Broadlands Park Residential Care Home

Broadlands Park is a residential care home providing personal care to up to 34 older people some of whom were living with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of using this service and what we found

The provider’s quality assurance system had not been effective at identifying concerns which were found during inspection. Not all risks had been identified and assessed to mitigate any harm they posed to people living in the service. The auditing processes had not identified contradictory information held within care records. This put people at risk of not receiving the care needed.

Staff had not received all the training required to meet their roles and needs of people who lived in the service. Although we had concerns regarding the deployment and numbers of staff, the situation had improved recently with increased recruitment including sponsorship of new staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, mental capacity assessments and best interest decision did not follow Mental Capacity Act guidance.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic and have made a recommendation the service reviews this to ensure it is meeting the requirements.

Medicines were managed consistently and safely. There was a medicine champion who oversaw the administration and worked closely with the GP to review the use of medicines.

People were given choices to ensure their needs were meet. A relative said, “[Person] has no problem with male or female staff. The service definitely meets [their] needs. [They] were wasting away in [their] bedroom at home and in here [they’re] looked after and has got company. [They] are happy. I’m happy. I’ve had a review of what they’re providing.”

Staff spoken to all said they enjoyed their job and how much they cared. One said, “Seeing [people] smile and you know you have done your job.” Another said, “doing little bits for individual people can make their day, just once a day, a little glint in their eye, a smile or remembering something. Anything. It is good to make people happy.”

The service had developed good relationship with health care professionals including the local GP. They had staff who were champions in such things as falls, continence and wound care, who ensured referrals were made in a timely way and these were chased so there was limited delay in people receiving the treatment they needed. Regular visits took place by GP and other Health care professionals who spoke very highly of the staff’s knowledge and experience. During these visits people with complex needs were discussed to ensure all available support was being provided.

The provider responded promptly to areas of concern raised with them and review systems and put appropriate measures in place to address shortfalls.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 May 2019).

Why we inspected

We received concerns in relation to management of people’s falls. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to risk management, adherence to the Mental Capacity Act 2005 (MCA), staff training and governance at this inspection. We have also made a recommendation the provider considers current guidance for people living at the service with a learning disability to ensure they are meeting the requirements.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Broadlands Park is a care home that offers care and support for up to 34 older people some of whom were living with dementia. There were 33 people using the service at the time of our inspection visit.

People’s experience of using this service

• People were supported to be safe. Staff understood their responsibilities to protect people from abuse and avoidable harm. Risk was assessed and managed. People’s human rights and freedoms were respected within their risk management plans.

• Routine checks and maintenance were carried out on the premises and equipment. Staff knew what to do in the event of an emergency, accident or incident.

• There were enough staff to meet people’s needs and to spend time with them. Staff were recruited in a safe way.

• People’s medicines were managed in a safe way and were reviewed by the prescribing doctor to make sure they remained effective. People had access to the healthcare services they required. Staff referred people promptly and followed the advice and guidance provided by healthcare professionals.

• People had enough to eat and drink. Where people were at risk of malnutrition or dehydration, staff took action to manage the risk and monitored the amount they ate and drank.

• The premises met the needs of people who used the service. People’s rooms were personalised. The premises were clean and tidy throughout. Staff knew how to reduce the risk of infection. They had access to the protective equipment and cleaning products they required to achieve this.

• Staff had the training and support required to meet people’s needs. Care and support followed best practice guidelines and legislation. Staff had opportunities to learn and develop their skills and qualifications.

• Consent to care and support was always sought in line with legislation and guidance. People were encouraged to make choices and decisions about their care and support and the things they did each day.

• Staff were kind and compassionate. People and staff had developed positive relationships. Staff were passionate about their work and motivated to improve outcomes for people and support them to become more independent. Privacy and dignity was promoted by all staff.

• Staff knew people well. They knew about the things that were important to people and the things that may cause distress. Staff knew the best way to communicate with people and how to offer support and reassurance when this was required. People were able to follow their interests and hobbies and took part in culturally relevant activities.

• There was a complaints procedure and people were confident speaking with staff about any concerns. People, relatives and staff were asked for their feedback on the home and their views and opinions were listened to and acted on accordingly.

• Staff understood their roles and responsibilities. They received the training and support they required. There were strong leadership and support structures in place. Staff and managers shared a vision based on providing person-centred care and support and improving outcomes for people. There were effective systems in place to monitor the quality of the service and to drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection we rated this service Good (report published on 17 May 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 17 and 18 May 2016 and was unannounced.

Broadlands Park provides care for up to 34 people. The home supported people who were over 65 years of age some of whom were living with dementia. The building offered accommodation over two floors, but most of the accommodation was on one level and purpose built.

There was a registered manager in place, a tier of senior staff including a member of staff who provided ‘management support’. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People benefited from being supported by staff who were safely recruited, well trained and who felt supported in their work by their colleagues and by the manager. There was consistently enough staff to safely meet people’s individual needs.

Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns. Medicines were managed and stored safely and adherence to best practice was consistently applied. People received their medicines on time, safely and in the manner the prescriber intended. The service regularly audited the administration of medicines.

Staff knew and understood the needs of people living at Broadlands Park.

Staff received yearly appraisals. Staff practice was not observed as often as the manager wanted. The manager was monitoring this and in communication with senior staff whose responsibility it was to observe practice. Staff did not have formal supervision; however staff said they were in regular communication with the manager and senior staff.

Staff told us they were happy working at Broadlands Park. They assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was depriving some people of their liberty in order to provide necessary care and to keep them safe. The service had made applications for authorisation to the local authority DoLS team. The service was working within the principles of the MCA.

People’s care plans contained important, relevant and detailed information to assist staff in meeting people’s needs. People and their relatives had been involved in making decisions around the care they received. People’s needs had been reviewed. The service was introducing a new system with the aim to increase people’s involvement in their reviews.

The service had good links with community healthcare teams. People were supported to maintain good health and wellbeing. The service reacted proactively to changes in people’s health and social care needs.

The service did not have good links with the local community. However the manager said they were aware of this and wanted to develop this area.

People were encouraged to maintain relationships with others and the service actively welcomed family members and visitors to the home. There were planned activities on a weekly basis. The service found creative ways to try and stimulate people.

There was a positive and open culture. There was a homely and welcoming atmosphere to the home. Relatives felt involved and listened to. They were confident that any concerns they may have would be addressed. There were systems in place to monitor the quality of the service. The manager and the management support were involved and present in the daily life at Broadlands Park.