Inspection on 29/07/08 for Brackley Cottage Hospital

This inspection was carried out on 29th July 2008.

CSCI found this care home to be providing an Adequate 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

Brackley Cottage Hospital 15/05/09

Brackley Cottage Hospital 15/08/07

Brackley Cottage Hospital 26/02/07

Brackley Cottage Hospital 03/05/06

Brackley Cottage Hospital 06/12/05

Brackley Cottage Hospital 11/11/04

Brackley Cottage Hospital 24/06/04

Brackley Cottage Hospital 01/09/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Brackley Cottage Hospital Pebble Lane Brackley Northants NN13 7DA Lead Inspector Mrs Carole Burgess Unannounced Inspection 29th July 2008 09:45 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 Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackley Cottage Hospital Address Pebble Lane Brackley Northants NN13 7DA 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) 01280 702388 01280 700329 brackley.hospital@virgin.net Brackley Hospital Trust Manager post vacant Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The total number of service users must not exceed 14. The 14 service users will be in the category of OP No one falling within the category of intermediate care may be admitted to the home when there are 9 persons in this category already accommodated within the home. No-one falling within the category of OP receiving nursing care and not intermediate care may be admitted to the home when there are 5 persons in this category already accommodated within the home. The beds located in the multi bedrooms must only be used for service users receiving intermediate care for rehabilitation, and must not be used for any other category, including palliative care. Service users whose anticipated stay exceeds 8 weeks may not be admitted into the intermediate beds. 15th August 2007 Date of last inspection Brief Description of the Service: Brackley Cottage Hospital is registered as a care home for older persons and provides nursing and intermediate care for up to fourteen people. The Hospital is situated in the market town of Brackley and is close to a bus route, a park and all the local amenities. Although there are no parking facilities within the grounds, parking is available along Pebble Lane where the hospital is situated. The Hospital also provides a 24-hour First Aid Unit that is open to the general public. There is a Registered Nurse on duty at all times. Accommodation is on the ground floor; this comprises of two four bedded rooms, one double room and four single rooms. There are five beds for people requiring long-term, residential care and two four-bedded wards (one male & one female) and a double room for people requiring intermediate care. People receiving intermediate care can remain at at the Hospital for up to eight weeks. There are no en suite facilities but there are two bathrooms with adaptations for assisted bathing. There is a small communal sitting room and a small garden with seating to the Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 5 rear of the property. The Statement of Purpose/Service Users Guide & last Inspection Report are available on request (these provide information on how the home is organised and what services they provide) and are provided for people who intend to use the service. At the time of the inspection the Responsible Individual (RI) said that weekly fees ranged from £615 for a shared room to £630 for a single room. There are extra charges for hairdressing and newspapers. NB. Although Brackley Cottage Hospital is registered with the Commission For Social Care Inspection (CSCI), the environment does not and cannot meet the National Minimum Standards due to the layout and age of the building and has more of the atmosphere of a cottage hospital than a care home. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 stars. This means the people who use this service experience adequate quality outcomes. ‘We’ as it appears throughout the Inspection Report refers to ‘The Commission for Social Care Inspection.’ The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. Planning for the inspection included reviewing the previous inspection report, assessing notifications of significant events, reviewing any complaints received about the service and reviewing the service history to date. The site visit was unannounced and took place over six hours. We selected two residents/patients and tracked the care they received through a review of their records, discussion with them (where possible), other people who use the service, the care staff, and observation of care practices. We spoke with staff members regarding training and support. We sent out pre-inspection surveys to people who use or are involved with the service. We received four replies from staff, three replies from residents/patients and three replies from GPs’. The surveys indicated that this is a good service and that residents/patients are well cared for by caring staff. Residents/patients said that they were happy with all aspect of care. One person said service was ‘first class’ with ‘great cooking’. Two replies indicated that more could be done to provide appropriate activities. One person said that they could not take part because they were bed bound and the other said that it was it was not applicable because there were no organised activities. Staff were positive about the care they provided and said, ‘we are committed to the care and wellbeing of our service users’ ‘we provide good, wholesome food, freshly prepared on the premises, using local produce. The GP’s said that people received ‘individual care with excellent nursing/patient ratio’, ‘good nursing care’, and ‘excellent food’. They also said that the dignity of people was maintained at all times and that privacy was maintained within the limitations of the building. One GP felt that additional physiotherapy would be helpful as would faster access to Occupational Therapy (OT) services. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 7 The Responsible Individual (RI) who is also the general manager and other staff and the residents/patients spoken with were positive and helpful during the inspection. NB. Staff referred to people receiving intermediate care as ‘patients’ and those people receiving private residential care as ‘residents’. Therefore ‘residents/patients’ will be used throughout the report. The service is known locally as Brackley Cottage Hospital so the term ‘hospital’ is used in place of ‘home’ throughout the report. What the service does well: What has improved since the last inspection? The hospital continues to provide a very good standard of care. The room identified at the last inspection had been redecorated and now looked fresh and clean. Door alarms have been fitted in response to an incident where a patient wandered out and could have been at risk. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 8 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 9 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 Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents/patients and their relatives are provided with sufficient information, to enable them to make an informed choice if the service is the right one for them. EVIDENCE: The Statement Of Purpose/Service Users Guide was being reviewed and updated. It was provided for all prospective residents/patients and was made available for people admitted for intermediate care. Some people spoken with were unsure whether they had received this information. Two people said they probably had but could not remember. However, two respondents to the preinspection survey indicated that they had received sufficient information about Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 11 the hospital before they moved there as residents and it had helped them to decide if it was the right home for them. There were signed copies of the home’s Terms & Conditions (contract) for each resident/patient, kept in separate files with copies supplied to the residents/patients on admission. Two residents’/patients’ care plans that were reviewed contained a preadmission assessment to show that the hospital could meet their specific health, welfare, and social care needs. They included personal details, relative and GP contact numbers, a past and present medical history, current health care requirements and medications. Residents who were admitted into one of the five long-term nursing beds had been visited prior to them moving to the home to ensure that their needs could be met. Patients admitted for intermediate care had a verbal and written a referral provided by their GP. One patient said that his GP had phoned the home prior to his admission to talk to the nurses. This ensured that staff had the information they required to enable them to provide the appropriate care for residents and patients. Patients admitted for intermediate care may be admitted for various reasons: One patient said that he had been unable to walk so could not look after himself as he lived alone. He said that he had been given excellent care by the staff and was hoping to go home soon. He was later seen walking unaided to the sitting room to watch television. The Registered Nurse explained that if necessary a requests is made and an Occupational Therapist (OT) takes the patient home for a pre- discharge visit. They check and order any special equipment needed to help the patient with their daily activities, and assess if they will be able to cope. If needed equipment is ordered propr to the patient returning home. A ‘discharge summary’ is then sent to the patient’s GP to ensure that they are followed up by the local health care team. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents/patients are well cared for and have their health and personal care needs met. EVIDENCE: Residents’/patients’ care plans provide nurses and carers with good information about the health and personal care needs of the residents/patients. The care plans were comprehensive and covered all of the resident/patients needs, what care was needed, and what actions the staff needed to take to meet those needs. All care plans were regularly reviewed and updated as necessary to ensure that people continued to receive the care they needed. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 13 Risk assessments were in place for such things as falls management, pressure area care and nutrition and for residents who required bedrails to ensure that they were appropriate for the residents/patients care and safety. Care plans had been signed by the resident/patient and/or their representatives to show that were involved in and agreed with their personal plan of care. A visitor said that s/he had been consulted about the plan of care for her relative and was happy with the care provided. In addition to a daily records, information regarding contact with healthcare professionals such as GP’s, District Nurses, Social Services and other hospitals was recorded in the ‘Communication Book’ to ensure that healthcare needs and treatments were addressed. This information was then placed in the residents/patients noted upon discharge to ensure that a detailed picture of care was retained. A pre–inspection survey completed by the trained staff indicated that they felt that residents/patients required more OT and physiotherapy input prior to discharge. This was discussed with the RI who said that it was under consideration. Medication policies and procedures were satisfactory at the time of inspection. Registered Nurses administer medication and the residents/patients received their medication safely and as prescribed. During this and previous visits it was noted that the door to the treatment room, where the medication is stored, was unlocked. Although most medicines were locked away (those in the fridge were not) the door is off the main corridor and provided easy access to resident/patients and visitors alike. The door should be kept locked when not in use to ensure the safety of patients and prevent unauthorised access to medication. There were no resident/patients self-medicating at the time of the visit but there was a policy and procedures for staff to follow if a resident/patient should wish do so. Homely remedies, such as cough syrups can be provided if required, if agreed with the residents’/patients’ own GP. Observation during the inspection showed that staff knew how to protect and promote peoples privacy and dignity. Staff spoke to residents/patients and visitors in a respectful, friendly, quiet and helpful way. A resident/patient said that, ‘the nursing staff and all the staff were wonderful’. She also said that the domestic staff were always helpful and ‘nothing was too much trouble for anyone’. The residents/patients spoken with said that they could not want for better care. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Resident/patients are well supported by staff to maintain choice and control in their everyday lives but the hospital does not meet all of the residents’/patients’ social expectations and preferences. EVIDENCE: The Hospital has close links with the local community. Volunteers give there time and help with afternoon teas or chat with the residents/patients and fundraising events have been held in the town on their behalf. There was a regular Church of England service every Wednesday and other denominations could were upported where required. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 15 Birthdays and festival days such as Chistmas and Easter are celebrated. Birthdays are celebrated with a homemade cake and shared by all of the residents/patients. There was a small sitting room with a television and video player, with videos, books, large print books, puzzles and games. The RI indicated that this room was not well used, although they had recently held a birthday party for a resident/patient in there. On the day of inspection most of the residents/patients spent most of the day sitting in or by their bed. Some people were reading, others were chatting or sleeping. One person went to the small sitting room to watch television in the afternoon. There was no one with an overall responsibility for activities. During this, the last inspection and in the pre-inspection surveys a number of residents/patients had identified the lack of activities as a problem. During the last inspection the Registered Manager (who has since left) said that restrictions the building made it difficult to get people together, and that it was very difficult to get people to join in any activities. When asked if they would like activities provided, two people said ‘yes’ as there was not much to do exept read, others were unsure what might be offered and said they were alright with things as they were. There was some information regarding residents’/patients’ past and present hobbies and social activity preferences recorded in their plan of care. These could be improved to provide a more rounded picture of what activities people preferred and responded to. Activities should be integral to residents’ care to ensure that their lifestyle expectations and preferences were met and their psychological wellbeing maintained, which is especially for those people receiving intermediate care who will be returning home and also for those people with some degree of short-term memory loss or dementia. It was interesting to note that two of the patients, receiving intermediate care that lived alone, said that being with other people had rekindled their interests. This could be built upon so that they could continue with old and new interests and hobbies once they were able to return home. Visiting is positively encouraged to enable residents/patients to maintain contact with family and friends. One visitor said that she was always made welcome by staff and could visit whenever she liked; and a resident/patient said that her family visited most days. The hospital had a 4 Star rating certificate from the Environment Health Officer. All of the meals were prepared in the home’s kitchen by the cook. There were choices at all main meal times. Special diets such as diabetic and soft diets were catered for. Likes and dislikes and any special diets were Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 16 recorded on a board in the kitchen so that staff had easy access to this information. The food provided for lunch looked nutritious, well presented and residents/patients who required assistance were given this in an unobtrusive manner. The hospital does not have a dining room and trays were taken to the residents’/patient’s bedside. Residents were weighed regularly where necessary, and had a nutritional assessment in their care plan to ensure that their dietary needs were met. All of the residents/patients spoken with stated that the food was extremely good. One person said that the food was very nice and that she had regained her appitite since she was admitted and now felt well again. A relative and other residents/patients said that the food was always good. A staff member said that accurate recording of intake and output of food and fluids could sometimes be problematic when plates and glasses were removed and not recorded on the resident/patients chart. This should be addressed to ensure where a residents’/patients’ food and fluid balance needs monitoring it is done so accurately as inaccurate records could affect clinical judgments and care outcomes. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are satisfactory. EVIDENCE: The hospital has a complaints policy and procedure, which was available in the Statement of Purpose/Service Users Guide. When next reviewed and updated it should include contact details of the local Social Services and CSCI so that people who use the service have current information if they need to make a complaint. It was recommended that the complaints policy and access to advocacy services are displayed in the reception area so that they are easily accessible and so that people can access independent advice if necessary. Neither the CSCI nor the Hospital has received any complaints about the service. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 18 The Hospital had a ‘safeguarding’ and ‘whistle blowing’ policy and procedure but these needed to be updated to reflect information provided in the local ‘Safeguarding Vulnerable Adults’ policies and procedures based on the Department of Health ‘No Secrets’ 2000 guidance. Staff had not been provided with ‘safeguarding vulnerable adults’ information and training either during their induction period or within mandatory training so that they do not have knowledge of current safeguarding policies and procedures. However, residents/patients said they felt very safe and trusted all the staff at the Hospital Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Brackley Cottage Hospital does not and cannot meet the National Minimum Standards due to the age and layout of the building but residents/patients are provided with a clean and comfortable standard of accommodation. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 20 EVIDENCE: Brackley Cottage Hospital was the local cottage hospital. The shared rooms used for intermediate care resemble hospital wards with four beds in each with only a small sitting room for communal use. The shared room and the single rooms used by long-term residents were personalised and residents were able to bring in their own possessions and small items of furniture. There are no en suite facilities but there are sufficient toilets and bathrooms with assisted bathing facilities. On the day of the visit the Hospital was clean and tidy and residents/patients spoken with were satisfied with the accommodation provided. One person said that a shared room made it difficult to sleep as another patient was confused at night and kept her awake. There was a small garden with seating to the rear of the building for the use of residents/patients and their visitors. The current accommodation within Brackley Cottage Hospital does not meet the National Minimum Standards. Both the CSCI and the Trustees are aware of this and certain restrictions are currently in place, including only admitting one person who needs assistance with hoisting in each shared room. The Trustees are currently tendering for internal and external redecoration to make improvements where they can. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are sufficient in number to meet the current residents’/patients’ needs and provide a good standard of care. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 22 EVIDENCE: There were 10 residents/patients at the time of the inspection. Staffing levels, at the point of inspection, were in line with those suggested by the Department of Health Residential Forum Guidelines and were sufficient to meet the current residents’/patients needs. The RI uses the NHS dependency tool to calculate monthly staffing requirements. There was a Registered Nurse on duty at all times, day and night with three care staff on the early shift and one carer on the afternoon and night shift, In addition, there were ancillary staff such as a secretary, cook and cleaners and a handyman. Both residents/patients and staff commented that staff had been ‘stretched’ recently as the Registered Manager had left, and there were staff on holiday and also some sickness. Staff said that they were doing extra shifts to cover but the evenings could sometimes be very busy an extra pair of hands would help. Resident/patients said that staff were working very hard to cover shifts but they said that they were still being very well cared for. Three staff files were checked during the inspection and showed that there was a satisfactory recruitment process that ensured that residents were well protected. There was a very basic induction programme that dealt mostly with familiarising new staff with the hospital. The induction did not include accessing competences in basic care. Staff had received annual, mandatory training in Health & safety, moving and handling, fire safety and resuscitation techniques and a number of staff had undertaken a food hygiene course. The RI said that, about seven care staff had completed National Vocational Qualification (NVQ) in Care, Level 2/3. It was recommended that management review both the induction training (to include basic clinical skills) and mandatory annual updates and included such things as ‘safeguarding vulnerable adults’, dementia and ‘safe handling of medicines’ for trained staff to ensure that they continue to have the skills and knowledge to support the people in their care. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management of the Hospital ensures that it is run in the best interests of the residents/patients and that their health, safety and welfare are promoted and protected. EVIDENCE: The Registered Manager had left some months ago and the RI has applied to become the Registered manager for the service. A nurse co-ordinator was due Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 24 to start taking over the clinical lead to provide a focus on resident/patient care and staff support. It was evident during the inspection that residents/patients benefit from a positive culture that fosters good relationships between staff, residents/patients and visitors to the Hospital. Residents/patients were very complimentary about the staff and could not praise them enough for their dedication and care. Staff had not been regularly supervised since the Registered Manger left. This should be resolved when the nurse co-ordinator takes up post ensuring that all staff receive annual appraisals and regular supervision (a regular review of staff’s personal and training needs in relation to their work). The implementation of an improved training programme, and regular, recorded supervision, should ensure that staff have their training needs identified, and that they continue to have the necessary skills to provide a good service for the residents/patients. Health and Safety Policy and Procedures, showed that the RI & Trustees were mindful of their responsibilities to make sure that residents live in a safe environment. The hospital allowances. does not manage any residents/patients monies/personal As the current accommodation within Brackley Cottage Hospital does not, and cannot, meet the National Minimum Standards the Trustees are currently tendering for internal and external redecoration to make improvements where they can. The Trustees have agreed to keep the CSCI informed of their progress in securing funding for a new home. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP12 Good Practice Recommendations It is recommended that the treatment room be kept locked at all times to ensure the safety of resident/patients and prevent unauthorised access to medication. It is recommended that that appropriate activities are offered so that residents/patients receive stimulation that suits their preferences and capacities, improves their mental wellbeing and aids their recovery. DS0000012602.V369121.R01.S.doc Version 5.2 Page 27 Brackley Cottage Hospital 3. 4. 5. 6. 7. OP15 OP17 OP17 OP36 OP30 It is recommended that food and fluid balance charts are closely monitored so that accurate recording informs clinical judgements regarding people’s nutritional status. It is recommended that the complaints policy be updated to include contact details of local Social Services and CSCI. It is recommended that information about advocacy services are provided. It is recommended that that all staff are provided with regular, recorded supervision. It is recommended that induction and mandatory training programmes are reviewed to include ‘safeguarding vulnerable adults’, and dementia care, and medication training for trained staff. Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Brackley Cottage Hospital DS0000012602.V369121.R01.S.doc Version 5.2 Page 29 - 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!