records of two recently employed staff members were examined and found to contain essential information including written references and evidence of identity. Records showed that all staff received induction training, and training in core subjects including safe moving and handling. Care Homes for Older People Page 17 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed and maintained to promote the safety and well being of service users. Evidence: The current manager has been in post since November 2009 and is in the process of applying to become the Registered Manager. Her work is supported by a deputy manager, a periodically visiting Area Manager from the provider organisation and a team of care and household staff. The home has good processes for quality assurance including the periodic issue of satisfaction surveys to residents and their representatives, and regular auditing of internal process including care planning, medicine handling and recruitment processes. Records are kept of all accidents and include evidence of subsequent investigation, with periodic audit to identify any trends e.g. time, place, person, and activity. Care Homes for Older People Page 18 of 22 Evidence: The home does not manage the finances of residents, those who are unable to do this for themselves have appointed relatives or representatives to do this on their behalf. There are good processes for staff recruitment and induction. Records indicated that fire safety equipment has been checked and tested at the required frequencies. A sample of records relating to the maintenance and safety of the premises and equipment were examined and provided evidence that routine checks and tests are carried out to ensure the safety of the various items and installations. Care Homes for Older People Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 20 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 21 of 22 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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