Inspection on 05/03/07 for Brackley Fields Country House

This inspection was carried out on 5th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brackley Fields Country House 11/04/06

Brackley Fields Country House 06/10/05

Brackley Fields Country House 14/07/05

Brackley Fields Country House 07/10/04

Brackley Fields Country House 26/04/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brackley Fields Country House Halse Road Brackley Northants NN13 6EA Lead Inspector Irene Miller Key Unannounced Inspection 5th March 2007 10:00 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 Fields Country House DS0000012716.V331861.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 Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackley Fields Country House Address Halse Road Brackley Northants NN13 6EA 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 704575 01280 704614 s@brackley32.fsnet.co.uk Lt Col John Richard McLennan Rayner Mrs Judith Rayner Lt Col John Richard McLennan Rayner Mrs Judith Rayner Care Home 24 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (24) of places Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one service user over 50 years of age with Alcohol Dependence 11th April 2006 Date of last inspection Brief Description of the Service: Brackley Fields Country House is situated in a rural location on the edge of Brackley town. It stands in it’s own grounds set back from the road, with private car parking. Resident’s accommodation is in single or double rooms, either in the original house or in a single storey extension. There are currently three lounges, two conservatories, a library and a dining room. A pleasant and well-kept garden is also available The Home offers twenty-four hour personal care for up to 24 frail older people including 5 residents with a diagnosis of dementia. The home is owned and managed by Lt Col John Richard McLennan Rayner. Current fees range from £410.00 to £490.00. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for service users and their views of the service provided. This inspection was a ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000, for homes providing care for older people. The primary method of inspection used was ‘case tracking’ which involved selecting two residents, reviewing their health, social, emotional and physical needs and tracking the care they receive. Two care plans were looked at (a care plan sets out how the home aims to meet the, personal, health, social and emotional needs of the resident), and discussion took place with residents and staff and general care practices were observed. The homes policies, procedures and records in relation to staffing recruitment and training, concerns and complaints, medication management, and general maintenance and upkeep of the home were viewed. The inspector spent two hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes previous inspection reports and other information relating to the home. The registered manager/provider was Lt Col John Raynor was available at the home on the day of inspection and the inspection took place over a period of approximately six hours. What the service does well: Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 6 The ethos, leadership and management style of the home ensures that residents live in a home that is run in their best interests. There is a strong emphasis on ensuring that residents have regular and appropriate activities to engage in, and there is good support from the local church. An extension to the main property was in the process of construction the building works were well managed and caused the least disruption for existing residents as possible. 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 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 Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (Standard 6 is not applicable to this home). Quality in this outcome area is good. Prospective residents only move into the home once a full assessment has been made of their needs, and that it is confirmed that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans viewed there was pre assessments and ongoing assessments of needs available. Resident’s contracts were available that set out the terms and conditions of occupancy, which had been signed by the resident or their representative. New residents are offered a trial period of one month, however there is no formal system for a review meeting to take place at the end of this period, to confirm in writing to the resident that the home can continue to fully meet the new resident’s needs. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 & 10 Quality in this outcome area is adequate. The reliance of information on the resident’s health and personal care needs being verbally communicated between the staff has the potential to place residents at risk of their needs not being fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within one of the care plans viewed there was reference within the daily notes of a resident requiring to be seen by the district nurse for treatment to a pressure area, and there was reference to the district nurse having provided the pressure area treatment. However within the residents care plan there was no clear written instruction for staff to follow on the prevention and management of pressure area care and documentation within the care plan did not reflect the current needs of the resident. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 10 The staff receive a verbal handover, on the day-to-day needs of residents that outlined changes in the residents condition, however the information was not communicated within the care plans. The medication storage and administration records were viewed, and in general the records were well maintained, however there was some gaps in staff signatures on the medication administration record charts (MAR), which were brought to the attention of the deputy manager during the inspection. The staff were observed during the inspection assisting residents with their day to day needs, the staff were observed to be respectful to residents and there was a relaxed and friendly atmosphere within the home. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is excellent. The lifestyle in the home matches resident’s individual expectations and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In discussion with residents they said that they were happy living at the home, that the staff were very helpful and kind. On the morning of the inspection the homes activity co-ordinator spent time with a group of residents in the lounge, facilitating a quiz Within the front entrance to the home there was a resident notice board that displayed the homes activity plan, the plan contained a variety of interactive entertainment topics for residents to participate in. One of the themes for a quiz was about the religious period of Lent, when speaking with residents they said that they enjoy the quizzes and that visitors call into the home from the local church, the residents confirmed that Holy Communion takes place regularly. Residents said that the flexible visiting arrangements were good and that they could see their families whenever they wished. Within daily notes there were Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 12 records available to demonstrate when residents had received visitors and when they had participated in outings. Residents were observed within the homes dining room receiving the lunchtime meal, the atmosphere was congenial, with residents chatting during the meal. Staff were observed to provide support for residents who required feeding, in a discreet and relaxed manner ensuring the residents dignity was preserved at all times. The meal portions were of a good size and well presented. The tables were nicely set and condiments were available on the tables for residents to use if they wished. Residents said that they enjoyed the food available at the home and could choose an alternative to the meal on any given day if they wished. The kitchen area was clean, tidy, and well organised, and staff were observed wearing protective clothing when entering the kitchen and food preparation areas. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. Residents can be assured that any concerns or complaints they may have will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A comments and complaints book was available within the front lobby/conservatory for residents and their representatives to access should they wish. No records of any concerns or complaints being raised since the last inspection, and no complaints had been received about the home by the Commission for Social Care prior to the inspection taking place. Training was provided for staff on safeguarding adults, and there was guidance available to follow in the event of any allegation of suspected or actual abuse taking place, that follows the protocol of the Northamptonshire Inter Agency policy and procedure for the protection of vulnerable adults. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 14 Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 15 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): Standards 19 & 26 Quality in this outcome area is good. Residents are provided with comfortable, homely surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour of the building was conducted, work was in progress on the building of an extension to the home, and the building work appeared well managed and did not encroach on the residents living within the home. Within one of the shared bedrooms viewed the privacy curtain had been removed from the ceiling track, this was brought to the attention of the deputy manager during the tour of the building, who said that it would be attended to promptly. The bedrooms were pleasantly decorated and contained items of personal belongings, and privacy screens were available within the other shared bedrooms. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 16 The communal areas of the home seen were well maintained and pleasantly furnished. The first floor bath enamel surface was scratched and chipped, however the deputy manager confirmed that this bath was no longer in use and the extension plans indicated that this bathroom was to be removed. The laundry facility was clean and tidy, and there was good cross infection reduction practices in operation. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 17 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): Standards 27,28,29 & 30 Quality in this outcome area is good. Residents are cared for by a staff team that are trained and competent to fulfil their duties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing at the home on the day of the inspection was sufficient to meet the needs of residents Two staff recruitment files were viewed which contained the information required to demonstrate that thorough recruitment practices were followed. Staff said that the management supported them and that training was provided. The Staff were knowledgeable of individual residents needs and capabilities and responded to residents in a caring and sensitive manner. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 18 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): Standards 31,33,35 & 38 Quality in this outcome area is good. The ethos, leadership and management style of the home ensures that residents live in a home that is run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management approach is supportive and open, residents spoke highly of the registered manager and of the services provided at the home, saying that they were happy living at the home. A formal annual quality assurance system was in place to gain the views of residents on the services that the home provides, and the registered manager/provider is in day to day contact with the home. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 19 The staff receive verbal updates during the shift handovers on the changing health and personal care needs of residents, however the changing needs were not always transferred into the residents personal care plans, therefore the written information was not an accurate reflection of their current needs. Within the care plans viewed there was a lack of written instruction for staff to follow, which supports that further work is required in improving the information contained within the care plans. The resident’s monies and confidential information were held securely and access limited to ensure that their financial interests and privacy was safeguarded. Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 3 X 3 X 3 X X 3 Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 21 Yes 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 Standard OP8 Regulation 15 Requirement The incidence of pressure sores, their treatment and outcome must be recorded in the service users care plan and reviewed on a continual basis. Moving and Handling Assessments must be recorded in the service users care plan and reviewed on a continual basis. When medication is administered, staff must sign the medication administration record. Timescale for action 30/04/07 2 OP8 15 30/04/07 3 OP9 13 (2) 30/03/07 Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 22 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 OP5 Good Practice Recommendations Following the ‘trial period’ The registered provider should introduce a system for a formal review to take place with the service user and/or their representative. Records should be available of weight gains or losses, where resident’s weights are unable to be assessed through refusal or incapacity this should be recorded within the care plan. 2 OP8 Brackley Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Fields Country House DS0000012716.V331861.R01.S.doc Version 5.2 Page 24 - 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!