Inspection on 02/10/09 for Brooklands 2

This is the latest available inspection report for this service, carried out on 2nd October 2009.

CQC 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.

Other inspections for this house

Brooklands 2 11/04/07

Brooklands 2 24/10/06

Brooklands 2 03/11/05

Brooklands 2 20/07/05

Brooklands 2 17/03/05

Brooklands 2 06/10/04

Similar services:

Flint House

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Brooklands 2 11 Old Parr Road Banbury Oxon OX16 5HT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kate Harrison     Date: 0 2 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Brooklands 2 11 Old Parr Road Banbury Oxon OX16 5HT 01295262083 01295278404 mail@brooklandsnh.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brooklands 2 Ltd care home 56 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 56 The registered person may provide the following category/ies of service only: Care home with nursing (N) to service users of the following gender: Either Whose primary needs on admission to the home are within the following re home with nursing (N) to service users of the following category: Old age, not falling within any other category (OP) Dementia (DE) Physical disability (PD) Learning disability (LD) Date of last inspection Brief description of the care home Brooklands 2 is a three storey late Edwardian listed town house situated in a residential road within easy access of Banbury town centre. The accommodation at Brooklands 2 has recently been expanded and upgraded and now is spread over three floors served by two passenger lifts. The homes accommodation is predominantly Care Homes for Older People Page 4 of 27 Over 65 0 0 56 0 56 56 0 56 Brief description of the care home single rooms, mainly ensuite, and some double rooms. There are nine communal rooms dispersed around the ground and first floors, seven assisted bath shower rooms covering each floor, and three small enclosed gardens with patio areas. There is a registered nurse on duty at all times supported by a team of care staff, and the proprietors, Mark Taylor and Madeline Taylor, are usually available in the home. Fees range from GBP 650.00 to GBP 750.00 per week. There are additional charges for telephones, hairdressing, chiropody and personal items. Some additional charges may also be made for outings and to accompany people to hospital appointments. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the home was an unannounced Key Inspection, and was carried out by one inspector accompanied by our expert by experience on one day between 9.30am and 5.30 pm. It was a thorough look at how well the service is doing. It took into account detailed information provided by the home through the homes self assessment document, the Annual Quality Assurance Assessment (the AQAA) and any other information we received about the home since the last inspection. The AQAA was completed and received by the expected date, was detailed and contained all the information we needed to plan our visit. We looked at records and documents relating to the care of the people living there. We saw recruitment records and information about staff training and looked at how peoples medication was managed. We saw the communal areas of the home and some private rooms used by people living there. We requested further information following our visit, and the home supplied all the information we needed. We asked the views of the people who live in the home, through questionnaires we had Care Homes for Older People Page 6 of 27 sent out. We also sent surveys to healthcare professionals involved with the home and to staff members. Altogether we received 12 completed surveys from staff, healthcare professionals and from people living in the home, and their views are reflected in this report. We spoke to several other people living in the home during our visit, to the manager, some staff members and to the proprietors and discussed the running of the home with them. This inspection was a thorough look at how well the home is meeting the standards set by the government and in this report we make judgements about the outcomes for the people living in the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Older People Page 8 of 27 order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they are admitted to the home. The home is planning to provide intermediate care in the near future. Evidence: Usually Mrs Taylor carries out the pre-admission assessments wherever people are living or hospitalised, and completes the homes pre-admission assessment form to get a full picture of peoples needs. We saw three pre-admission assessments carried out by the home before the individuals were admitted, and saw that all the necessary information was available to decide if the home could meet their needs. We discussed the admission procedure with the registered manager and she confirmed that when it is not possible due to distance for a pre-admission assessment to be carried out, that a care manager or healthcare professional sends the home as much information about the person as possible so that a decision can be made about admission. The home has a four week trial period for people to decide if they want to stay permanently at the home. Care Homes for Older People Page 11 of 27 Evidence: The home is planning to provide intermediate care in the near future, in a designated area of the expanded home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their health and personal care needs met. Evidence: We saw that care plans are developed from risk assessments and that actions are recorded for care staff to carry out, so that the health and welfare needs of the people living in the home are met. We noted from care records that people are registered with a local general practitioner (GP) of their choice and that GPs and other healthcare professionals visit the home regularly. We discussed the care of pressure wounds with the registered manager and saw that the home liaises with the GP and the appropriate NHS professional when advice is needed. The homes nurses receive training about wound care and the next update is due in October 2009. We saw from the homes records that the home has plans to improve and share learning throughout the home, epecially for the nurses, to make sure they keep updated with developments. The homes booklet About Me shows the individuals preferences about their daily routines, and we saw that the care plans take this information into account to personalise the care plans. We noted that staff treat people with respect, in their approach to individuals and by respecting their stated preferences. The healthcare Care Homes for Older People Page 13 of 27 Evidence: professionals who replied to our survey said that the home sought advice about health and social care needs, respected peoples privacy and dignity and responded to the different needs people had, such as gender, race, ethnicity and faith. We looked at how the home manages medication and saw that there is a system in place to make sure that all the medication received int the home is recorded and administered as prescribed. We noted from the records that some medication recently received was not recorded and the registered manager took this issue up with the appropriate nurse, so that the error would not be repeated and the medication was appropriately recorded. Medication at the home is audited regularly so that any shortfalls can be addressed. The majority of people who responded to our survey told us that the home always makes sure that they get the medical care they need. People commented: I am happy with the standard of care, the staff care for me well, and good personal care. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the homes routines are relaxed, people find daily life in the home boring and miss out on the social opportunities and exercise a well organised lunchtime could bring. Evidence: The home has a 4 week schedule of activities but the homes experienced activity organiser has recently temporarily left the home. Two carers are now responsible for the provision of activities and the homes manager who has training in activities provision told us that she oversees their work. Activities regularly scheduled include arts and crafts, singing, newspaper discussion and quoits. We understood that the outings usually available at the home were suspended during the renovations and new build and have not restarted. We saw that records are kept of activities carried out by individuals, but also noted that recordings can be irregular, so it is not clear if individuals have taken part in regular activities. We noted that on the morning of our visit no activities were provided and people commented about the lack of stimulation. We noted that there were few interaction between staff members and the people who live in the home, and some people spend most of their day sitting in the same room. Some comments reflected their sense of time passing slowly: The time passes very slowly. We need people to speed it up. I dont like it much here. Not really. Its a bit Care Homes for Older People Page 15 of 27 Evidence: boring. The TV is on all the time. Its sometimes a bit noisy. It gets a bit boring here, with nothing to do. Some people told us through our survey that the home organises activities that they can take part in if they want to, but others said that there are not enough activities available. We understood that the home intends to make better use of the homes new facilities, including the lounge and dining areas and the gardens. The homes AQAA says that the seasons are marked in the home, and a staff member also made a similar comment, but we saw no evidence in the home about Autumn to interest people, such as plants or pictures showing the changing leaves or the coming of Halloween. Most people remained in their chairs for lunch, and were not encouraged to sit together at the dining tables. We observed that the staff expected people to have lunch on trays, not at the dining tables. We saw that staff brought trays to small tables positioned in front of the individuals and that none of the dining tables in the different areas were used. No help was given to set out the cutlery in the first floor lounge/dining area and the trays were brought by a kitchen assistant with minimal contact with the individuals. We noted that care staff were not available to help people over the lunch period, and that one person did not receive lunch at the same time as others and had to request the meal when someone came later into the room. Food was cold when some individuals received it. We were informed that a new heated trolley had been purchased and that the safety certificate was awaited, after which the tolley would be in use. We discussed the poor use of the dining areas with the managers and were told that usually the dining table in the front of the home is used. There are plans to improve the lunchtime experience for people living in the home by providing more staff and having a person responsible for overseeing lunchtime so that it is a positive social experience for people. The majority of people who replied to our survey told us that they like the meals provided at the home. Visitors are welcome to the home and a visiting family told us that they are always welcomed and can take their relative out whenever possible. Ministers of religion are welcomed to the home and can arrange services if people want them. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home know what to do if they want to complain and are protected from harm by the homes procedures and staff training. Evidence: We saw that a copy of the homes complaints procedure is available in the hallway and contains all the information needed about making a complaint. The procedure is available in large print and is explained to people if necessary. We saw the homes record of complaints and noted that the home responds within the expected timescales. People told us that they knew whom to tell about concerns and the majority knew how to make a formal complaint. The home has a safeguarding procedure dated August 2005, and it needs to be updated to reflect the current local safeguarding arrangements and our details. Staff receive training at induction and at intervals afterwards about how to recognise and respond to safeguarding issues. Some individuals living in the home have requested that stairgate type barriers be used to prevent other people from casually entering their rooms. The proprietors said that there are risk assessments in place to make sure they do not pose an unacceptable risk in case of fire and that there are records available to show that the individuals requested the barriers. We noted that all the stairgates we saw in use were open and did not pose a fire risk. The home has had experience in addressing issues about safeguarding and the managers have attended training about the Mental Capacity Act 2005, including what the Deprivation of Liberty safeguards mean for the home. We spoke to a member of staff about the homes Care Homes for Older People Page 17 of 27 Evidence: safeguarding procedure, who knew how to respond if there was a suspicion or allegation of harm. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are gradually benefiting from the improved environment. Evidence: The new area of the home has recently opened and the staff and managers are experimenting during the transition period to see how the space can be used so that people living there get the best benefit. The environment is much improved following the building of the new area and the continuing refurbishment of the old part of the home, with more communal space, choice of secure outdoor space and safety features such as the mister fire safety system. New kitchenettes are provided in the lounge/dining areas to give people more independence and to make it easier for staff to attend to peoples needs without leaving the room. Some features are in place to help people with dementia find their way around the home, such as signage on bathrooms and the home is mindful that other features may need to be added, when more people with dementia will be admitted. The home has a full time member of staff responsible for maintenance and there is a system in place to manage routine maintenance. The new laundry is situated in the basement, and has appropriate facilities to meet the needs of the people in the home. Design features are in place, such as the laundry shute, to help control the spread of infection. The home has policies and procedures about infection control in the home and staff members receive training at induction. We saw that the home provides updates on infection control training, most recently in Care Homes for Older People Page 19 of 27 Evidence: September 2009. Some people commented that the home has at times smelt of urine but the majority of people who responded to our survey told us that the home is fresh and clean. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is going through a time of transition and expansion and is working to meet all the needs of the people living in the home. Evidence: We saw the staff rota showing the mix of staff available over the 24 hours, and noted that there are nurses, carers, catering and housekeeping staff available, as well as the management team and administrator. The majority of people living in the home who replied to our survey said that there were usually enough staff available when needed, but we were concerned that not enough staff were available. No activity was provided during the morning of our visit, so people had little to interest them and said they were bored. There were no staff members in some areas of the home to help people at lunchtime to move to the dining tables or to be available in the dining room in case someone needed assistance. Few people were helped to move about to explore the new indoor and outdoor space, and most people who needed help to move about spent a lot of time sitting in the same place. The expanded environment has brought new challenges regarding staffing, and the homes managers are aware of this and are looking at better allocation and the use of more part time staff. The proprietors discussed the difficulty in retaining trained staff due to market conditions, and explained the measures in hand to address the need for more staff. We understood that the home is recruiting more staff, and is developing a home bank of staff so that carers and nurses will be available at short notice. The Intermediate Care unit is due Care Homes for Older People Page 21 of 27 Evidence: to open in the near future and the home needs to make sure that enough trained staff will be available to meet the needs of all the people in the home. The home provides induction training to the Common Induction standards and encourages staff to take the National Vocational Qualification (NVQ) Level 2 in Care. 65 of the care staff hold the NVQ Level 2 and most care staff are taking training either to NVQ Level 2 or beyond. Staff members told us through our survey that they received training to meet the needs of the people they look after. Training is provided to give carers the skills and knowledge they need, such as moving and handling, health and safety and safeguarding training. A recent audit of training needs identified that the homes nurses need more training and plans to provide the necessary update training is in hand. Two nurses recently attended update training on wound care and the home is in contact with a local organisation to make sure that all the homes nurses receive the new and update training they need. There is a trainer responsible for providing dementia training for staff and most of the homes staff have received training about caring for people with dementia. We saw the homes recruitment procedure by checking three staff files, and noted that a system is in place to make sure that the necessary information from the Criminal Records Bureau is available before new staff start work. We saw that one reference was missing from an individuals file and the home said it would address this issue. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is improving its systems so that daily life will improve for the people living in the home. Evidence: The homes registered manager has worked at the home for many years and completed her NVQ Level 4 in December 2008. She is supported by a deputy manager and the homes management team including an administrator. The management team has been strengthened recently by the addition of a new member who has particular responsibilities, including staff training. Regular quality assurance surveys are carried out and include surveys to relatives and people living in the home about the homes facilities and services. The AQAA shows that the home has responded to suggestions in this years annual quality assurance exercise, by adding more home made cakes to the afternoon teas, making some requested changes to individual rooms, more decorating and replacing of chairs and other furniture. Other audits are undertaken in the home and have resulted in better criteria for assessing risk of falling and making more referrals to the NHS falls service. The management team is conscious of the Care Homes for Older People Page 23 of 27 Evidence: extra pressures the coming opening of the Intermediate Care Unit will bring, and is arranging more meetings with the local GP surgeries so that there will be a common approach to health issues and any issues arising can be addressed quickly. The home does not manage money for people living at the home, and instead sends invoices regularly. People who cannot manage their financial affairs have help from relatives, their representatives or from the local authoritys money management scheme. The home has a health and safety policy statement and makes sure that staff have the training they need to work safely in the home. There is a health and safety plan and a fire risk assessment in place. The AQAA shows that improvements have been made to the safety systems, in fire prevention, detection and evacuation, and this works for the benefit of the people living in the home. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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