Inspection on 19/01/06 for Brackenthwaite

This inspection was carried out on 19th January 2006.

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 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

Brackenthwaite 17/07/06

Brackenthwaite 24/05/05

Brackenthwaite 22/09/04

Brackenthwaite 04/05/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brackenthwaite Senhouse Street Whitehaven Cumbria CA28 7ES Lead Inspector D Jinks Unannounced Inspection 19th January 2006 10:15 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 Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 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. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brackenthwaite Address Senhouse Street Whitehaven Cumbria CA28 7ES 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) 01946 852561 www.cumbriacare.org.uk Cumbria Care Ms Susan Meyers Care Home 30 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (30) of places Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. A maximum of thirty older people (30 OP) including three people over the age of 65 with dementia (3 DE(E)). The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 24th May 2005 Date of last inspection Brief Description of the Service: Brackenthwaite provides accommodation and care for up to 30 older people, 3 of whom may have dementia. The Home is situated in the centre of Whitehaven, close to all the towns services and amenities. Brackenthwaite is operated by Cumbria Care, an internal business unit of Cumbria County Council. The accommodation is provided on three floors and there is a passenger lift for ease of access. The Home is divided into three separate living areas. On the ground floor there is a lounge/dining room with small kitchen, plus a further quiet lounge with bedrooms, toilets and an assisted bathroom nearby. Also on the ground floor is another lounge/dining room, and the bedrooms and bathroom for the people who use this lounge are on the third floor. There is a lounge that can by used by those people who wish to smoke, and a spacious entrance hall with seating. On the second floor there is a lounge/dining room with small kitchen area, with bedrooms, toilets and assisted bathroom nearby. There is a garden area to the rear of the home with raised flowerbeds, a greenhouse and seating. There is parking to the side of the home. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over one day. There were 29 people living in the home on the day of the inspection. A full tour of the home was undertaken during the inspection. Part of the day was spent talking to service users, individually and in small groups. The manager, cook and care staff were also spoken to. The visit included looking at a sample of the records kept in relation to the people living at the home and the staff working at the home. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that people living in the home have access to leisure, social and cultural activities which suit their needs. People should be given opportunities and encouragement to participate in such activities. The meals and menus in use at the home should be reviewed with the involvement of the people living at the home to ensure that a varied, appealing and nutritious diet is offered at all times. Some of the areas used for food storage were disorganised and need to be rearranged. The cook needs to ensure that food is stored correctly and includes the labelling and dating of stored food. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 6 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. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 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 Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 5. Service users have their needs thoroughly assessed prior to moving into the home. This ensures that service users and their representatives know that the home is suitable and will meet their requirements. EVIDENCE: The files looked at during the inspection contained detailed assessments of the needs of each service user. The assessments had involved the service user, their family members where appropriate, senior staff from the home and the service user’s social worker. Service users were able to visit the home prior to admission and live at the home for a ‘trial’ period to ensure as far as possible that the home was suitable. A further assessment/review had taken place at the end of the trial period in order to gather the views of the service user, staff and social worker. Service users were also given a contract of terms and conditions, which provided information about the home, the fees and additional services that were available. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 The home records the assessed health and personal care needs of service users in their individual care plan. This helps to ensure that staff at the home assist service users appropriately. There are systems in place at the home to help ensure that service users receive their medication as prescribed. EVIDENCE: Samples of care plans were looked at during the inspection. They contained detailed information in respect of the individual care needs of each service user. The plans included risk assessments and moving and handling assessments, which had been reviewed regularly. Appointments to and visits from other healthcare professionals (for example district nurses, opticians and chiropodists) were recorded in the care plans. This shows that service users have access to specialist services when necessary. Records to monitor service users weight and bathing routines were not always fully completed in line with the home’s procedures. Medicines at the home were stored in a well-organised and safe manner. Records of the administration of medication had been kept. The home has introduced a good practice procedure where a second care assistant ‘checked’ the medication being given. The procedure was observed during the inspection. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 10 The second care assistant did not appear to be aware of her role in this process. This was brought to the attention of the manager at the home and the inspector suggested that the manager discuss this process at the next staff meeting to remind staff of the procedure. Three service users at the home managed their own medication. An assessment had been made and the service users had been provided with a secure place in which to store their medication. After the last inspection of this home, the manager had devised a document to help ensure the safe administration and monitoring of a medicine called Warfarin. The document had been used for a short time but then had been discontinued. The recording systems kept at the home to ensure the safety of service users taking this medicine were incomplete and this shortfall was brought to the attention of the manager for urgent action. Service users said that they were happy with the care that was provided. Care staff had access to service users care plans and were aware of the personal care needs of the service users. This information helps care staff to support service users appropriately and with respect for their privacy and dignity. During the inspection, a personal monitoring sheet regarding a service user had been placed on a notice board in a lounge area. This was brought to the attention of the manager and the document was placed on the service users personal file. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Service users maintained contact with their family and friends. The home did not provide sufficient social and recreational activities for the people living at Brackenthwaite. This potentially restricts the lifestyle and preferences of the service users. EVIDENCE: Service users said that they received visits from their families and friends. They also said that when the weather was better their visitors sometimes took them out into the town. Service users were able to choose whether they spent their time in their own rooms or in one of the communal areas. Service users were able to bring some of their personal possessions with them to the home to keep in their own rooms. A senior member of staff had been given responsibility for activities and events held in the home. On the day of this inspection visit it was noted that the people living in this home were sat in the communal lounges with the television on. Service users said that although they were satisfied with the care, there was nothing for them to do. The four weekly menus were looked at during this visit to the home. Service users had a choice from two dishes at each mealtime. Service users said that they were able to choose from the menu and further alternatives would be available. One service user said that the food was always the same with little variety; whilst another said there were too many stews and casserole type Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 12 meals. The meals offered at teatime were often convenience type food with very little nutritional value. The menus were limited with very little variety. The dining areas were light, clean and airy with a small kitchen area attached to them. A selection of drinks and other refreshments were offered to service users throughout the day. Service user meetings were said to be held from time to time. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has procedures in place and provides training for staff to help ensure that service users are protected from abuse. EVIDENCE: The home has robust procedures when recruiting new members of staff. References and checks are made on potential staff to ensure that they are suitable to work with vulnerable adults. Staff are given training to help them understand adult abuse and adult protection. A copy of the local authority’s adult protection procedure was available in the home for staff to refer to. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 25 and 26 The communal and private accommodation is decorated and furnished to a good standard providing a pleasant and comfortable environment for the people living at this home. Specialist equipment is available in the home to assist service users to maximise their independence. Staff have received appropriate training in order to use the equipment safely. EVIDENCE: The home is comfortable and generally well maintained. On the day of this inspection the home was clean and hygienic. The manager provided details of the areas that were to be re-decorated before the end of March 2006. These areas included eight bedrooms, a small lounge, which was formerly a smoking room, the staff toilet/changing room in the kitchen area, which had been smoke damaged and a new carpet in one of the communal areas. The bathrooms were bright, clean and decorated in a homely fashion. It was noted that soap dispensers had not been provided in the bathrooms. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 15 One communal toilet and a shower room were being used to store furniture. This was discussed with the manager and she was advised that these rooms should be locked if they are to be used as storage areas. Another communal toilet did not have paper towels nor a waste bin available and waste had been disposed of inappropriately. Specialist equipment, including hoists, wheelchairs and walking frames, were available to assist with the mobility and/or transferring of service users. The laundry was suitably sited and equipped with procedures in place to help ensure the control of infection. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Robust recruitment and selection procedures are used by the home when appointing new members of staff. Staff participate in relevant training courses and are regularly supervised. This helps to make sure that service users are safe and cared for by suitable and competent staff. EVIDENCE: At the time of the inspection, sufficient numbers of staff were on duty in order to meet the needs of the service users. In addition to the care staff, a domestic was on duty and a cook and kitchen assistant. The personnel files of several members of staff were viewed during this inspection visit. References had been taken up together with criminal records bureau checks (CRB) and protection of vulnerable adults list (POVA) checks prior to the employment of staff. Training records showed that staff had participated in relevant training such as moving and handling, first aid, infection control, food hygiene and fire procedures. Some staff had completed National Vocational Qualifications (NVQ) in care. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36, 37 and 38 The registered manager is competent, experienced and ensures that staff are recruited, trained and supervised appropriately. This helps to make sure that the home is run in the best interests of the people living at the home. EVIDENCE: Care staff at the home are regularly supervised. Supervision records indicate that practice issues and training are discussed with staff. Staff meetings also take place and minutes are kept of these meetings. Although service user care plans were of a high standard, there were some aspects of the records that needed attention. In particular, records relating to bathing and weight monitoring need to be reviewed to ensure that information is recorded in an accurate and timely way, carefully following the home’s own procedures. Staff have all completed fire training. A fire risk assessment is in place, fire fighting equipment, fire alarms and emergency lighting/exits are all checked regularly with written records kept. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 18 The fire officer had recently visited the home and had identified three areas that required immediate attention. Two of the items had been addressed by the home. The outstanding matter regarding the disposal of old mattresses were discussed with the manager and required her urgent attention. A visit to the kitchen was made during this inspection, which was found to be clean and hygienic. Food storage areas were also looked at. Fridges and freezers contained food that had not been stored correctly. Opened food packets had not been dated and labelled. Food had also been left uncovered. The pantry had been reorganised and was tidy although a large container of cereal had not been re-sealed properly and some of the contents had spilled out. The records of the fridges, freezers and cooking temperatures were looked at. The records had not been kept over a period of one week when the cook was on holiday. These matters were discussed with the cook and the manager during the inspection, as they required urgent attention to ensure that service users are protected. Risk assessments were in place regarding the various needs of service users and had been reviewed and updated regularly. Colour coded waste bags and protective clothing were available in order to manage infection and prevent the spread. Where accidents or incidents had occurred a carefully documented record had been kept. Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 19 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 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 3 X 3 X X 3 2 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 X X X X X 3 2 2 Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 20 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 OP8 Regulation 15, 17 Requirement Records relating to service users nutritional screening, weight gain or loss and records relating to bathing routines must be kept up to date and on the service users personal file. This will ensure that accurate and regular monitoring of service users will take place. A safe system for monitoring service users prescribed the drug ‘Warfarin’ must be introduced. The system must include a record of when blood tests are due, carried out and the resulting changes to the medication. Records relating to service users must be kept private and confidential and kept on their personal service user plan at all times. Service users must be consulted about leisure, social and cultural interests and the home must provide suitable facilities and a programme of suitable activities. The manager must ensure that service users receive a varied, DS0000036544.V279041.R01.S.doc Timescale for action 14/02/06 2 OP9 OP37 13 14/02/06 3 OP10 OP37 15, 17 14/02/06 4 OP12 16 01/03/06 5 OP15 16 01/03/06 Brackenthwaite Version 5.1 Page 21 6 7 OP19 OP19 23 23 8 OP38 13, 16 appealing, wholesome and nutritious diet. The menu plans must be reviewed in consultation with the service users. The staff toilet/changing area for kitchen staff must be repaired and redecorated. The home must comply with the requirements of the local fire service. Rooms used for storage must be kept locked at all times. Old furniture must be disposed of as soon as practicable and not stored by the external waste bin area. Food storage areas including fridges and freezers must be reorganised and tidied in line with food hygiene requirements. Food must be stored and covered correctly and must be clearly labelled and dated. 31/03/06 14/02/06 01/03/06 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 OP9 Good Practice Recommendations Staff should receive refresher training regarding the medication checking procedure used by the home. This will help ensure that they are aware of their duties and responsibilities when assisting with the administration of medication. The manager should consider the installation of soap dispensers in bathrooms to enable staff to maintain good hygiene procedures. 2 OP26 Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 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 Brackenthwaite DS0000036544.V279041.R01.S.doc Version 5.1 Page 23 - 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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