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.