Archived: Broadlands Nursing Home

Updated 18 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

It was undertaken by an inspector, a specialist advisor, who was a nurse and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before our inspection we reviewed information we held about the service and the provider.

During the inspection we spoke with ten people using the service, seven relatives, a nurse, four care workers, the chef and the kitchen assistant and the manager. We also spoke with a social worker and a GP.

We spent time observing care and support being delivered and we also used the Short Observational Framework for Inspection (SOFI) because some people could not tell us about the service they received as they could not always communicate with us verbally. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at five people’s care records, five staff files and records relating to the management of the service including quality audits.

Updated 18 May 2015

The inspection took place on 16 March 2015 and was unannounced. The last inspection was on 24 and 28 October 2014 to check whether action had been taken in respect of six warning notices we served on the provider for breaches of regulations. We found the provider had made some progress with meeting the regulations but was still breaching regulations in relation to care and welfare, assessing and monitoring the service, cleanliness and infection control and meeting nutritional needs. At this inspection we also checked on other breaches of regulations we identified at our inspection on 30 July and 7 August 2014 where we had asked the provider to make improvements. These breaches were in relation to safeguarding people from abuse, respecting and involving people, complaints and supporting workers.

Broadlands Nursing Home is a care home for up to 25 people with nursing needs, many of whom are living with dementia. At the time of our inspection there were 18 people living at the home.

The service did not have a registered manager in post. There was a newly appointed manager who had made the necessary application to become the registered manager. 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.

Staff knew, but did not always take, the necessary action to keep people safe in cases of possible abuse, such as when people sustained unexplained bruising. You can see what action we told the provider to take at the back of the full version of the report.

People’s care plans and risk assessments did not always contain sufficient accurate information. This meant staff were not always able to follow these documents as guidance on how to provide care appropriately. We were unable to evidence people received the right care and treatment when they developed wounds such as pressure ulcers. This was due to poor recording in wound management care plans and risk assessments, and of treatment records.

The manager had not ensured all people were able to reach a functioning call bell to call staff when they required assistance. However, the premises and equipment were clean and safe with regular health and safety checks carried out. Specialist equipment such as slings, hoists and pressure relieving mattresses were in place to help ensure people receive safe care.

Medicines management was safe. Decisions to administer medicines to people covertly were made in their best interests and the medicines policy contained sufficient detail on this to guide staff.

There were sufficient staff on duty to meet people’s needs. Recruitment practices were safe as checks were carried out before staff were employed to find out if they were suitable to work in the home.

People received the right support to eat and drink sufficient amounts and food was served at an appropriate temperature. Staff monitored people’s nutritional status appropriately and took the necessary action when there were concerns about people’s weight, such as referring them to appropriate professionals.

Staff received suitable training to carry out their roles and the manager had recently implemented a programme of staff supervision to provide individual support to staff.

Staff understood how to gain people’s consent before they provided care. The manager understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS). They had made several applications so that where people needed to be deprived of their liberty, this was carried out safely and in the correct way. These safeguards are there to help make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

People’s views and preferences in relation to their care, or the views of their relatives where appropriate, were not always recorded. This meant staff who were not familiar with the needs of the person they needed to care for or who were new to the service were not always able to refer to this information to provide care to people in the ways they wanted. However, regular staff had a good understanding of people’s preferences and wishes through discussion with them. People were treated with kindness, dignity and respect by staff.

People were provided with a range of activities to keep them stimulated both inside and outside the home. People and relatives were involved in discussions to plan activities.

People were encouraged to say what they thought about the service. There was a complaints policy that was available to all. The manager ensured complaints and suggestions were clearly recorded and acted upon to resolve issues raised.

The manager was aware of their roles and responsibilities and monitored the quality of the service provision through a range of audits. However, these audits had not identified the issues we found in relation to care planning, risk assessing, safeguarding, wound management, involving people in planning their care and recording their views.

The manager and director regularly gathered the views of people using the service and their relatives through regular meetings and questionnaires. The manager involved staff in the running of the home through a number of initiatives including regular staff meetings.

At this inspection we found breaches in relation to safe care and treatment, person-centred care and safeguarding. You can see what action we told the provider to take at the back of the full version of the report.