Archived: Broadway Residential

Updated 19 May 2018

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.

This inspection took place on 16 April 2018 and was unannounced. The inspection team included two adult social care inspectors 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 care service.

Before our inspection we reviewed the information we held about the service. This included the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the local authority and Healthwatch to ask for their views.

We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with the registered manager, the care quality manager, the activity coordinator, three members of the care staff and eleven people living in the home. We also spoke with three relatives who visited the home during the inspection.

We looked at the care files of four people receiving care, four staff recruitment files, medicine administration charts and other records relevant to the quality monitoring of the service. We completed a Short Observational Framework for Inspections (SOFI) which provided information on the frequency and nature of contact experienced by people living with dementia. We also ate lunch with people and observed the delivery of care at various points during the inspection.

Updated 19 May 2018

This inspection took place on 16 April 2018 and was unannounced.

Broadway Residential is a residential care home situated in the middle of a housing estate in a suburb of Liverpool, providing support for up to 17 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection, there were 16 people living in the home.

A registered manager was in post. 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.

At our last inspection in April 2017 we identified a breach of regulation 12 of the Health and Social Care Act 2008 because; care plans were not in place for all identified health needs to guide staff how to support people with these needs, and risk assessments were not all up to date to enable risk to be monitored and mitigated. Following the inspection the provider submitted an action plan which detailed how they would become compliant with regulation. As part of this inspection we checked to see if the necessary improvements had been made and sustained.

The four care records that we saw had been extensively re-written following the last inspection and in accordance with the timescales submitted in the action plan. Each of them was well-detailed and reflected the full range of people’s care needs including any risk to their health, safety or wellbeing. The provider was no longer in breach of regulation in this regard.

Each of the people we spoke with told us they felt safe living in Broadway Residential. Staff were safely recruited and deployed in sufficient numbers to meet people’s needs and keep them safe.

The staff we spoke with understood their responsibilities in relation to safeguarding people from abuse and neglect. They were able to explain different types of abuse, potential signs of abuse and how they would report any concerns.

Medicines were stored and administered safely in accordance with best-practice. Staff had completed training in relation to safe medicine administration and had their competency assessed to ensure they were sufficiently skilled to manage medicines safely.

The home was clean and free from obvious odours. The risk of infection was reduced because staff had easy access to personal protective equipment (PPE) including gloves and aprons and acted in accordance with the provider’s policy.

We looked at accident and incident reporting within the home and found that they were reported and recorded appropriately. The registered manager maintained a monthly log of all accidents and incidents within the home and reviewed them each month to look for any potential themes or trends.

During the last inspection we identified that records relating to the Mental Capacity Act 2005 (MCA), and in particular capacity assessments were not always completed in accordance with best-practice guidance. We made a recommendation regarding this. As part of this inspection we checked to see if the necessary improvements had been made and sustained.

The records that we saw provided evidence that people’s capacity to consent was assessed appropriately and in relation to a range of decisions.

Staff we spoke with told us they were well-trained and felt well-supported through supervision. They also said they could raise any concerns they had with the registered manager at any time.

People told us they enjoyed the food at Broadway Residential. As part of the inspection we joined people living at Broadway Residential for lunch. The menu offered a good choice of nutritionally balanced meals, and people could request an alternative if they wished.

People living in Broadway Residential were supported by the staff and external health care professionals to maintain their health and wellbeing. The care files we looked at showed people received advice, care and treatment from relevant health and social care professionals, such as the GP, neurologist, dentist, optician and district nurses.

We saw that the provider and registered manager had considered the needs of people living with dementia in the building. Each bedroom door was individually named and painted in a bright colour. Photographs and familiar objects were used to help people identify their rooms. Signage was used throughout the building to help people find toilets and bathrooms.

People spoke positively about the staff and their approach to the provision of care. It was clear from our observations and discussions with staff that they knew people well and were able to respond to their needs in a timely manner.

People told us that friends and relatives were free to visit at any time. Relatives made use of the communal areas, but could also access people’s bedrooms for greater privacy. We saw that some people held a key to their bedroom door and kept it locked when they were using the communal areas.

People’s needs in relation to equality and diversity were considered as part of the assessment and care planning process. All of the people had needs relating to their age. At the time of the inspection none of the people living at the home had specific requirements relating to their culture, sexuality or other protected characteristics. However, a minister came into the home regularly to attend to people’s spiritual needs.

Care files contained a pre admission assessment which helped to ensure that people’s needs were known and could be met effectively from the day they moved into the home. People and their relatives were involved in assessments and care planning.

Broadway Residential employed an activities coordinator to develop and facilitate a range of group and individual activities. Most people spoke positively about the activities available and we saw examples of people taking part.

People had access to a complaints procedure and this was displayed within the home and within the service user guide provided to people when they moved into the home. The registered manager maintained a log of all complaints received as well as any actions taken and the outcome from them.

During the last inspection we identified that audit process had not always been effective in identifying issues of concern. We made a recommendation to improve practice. As part of this inspection we checked to see if the necessary improvements had been made and sustained.

We saw completed audits in areas such as; accidents/incidents, care plans, medicines and infection control. The audits that we saw were detailed and identified actions to be completed to improve safety. For example, the most recent kitchen audit identified that new shelves were required and fridges needed cleaning. These actions had been completed.

We asked people their views of how the home was managed and feedback was positive from people receiving care, their relatives and staff. The registered manager understood their responsibilities in relation to registration with the Commission.

Ratings from the last inspection were on display within the home as required.