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Broad Oak Manor Care Home Good


Inspection carried out on 16 May 2017

During a routine inspection

Broad Oak Manor Care Home is registered to provide accommodation and personal care for up to 42 older people who have complex health conditions requiring nursing care. There were 37 people living at the service on the day of our inspection. The accommodation was spread over two floors with a lift to help people move between the floors easily.

At the last inspection, on 11 February 2015, the service was rated as Good. At this inspection we found the service had remained Good.

People continued to be safeguarded from abuse by staff who knew and understood the procedures in place and what their own responsibilities were within these. Staff were confident concerns would be acted on immediately by the management team. People were protected from the risks they faced as an individual. The nursing staff identified risks and made sure guidelines and management plans were in place to control the risks. Accidents and incidents continued to be recorded well and improvements made to keep people safe by close analysis.

There were sufficient numbers of nursing and care staff available to support people and to meet their needs. Safe recruitment practices were still in place to make sure the service employed only suitable staff. New staff were given the training and support they needed to do well in their new role. Refresher training continued to make sure staff updated their skills.

People were supported to have their healthcare and nutritional needs met. Specialist advice was sought by the nurses when necessary to make sure the advice was available to care for people’s needs well.

Although the staff completed daily charts to record people’s food and fluid intake as well as changes to their position in bed, these were not always recorded consistently. We have made a recommendation about this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported by nurses and staff who knew them well and were therefore able to support them in a person centred way. The atmosphere in the service was relaxed and friendly where people and staff interacted well.

People had access to a range of activities to suit most preferences. Outings to places such as the theatre were regular. Residents meetings and regular surveys ensured people’s involvement and views were sought.

People, their relatives and staff thought the service was well run and thought the new registered manager was making further improvements to an already good service. The registered manager and deputy manager reacted quickly and positively to areas for improvement. The provider and registered manager effectively used monitoring and auditing tools to ensure the quality and safety of the service continued to be maintained and improved.

Further information is in the detailed findings below.

Inspection carried out on 11 and 16 February 2015

During a routine inspection

Broad Oak Manor provides accommodation, personal and nursing care for up to 42 people. The building is a period property with a modern annexe and accommodation over two floors. There is a passenger lift giving access to all floors in the main part of the building. There is a stair lift providing access to bedrooms in the annexe. There are three lounges, a dining room and an accessible well-maintained garden and grounds.

There is a registered manager at the service. 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 was run.

When we last inspected the service on 31 January 2014, we found that there was breach of the Regulation 18 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2010. Systems were not in place to make sure that people were always asked for their consent to aspects of their care and treatment. We asked the provider to take action to make improvements and we found that these actions had been completed.

The provider had taken reasonable steps to make sure people were safe. People told us they felt safe living at the service. Staff had completed training in how to protect people and knew the action to take if they suspected abuse. Staff understood the whistleblowing procedure and knew who to report any safeguarding or whistleblowing concerns to.

Risks to people’s health and safety were assessed and measures put in place to always try to avoid them. There were environmental and individual risk assessments, staff understood the guidance they were given on risk prevention and how to put it into practice.

Information about accidents and incidents was recorded and analysed, so that staff could put measures in place to try to prevent them happening again. People were provided with the equipment they needed to keep them safe.

Staff knew how to protect people in the event of an emergency and they had guidance to follow if needed.

Sufficient staff were employed in each area of the service each day to meet people’s needs and keep them safe. People were familiar with the staff and staff understood people’s individual needs and preferences. The provider followed safe recruitment practices to make sure staff were suitable to work at the service.

Systems were in place for the safe storage and administration of medicines. People received their medicines when they needed them.

Policies and procedures were in place that staff understood and followed correctly to make sure they protected people from the risk of cross infection.

People’s needs were assessed before they moved to the service. People were involved whenever possible in planning their own care. The staff responded to people as individuals and met their needs because they knew them well.

People and relatives told us that staff looked after people well and their health needs were met. Staff made sure they contacted health professionals when necessary and followed the advice health professionals gave them. People told us, “They looked after me wonderfully when I’ve been ill” and “They do worry about you when you are not well”.

Staff were kind and caring. Relatives told us, “I hear kindness when I listen to the staff talking to others, it is all good”, and that the care was, “Above and beyond”. Staff told us they had time to talk with people. A member of staff told us, “We provide the best day we can for them”. The provider made sure that there were sufficient staff on duty to meet people’s needs. Staff were well trained and supported. Staff told us that the registered manager and senior staff were approachable and they could always ask them for advice when necessary.

Staff respected people’s wishes for the end of their lives.

People were provided with a varied diet that offered plenty of choice and met their needs and preferences.

Staff respected people’s privacy and dignity. Staff understood how to communicate with people who were living with dementia or were unable to express their views verbally. Staff promoted people’s independence, equipment to aid independence was available and staff explained how they helped people to maintain independence skills.

Staff were trained in the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). If necessary people’s capacity for making decisions was assessed and documented and the level of decisions that people were able to make recorded. Best interests meetings were held if people were not able to make a significant decision themselves.

People had opportunities to take part in a range of activities, events and outings. People were consulted about what activities and outings they would like and the provider acted upon their views. Staff understood that people’s spiritual beliefs were important to them and supported them to take part in their chosen faith.

There were systems in place to gain people’s views about the service. These included surveys, residents and relative’s meetings, and the registered manager was available to speak with people individually. There was a complaints procedure and any concerns or complaints were taken seriously and addressed.

Systems were in place to monitor the quality of the service. These included a range of checks and audits such as health and safety, medicines, training, infection control and care records checks.

Inspection carried out on 31 January 2014

During a routine inspection

We found that before people received any care or treatment they were not asked for their consent and the provider could not show that they had acted in accordance with their wishes.

We found people did experience care, treatment and support that met their needs and protected their rights.

We found that people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found the provider did have effective system to regularly assess and monitor the quality of service that people receive.

We found that the provider did have an effective complaints system available. Comments and complaints people made were responded to appropriately.

People we spoke to told us they liked living at the home. Comments included �It�s lovely here� and �the food is excellent�.

People and relatives we spoke to told us they were looked after at the home. Comments included �The girls here are lovely� and �the staff work very hard�

Inspection carried out on 24 January 2013

During a routine inspection

We spoke with four people who used the service, five members of staff, the providers appointed manager and her deputy. We saw other staff carrying out their duties, and briefly met some of them. We found that the atmosphere of the home was relaxed and friendly. We saw that staff treated people with respect and promoted their dignity. Comments received from people using the service included �I am happy here�. Another person told us, �I�m very comfortable and well looked after". We were told that the food was of a good standard and alternative menu choices were available. Staff received a comprehensive range of training to ensure that they had the necessary skills to support the people who lived there. The home was undergoing a major refurbishment at the time of our visit. We saw arrangements had been made so that people who used the service were kept informed about the progress of the refurbishment work and the unavoidable disruption to their daily lives was minimised by careful planning.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name(s) appear because they were still a Registered Manager on our register at the time. The providers appointed manager who started work at the home on 07 January 2013 confirmed that she had applied for registration with CQC and had begun the �fit person� process.

Inspection carried out on 19 December 2011

During a routine inspection

We talked with five people living in the home during the course of the visit. Their comments included:

�It�s all lovely here. The staff come quickly if I call them, and they are always kind and helpful. The nurses explain anything I ask about, and are very good.�

�They look after me very well in here. I like going down to the lounge to join in with things � there�s always lots going on.�

�I�m very happy here. Everyone is kind and thoughtful. The food is really good, and there�s lots of choice.�

Reports under our old system of regulation (including those from before CQC was created)