Broadwindsor House

Broadwindsor House is a residential care home providing personal care to 20 people at the time of the inspection. The service can support up to 24 people.

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

People told us they felt safe living at the home. Relatives agreed. Staff told us they would feel confident whistleblowing if they observed or heard about poor practice.

Risks to people were assessed, recorded and regularly reviewed. This included those related to any health conditions and the home environment. There were enough staff on duty to meet people’s needs.

People told us they received their prescribed medicines on time. Relatives confirmed this. Medicines were only administered by staff with the relevant training and ongoing competency checks.

Infection and control procedures were robust and protected people, staff and visitors from harm. People told us their family and friends could visit without restriction.

Accidents and incidents were recorded and analysed. This supported the timely identification of themes and trends and the action required to help prevent a recurrence. Learning was shared.

The home had a positive culture. Staff enjoyed working with their colleagues and fully supported each other. Staff felt supported both in their work and with challenges that arose in their personal lives.

Professionals who visited the home regularly spoke positively about the management and care people received.

The registered manager and staff had a clear understanding of their roles and responsibilities.

The registered manager was highly thought of. There was unanimously positive feedback about them from all stakeholders. People and relatives felt the home was well managed.

The home undertook annual satisfaction surveys to gather the views of people, relatives, staff and professionals. Feedback was entirely positive.

The registered manager and deputy manager undertook various audits providing a robust oversight of quality and risk in the home. Staff were encouraged and supported to develop their skills and obtain further qualifications.

The home had established and maintained good working relationships with other organisations such as GP surgeries, social workers, district nursing teams and local frailty team.

Management recognised the part the home played in the local community. This included strong links with volunteers, a village school, college and donating to local events.

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 good (published 14 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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 remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Broadwindsor House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Broadwindsor House provides accommodation for up to 21 people, at the time of the inspection there were 15 people living there. People need support with their personal care. The home provides support for mainly older people, including people living with dementia.

There is a registered manager 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. The registered manager was well qualified and had the experience needed to carry out their role. Relatives told us they found them open and approachable. Relatives we spoke with all said they were very happy with the care provided at Broadwindsor House and would recommend the service.

People remained safe at the home. People told us there were adequate numbers of suitable staff to meet their needs. People received care promptly when they asked for help. Staff told us they were able to take time with people and call bells were answered promptly.

Safe systems were in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely.

Care plans included MCA assessments and clearly stated if the person had capacity to agree and give consent. Where representation was required the correct procedures had been followed.

Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected their needs and individual wishes. Risk assessments which outlined measures to minimise risks and keep people safe.

Staff had attended training in safeguarding people and had access to the organisation’s policies on safeguarding people and whistle blowing. People were supported by staff who had undergone an induction programme which gave them the basic skills to care for people effectively. Staff were positive about their training opportunities, one member of staff told us, “My training is good, it has changed my practice. For example I now look more closely at people skin when I am helping them to ensure there are no marks that might need more cream”.

People’s nutritional and hydration needs were assessed and monitored to make sure they received a diet in line with their needs and wishes. Where concerns were identified, staff sought support from professionals.

People were supported to access external health professionals, when required, to maintain their health and wellbeing. Health professionals visited the home on a regular basis. Documentation was updated to reflect the outcomes of professional visits and appointments.

People had access to dedicated activities. Activities took place three afternoons a week. Staff supported people with activities in the mornings or by supporting people with their chosen activity such as a daily walk around the grounds. One visitor told us, “I now expect to come into the home and see the staff team interacting with people”.

There was a clear management structure. The registered manager was supported by a deputy manager who staff told us were supportive and approachable. There were systems in place for monitoring the quality of the service.

Two people who lived at the home told us that they understood the care choices available them, and could have their views taken into account in the way their care was delivered. A person said, "They are very good at asking you about things."

We found that people's needs were assessed, and care was planned and delivered to meet people's needs. A person's relative told us, "I am aware that my father has a care plan." We saw that people's care was regularly reviewed and their personal information was held securely.

We saw that the home had taken steps to ensure that people were protected from abuse and that their human rights were respected and upheld. A person told us, 'I feel safe here.' Another person told us, 'The people here are friendly and get on well together.'

We viewed a selection of staff records, and saw that relevant checks had been carried out when the home employed staff.

The home had appropriate systems in place to ensure that people's comments and complaints were listened to and acted on effectively. A person told us, "Staff take concerns seriously, they do listen."

During the inspection on 25 September 2012, we saw that although the service was conducting some audits, the audits of care plans had not identified that the Malnutrition Universal Screening Tool (MUST) was not being used appropriately by staff. The information recorded on people's MUST documents was not clear and people may have been at risk of malnutrition that was not identified or acted upon. We also saw that people's medical records had not been completed correctly and that people may not have received care or treatment in line with their wishes.

During this inspection, we found that all staff currently employed by the home had completed training in the identification of people at risk of malnutrition and in the use of MUST. A new audit system of the MUST had been implemented and this demonstrated that people's risk of malnutrition was recorded clearly. The home had consulted with relevant GP's and Do Not Attempt Resuscitation (DNAR) orders had been reviewed so that people's care would be in line with their wishes.