This inspection was carried out on 4th December 2008.
CSCI found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Bluebrooke Residential Care Home 242 Stourbridge Road Catshill Bromsgrove Worcestershire B61 9LE The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Philippa Jarvis Date: 0 4 1 2 2 0 0 8 Information about the care home
Name of care home: Address: Bluebrooke Residential Care Home 242 Stourbridge Road Catshill Bromsgrove Worcestershire B61 9LE 01527877152 01527557409 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Oldfield Residential Care Limited care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability 46 0 0 Over 65 0 46 46 Conditions of registration: The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability - over 65 years of age (PD(E)) 46 Old age, not falling within any other category (OP) 46 Dementia (DE) 46 The maximum number of service users who can be accommodated is: 46 Age: Dementia (DE) age 55 and above. Date of last inspection Brief description of the care home Care Homes for Older People Page 2 of 10 Bluebrooke Residential Care Home is registered to provide personal care for up to forty-six older people who are frail, or who may have a physical disability. The home may also accommodate people over the age of 55 years who have a dementia illness. The total number of people who can live in the home is forty six. The large, detached property, standing in its own grounds, is situated in a pleasant residential area, approximately two miles from Bromsgrove town centre. There is also a small enclosed garden that is accessible to residents. The home was purchased by Oldfield Residential Care Limited in April 2004. The Responsible Individual is Mr Simon Badland, and the Company has several homes in the group. There is no registered care manager in post. There is a manager designate, Ms Cindy Hawkins. We have not received an application from Ms Hawkins for registration as the manager of the home. The Service User Guide was being revised. This should contain information about current fee levels when it becomes available. Care Homes for Older People Page 3 of 10 What we found:
We visited Bluebrooke Care Home because concerns had been raised with us about an accident had by a resident. We arrived at 5.30 the morning. Six residents were up, dressed and sitting in the lounges. Several of them were asleep. Thestaff on duty told us that the people in the lounge were those who tended to get up early and wander. One lady had been unwell overnight and we were told that she had been brought downstairs so they could keep an eye on her. She was dressed in her day clothes. The night carers told us that they had a list of 12 residents to get up before the day staff came on duty at 7.45am. They also told us that they did not wake people up, although we did see them knock on one persons door before entering, which was likely to have woken him. When this person was leaving his room, having been attended to by staff, we observed that one footplate was missing from his wheelchair and a member of staff walked along holding his feet off the floor. We saw that people were offered cups of tea and biscuits when they got up and before breakfast was available at around 7.45am. There were three night staff on duty, one of whom was designated as a senior carer. These staffing arrangements were reflected in the rota. We found that the staff rota we were first shown for night of the accident detailed above was not accurate as one of the carers listed was on annual leave. The senior carer changed this to reflect what he thought were the actual staffing arrangements. Later we were shown a second staff rota that reflected the actual staff arrangements for that night. We looked at the staff training records for two of the staff on duty at night and found that the staff had taken appropriate core training to work in the home although some elements were in need of refresher training. We were told that currently the home only has one senior carer to work nights and is in the process of recruiting a second senior carer to work in this capacity. This means that there are some nights when there is no senior member of staff on duty. We were uncertain how the home manages the administration of medication overnight as we were told that only the senior carer is allowed to carry out this function. We found that the accident that led to our visit was recorded in the residents daily notes. These indicated that the staff on duty had called for a paramedic when they found her. They also said that an accident form had been completed and a notification made to us as this was a serious accident. There was no entry in the accident record although we did receive a notification the day after our visit. We were told that this resident was prone to falls and there was a further one recorded in her daily notes a few days previously. We asked to look at the falls risk assessment for this resident. There was no falls risk assessment in her care plan. A mobility assessment had been written in July 2007 and there was no evidence of review since that date. We were shown a form that the home intends to bring into use entitled Risk Asessment Screening Tool for Falls which will provide a useful tool for carrying out Care Homes for Older People Page 4 of 10 these risk assessments when in use. We found there was some lack of clarity over administration of medication to this resident. On the record of administration her Haloperidol had not been administered from 3rd to 18th November. We also saw that there were two recent occasions when the record of administration had not been signed and there was no reason to indicate why these spaces were blank. The communal areas of the home were clean and well presented although there was a smell of urine throughout the home. We saw two toilets that were unclean and smelled offensive. We found that they were in this condition for at least two hours. We did not review the requirements made following the last key inspection in April 2008. We are aware that we have not received an application for registration form the manager designate. It is a legal requirement that the person in day to day charge of the home makes application to the commission to be registered in this capacity so we can assess whether they are qualified, competent and experienced to run the home. What the care home does well: What they could do better:
We had some concerns about the number of people who were up and dressed for the day at 5.30am particularly as they were then asleep in the communal areas. The home should review whether it is possible to encourage them to return to sleep in their rooms. Each resident who is prone to falls should have a falls risk assessment and this should be reviewed each time they fall. This will provide a tool for the home to assess whether they can take action to prevent further risk of falls. The home needs to make sure that the administration of medication to residents is carried out in a way that is accountable and takes into account the medication prescibed to them. Each wheelchair in use in the home should be properly maintained to ensure the safety of the residents and of the staff. The home should keep a copies of staff rotas in a secure manner as these form part of their record of conduct. Any amendments should be signed by the person making the amendments. We were concerned about the cleanliness of the toilets in particular. Care Homes for Older People Page 5 of 10 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 set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Care plans should document up to date medication records. This is in order to ensure that medication records for people who use the service are accurate. 31/05/2008 2 9 13 Controlled Drug (medication 31/05/2008 requiring special storage and recording arrangements) records must accurately document the amount of medication stored within the service to ensure that legal requirements are met. You should ensure Medicine 31/05/2008 records for the administration of medication must correctly document what has been administered or record a reason why it was not administered in order to ensure that the people who use the service are safeguarded. You should develop a range 31/08/2008 of social activities so that residents have the choice of whether to be involved in an active social life and stimulation in the home. A representative of Oldfield 30/06/2008
Page 7 of 10 3 9 13 4 12 12 5 31 26 Care Homes for Older People Residential Care Ltd, the service provider, should visit the home at least once a month and prepare a report following this visit. This is to report to the company on how the home is functioning and to identify whether they need to take any action to improve the quality of the service. 6 31 8 The manager designate must 31/08/2008 submit an application for registration in this capacity. This is so that we can assess whether hey are qualified, competent and experienced to run the home on a day-today basis. Care Homes for Older People Page 8 of 10 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 1 8 13 The home should carry out a 19/12/2008 falls risk assessment for each resident at risk of falling. This will help the home to identify strategies to help prevent risk of further falls. 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 1 38 All wheelchairs in the home should be serviced to ensure that they are in good working order and safe for residents and staff to use. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
