The Care Quality Commission
  • Care Home
  • Care home

Archived: Broadview

Overall: Requires improvement read more about inspection ratings

245 Brompton Farm Road, Strood, Rochester, Kent, ME2 3NW (01634) 717295

Provided and run by:
Mrs Marian Parkinson and George Patrick Parkinson

All Inspections

30 November 2015

During a routine inspection

The inspection was carried out on the 5 November 2015 and was unannounced.

Broadview provides accommodation for three people with learning and physical difficulties, who require personal care and support. The accommodation is provided in a single storey detached bungalow. There is a communal living room, kitchen, three bedrooms and communal bathroom. Outside there is a good size garden which people have access to. There were three people living in the home when we inspected.

A previous inspection took place on 9 September 2014 and found concerns over Safeguarding people who use services from abuse, management of medicines and assessing and monitoring the quality of service provision. We asked the provider to take action. At this inspection we found improvements had been made.

There was a registered manager employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People at the home told us that they felt safe. There were safeguarding policies and procedures in place that were being followed and staff were fully aware of their responsibilities in reporting safeguarding incidents and what the procedures were for this. There was a whistleblowing policy in place and staff told us they knew how to use it if they needed to.

Recruitment practices were not always robust. The provider’s policy was to only explore the last 5 years in employment history and there were large gaps in employment history on some staff files. We have made a recommendation about this.

There was no formal way of assessing dependency levels of people living in the home in order to determine the correct staffing levels to meet people’s assessed needs. Some people required one to one care. Staffing rotas showed that at night there was only one member of staff on duty but they had access to an on call system if they needed assistance.

People had been involved in planning for their care needs. Care plans provided information and guidance for staff on how to support people to meet their needs. Risk assessments were robust; clearly identify risks and what to do to mitigate those risks.

Staff had received training specific to people’s health needs, such as training in administration of epilepsy medication and PEG feeding. Training considered mandatory by the provider was up to date for all staff.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had received training on Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Care plans evidenced that people’s capacity was taken into account and how this affected the care they received from the home.

There were policies and procedures in place for the safe use and administration of medicines. People had access to GPs and other health care professionals. Prompt referrals were made for access to specialist health care professionals.

People were supported to help themselves to snacks and drinks throughout the day. Staff told us that people were involved in choosing what they wanted to eat by helping order the food shopping on line. People with special dietary requirements were catered for.

Some people had lived at the home for a very long time and staff knew them very well. We saw and heard staff engage in meaningful and kind conversations with people.

Some people were encouraged to be independent, but there was no evidence that people who were less mobile were encouraged to be independent.

There was a clear, easy read complaints policy and procedure in place but not all details of the relevant authorities were included. We have made a recommendation about this.

The registered provider had sought the views of people living in the home as well as other stakeholders. The results of the latest survey were used to make necessary improvements.

The quality assurance and monitoring systems in place were robust and allowed the registered manager to established areas that needed improvement. Action plans had been drawn up from the audits and the registered manager was making required improvements.

Staff talked about an open culture and promoting the visions and values of the home. The registered manager was aware of their responsibilities in reporting to CQC and was up to date with current legislation. They kept up to date with best practice and proactively researched their field to make improvements to the lives of people living at the home.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

9 September 2014

During a routine inspection

The inspection was carried out by one inspector over a time period of six hours. During this inspection, the inspector focused on answering five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us.

There were three people who used the service at the time of our inspection. Two of the people using the service had complex needs which meant they were not able to tell us about their experiences.

We looked at the care records of the people who used the service. Care records are documents which identify a person's needs and how staff can meet those needs, including assessments of identified risks for each person. We also looked at staff training records, medication records, the service's satisfaction surveys and policies and procedures.

We met and spoke with the registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. We also met and spoke with two members of care staff.

Is the service safe?

Staff had been trained in the safeguarding of vulnerable adults. Training included the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No recent applications had been submitted or approved. The manager knew about guidance from the CQC about the criteria for making an application for DoLS and how to do so.

However, we found that people who used the service had not been protected from the risk of abuse. This was because information about an allegation had not been shared with the relevant Adult Social Care Department. A compliance action has been set and the provider must tell us how they plan to improve.

People who used the service benefited from safe care and support, due to good decision making and appropriate management of risks to their health, welfare and safety. Risk assessments with clear action plans helped make sure people were protected from foreseeable hazards.

People who used the service had not been protected against the risks associated with the management of medicines. This was because adequate records had not been made of the administration of medicines. A compliance action has been set and the provider must tell us how they plan to improve.

Is the service effective?

One person who was able to speak with us told us that they liked living in the home and had been well cared for. The delivery of care was in line with people's care plans and assessed needs. We found that people had received effective care and support to be able to eat and drink sufficient amounts to meet their needs. Staff had received training to meet the needs of people who used the service.

Is the service caring?

We found that people who used the service were supported by kind and attentive staff. One person who used the service told us that the staff 'are good', and that they were pleased they had been able to move into the home. We saw staff provide emotional support and reassurance. Staff conveyed understanding and compassion when speaking with people who were distressed. We saw people who could not speak smiling in response to staff attention and gesturing to indicate that they enjoyed their company.

Is the service responsive?

People's needs had been assessed before care and support began. Their care plans were reviewed regularly to reflect any change in their needs. People's care plans included their history, wishes and preferences. People's views were sought about the quality of care that they received and their views were acted on. Staff told us that they were listened to and their suggestions were considered and taken into account.

Is the service well-led?

We found policies and procedures were in place that addressed important aspects of the service. Policies had been periodically updated. Staff had been made aware of the updates.

A system of quality assurance to identify how to improve the service had been developed. The quality assurance system had not been wholly effective. This was in relation to protecting people who used the service against the risks of inappropriate or unsafe care and support. A compliance action has been set and the provider must tell us how they plan to improve.

People and their relatives or representatives had been consulted about how the service was run and survey questionnaires were sent out, collected and analysed. Staff told us they had been able to share their views and that they were listened to.

27 June 2013

During an inspection looking at part of the service

At our last inspection 10 April 2013 we found that the provider had not taken steps to maintain safe standards of hygiene to ensure that people who lived there were protected from the risk of infection. During this visit we found that improvements had been made and all areas of the home were clean and safe standards of hygiene were being maintained.

There were two people living in the home at the time of our visit. The atmosphere in the home was calm and relaxed and people were content.

10 April 2013

During a routine inspection

At our last inspection 24 November 2012 we found that the provider had not taken steps to ensure there were enough staff on duty at all times of the day and night to make sure people were safe and their needs were met in a timely manner.

During this visit we found that improvements had been made and staffing levels had been increased.

There were three people living in the home at the time of our visit. We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us about their experiences. We observed how people interacted with care staff and the manager. The atmosphere in the home was calm and relaxed and people were content.

We found evidence that consent was obtained from people wherever possible before care and support was provided. People's care and welfare needs were met and there were enough staff to make sure people received the care and support they needed.

We found that there were areas of the home where standards of hygiene were not being maintained to an adequate standard to make sure that people were protected from risk of infection. We have also highlighted an area in this report that the provider may find it useful to note in order to improve the effectiveness of their quality assurance systems.

24 October 2012

During a routine inspection

There were two people living in the home at the time of our visit. We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us about their experiences. We observed how people interacted with care staff. We found evidence that people's care and welfare needs were met and medication was handled safely to make sure people were protected and their health needs were supported. Staff were given appropriate professional development to enable them to understand people's needs and provide appropriate care and support. There were not always enough staff to make sure people's safety was ensured.