Care Home: High Broom Care Home

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What the care home does well Typical Quotes from residents were as follows "Well run home staff are nice"; "Staff are very nice girls always respond if you want anything; Meals are nice I like my room". "Staff are excellent one or two shine" attend resident meetings and enjoy the variety of social events". Typical quotes from relatives and Social Services professionals connected with the home were as follows "Staff follow advice and have good knowledge"; "I would recommend this unique service there is a good admissions process"; " I placed someone a year ago. It is a nice home with a good en-suite room. I am aware of residents meetings and the service is proactive"; " I am very positive about the home and good care plans are developed and followed which has helped a resident settle in smoothly "; "The home is picking up now with the new manager care is good pleased with it better than other homes"; " Residents are well looked after very happy, home always clean, the food is good ". The service is good at ensuring that it only accommodates residents whose needs it can meet. Care plans contain good information for staff to follow. Care planning has become more individualised. The home takes steps to ensure that it is run in the best interests of residents and have several methods for gaining their views on the services they receive. Complaints or concerns are investigated properly and residents are confident in airing their views. Resident`s benefit from an impressive environment and spacious grounds including excellent gardens. An exceptional number of staff have gained the basic National Vocational Qualification in Care at level 2. Resident`s benefit from staffing levels that are flexible and respond to changing needs and staff who care for them in the way they prefer. Measures to ensure the control of infection are very good. What has improved since the last inspection? Evidence indicates that measures to improve quality have improved in a range of areas that are important to residents. Residents are more regularly consulted on their views with detailed meeting and minutes recorded and action-plans followed up. Clarity around the home`s admissions process has improved further. Prospective new residents and their advocates now have fuller and more accurate information, at the right time, to inform their decision about whether to move in. Care plans show more resident involvement and are more regularly reviewed. The manager has improved health and safety measures to ensure better protection for residents. Residents now benefit from an even wider range of activities based on their preferences with further plans finalised. The overall amount of resident involvement in the home has been enhanced by the introduction of the new manager in August of this year. This has coincided with more effective administration of the home and clearer planning and monitoring of all areas to the benefit of residents. What the care home could do better: The new home manager has identified all the necessary areas, which need to improve, and has clear and effective plan which is being worked through. None of the minor shortfalls are currently affecting resident outcomes, which are good. The main priority identified in the Inspection is that new staff commence the required induction training [Skills for Care] as soon as possible to ensure they have the basic knowledge in order to best support residents. The service is currently operating without a registered manager and therefore needs to submit an application to be registered as a matter of urgency. CARE HOMES FOR OLDER PEOPLE High Broom Care Home Stone Cross Crowborough East Sussex TN6 3SL Lead Inspector Jason Denny Key Unannounced Inspection 26th November 2007 10:20 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service High Broom Care Home Address Stone Cross Crowborough East Sussex TN6 3SL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01892 654027 01892 665713 helen.hawthorn@agecare.org.uk HighBroom@agecare.org.uk Tony Lyne - Director Helen Hawthorn Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That a maximum of forty two (42) older people be accommodated. A maximum of thirteen (13) older people are accommodated in the close care cottages. That the service users are aged 65 years or over on admission. That one (1) service user can be accommodated aged between 60 and 65 years on admission as long as their individual needs can be met. 20th June 2006 Date of last inspection Brief Description of the Service: High Broom is a large detached house set in extensive grounds in a quiet country lane on the outskirts of Crowborough. The home is one of a group of four homes run by Age Care, a charity that was formed in 1863 under the Royal Surgical Aid Society. Crowborough town is approximately one mile from the home, with access to local shops, banks and other services. There are rail services to London and bus services to Tonbridge Wells and Brighton. The home is currently registered for 42 older people that include accommodating a maximum of 13 users in semi- independent cottages located within close proximity to the main house. The service users of the cottages choose how much contact they have with the other service users and staff and often join the residents of the main house at meal times. Staff check on residents in the cottages in the morning and there is a call system. If the needs of the service users change over time, they can be admitted to the main house. A lift is available in the main house. Fees are broken down into 3 elements; hotel charge, care requirements and accommodation. Charges vary according to room size and needs of residents and currently range from £1,900 per to £3,350 per month. All the entertainment and activities provided are included in the fees. Additional charges are made for hairdressing and chiropody. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced key Inspection, which included a visit to the home which took place between 10.20am and 3.40pm on November 26th, 2007. The inspection focused on checking that the good outcomes evidenced in the last inspection report of June 20th 2006 have continued. The visit also included reviewing progress with the improvements required in the last report. Part of the visit focused on how newer residents were settling in along with the impact of the new manager. Care records of some new and established residents along with health and medication needs were looked at. Discussions with management looked at lifestyle opportunities. The inspector toured some communal areas of the home with meal arrangements examined and sampled. A record of complaints was inspected. Staffing was looked at in detail along with how quality is maintained and improved upon. The inspector spoke with five current residents. The inspector spoke on the phone with five relatives and three social services professionals connected with the home following the visit. The timing of the inspection coincided with an outbreak of Norovirus affecting most residents in the main house. Due to residents being advised to remain in their rooms and the added requirements on staff in relation to infection control the Inspector spoke with less residents and staff than planned for. The independent cottages were not visited as a precautionary infection control measure. In addition it was not possible to observe care practices or activities, as residents were not using communal areas. The home sent back to the Commission a completed Annual Quality Assurance Assessment before the visit, which informed the inspection. All eight-outcome areas are judged to be Good, with no major improvements required. What the service does well: Typical Quotes from residents were as follows “Well run home staff are nice”; “Staff are very nice girls always respond if you want anything; Meals are nice I like my room”. “Staff are excellent one or two shine” attend resident meetings and enjoy the variety of social events”. Typical quotes from relatives and Social Services professionals connected with the home were as follows “Staff follow advice and have good knowledge”; “I would recommend this unique service there is a good admissions process”; “ I placed someone a year ago. It is a nice home with a good en-suite room. I am aware of residents meetings and the service is proactive”; “ I am very positive about the home and good High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 6 care plans are developed and followed which has helped a resident settle in smoothly “; “The home is picking up now with the new manager care is good pleased with it better than other homes”; “ Residents are well looked after very happy, home always clean, the food is good “. The service is good at ensuring that it only accommodates residents whose needs it can meet. Care plans contain good information for staff to follow. Care planning has become more individualised. The home takes steps to ensure that it is run in the best interests of residents and have several methods for gaining their views on the services they receive. Complaints or concerns are investigated properly and residents are confident in airing their views. Resident’s benefit from an impressive environment and spacious grounds including excellent gardens. An exceptional number of staff have gained the basic National Vocational Qualification in Care at level 2. Resident’s benefit from staffing levels that are flexible and respond to changing needs and staff who care for them in the way they prefer. Measures to ensure the control of infection are very good. What has improved since the last inspection? What they could do better: The new home manager has identified all the necessary areas, which need to improve, and has clear and effective plan which is being worked through. None of the minor shortfalls are currently affecting resident outcomes, which are good. The main priority identified in the Inspection is that new staff commence the required induction training [Skills for Care] as soon as possible to ensure they have the basic knowledge in order to best support residents. The service is currently operating without a registered manager and therefore needs to submit an application to be registered as a matter of urgency. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, & 6. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Prospective and existing Residents benefit from comprehensive assessment with steps taken to ensure they are comfortable with their decision to move in and who continue to get their needs met. EVIDENCE: Preadmission assessment documentation for three of the newest residents was examined and found to contain a full range of good information. The manager had assessed all residents prior to them moving in as shown in the dates on documentation. All had been offered a trial visit with written evidence of when this had been taken up. The inspector spoke with those new residents who were well enough who confirmed that they were pleased with the home. The home had also obtained copies of relevant assessments such as Social Services assessments where possible and this information had been transferred into the High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 10 care plan. In addition to the pre admission assessment the manager asks the resident or their relative to complete a questionnaire, which provides the home with valuable information. This information is now included in the care plan where appropriate. The home now informs the prospective resident in writing of the outcome of their pre assessment confirming they can meet the needs assessed. The assessment process has also been tightened up with the Head of Care and the manager working more closely to ensure that only suitable persons moving into the independent cottages where staff are not based and where apart from morning calls visit on request. The home showed someone in the cottages moved into the main house in the month of the Inspection due to increased needs and need for closer staff support Since the last Inspection the home has updated the service user guide and statement of purpose, which contains details of the new manager. This ensures that anyone thinking of moving into the home has accurate and timely confirmation prior to moving in. The manager explained how she is looking to make the resident guide more accessible in terms of how information is presented such as a greater use of photographs and talking tapes for those visually impaired. The home was found to have introduced a new contract, which fully meets changing legal requirements effective from 2006. A contract of a newer resident was sampled which was found to have been signed during the one month trial period by all parties including the resident. The contract clearly identifies the fee breakdown and all other relevant information. The manager explained how all residents are currently going though the practices of having the new style contract issued and agreed to ensure written evidence that their full rights are protected. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10. People who use this service experience Good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from good care planning that is subject to regular review in line with changing needs. Residents are protected by the home’s good medication practices. EVIDENCE: Four Care plans were examined and found to be in good order. The information provided is detailed. Care plans are now formally reviewed as shown in written evidence on at least a monthly basis. Plans clearly showed when changes had been made such as the move of one resident into the main house due to increased care/mobility needs. Another plan showed changes to medication in August 2007. The new Head of Care employed shortly before the last inspection discussed the plans with the inspector and demonstrated how the High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 12 plans have improved in order to make them more user friendly and more personalised, which has helped ensure the care provided is resident focused. The plans show residents’ independence skills and capacity to influence their care such as the introduction of nighttime agreements whereby residents that have capacity indicate what support they wish to receive. The care manager also indicated that along with her monthly meetings with seniors that residents have been invited to choose their own key workers. Daily records were found to contain good and useful detail such as in relation to activities participated in. Medication records were examined and were in order. It was not possible to observe medication being dispensed in communal areas due to the infectious outbreak. Care-plans were found to show medication needs. The new home manager has switched the system of medication dispensing to a system agreed to be more effective and safer and one in which all staff have been trained in. The manager confirmed how regular checks are made to ensure that any potential errors are promptly dealt with. Residents who self- medicate have recently received updated guidelines based on best practice to protect their interests. The home’s self- medication policy allows for residents agreeing to management carrying out spot checks with their assistance. Visiting health care professional confirmed that appropriate referrals are made, and that care standards remain good. Observation of care practices and how staff interacted with residents was not possible on the day of inspection due to each resident being advised to remain in their room with care given on a private 1:1 basis. Relatives and residents confirmed that care remains good and is promptly given as required. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 People who use this service experience Good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from organised activities that are varied and interesting. Residents benefit from a high level of involvement in the running of the home. Residents benefit from good food, which continues to improve. EVIDENCE: The home provides residents with the opportunity to participate in appropriate, enjoyable and stimulating activities. Resident and relatives confirmed that there is always something going on as shown in the monthly-published list of activities with planed activities each day. Relatives also indicated how activities have improved in range such as motivate exercise and quiz events by visiting specialists and seasonal events such as Remembrance Day Services held in the home. In response to residents views in a recent meeting the manager confirmed that the home would be accessing the mini bus used in another of the organisation’s homes. Coupled with this is the plan to increase the High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 14 dedicated activities coordinator’s hours from 8 to 14 hours per week as highlighted in the homes Annual Quality Assurance Assessment and by the manager during the visit. Care plans now record individual preferences in relation to leisure activities. Routines are fully flexible and are individualised and recorded. Activities currently on offer in the home include quality circle group, summer fete, Club ‘100’, painting classes, library of books both the homes’ own and books form the local library, greetings cards are for sale in the hallway where there is also a post box and information about activities and events on in the local area. All activities provided by the home are included in the fees with the exception of hairdressing and chiropody. There is a function room in the bungalow annex, which is available, free of charge for residents to book. This is used to entertain visitors hold celebrations etc. Resident involvement in the running of the home has increased with the introduction of regular residents meetings as shown in minutes for both the cottages and the Main house where all aspects of the service are discussed with the manager. Suggestions from residents in recent meetings such as November 1st 2007 have included resuming an art class, replacing some music systems and a range of other equipment. The home’s action plan in response to these suggestions was found to be robust and agreed with residents A meal was sampled and found to be hot, wholesome, nutritious and well presented. A choice was available and service users stated that they are asked on a daily basis what their preference is for the day. The home’s menu was examined and confirmed that a varied diet is provided. It is recognised that the home has worked hard to make improvements to the arrangements for the provision of food at meal times and continues to do so. Relatives and residents confirmed that food has improved. A comments book is maintained which shows increased satisfaction. The manager of the home closely monitors food provision as shown in action taken against one of the previous cooks when standards had declined. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, & 18. People who use this service experience Good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from prompt and effective responses to any area of concern brought by them or their representatives. EVIDENCE: A complaint made to the Commission of Social Care Inspection (CSCI) since the last inspection by a relative regarding the care of resident on three separate occasions and the response by the then manager was passed to the organisation to investigate. The Society upheld the complaint and improvements have been made. The complaint was thoroughly and appropriately investigated and all the concerns raised were addressed. The resident concerned has moved on to nursing care, a decision which due to unnecessary delays had contributed to continuing concerns and complaints. The new manager demonstrated a clearer understanding of when it become unsafe to keep providing a service to those who need nursing care. Some residents and relatives indicated how the openness and inclusiveness of the homes management has improved. The home’s complaint file showed that the complaint above has been the only formal complaint since the last inspection as confirmed by the manager of the home. The home has introduced a new complaints recording system to High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 16 improve accessibility and ensure that the full procedure is followed. In addition the home was found to have introduced a minor concerns book whereby residents and others can record any minor issues to have addressed to prevent escalation to formal complaints. A number of entries were found in this book with all necessary action taken. Appropriate safeguarding referrals are made by the home when required. Referrals to the mental health service continue to be low as confirmed by a visiting community nurse, which indicates how compatibility of residents is maintained and how the service meets needs. Relatives confirmed how any issues between residents are resolved quickly. The home has a copy of the local adult protection policies, procedures and guidelines and provides staff with the appropriate training in recognising abuse. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24, 25, & 26. People who use this service experience Good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a pleasant, clean, safe, and spacious environment, which is excellent in some respects. EVIDENCE: The Inspector had a limited tour of the building due to concerns regarding the infection that day spreading across areas of the home. Three resident who were not infected were spoken with in their rooms and two others in the reception area of the main house. The cottages for those who are more independent were not visited to ensure the infection that day did not spread from the main house. The gardens surrounding the home are immaculately maintained and are accessible to residents via level access and ramps from the main house and High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 18 bungalows. Ample seating is provided around the garden and there are tables and chairs to the rear of the building on the patio where shade is provided by umbrellas. The communal areas of the home are decorated and furnished to a high standard and there is a water dispenser in the lounge. All areas of the home inspected were found to be clean and hygienic. At the time of the Inspection the home had been advised not to use a vacuum as an infection control measure. Each bedroom has an alcohol rub dispenser. Residents’ bedrooms are personalised and meet their needs. Some service users have brought their own furniture and others have chosen to use those provided by the home. All health and safety issues outstanding from the last inspection have been attended such as the need for a window restrictor to be fitted and for risk assessments to be undertaken in relation to the stairs to the fire escape on the top floor. Hot water checks are now more frequent. The manager recently conducted a two day audit and inspection of all parts of the building leading to further improvements to the home action plans for improvements and supervision of maintenance tasks. The home is investigating alternatives to the arrangements for access to the four rooms on the top floor, which are currently accessible only via a small flight of stairs. This may lead to one of the rooms being altered to allow for better accessibility. Once access is improved the environment can be assessed as excellent overall. Infection control measures were found to be fully acted upon in relation to the outbreak at the time of the Inspection such as the compulsory wearing of masks and uniforms for visitors to areas used by residents. The home was found to have accessed full health advice along with circulating this to all residents. The cause of such a major outbreak was not known at the time of the Inspection. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 People who use this service experience Good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from sufficient staff that are generally suitably trained and supervised to ensure they are able to deliver knowledgeable and safe care. EVIDENCE: Staffing rotas were examined and discussed with the manager confirming that there are sufficient numbers of staff on duty at all times to meet the needs of the residents. This consists of five carers in the morning one of whom is the senior who visits the cottages dropping by carer in the afternoon down to two waking night- care for around 35 current residents. The manager indicated that most residents have low needs and staff is adjusted such as at night when needs increase. The manager also confirmed that staffing levels are higher than at the last Inspection for the same number of residents in relation to weekends where care staff numbers are now the same as weekdays. The only query raised is around the fact that no cleaning staff are employed at weekends with care staff having to attend to this therefore lowering available staff. The home was asked to review this although no residents or relatives indicated that this was High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 20 affecting needs. Resident indicated that staff respond promptly to their needs. Resident also indicated that staff have good communication skills. The use of agency staff is now limited and this is a continued improvement shown over successive Inspections. It was not possible to interview permanent staff mainly because they were heavily occupied dealing with each resident in their own rooms rather than residents being in communal areas receiving support. In addition a number of permanent staff were off sick due to the infectious outbreak resulting in a higher amount of agency staff. The staff room contains detailed information for staff to refer to in relation to Dementia care, Parkinson Disease, Diabetes, Osteoporosis, Manual Handling and strokes for example. There is also information on forthcoming courses that staff can nominate themselves for. The target of 50 of the care staff employed by the home achieving a national Vocational Qualification (NVQ) in Care at Level 2 or above has been exceeded and is around 78 as confirmed by the home’s Annual Quality Assurance Assessment. Recruitment files of two newer staff were examined with all necessary information in place to demonstrate that all checks had been carried out. All new staff work under supervision until their CRB disclosures [police checks] come back clear. Application forms were completed although there is no section to account for any gaps in employment history. The home was advised to improve such forms to reduce the likelihood of prospective new staff not disclosing where they may have been disciplined in previous employment. Four of the newest staff have not commenced either a TOPPS induction [previous induction in place] or the Skills for Care, which was compulsory for all new staff from October 2006. Some of these staff are the responsibility of the previous manager. The present manager agreed to address this as soon as possible. These staff had carried out an in-house induction. The appointment of a dedicated human resource person for the organisation will also assist the home. On arrival at the home the inspector was unable to distinguish different members of management and staff due to the absence of name badges or uniform. A point also made by residents and highlighted in a recent meeting. The manager indicated that this area is being looked at to reduce confusion. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38. People who use this service experience Good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed home, which has effective measures in place to improve quality. Residents benefit from improved safety measures EVIDENCE: The new manager of High Broom is qualified and experienced and has managed the home Since August 2007 following the retirement of the previous manager. The new manager has yet to submit an application to be registered and agreed to do so as soon as possible. The manager was found to be highly High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 22 motivated and realistic about where the service is at and how it can move forward to improve quality in the best interests of residents. A number of initiatives have already begun such as regular resident meetings and other measures such as improvements to activities and food. All those spoken with during and after the Inspection indicated that High Broom is a well run home well placed to make further improvements. The home gathers stakeholder’s views in a number of ways, and residents have the opportunity to attend quality circle meetings on a regular basis to discuss relevant issues. There is a staff representative committee that meets four times a year where staff from all the Surgical Aid Societies’ homes meet with the Chief executive and an elected member to discuss issues relating to the services they provide. In addition a quarterly resident’s committee and meeting has been set up with the last meeting during the month of the Inspection. The manager has set up a committee whereby the Residents can influence how funds are raised for their benefit through the Friends of High Broom. Minutes of a resident’s meeting on September 17th, 2007 in the cottages and the Main house on November 1st 2007 showed good resident involvement and suggestions such as having access to their own minibus. A detailed catering audit was carried out in October along with a two audit of all health and safety areas. A Resident six-monthly survey carried out in October 2007 contains a detailed summary and action plan of 21 resident s [main house] who took part with 19 very satisfied or satisfied. All individual comments were shown. The home purposely does not manage any resident monies or handle benefits or any financial affairs of residents. Each resident has a safe in their room with a minor number of residents requesting that some valuables are stored in the home safe. A full-itemised list is maintained with access strictly limited to management. Health and safety records were examined and found to be in order as confirmed by the homes Annual Quality Assurance Assessment. Staff continue to receive training in all related areas such as food hygiene. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP30 Regulation 18[c][1] Requirement That the Registered Person must ensure that staff undertake the appropriate induction on commencement of employment in the home and before starting any shifts as required by Skills for Care. That the recently employed staff commence and complete these inductions within the timescales. Timescale for action 31/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. Refer to Standard OP27 OP27 OP29 Good Practice Recommendations That staff and management wear name badges to identify their role within the home to reduce confusion. That staffing levels are reviewed at weekends in relation to domestic/cleaning staff. That the application form accounts for gaps in employment history. DS0000021134.V352432.R01.S.doc Version 5.2 Page 25 High Broom Care Home 4 OP31 That the manager submits an application to be registered as soon as possible. High Broom Care Home DS0000021134.V352432.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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