Inspection on 07/04/08 for Brownhill Care Limited

This is the latest available inspection report for this service, carried out on 7th April 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Brownhill Care Limited 307 Brownhill Road Catford London SE6 1AL Lead Inspector Unannounced Inspection 7th April 2008 09:15 Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 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 Brownhill Care Limited DS0000068794.V361391.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 Adults 18-65. 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. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brownhill Care Limited Address 307 Brownhill Road Catford London SE6 1AL 0208 465 0048 0207 207 1705 SDooraree@aol.com 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) Brownhill Care Limited Oudaysingh Shyam Dooraree Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (excluding nursing) and accommodation to service users of both sexes whose primary care needs on admission to the home are within the following category:Mental disorder, excluding learning disability or dementia (Category MD) The maximum number of service users who may be accommodated is 7 2. Date of last inspection 21st June 2007 Brief Description of the Service: 307 Brownhill Road is a registered care home for those residents suffering mental health disorder. It accommodates up to seven residents of both sexes. The home is an adapted large domestic house on a main road in Catford. It is well served by local buses and the main line station is relatively close. All amenities are situated in Catford town centre. All bedrooms are single and there are communal areas located on the ground floor. There are no adoptions in the home or equipment. The stairs are steep in places and all residents need to be physically able to live in this home. The focus of the home is rehabilitation for those residents who have enduring mental heath problems. It is envisaged the length of stay will be up to five years. Move on to more independent accommodation is the ultimate goal. All health care support is provided through the local community and residents with staff support are expected to access services. Aftercare in respect of mental health issues is provided through multi disciplinary teams and outpatient attendance. Educational, leisure and employment is also accessed within local resources. Visiting is open, family contact and engagement with the local community is encouraged. Weekly fees start at £900.00 up to £1,500. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit, which forms part of the inspection, was conducted unannounced over a one day period. At the time of the site visit there were five people living in the service. During the course of the inspection the views of people using the service, staff and a visitor were obtained. The Manager facilitated the majority of the visit and produced all documents requested. The records inspected included admission assessments, care plans and supporting documentation pertaining to those people living in the home. Medications were inspected. General observations were undertaken including interactions between staff and those people living in the home. The range of rehabilitation support provided by staff was noted. Other documentation inspected included staff files, training and supervision records. Health and safety maintenance certificates were also inspected. During the inspection comment cards were handed out to those people in the service including staff. One staff interview was conducted. Health professionals who had contact with the service were telephoned for their comments. Feedback was provided at the end of the site visit to the Manager. At the point of writing this report no comment cards had been received from residents, staff or relatives. The people who use this service prefer to be referred to as residents, which are the term, used in this report. What the service does well: The service is a new facility having opened August 2007. In the eight months since opening the Manager has worked hard to address the Regulations and provide a good service to those people who live in the home. There was evidence received from members of the multi disciplinary team that good systems for communication and contact between the home and other professionals were in place. They also stated that good progress had been made particularly with one resident who was known to require a lot of support when out of hospital settings. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 6 The home is well maintained. 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 Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed prior to admission and information regarding the facilities and services is provided to them. This enables residents to make an informed choice on whether the home is suitable. In addition it furnishes staff with information on prospective residents to establish if they are able to meet that person’s needs. EVIDENCE: The Statement of Purpose and the Service User’s Guide were both available. In the Statement of Purpose the organisational structure referred to cooks maintenance and domestics none of which are employed by this service, as people who use the service undertake these tasks as part of on going rehabilitation. This needs to be revised. The information of two people currently living in the service was inspected and this included their assessment information. Included in the pre admission records was compressive information received from the placing authority. There was an overview of the person’s risks. The form headed the “Assessment Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 10 of needs – daily living “was not completed. There was an assessment profile sheet which detailed next of kin and multi disciplinary support contact details. In the assessment information evidence of trial visits was available. One such entry was in relation to a trial visit made to the service on 25/2/08. It had been identified through the trial visit that a grab rail needed to be installed an Occupational Therapist had undertaken an assessment regarding this and a grab rail fitted 27/2/08 two weeks prior to admission. In the second file again there was information on a general risk assessment and a trail visit. The assessment of daily living form was in a tick box format with some additional comments. A GP report was available. The terms and conditions forms in the two files were without the rooms to be occupied by the resident. The actual fee payable not stated. The notice period is four weeks. Included in this document was a statement stating that property and contents would not be covered by the homes insurance policy. One of these was without the resident’s signature. The information in respect of house rules as also not signed. The home must confirm in writing, that following the assessment, they are able to meet the needs of the residents. Please see requirement 1. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans reflect the needs of the residents to enable staff to support them in their rehabilitation. Risk assessments were not sufficiently developed for some areas, hence residents may not receive the appropriate level of intervention, which may cause them to deteriorate and place others at risk. EVIDENCE: Residents in this home are subject to mental health aftercare referred to as Care Plan Approach (CPA), of which there are two levels standard and enhanced. Of the five residents, four were on enhanced CPA and one on standard. Enhanced CPA is a higher level of input, monitoring and support than that of the standard CPA. Three care plans were selected for inspection. In general the care plans reflected individual needs and the interventions were appropriate to meet the problem. The care plans need to be further developed to fully include social Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 12 and rehabilitation activities. There were in some files, a programme of activities for the individual person. There were no signatures indicating input into the care plan by residents or their advocate. Evidence that the residents have been involved with the care planning process, needs to be available this would promote engagement and understanding of the care plan. In one file there was no description on the individual including weight or height. This is important as residents may go missing and a clear description will be needed for the police. Some of the daily events recorded were lacking in detail i.e. “Service user had a pleasant shift “. Daily events must be comprehensive and reflective of that day’s events to ensure accurate communication between staff. This is essential when there are residents with volatile changeable behaviour patterns. The files contained a form outlining the identified risks pertaining to the residents. In both files there were a number of areas identified. There were not specific risk assessments in respect to the issues identified. The Manager stated that these were issues, which were not current but were recorded simply to provide information to staff. In one file the resident who was diabetic, had records indicating high blood sugars. This resident was said to be drinking excessive amounts of coke. A risk assessment should have been in place to address this issue and his noncompliance with the diabetic diet included in the care plan. One resident was on Section 17 Mental Health Act, extended leave of absence the forms relating to this were incorrect both in terms of the name of the home and without the address. The last Leave of Absence form was up to 27/3/08 and had expired. This was pointed out to the Manager who during the course of the inspection produced another form covering the current period. There was information in relation to contact with the multidisciplinary team including notes on attendance at ward rounds. The multidisciplinary appointment sheet contained good information. Key working sessions are recorded. Please see requirement 2. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16, 17.Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff to partisipate in activities both within the home and the community as part of their rehabilitation. EVIDENCE: The inspector spoke to three residents and one visitor during the site visit. Visiting is open and encouraged. People who use this service are free to leave the home when the want to and this was evident as people were coming and going during the day. People who use this service are supported with activities of daily living including cooking cleaning budgeting etc. There were limited activities staking place during the site visit. This may have been because the inspection required staff to assist hence encroaching on time spent with residents. Two residents prepared light meals at lunchtime Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 14 People who use this service were either smoking in the allocated smoking room or spending time in their bedrooms. The TV in the main lounge was not on although individuals have their own entertainment in their bedrooms. Residents in this home require a lot of staff support and input to motivate them so they become involved with activities to maximise their rehabilitation. Limitations in this area were evident due to staffing levels. The minimum staff levels leave little time for some activities particularly 1:1 sessions. Comments were received in relation to the food. One person requested that ethnic and cultural dishes were supplied as well as fresh fruit and vegetables. There was a menu, which offered a choice of meals although these were mainly English. This was discussed with the Manager who pointed out that each person living in the home wanted different meals, which in effect meant five different breakfasts lunches and supper. The inspector reiterated that residents must be provided with a menu of their choice. In a home where meal preparation is part of the rehabilitation this issues could be addressed through this. The supplies were checked in the kitchen. The freezer was full with various items there was little in the way of fresh fruit and vegetables. The kitchen is kept locked. This is opened and residents accompanied into this area to make drinks and meals. The Manager stated that if bowls of fruit were put in public places certain people ate all of it leaving nothing for others. One way to address this may be that everyone has their own fruit in their bedrooms. Comments received from the multi disciplinary team indicated that one resident had made great progress in terms of participation in leisure and social activities. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Healthcare needs are well provided for in this service with support from multi disciplinary team members. Medications are safely managed which affords protection to residents. EVIDENCE: Within the home there are two male and three females living in the service. Including the Manager, there are male and female staff employed to address personal care issues. The medication systems were inspected and part of the administration observed. The medication policy refers to a “First Level Nurse “ throughout the document. This needs to be amended, as this is a care home and qualified nurses are not employed in that capacity. There was BNF, which is a drug reference book, available dated 2004 and an older one dated 97. There was information in the medication files regarding drugs including the printed leaflets and hand written notes. The staff member who was observed administering the medication had received training on the subject and was a trained nurse in her own country. The supplying pharmacist provides staff training. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 16 Residents in this home can be on a number of drugs, some of which may have adverse side effects. Staff need to be alerted to side effects as well as issues of non-compliance as this can be an issue with mentally ill residents. The medication was safely stored and no overstocking noted. Those medications received in to the home are recorded as well as those medications returned. Care needs to be taken to ensure all allergies are recorded on the Medication Administration Record (MAR). The homely remedies consisted of paractamol only, although this did not indicate which residents were to be included. Currently none of the people in the service self medicate. In preparation for this the home needs to develop a protocol for self-medication and a supporting risk assessment. Lockable drawers are available in every bedroom in the event self-medication procedures are introduced. Residents are registered with a local GP service and one has retained their own GP. All other health care is accessed through the community provision with staff support. Mental health support is provided through the multi disciplinary team working collaboratively with the home. The inspector spoke to the Care Co ordinator for resident who was in the service. She was extremely pleased with the service provided. She said that the Manager had worked exceptionally well with a resident who is known to be extremely difficult. In addition she stated that the home had relayed information and that communication between the two parties was good. In her opinion, ” He (The Manager) has persevered with a very difficult patient “. This service had continued where others would have not and all to benefit the service user who had remained out of hospital. They had since this success, placed another very difficult resident in the home. She was unable to comment on other staff members, as she had liaised wit Mr Dooraree only. Another member of the multi disciplinary team was contacted. The Social Worker was also very positive about the service commenting that they seek advice on issues communicate well. One area, which needed further development, was leisure facilities. For the one resident they had in the home they were pleased with her progress. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information on how to make a complaint is available to all who use the service and ensures that their concerns are addressed. Safeguarding policies, procedures and training ensures residents are protected. EVIDENCE: The complaints procedure was on display in one part of the hall. This should be located more centrally for easy visibility. Other documents, which had information on complaints, included the Service User’s Guide. The complaints log needs to be expanded upon to include all complaints made, action taken, outcomes of investigations and whether it is resolved to the complainant’s satisfaction. Residents in this service are particularly vulnerable and must be protected by a system where complaints are received openly, taken seriously and actioned appropriately. The home has policies and procedures in respect of adult protect. These include comprehensive information received from Social Services including interagency guidelines. The support worker when asked about adult protection matters was aware of the need to report it and was aware of external bodies including Social Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 18 Services. She knew that she had to make a written record of any allegations or incidents. The one staff interviewed was aware of how to action suspected abuse and report it externally. Those people using the service stated that they would report incidents or complaints to the staff working in the home or their Care Manager. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are provided with clean, comfortable accommodation, which provides a homely environment and is suitable for their rehabilitation needs. EVIDENCE: The home is an adapted building in a Victorian house, located on a main road in Catford. It is easily accessible by public transport with several local buses serving the area and a main line railway station close by. There is an enclosed garden to the rear of the building. The action to address the raised curb, which accesses the parking to the front of the building, is in the process of being addressed. The Manager advised the inspector that he was waiting for the relevant authorities to inspect the site in relation to access from the main road. A letter confirming this was provided. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 20 The communal areas were well maintained with comfortable furniture. This can be difficult with this type of client and this is to be commended. The kitchen and laundry areas were also clean and tidy. Only two bedrooms were inspected as people who use the service either were not in to invite inspection or they did not want their bedrooms inspected. All bedrooms are lockable and keys are issued. The people who use the service are not issued with a front door key this has been the subject of much debate and if this is to be criteria of living in the home it must be reflected in all appropriate documents including contracts and Statement of Purpose. Bedrooms were to a variable standard one tidy and well kept the other untidy with used yogurt pots and other items on the floor. One had no pictures on the wall. One comment made by two people in the service was that the home was cold particularly during the evening. The communal areas were not warm although a thermometer indicted the room was at an adequate temperature. The hot water was also tepid and would be not sufficiently hot to bath. The home has no lift access and the steep stairs require that people who use the service are fully mobile to live in the home. Adaptations had been made for people who use the service. One person in the home had requested a handrail to be fitted for their security this was addressed. There is a smoking room on the first floor, which is fitted with good ventilation and has windows. It was noted that two of the clocks in communal areas were wrong. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are minimal and therefore place limitations on residents rehabilitation and leisure activities particularly those external to the home. Staff training needs to be comprehensive to ensure that residents care needs are meet and they receive effectively support. EVIDENCE: As the inspector arrived the home was staffed by one support worker. The staff member explained the Manager would be attending the home during the morning, which he did. It was some time before he arrived and there was some concern by the inspector about only one staff member on duty. On several occasions the staff member was unable to be located. The people who use this service are particularly vulnerable and can display unpredictable behaviours. It was evident form documentation that some had a history of violence and aggression be it because of their mental illness. Mr Dooraree was confident that staff were sufficiently safe whist lone working although portable alarms were available in the event staff felt that they needed them. In cases where there is one staff member working as there is on the night shift then risk assessments must be developed in line with the lone working policy. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 22 The off duty rota indicted that two staff were employed during the daytime period and one a night. All staff are employed on a bank basis in so much as they are not issued with a permanent contract. This situation has been in place since the home opened. The Manager explained that this was due to the fact that he wanted to establish how suitable the staff member was before issuing permanent contract. This situition provides limited job security to staff. All staff must be provided with employment rights and the home must work in line with employment law. Three files were selected for sampling of recruitment procedures. Two were those of support workers and one was the wife of the Manager. All three files contained evidence of CRB and POVA first checks conducted by an umbrella body. The two support workers had references in place although some were not validated by means of a company stamp or headed paper. It was difficult to establish what relationship the referees had to the employee. It was not clear if it was the last employer. Other recruitment checks made included a self-declaration medical questionnaire and notes taken from the interview. All three files had identity checks including copies of passports. The wife of the Manager is due to start work in the home, although has not yet done so and was not included on the off duty rota. Her personnel file did not have references included. Offer letters were on file although job descriptions, terms and conditions of employment, and contracts were not. The Manager stated that the offer letter set out the main principals of the contract although there was no official contract on place. This needs to be addressed. The staff induction form was in place although only one part of this was available. It is in line with TOPPS recommendations. The induction form covered the key points of working in a care home although nothing on mental health. The form was made up of two sheets, one of which was missing. This was said to cover the mental health induction although this could not be located. When it was eventually located this section this section was not signed by either the employee of the employer. The staff member on duty was interviewed she confirmed that she was experienced in field of care work. She was a trained nurse in her own country but had not completed the conversation training to be registered with the NMC; she had worked in the home since it opened. Currently she was doing her NVQ training. She confirmed training in some of the mandatory topics as well as on the topics of medication and abuse. Some of the training she had completed when she was employed with the agency where she had worked previously. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 23 She has some awareness of mental health conditions although with the complexity of the problems some of the people in the service displayed this needs to be more in depth and further training provided. Two staff are NVQ level 3 trained and one staff NVQ level 4. Please see requirements 3 and 4. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that they are being cared for in a well managed and maintained home. Every encouragement is given to residents to enable them to play an active part in the planning of the home’s services. EVIDENCE: Mr Dooraree is the owner manager of this establishment; he started the RMA February 2008. This qualification is appropriate for Managers of residential settings and provides them with a good knowledge of managing such facilities. He has completed the process through the CSCI to become the Registered Manager. He has had previous experience of managing a care setting locally prior to opening this home. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 25 A selection of health and safety documentation was inspected and found to be satisfactory. The home has no lift or lifting equipment. Radiators are without protection covers and these should be risk assessed for safety There was a fire risk assessment in respect of the home, although not dated. Fire records indicated that weekly fire alarm testing was undertaken and emergency lights tested. Fire drills had been conducted October 07 and February 08. A list of residents and staff who attended was available. It is recommended that staff, and where possible residents, sign for all training received. Fire door guards were in situ for the lounge area. The minutes of staff meeting were available. It was evident that these are held frequently. Minutes of residents meetings were also available again regularly. Two resident monies were inspected. One resident had no money and actually owed the home’s petty cash money, the other was correct. Receipts were retained and resident’s signatures were in place for transactions. A system must be developed to undertake an annual review of the service, which incorporates the views of those working, visiting and living in the service. Please see requirement 5. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 2 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 34 35 36 2 3 X 2 X LIFESTYLES Standard No Score 11 12 13 14 15 16 17 2 3 3 2 3 3 2 X 2 2 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000068794.V361391.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brownhill Care Limited Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 27 No 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. YA3 Standard Regulation 14(D) Requirement The Registered Manager must confirm in writing that following their assessment the home is able to meet the resident’s needs. Timescale for action 30/06/08 2 YA9 3 YA32 13 (4)(c) 18(1) (a) 4 YA34 19(1) (b) Comprehensive risk assessments 30/06/08 must be developed to prevent the resident or others suffering harm All staff must be trained to 30/06/08 undertake the work that they perform to include mandatory topics and those specific to the resident group. Staff who work in the home must 30/06/08 be protected by employment law and be provided with contracts, job descriptions, terms and conditions to afford them protection and demonstrate robust recruitment procedures Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 28 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. Refer to Standard YA20 Good Practice Recommendations The Registered Manager should investigate self-medication policies and procedures for use in the home. 2 YA22 A complaints log should be developed to detail complaint made investigation undertaken and outcomes. Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Brownhill Care Limited DS0000068794.V361391.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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