Latest Inspection
This is the latest available inspection report for this service, carried out on 8th June 2010. CQC found this care home to be providing an Good service.
The inspector found no outstanding requirements from the previous inspection report,
but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for Broomy Hill Nursing Home.
What the care home does well The home carries out detailed assessments of people`s care needs before they move in, so that staff know the care that needs to be provided. Care plans are generally detailed and contain enough information for staff to be able to provide a good standard of care. There are ongoing improvements to the environment, which will make it easier for people with dementia to find their way around the home. Staff are recruited following robust recruitment and selection procedures, and receive training which gives them the skills and knowledge they need to fulfil their toles. What the care home could do better: Medication is not always managed safely, and this puts people at risk of not receiving their medication as prescribed. Some risk assessments do not fully address people`s individual needs, such as the need to assess the risk for people who are risk of falling, and put a plan in place to reduce therisk. Random inspection report
Care homes for older people
Name: Address: Broomy Hill Nursing Home 43 Breinton Road Hereford Herefordshire HR4 0JY two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sarah Blake Date: 0 8 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Broomy Hill Nursing Home 43 Breinton Road Hereford Herefordshire HR4 0JY 01432274474 Telephone number: Fax number: Email address: Provider web address: lwilliams@ashberry.net Name of registered provider(s): Name of registered manager (if applicable) Mr Philip Weeks Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashberry Healthcare Ltd. care home 40 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 40 40 Age: Dementia (DE) age 55 and above. Mental disorder, excluding learning disability or dementia (MD) age 55 and above. The maximum number of services users who can be accommodated is: 40 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 40 Mental disorder, excluding learning disability or dementia (MD) 40 Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Ashberry Healthcare Limited was registered as the Provider at Broomy Hill in July 2006. The home is situated in a residential area close to the centre of Hereford city. It provides 40 places for older people who have nursing care needs arising from mental health or dementia related conditions. There is information literature describing the service and copies of this are displayed at the home. Potential residents, or their representatives, are given an information welcome pack when they come to view the accommodation. A schedule of fees can be obtained from the home. There are additional charges made for hairdressing, chiropody and toiletries. A copy of this inspection report can be viewed at the home. Care Homes for Older People Page 3 of 10 What we found:
This was an unannounced inspection. One of our inspectors spent half a day at the home to look at various aspects of the home and how people are cared for. We saw some parts of the building, and looked at some of the most important records such as those about care needs, medication and staff training. We were able to see staff supporting people and we got a picture of day to day life in the home. We also received feedback from people who live in the home and from staff who returned surveys to us. We looked in detail at the records for two people who live at the home. One person had recently moved into the home, and we saw that an assessment of their needs had been carried out before they moved in. This assessment included detailed information about their care needs, so that the home could be sure that it could meet the persons individual needs. We found that care plans were generally detailed and informative. We saw that one person was at risk of developing chest infections. The care plan was very detailed, and told staff clearly how they could reduce this risk. The care plan also included information about the signs and symptoms of chest infections, so that staff would know what to look out for. One person had recently had a fall, but there was no risk assessment or care plan to tell staff how to prevent this happening again. This is important, because falls in older people can lead to serious injury and loss of mobility. We will be making a requirement that the home carries out risk assessments and puts care plans in place for people who are at risk of falling. We looked at the records which the home keeps to show how medication is managed. We saw that some peoples Medication Administration Record (MAR) sheets had been handwritten by nurses at the home. These MAR sheets had either not been signed at all or had only been signed by one nurse. It is important that two staff sign whenever handwritten instructions are added to a MAR sheet, as this reduces the risk of errors. One persons handwritten MAR sheet showed that they had come into the home with 28 tablets of Aspirin 75mg in a pack. The MAR sheet showed that four tablets had been administered to the person, which meant that there should have been 24 tablets left in the box. When we counted the tablets in the box, we found that there were 54 tablets, plus one loose tablet. We checked seven different medications, and found that there were errors in recording each medication. In some cases, it appeared that medication had been administered but not recorded, and other medication appeared to have been recorded but not administered. In other cases, we were not able to carry out an accurate stock check of the medications, as there was no record of the original amount that had been received into the home. All these errors mean that people cannot be confident that they will receive their medication as prescribed. We will be making requirements about how the home manages medication, to ensure that it is managed safely. The manager has contacted us since the
Care Homes for Older People Page 4 of 10 inspection to tell us what he is doing to improve the management of medication. We saw that staff were kind and caring when supporting people at the home. We observed a member of staff gently guiding someone away from a situation which was clearly upsetting them. The staff member was speaking calmly and reassuringly to the person, and stayed with them until they were calmer. Training records showed that staff receive training about dementia care, and the attitude of staff showed that they understand some of the ways in which they can effectively support people with dementia. The manager told us that he has plans to change the environment of the home, to give a sense of meaning and purpose. This will help people with dementia to orientate themselves around the home more easily. For example, the manager plans to decorate the corridor by the kitchen with a theme of food and cooking. These sensory stimuli should help people with dementia to make more sense of their surroundings and not to feel lost within the home. We saw that the doors to toilets and bathrooms had been brightly painted, so that people could easily see them and find their way to them when necessary. We looked at records for some members of staff and saw that the home had carried out their recruitment and selection safely. For example, all the required checks, such as Criminal Records Bureau (CRB) checks and two written references, had been carried out before staff started work at the home. This helps to protect people who live at the home by making sure that only suitable staff are employed. The manager has applied to be registered with the Commission as the Registered Manager of the home. At the inspection he showed that he has a very good understanding of the needs of people with dementia, and that plans are in place to make improvements to the service, so that people will continue to receive a service which is responsive to their individual needs. What the care home does well: What they could do better:
Medication is not always managed safely, and this puts people at risk of not receiving their medication as prescribed. Some risk assessments do not fully address peoples individual needs, such as the need to assess the risk for people who are risk of falling, and put a plan in place to reduce the
Care Homes for Older People Page 5 of 10 risk. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 7 15 (1) and (2) You must ensure 23/07/2010 that, where people are at risk of falls, care plans are in place, and are sufficiently detailed to enable staff to understand how to prevent falls. This is so that the risk of people falling is minimised as far as possible. 2 9 13 (2) You must ensure that accurate recordings are made of any medications that are left over from previous medicating cycles. This is so that people can be confident that medication is managed safely. 23/07/2010 3 9 18 (1)(a) You must put an 23/07/2010 effective system in place to ensure that staff are suitably qualified, experienced and competent to safely administer medication, before they administer medication to people in the service.
Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 This is so that people can be confident that they will receive their medication as prescribed. 4 9 13 (2) You must make 23/07/2010 arrangements to ensure that all medication is administered as directed by the prescriber. This is so that people can be confident that they will receive their medication as prescribed. 5 9 13 (2) You must put an effective 23/07/2010 system in place to ensure that medication administration records are accurately maintained. This is so that people can be confident that medication is managed safely. 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 9 You should ensure that any handwritten instructions on the MAR sheets are signed by two people, so that the risk of errors is reduced. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 noncommercial 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. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
