Broadacres Care Home

Broadacres care home is a residential care home providing personal care and support to older people and people living with dementia. There were 25 people using the service at the time of the inspection. The service can support up to 50 people.

People's experience of using this service and what we found

Management oversight at the service was not always effective. We found audits were irregular and did not always identify issues at the service which required attention. People living at the service and staff had confidence in the manager and the service worked well with other professionals to improve people's care.

Appropriate measures and risk assessments were not always in place to support infection prevention and control to keep people safe. The home environment was predominantly clean and well maintained although some areas required attention.

Risks associated with people's mobility and health conditions had been assessed. People received their medicines safely and there were safeguarding procedures in place to protect people from abuse. People were supported to maintain good health and to eat and drink well. Staff involved other professionals when people became unwell or required additional services

Staff were recruited safely, and pre-employment checks were carried out prior to them commencing work at the service. There were enough staff, day and night, to support people's needs.

Incidents and accidents had been monitored for future learning.

Staff felt supported by the manager. Staff had received supervision to help them in their roles and training had been completed or in the process of being arranged for them.

The manager understood their regulatory responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (report published 25 December 2018)

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Concerns were identified. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified a breach in relation to good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

The home had a system in place to support relatives to visit their family members by using the garden area and outside space. On arrival to the home, essential visitors were asked to complete and sign a screening form regarding COVID-19 symptoms and were asked to sanitiser their hands, put on a facemask and have their temperature checked prior to moving from the reception area. This assisted in identifying visitors who may be at a higher risk of transmitting an infection to people living in the home.

Staff had taken steps to support people in maintaining contact with family and friends. This included the use of phone and video calls.

Risk assessments were in place to support people who were shielding. Social distancing was observed as for as it was practicable to do so. Staff always wore appropriate PPE, regularly washed their hands and applied hand sanitiser.

Tests for COVID-19 were carried out weekly for staff and monthly for people living at the service. If a test result was positive, the person was required to isolate in line with government guidance.

The home was clean and there were no malodours. Staff had access to cleaning products and the cleaning of high touch areas such as door handles and hand rails, were cleaned regularly. However, the laundry was untidy, and some areas of the home were in need of maintenance to ensure they could be cleaned effectively. The registered manager was aware of these issues and working towards resolving them.

Staff had completed training in infection control, COVID-19 and donning and doffing PPE. The registered manager had completed competency checks to ensure all staff understood how to complete donning and doffing appropriately.

Further information is in the detailed findings below.

Broadacres is a ‘care home’. 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.

The home is located close to the town centre of Rotherham, South Yorkshire. It is in its own grounds in a quiet, residential area, but close to many amenities and public transport links. The home accommodates up to 50 people with support needs including dementia. At the time of the inspection 41 people were using the service. The home comprises two discrete units, each with a mix of en suite bedrooms and bedrooms without an en suite, as well as lounge and dining areas.

The service had 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 and associated Regulations about how the service is run.

We observed a genuine warmth when staff spoke with people and people told us they had good relationships with the staff.

Mealtimes were observed to be comfortable and pleasant experiences for people. People told us they enjoyed the food available and said it was plentiful.

Staff told us they received a good level of training, and we observed staff were knowledgeable and competent.

Medicines were stored and handled safely, with staff having appropriate training to ensure that people received medicines in a safe way.

Where people were at risk of harm, or presented a risk to others, there were appropriate risk assessments in place to ensure staff kept people safe.

Recruitment procedures were sufficiently robust to ensure people’s safety.

The home had an activities coordinator who devised a varied activities programme, including activities both within the home and within the local community.

There was a formal complaints procedure in place, and people we spoke with told us they would feel confident to complain if they wished to.

The management team were accessible and were familiar to people using the service. The provider had a comprehensive system in place for auditing the quality of the service, and for obtaining and acting on feedback from people using the service and their friends and relatives.

We found that improvements were required to the way the provider obtained and recorded people's consent to their care and treatment.

Broadacres Care Home is a 50 bed residential care home for older people, including those living with dementia. It is in the Parkgate area, close to the centre of Rotherham. The home provides accommodation on two floors. The upstairs unit is known as Rosehill and the downstairs unit is known as Clifton. At the time of our inspection there were 23 people using the service.

The service did not have a registered manager in post at the time of our inspection as they had left 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 is run. However, the registered provider had appointed an experience temporary manager to oversee the home until a new manager could be recruited.

Throughout our inspection we saw staff supporting people in a caring, responsive and friendly manner. They encouraged them to be as independent as possible, while taking into consideration their abilities and any risks associated with their care. The people we spoke with made positive comments about how staff delivered care and said that overall they were happy with the way the home was currently managed.

The majority of people told us they felt the home was a safe place for people to live. Assessments identified potential risks to people, and management plans were in place to reduce these risks. Staff were knowledgeable about how to recognise signs of potential abuse and aware of the reporting procedures.

Overall the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) legislation were met. 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 support this practice.

Medication administration was being safely managed, but the medication storage arrangements were under review due to lack of space and facilities.

Recruitment processes were robust, which helped the employer make safer recruitment decisions when employing new staff.

We found there was a lack of evidence to show staff had completed a structured induction into the home. Essential staff training had been provided, but not all staff had completed initial or refresher training in a timely manner. There was also a lack of evidence that staff support sessions had been regularly provided in line with the registered provider’s expectations.

The registered provider had suitable arrangements in place that ensured people received good nutrition and hydration. Care files identified any specific dietary needs people had, and staff were knowledgeable about each person’s individual preferences and needs.

Complaints and concerns had been managed in line with the company policy, which was displayed in the home. Complaints received had been recorded and investigated appropriately. The people we spoke with told us they would feel comfortable speaking to any of the staff if they had any concerns.

People spoke positively about the management team. There were systems in place for monitoring the quality of the service provided and highlighting areas for improvement. We found the manager and staff team listened to and learnt from the feedback of others, which helped to make changes to improve the service.

During our inspection, 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 the report.