Care Home: Broom Haven

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What the care home does well The service has a stable staff group who know the people well. They have developed Makaton signs to enable them to communicate with people who use the service. The people have lived at the home for a number of years, and they are supported to maintain contact with their family. The staff encourages people to maintain their interests and hobbies, although staffing levels could be better to enable more flexibility when organising trips out of the home. What has improved since the last inspection? They have addressed the requirement made at the last inspection of the service by ensuring peoples privacy and dignity was maintained. The lock of the shared bathroom had been repaired. What the care home could do better: The manager was unavailable during this inspection and staff rotas confirmed that he was not included in the shift pattern. He must be able to demonstrate to CQC how he is in charge of the day to day management of the home. It is dissapointing to see that the home has no clear leadership, and documents looked at shows reviews and training has been affected by the lack of direction. Care plans must be further developed to ensure they are person centred. The plan must be reviewed at regular intervals to ensure they are up to date and reflect the current needs of people. Medication procedures were followed, although one of the staff did not have the required training to safely administer medication to people. Other staff should have their competencies assessed to ensure they can administer medication safely, as they last had any training in 2004 in this area. Staff require training in a number of areas (as stated in the report) and recruitment procedures must be improved to ensure they all have all the required employment checks including a application, two references and Criminal Record Bureau check. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Broom Haven 1a Broom Grove Rotherham South Yorkshire S60 2TE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Valerie Hoyle     Date: 1 2 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Broom Haven 1a Broom Grove Rotherham South Yorkshire S60 2TE 01709821418 NONE gail@tipple9039.fsnet.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : John Tipple care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 3 Broom Haven is registered for three younger adults with learning difficulties who mainly communicate using Makaton. Staffing levels are sufficient to ensure people can be supported to pursue life skills and leisure activities. The property is a modern four bedroom detached bungalow in a residential part of Rotherham. It has three single bedrooms, a sitting/ dining room, a domestic kitchen, bathing facilities and a staff sleeping in room. There are lawns to the front and side of the house. The area is enclosed and has an outdoor seating area for the service users. The home is close to local amenities and a short walk or bus ride in to the town centre of Rotherham The scale of charges was from 350 pounds per week in June 2009. Information about the home would be available to prospective people by contacting the home. The last inspection report dated 14th June 2007 was available on request from the manager. Care Homes for Adults (18-65 years) Page 4 of 27 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: one star adequate 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: The quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. This unannounced inspection took place over 4 hours starting at 10:30 finishing at 14:30; this included a partial inspection of the home. Two staff were spoken to during this inspection; their views are included throughout the report. An Annual Service Review was undertaken on 12th June 2008 where we looked at the information returned from the registered provider, and surveys returned from people who use the service. Care Homes for Adults (18-65 years) Page 5 of 27 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Occupancy at the home remains high with all three beds occupied. Three peoples care plans were looked at. Policies relating to medication, complaints, protection of vulnerable adults and handling of peoples monies were looked at. Three staff recruitment and training records were looked at to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the deputy manager. The manager and registered provider is John Tipple; he has owned the home since 1996 and he has the required management qualifications, competencies and skills. The AQAA was sent to the home and was returned to us on time, which demonstrates responsiveness and cooperation. An Annual Quality Assurance Assessments is a selfassessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The inspector would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs could be met. Evidence: Although there had been no recent admissions into the home, the process for admission of people was discussed with staff. All people placed at the home had been admitted following visits to Broom Haven. The assessment documents were looked at and they confirmed there care needs. One person had been reviewed by social services and they confirmed the person continued to be appropriately placed. Care Homes for Adults (18-65 years) Page 9 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals were involved in decisions about their lives although this was somewhat restricted due to staffing levels. Care plans provided basic information and they were not person centred. Evidence: All three care plans were looked at to assess how peoples needs were met. The information was basic and there was no evidence to confirm that people were involved in developing their own plan. Records show that internal reviews had not taken place since September 2008, although the schedule found on the care plan indicated that reviews should have taken place in January 2009 and May 2009. The staff were able to produce health action plans and person centred plans although they had been archived and were not in use. There were some evidence of risk assessments, although they were not sufficiently detailed and had not been recently reviewed. People were generally supported to make decisions about how they spend their time, although their choices were restricted as there was only one member of Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: staff on duty. This means that peoples choice would be limited, as they would have to take part in the same activity. Care Homes for Adults (18-65 years) Page 11 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to make some decisions about their lifestyle and were supported to access places in the local community. Evidence: People were able to access local amenities, although this was limited due to staffing levels. One person attends a local training centre five days a week, while the two remaining people spend most of their time at the home. None of the people access education or paid employment although they do follow their interests which includes visiting charity shops, swimming, walks to local parks and shopping in the local town. People were supported to go on a paid holiday and staff said they were going to Butlins Skegness early in September. People maintain their family contacts and stay for holidays and overnight stays with parents. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: People were encouraged to help with routines inside the home, including keeping their bedroom tidy and assisting with laundry and helping prepare snacks and drinks. Mealtimes were relaxed with the main meal usually at teatime when all three people would be at home. People help with shopping for food, although this is usually undertaken by the manager of the home. Care Homes for Adults (18-65 years) Page 13 of 27 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. The health and personal care that people receive was based on their individual needs. The principles of respect, dignity and privacy were put into practice. Evidence: People were generally independent with regard to their personal care, although staff provide support where needed. Staff had responsibility for arranging healthcare appointments and there was evidence of visits to the dentist and consultants, to review their mental health. Health action plans had been developed although they had not been updated since 2006. One person was supported to manage their behaviour, which included strategies to defuse their agitation. An audit of medication stocks and records was looked at and were found to be correct. All except one member of staff had received training in the management of medication provided by a local college. There was no evidence to confirm staff regularly have their competencies assessed, which means they could need further refresher training. The staff completed their last training in 2004. Care Homes for Adults (18-65 years) Page 14 of 27 Care Homes for Adults (18-65 years) Page 15 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to express their concerns and have access to an effective complaints procedure, and were protected from abuse, and have their rights protected. Evidence: The home has a complaints procedure that was on display in the entrance of the home and was accessible to people who use the service. The procedure was also referred to in the Service Users Guide, and identifies the stages to follow, and includes the time scales to respond to complaints. The procedure should be updated to reflect the changes to the address and name of the Care Quality Commission. The AQAA confirmed that no complaints had been received since the last inspection of the service. The home has a copy of the Local Authorities Adult Safeguarding procedures, and they operate to those standards. Staff training records show that they require formal safeguarding adults training as they have only received internal training undertaken by the manager. The AQAA confirmed that there had been no safeguarding referrals since the last inspection. Staff support people with their personal money, and records were looked at. They were accurate, although one persons records did not have two signatures for all Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: transactions. Staff require refresher training to manage peoples behaviour, the last training was undertaken in January 2007. The training must be provided by an accredited organisation, to ensure staff have the skills and competencies to manage people who displays challenging behaviour. Care Homes for Adults (18-65 years) Page 17 of 27 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. The home provides a clean, hygienic and safe environment to maintain the health and safety of people who use the service. Evidence: A partial tour of the building found it clean and free from odours. The home provides comfortable communal areas with a lounge/dining area and a domestic kitchen. The grounds were tidy, and had appropriate seating. It was easily accessible to people who use the service. Individual bedrooms were personalised to peoples own tastes and the furnishings were of good quality. The home is close to local amenities, and people are able to walk to the town centre of Rotherham. Care Homes for Adults (18-65 years) Page 18 of 27 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff must receive refresher training to enable them to fulfill their roles within the home. Recruitment policies were weak as one staff member did not have a employment file. Evidence: The home employs four staff plus the manager to work with the three people who use the service. There is always one staff member on duty at all times including a staff that sleeps at the home. Staff recruitment files were looked at and three of the four staff had all the required employment checks including application form, two references and a Criminal Records Bureau check. We were unable to check the fourth member of staff file as it could not be found. The manager said she was an exemployee and her file had been archived. This means that a member of staff is working at the home and could pose a risk to people who use the service, as no current checks had been undertaken. This person should not work any further shifts at the home until checks have been obtained. Training records were looked at and it was disappointing to find that since the last inspection of the service there appears to have been little investment in the staffs development. Records show that refresher training is required in areas of infection Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: control, health and safety, moving and handling, food hygiene and two staff requires emergency first aid. Records show that staff have not received formal supervision for a considerable length of time. Care Homes for Adults (18-65 years) Page 20 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is not in day to day charge of the home which means there is no leadership and guidance. Health and safety procedures needs to be improved to ensure people are kept safe. Evidence: The registered manager/owner has the required qualifications and has considerable experience working with the current group of people who live at the home. It is clear from looking at rotas that he is not counted when covering shifts. Staff said he visits very regularly to undertake administrative tasks. He was unavailable on the day of the inspection. Records checked during this inspection show that there was a lack of leadership, which is reflected in the requirements made in this report. The home has a quality assurance system which is used to survey people who use the service to gain their views on the service, however there have been no annual audit since February 2008. Residents meetings have fallen behind schedule with the last recorded meeting being December 2007. The last recorded staff meeting was held in Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: October 2008, which means staff have not been supported or given the opportunity to discuss and concerns. The home maintains health and safety records including fire safety checks, however formal fire safety training has not taken place. Staff said they had fire drills (last drill was undertaken 21st April 2009) but they had not received formal fire training. Accident records were maintained although they need to consider how the records are used to maintain confidentiality and comply with data protection. They are currently recorded in a book with a number of complaints on one page. They should be stored on the individuals case file, and they should be looked at to assess any trends which may be developing. Care Homes for Adults (18-65 years) Page 22 of 27 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 Adults (18-65 years) Page 23 of 27 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 1 6 15 Care plans must be person 03/08/2009 centred and individuals must be involved in developing the plan. The plans must be regularly reviewed. To ensure the plan reflect the needs and wishes of individuals. 2 9 13 Risk assessments must be regularly reviewed. To ensure they minimise accidents and keep people safe. 03/08/2009 3 20 13 Only staff that have completed the medication administration training must administer medicines to people who use the service. To ensure people receive their medicines safely 03/08/2009 4 23 18 Staff must receive formal training in the protection of vulnerable adults. 07/09/2009 Care Homes for Adults (18-65 years) Page 24 of 27 To ensure people are safe and protected. 5 32 18 Staff must receive training in the management of challenging behaviour. So that they can meet the needs of people who use the service. 6 34 19 Staff must not work at the home until they have completed an application and two references and a Criminal Record Bureau check has been obtained. To ensure the right people work at the home and people are safe and protected 7 35 18 Staff must receive training to enure they have the required skills and competencies. To meet the needs of people who use the service 8 37 9 The registered manager 27/07/2009 must be able to demonstrate control of the day to day management of the home To ensure the home is managed in the best interest of people who use the service 9 42 23 Formal fire safety training must take place at least annually. 27/07/2009 07/09/2009 06/07/2009 03/08/2009 Care Homes for Adults (18-65 years) Page 25 of 27 To ensure staff are up to date with emergency procedures. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Staff should regularly have their competencies assessed to ensure they safely administer medication to people who use the service. The complaints procedure should be updated to reflect the up to date contact details for the Care Quality Commission. Staff must continue to work towards NVQ awards in care. Staff must receive formal supervision at least six times a year. Quality assurance survey should be sent out yearly to gain the views of people who use the service and other stakeholders. Residents meetings and staff meetings should be held at regular intervals to enable people to express their views. 2 3 4 5 22 32 36 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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