Inspection on 26/06/08 for Brookfield House Care Home

This is the latest available inspection report for this service, carried out on 26th June 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Brookfield House Care Home 23/05/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Brookfield House Care Home Brookfield Park Shrewbridge Road Nantwich Cheshire CW5 7AD Lead Inspector Ms Julie Porter Key Unannounced Inspection 26 June 2008 10:00 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 Brookfield House Care Home DS0000066254.V366313.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. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookfield House Care Home Address Brookfield Park Shrewbridge Road Nantwich Cheshire CW5 7AD 01270 624951 01270 628643 brookfield_house@btconnect.com None Mr Jayantilal James Bhikhabhai Patel 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) Mrs June Jones Care Home 45 Category(ies) of Dementia (11), Old age, not falling within any registration, with number other category (34) of places Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The registered person may provide the following categories of service only. Care home only - code PC to people of either gender whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP 34 Dementia - Code DE 11. The maximum number of people who can be accommodated is: 45. Date of last inspection 11 September 2007 Brief Description of the Service: Brookfield House provides care for forty-five older people. It is located in Brookfield Park about half a mile from Nantwich town centre, which has a range of shops, pubs and other amenities. It is within walking distance of the River Weaver and Nantwich Lake. The home is a two-storey building with a passenger lift providing access between the ground and the first floor. A variety of lifting aids, hoists and grab rails are provided for residents with mobility problems. All bedrooms are single rooms and contain hand-washing facilities; some of the bedrooms also have en-suite toilets. Staff are on duty twenty-four hours a day to provide care for people living there. Information regarding the cost of staying in the home is available from the manager. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This unannounced visit took place on 26 June 2008 and the findings were discussed with the manager on 02 July 2008. The visit lasted 6.0 hours in total and was carried out by one inspector. The visit was just one part of the inspection. Before then the manager was asked to complete a questionnaire to provide up to date information about services offered by the home. CSCI questionnaires were made available for people using the service and staff to find out their views. Other information received by CSCI since the service was last visited was also reviewed. During the visit we looked at records held at the home and the premises. What the service does well: What has improved since the last inspection? Staff have received training in protecting vulnerable adults, so that people living in the home are protected from harm. The items needed in the new wing - hand towels, soap dispensers, waste bins have all been provided so that people living there have access to appropriate facilities. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 6 Improved staffing records are being maintained in respect of work permits for overseas staff, so that the home can guarantee that the people employed in the home are suitable to work there. 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. Brookfield House Care Home DS0000066254.V366313.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 Brookfield House Care Home DS0000066254.V366313.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 and 6 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Information is available and the needs of people are assessed before moving in so they know that their needs can be met at the home. EVIDENCE: One care file was inspected to check what had happened before the person moved into the home. We also spoke to the person and their family during our visit. The relative said that the home had provided sufficient information to enable her and her relative come to the decision that a move to the home was appropriate. The relative said that she had visited many homes in the area and had preferred Brookfield. Although the move had been fairly recent the person said she had settled in nicely, enjoyed living there and enjoyed the company of others. Information was available to identify the persons’ needs in relation to mobility, personal care, health care and their interests. A life history for the person is Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 9 also available for staff so that they have an insight into the person’s life before moving to the home. The home does not offer intermediate care. Brookfield House Care Home DS0000066254.V366313.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, 8, 9 and 10 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The health of people living in the home is monitored so that they get the care and the support they need. EVIDENCE: Two care plans were inspected during the visit to check on the care being provided for people. Both showed that their health was being closely monitored and that the care plan was being reviewed monthly to check that it was accurate and effective. All the people who live at the home are registered with local doctors’ surgeries. Staff at the home maintain good links with community health services. A record is kept of visits to residents made by doctors, nurses and other health care professionals. The optician, dentist and chiropodist visit the home or residents can make their own arrangements. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 11 One care plan showed that one person living in the home had sustained an injury due to a fall; the care records had been updated following the accident to ensure that the person was supported with their mobility and personal care by two staff. The care plan also said that the person must have access to the call bell when in her room. This was found behind a chest of drawers and was brought to the attention of the manager. Both care plans showed that staff encourage people living in the home maintain a healthy weight. One relative we spoke with confirmed that the staff at the home support her mother well in encouraging her to eat. There is a medication administration policy for the home and training for senior staff who are involved with administering the medicines. Subject to a risk assessment people staying/living in the home can administer their medication. Brookfield House Care Home DS0000066254.V366313.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, 13, 14 and 15 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People are encouraged to keep in touch with their families and friends and to do as much for themselves as possible so they stay as independent as possible for as long as possible. EVIDENCE: The activities coordinator for the home is currently off work. However, the staffing rota showed that the manager had made an hour in each shift available to some of the care staff so they could organise activities for people living in the home. On the day of the visit we observed a reminiscence group, an old time musical video on in the main lounge and a group involved with relaxation. One person living in the home is well on the way to having a bumper crop of tomatoes this year. We spoke with this person and their family – the person obviously takes great pleasure in being able to maintain their interest in gardening. For those people who are not able to attend church there are regular visits by clergy to the home. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 13 Throughout the day people were seen coming and going and spending time with their friends and relatives. Three relatives were spoken with; all were very complimentary about the home and the staff. They said that they could visit at any time and that they had been made to feel very welcome. One relative said that she visited at different times of the day but always found her relative in good spirits and the home fresh and clean. She said that she often visited around the mealtimes and was satisfied her relative was eating well; she had in fact put on weight since living in the home. People are encouraged to keep their own money and manage their finances for as long as possible. Small amounts of money can be kept in the safe; one persons record was inspected and was being managed appropriately. People living in the home do so with some of their belongings around them. Records are kept of any personal items brought into the home. Lunch was observed on both days of the visit in both dining rooms; people in the small dining room were helped to move to the table and were seated waiting for lunch for twenty- five minutes before it was served. In the larger dining room people sitting at those tables where lunch was served first had almost completed their meal before others were served. On the whole people spoke positively about the food, the menus and the choice although nobody spoken with could recall if they had been told what was for lunch. Brookfield House Care Home DS0000066254.V366313.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 and 18 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Effective systems and processes are in place so that people living in the home are safeguarded from harm. EVIDENCE: There is a complaints procedure for the home and the details about it are available in the entrance hall. Relatives spoken with confirmed that they knew who the manager was and how to complain if they felt it was necessary. Relatives said that minor issues that they had brought up with staff had been acted upon promptly and efficiently. Three people living in the home who we spoke with said that they would speak directly with the manager if they were unhappy. We checked the home’s complaints log and found that no formal complaints had been made since 18 June 2007. The staff training record showed that staff had attended training on safeguarding adults from abuse in November 2007. Six staff have not received training either because they were not employed at that time or personal circumstances prevented them from attending. No referrals have been made by the home under the local authority’s safeguarding adults procedures. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 15 Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 16 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 and 26 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. There is a programme of maintenance and development for the home to make sure that residents live in safe, comfortable surroundings. EVIDENCE: On the day of the visit forty-three people were living in the home. The home has four lounge areas but only two get used regularly. The main lounge at the front of the house tends to be where most people congregate and as a consequence this is a very busy, noisy area. There is a potential for very crowded conditions particularly before lunch and when people have visitors. There is an ongoing programme of maintenance and renewal of the fabric of the building to maintain standards. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 17 Housekeeping staff are employed at the home and all communal areas seen were clean, fresh and well maintained during our visit. A number of commode inserts were seen and they appeared stained/discoloured; a housekeeper said that about nine needed replacing. This matter was discussed with the manager who ordered them immediately. One ground floor toilet (as discussed with the manager) needs a window restraint fitted to maintain the security of the premises. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 18 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, 28, 29 and 30 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Recruitment procedures for new staff for the home are thorough and staff are trained so that people living in the home are protected from possible harm or poor practice. EVIDENCE: Since the last visit the home has continued to provide a staff training programme. A further seven staff have recently been registered to undertake a national vocational qualification in care at level 2. Not all staff have current emergency aid certificates so the manager should review the staffing rotas to ensure that at least one person who is qualified in emergency aid is on each shift. The home manager is a moving and handling assessor and all but one member of staff have received training this year. During our visit, the operations manager for the home confirmed that fire safety training has been arranged for all staff to attend on 17 and 31 July 2008, in order to meet a requirement made at the last inspection. The manager confirmed that excepting some absence due to sickness it was possible to train all staff over the two days. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 19 Fifteen of the nineteen care staff have attended training on dementia awareness. Staff who work solely in the kitchen are employed at the home but care staff are involved with serving meals and making supper. These staff have not had any recent training on food hygiene. We looked at three staff files; all files were being maintained in good order and demonstrated that robust recruitment processes had been followed in recruiting staff, with all necessary recruitment checks being taken up to make sure that staff are suitable to work at the home. Since our last visit, records are being kept of overseas staff work permits. Two files we looked at provided evidence that the people had obtained residency. Staff completed questionnaire for the visit and were positive about their role and the contribution they make to lives of the people living in the home. They told us: “We are offered lots of training”; “this is an excellent establishment in which to work”; “Good team work and good management”. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 20 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 and 38 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The manager is aware of her responsibilities in running the home to ensure that the people living there are well cared for and the home is run in their best interests. EVIDENCE: The manager has completed the Registered Managers Award at NVQ level 4 and is a moving and handling trainer. She continues to adjust her working pattern to be able to monitor the performance of all the team in respect of their practice. The staffing rota shows the flexible hours she now works in order to do this although the rota is completed after her shifts so that she can make her checks unannounced to staff. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 21 Questionnaires returned to CSCI from staff state that they meet regularly with the manager to discuss their work and records showed that these meetings are taking place. Staff spoken with on the day of our visit said that there is always someone in the home to discuss concerns with or ask for advice and that they regularly have staff meetings. The home holds small amounts of money for residents who are unable to do so for themselves; the records for these were satisfactory. A sample of up to date safety certificates were seen for the following: • Fire safety equipment • Gas installation • Boiler • Electrical wiring • Passenger lift • Mobile hoist • Bath hoists The accident record was inspected and twenty-seven accidents have been recoded since the last visit; records were being maintained appropriately. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 22 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 2 3 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 X X 3 Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP30 Regulation 18(1) Requirement All staff who prepare or serve food to people who live in the home must receive regular training on food hygiene so that the residents are not put at risk by poor practice. Timescale for action 31/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP15 OP19 OP19 Good Practice Recommendations The manager should look at the way in which meals are served so that food is served promptly and people are kept involved. A window restraint should be fitted to the room discussed to ensure the safety of the building from intruders. Staff should encourage people to make full use of all the lounge spaces available in the home. Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Region CSCI Preston Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Brookfield House Care Home DS0000066254.V366313.R01.S.doc Version 5.2 Page 25 - 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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