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Inspection on 11/03/08 for Brecklands Nursing Home

Also see our care home review for Brecklands Nursing Home for more information

This is the latest available inspection report for this service, carried out on 11th March 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Staff offer care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. The preferred form of address for people who use the service is recorded in the care Plan. A varied and nutritious diet is offered. There is a comfortable sitting room and an accessible garden There is an activities programme and a monthly newsletter.

What has improved since the last inspection?

An improved training for staff is in place. A window has been replaced in the front of the house. The fridge and dishwasher have been replaced in the kitchen.

What the care home could do better:

The documentation for supervision of staff is now in place but not all staff have received supervision and the Registered Manager will work towards achieving this. This will be an amended requirement of this inspection. A programme of decoration is needed to address areas of chipped paint and worn carpet. This will be a requirement of this inspection.

CARE HOMES FOR OLDER PEOPLE Brecklands Nursing Home 28 Burnham Avenue Bognor Regis West Sussex PO21 2JU Lead Inspector Sheila Gawley Unannounced Inspection 11th March 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brecklands Nursing Home Address 28 Burnham Avenue Bognor Regis West Sussex PO21 2JU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 863218 01243 869769 Mrs Janet Mary Cole Mrs Lynda Rehman Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2007 Brief Description of the Service: Brecklands nursing home is a privately owned care home providing nursing care for up to nineteen residents in the category of older people. The home is a detached two-storey property in a residential area of the town of Bognor Regis. It is close to the town centre, within easy access to all local amenities and is half a mile from the sea front. Accommodation is provided in fifteen single and two double rooms. Four of the single rooms have en-suite facilities. A lounge with adjoined conservatory and a smaller dining room provide the communal space. A seating area is also available on the first floor. Information from the registered manager, received on the 21st January 2007, stated that fees for the home were £500 per week. The fees charged are £550. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit as part of the inspection process was carried out on 11/03/08. The Registered Manager facilitated the inspection and any documents required on the day were made available. Staff and people who use the service spoken to stated that they were happy in the home. Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Car inspection. The Home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. The home has met two of the requirements of the last inspection fully; the other one on staff supervision is partially met and will be an amended requirement of this inspection. What the service does well: Staff offer care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. The preferred form of address for people who use the service is recorded in the care Plan. A varied and nutritious diet is offered. There is a comfortable sitting room and an accessible garden There is an activities programme and a monthly newsletter. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, Standard 6 is not applicable People who use this service experience good outcomes in this area, as there is a clear assessment and admission process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an up to date and comprehensive Service User Guide and Statement of Purpose available to people who use the service and their residents or representatives to enable them to have information and make choices about the home. People who use the service have their needs assessed prior to admission. These assessments were seen in the care plans inspected. People who use the service spoken to confirmed that they had this assessment. Care management plans were also seen in care plans. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 9 Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 People who use this service experience good outcomes in this area because all needs are assessed and met, set out in a plan and residents are treated with respect. Medicines are handled appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people who use the service were case tracked and were also spoken to on the day. All residents had a plan of care. Their care plans were inspected and they contained information on health, personal, nursing and social need. The care plans were drawn up following an assessment of these needs. This included nutritional assessments, mobility, hygiene, continence, and pressure areas, and risk assessments. The risk assessments covered mobility, falls, nutrition and pressure area risk. There was evidence of monthly review and weight is monitored. Access to specialist health support is available as required including general practitioner, Parkinson’s disease specialist nurse and chiropodists Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 11 Staff were observed offering care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. Their preferred form of address was recorded in the care Plan People who use the service and relatives spoken to stated that care is offered as assessed. Medicines are received, stored, administered and recorded correctly. Medicine administration charts inspected were up to date. There are not any people who use the service who self medicate. The home is supported in the management of their medicines by a local pharmacy. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use this service experience good outcomes in this area, because lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service EVIDENCE: There is an activities programme in place, which is listed in a monthly newsletter. There is a gardening club and a singer comes in every two weeks. There is a library service. People who use the service spoken to stated that they were happy with daily life in the home. Birthdays are celebrated according to the wishes of people who use the service and they receive a gift. Visitors are welcome in the home and religious needs are met as requested. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 13 People spoken to also stated that they could receive visitors as they choose. People spoken to stated that they have freedom in daily routines such as when to go to bed and where to take meals. A hairdresser visits the home. The cook was spoken to. There is varied menu in place and choice is offered to residents. The meal seen prepared and served today appeared nutritious and people who use the service said they enjoy the food. The requirements of a recent Environmental Health Department inspection have been met. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use this service experience good outcomes in this area, as there are policies and procedures in place for complaints and safeguarding adults. This judgement has been made using available evidence including a visit to this service EVIDENCE: There is a clear and accessible complaints procedure in place which the people spoken to stated that they were aware of, although all stated that they did not have reason to complain. There is the facility to record any complaints. There have not been any complaints since the last inspection. There are policies and procedures in place regarding safeguarding adults and whistle blowing. Staff spoken to were clear about the procedures to follow in safeguarding adults allegations. Training records show that staff have training in safeguarding adults policies and procedures. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People who use this service experience good outcomes in this area because they live in a safe and well-maintained environment although some paintwork is chipped and the carpets are in places worn. This judgement has been made using available evidence including a visit to this service EVIDENCE: There is a comfortable lounge and a dining room. The home was neat and clean throughout and was free from offensive odours. People who use the service spoken to stated that they were happy with their rooms and facilities. Rooms can be personalised as people wish. Bedroom doors have been fitted with automatic door closure devices and radiators are covered. The carpets are generally worn with some stains in the hallways and particularly on the stairs. Some of the paintwork is also chipped. The AQAA did state that some Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 16 decoration is planned. This area will be a requirement of this inspection. There is an accessible well-maintained garden. The kitchen was clean and the recommendations of a recent Environmental Health Department inspection have been met. The laundry is sited away from where food is prepared, stored or served and has suitable washing temperatures to prevent the spread of infection there are sluicing facilities. The counter next to the sink was not impermeable to water for effective cleaning and the registered manager acknowledged that it needed to be replaced. She confirmed by telephone the next day that the maintenance man was completing the replacement of the counter. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use this service experience good outcomes in this area because needs are met by a staff trained and qualified to do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota showed sufficient numbers of staff on duty to meet the needs of people who use the service. There is sufficient domestic support. The manager is currently recruiting a Registered Nurse Seven of the fifteen care staff have completed the National Vocational Qualification Level 2 in care and another is about to start. All mandatory training on fire safety, moving and handling, infection control, first aid and health and safety is in place and training records were seen. There is a robust recruitment procedure in place and staff files inspected had all the required documentation; two written references, Criminal Records Bureau Clearance and POVA check, application form including employment history and terms and conditions. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 18 Induction training is in place and staff spoken to confirmed training is in place. All stated the home is a happy supportive place to work. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36,38 People who use this service experience good outcomes in this area because the home is run in the home is run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has been in post for 12 years and is a Registered Nurse. She undertakes training to maintain registration with the Nursing and Midwifery Council. The documentation to support regular supervision was seen but not all staff have received this as yet. Staff spoken to feel well supported and stated that they can approach the manager at any time. One staff member stated, “I couldn’t have asked for a better manager” Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 20 Quality assurance systems are in place. There are monthly staff meetings held at different times to facilitate staff attendance. The opinions of people who use the service are sought and changes made to menus are made. There is a questionnaire in place and there is a monthly newsletter. The people spoken to stated that they are very happy with the way the home is run. The money held for people who use the service is held separately, securely admission is recorded and receipted. The health and safety of people who use the service and staff is protected by the homes policies and procedures and the provision of trailing. Records to show the maintenance of utilities, electrical equipment and the lift were available. Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 23(2)(D) Requirement The registered person must ensure that a programme of routine maintenance and renewal of the fabric and decoration of the premises is carried out. The registered person must ensure that all staff receive formal supervision. Timescale for action 30/05/08 2. OP36 18 (2) 30/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brecklands Nursing Home DS0000024124.V359182.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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