Broadacres Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Care plans identified that people's needs were assessed but there was little evidence of how people were involved in their care planning or care plan review processes. People’s care plans lacked detail and agreed actions and outcomes for people and how they were supported to maximise their independence, choice and control. Observations of staff practice indicated teamwork between colleagues. The Provider confirmed that hospital packs are on the electronic system (PCS) and when someone goes into hospital PCS was used to generate a hospital pack. Observation of people in communal lounges did not identify that they were engaged in meaningful activities supported by staff.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We observed the mealtime experience throughout the home and found this could be improved. There was a lack of interaction between staff and people. Staff did not always support people to choose their meal. On one unit the menu displayed was only for breakfast and did not present the lunch options. People were not always offered alternatives if they refused the first option. There was poor communication between staff and people throughout the mealtime experience. There were limited or no explanations of the meals and desserts available to people to support them to make informed choices about their meals. Additional feedback from the local authority informed us that a person's first language was not English and their care plan recorded a language barrier because they did not speak English. There was no support in place to enable effective communication with this person and there was limited scope to involve them in reviewing their care and support needs without the use of an appropriate translation app or communication tool.

Discussions with staff confirmed that an app for a person who had additional communication was not used regularly even though their care plan indicates that an app or an interpreter should be used for communication. Staff told us they have learned how to communicate by using body language and facial expressions. Other communication was not good throughout the home, for example, notice boards on stairs required updating with current information and an interactive media screen that depicted a train coach had no explanation about what it was and it did not appear to be working and was not in use.

Care plans and risk assessments identified that people’s needs had been assessed but there was little evidence of how people had been involved in discussions about their care and support. People who had the capacity to make decision about their care had not been involved in developing or reviewing their care plan. People who had been assessed as needing specialist communication support via an app and/or a translator did not receive this support. Support provided for this person’s 1-1 care hours did not include specialist communication support and the person was engaged only through use of body language and facial expressions. Care plans and risk assessments were not all reviewed in a timely manner. For instance a selection of risk assessments for a person were only reviewed following the day of inspection. Information from this review about how a person communicated or expressed pain and the need for PRN (as and when) medication was not used to update PRN protocols in their medicines administration record (MAR) chart.

People were positive about the food and meals and told us, "It suits me, it is very good”, “Cornflakes. I always have cornflakes [for breakfast] and sometimes they give me toast. It’s all nice” and “Brilliant, [the food] is edible. Meat, carrots, peas gravy and potatoes followed by a sweet.” However, our observations of the mealtime experience throughout the home found it could be improved. There was a lack of interaction between staff and people. Staff did not always support people to choose their meals. On one unit the menu displayed was only for breakfast and did not present the lunch options. People were not always offered alternatives if they refused the first option. There was poor communication between staff and people throughout the mealtime experience. There were limited or no explanations of the meals and desserts available to people to support them to make informed choices about their meals. When we spoke with relatives and family members we were told there was always a sling available when people needed to transfer from bed to chair or wheelchair, "[Broadacres] have recently purchased a new one for [relative] because the old one had become stained."

When we talked to staff about involvement of families in discussions about care and support, a member of staff told us, "We speak with families all the time. I feel we do involve them but we might not always write it down." There was little evidence in care plans about how people were actively involved in discussions about care planning and support.

People's care plans were reviewed and people's needs were assessed but there was little evidence of how people were involved in their care planning or care plan review processes. One person's care plan did not make it clear how they had been involved in developing their care plan even though it states that they have full capacity for decision-making.

People were positive about the food and meals and told us, "It suits me, it is very good”, “Cornflakes. I always have cornflakes [for breakfast] and sometimes they give me toast. It’s all nice” and “Brilliant, [the food] is edible. Meat, carrots, peas gravy and potatoes followed by a sweet.” However, our observations of the mealtime experience throughout the home found it could be improved. There was a lack of interaction between staff and people. Staff did not always support people to choose their meals. On one unit the menu displayed was only for breakfast and did not present the lunch options. People were not always offered alternatives if they refused the first option. There was poor communication between staff and people throughout the mealtime experience. There were limited or no explanations of the meals and desserts available to people to support them to make informed choices about their meals.

There was limited communication between staff members throughout the care environment although visiting health professionals confirmed that staff were willing to assist then they visited people.

Feedback from the Local Authority identified a range of improvements that had been identified following their quality assessment visit and review. We spoke with healthcare professionals and they told us the staff assisted them when they were at the home. Healthcare professionals told us staff appropriately referred people to them and followed their advice. One nurse said, “Staff are always willing to assist people when the nurse visited.”

Observations of staff practice indicate there is teamwork between colleagues but that was limited. The Provider confirmed that hospital packs are available on the electronic care planning software system (PCS) and when someone goes in to hospital there is a section on the PCS system which can generate a hospital pack that travels between services with people. Copies of electronic medicine administration records (eMAR) would also be printed out and travel with the person.

People were positive about the food and meals and told us, "It suits me, it is very good”, “Cornflakes. I always have cornflakes [for breakfast] and sometimes they give me toast. It’s all nice” and “Brilliant, [the food] is edible. Meat, carrots, peas gravy and potatoes followed by a sweet.” However, our observations of the mealtime experience throughout the home found it could be improved. There was a lack of interaction between staff and people. Staff did not always support people to choose their meals. On one unit the menu displayed was only for breakfast and did not present the lunch options. People were not always offered alternatives if they refused the first option. There was poor communication between staff and people throughout the mealtime experience. There were limited or no explanations of the meals and desserts available to people to support them to make informed choices about their meals.

We spoke with healthcare professionals, and they told us the staff assisted them when they were at the home. Healthcare professionals told us staff appropriately referred people to them and followed their advice. One nurse said, “Staff are always willing to assist people when the nurse visited.” Although visiting healthcare professionals responded positively about how staff appropriately referred people to them, our observations of staff practice and our review of systems and processes identified there were some shortfalls in how staff supported people to live healthier lives.

Evidence from care plans indicated a lack of detail about people's needs and how they can be supported to maximise independence, choice and control. There were limited records of food and fluid intake in people's care plans who were assessed as high risk in relation to nutrition. When we carried out observations in the communal lounges people were not engaged in meaningful activities. Juice, water and milkshakes were available throughout the day and this was observed on the second day of inspection. The service had a hydration policy in place and had started doing a supper box for staff to use in the evenings and at night. This contained tinned foods, bread, porridge and snacks for people. This was mainly used on the upstairs unit due to some people not settling at night.

When we spoke to staff about how they support people to help them make informed choices they told us, "We ask people what they like and show options. We try to explain what we are doing but its hard when people have dementia."

Team managers did not feel supported by their manager to know or understand what should be going on for all the people receiving care and support.

Care plans were reviewed and the dates of reviews were recorded but there was no evidence of how people were involved in these reviews or how they were engaged to help improve their care and support outcomes.

We observed people being hoisted and this was carried out safely. Staff took the time to engage people in conversations about what was happening throughout the process and kept them informed about when the hoist was going up and down. This put the person at ease and demonstrated that staff were able to deliver person centred care to people and engage them in their own care and support.

When we spoke to staff about how they support people to help them make informed choices they told us, "We ask people what they like and show options. We try to explain what we are doing but its hard when people have dementia."

When we reviewed people's care plans we could not see clear evidence of how people were involved in conversations and discussions about consent to care and treatment although we did observe staff engaging people in conversations about their own care and support.