Inspection on 06/10/05 for Brackley Fields Country House

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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 05/03/07

Brackley Fields Country House 11/04/06

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 Unannounced Inspection 6th October 2005 09:30 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.V255229.R01.S.doc Version 5.0 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.V255229.R01.S.doc Version 5.0 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 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.V255229.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one service user over 50 years of age with Alcohol Dependence 14th July 2005 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. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Residents, and upon their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting two residents and tracking the care they receive through review of their records, discussions with them were possible, and with the care staff, and observations of care practices. The inspection took place over a period of four and a half hours and was carried out on an unannounced basis. Prior to the inspection taking place the inspector spent one hour planning the inspection through reviewing previous inspection reports and other documentation in relation to the home. On the day of the inspection there was twenty two residents living within the home. The Registered individual and the deputy manager were present for most of the inspection. What the service does well: The home offers a friendly and welcoming environment, which aims to provide activities for residents that match their individual expectations and preferences. Holy communion takes place on the first Thursday for residents who wish to attend. There is low staff turnover the staff team are loyal and dedicated in providing care for the residents. One of the care staff is qualified as a National Vocational Qualification level 2 Assessor; the registered individual provides time off duty for the member of staff to fulfil this role, to support staff in achieving their National Vocational Qualification Level 2. Residents are encouraged to maintain links with relatives and friends in the community visiting arrangement are flexible. Residents are provided with a homely place in which to live, the décor and furnishings are traditional and the standard of hygiene is good. Residents speak highly of the good quality of meals available and residents and their representative’s views are sought through a quality assurance system to identify where the home can improve on the service provided. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 6 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. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 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.V255229.R01.S.doc Version 5.0 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): 1,2,3,4 & 5 Standard 6 is not applicable. There is a possibility that prospective residents may not have sufficient information prior to admission to be confident that the home will meet their individual needs. EVIDENCE: Prospective residents and their representatives are given basic information on the services provided at the home. The statement of purpose and service users guide require reviewing, so that prospective residents are able to make an informed choice about living at the home. Resident’s contracts are in place that set out the terms and conditions of occupancy, and had been signed by the resident or their representative. Pre assessments are in place, however the care plans generated from the needs assessment need to be more detailed with clear instructions on how residents needs and expectations are to be met. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 9 New residents are offered a trial period of one month, however there is no formal review meeting at the end of this period, to establish if the home is and can continue to meet the residents needs. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 10 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 & 10 The care plans are unsatisfactory which could place the residents at risk of their health, emotional and personal care needs not being fully met. EVIDENCE: The registered individual informed the inspector that a care-planning package, had been recently purchased, and was waiting its arrival in the post. There had been little progress made on improving the existing care plans. The care plans looked at did not provide sufficient information on how the individual health, emotional and physical needs of residents were to be met. There was no full assessment of the emotional needs of residents living with dementia, or any clear detailed instructions for staff to follow when caring for residents who display physical or verbal aggression towards them. Residents moving and handling assessments had not been completed, when the inspector questioned this with the deputy manager it was identified that there had been a misinterpretation of who was required to undertake the assessment, it had been assumed by the deputy manager that it was required to be completed by a qualified moving and handling instructor. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 11 At the beginning of each shift the staff receive a verbal handover, which ensures that they are informed of day to day changes in the needs of residents. Staff were observed to have positive relationships with residents and there was a relaxed and friendly atmosphere, there was no evidence of any shortfalls in this area. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 12 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 & 15 The home aims to provide activities for residents that match their individual expectations and preferences. EVIDENCE: The home has recently employed a new activity co-ordinator, through discussion it was evident that there had been lots of thought as to what activities would be suitable for individuals and group settings. Holy communion takes place on the first Thursday of every month. On speaking with residents they said that they were happy living at the home and that they could see their families whenever they wish. The lunchtime meal on the day of inspection was beef in red wine sauce with fresh vegetables, and the sweet was manchester tart, the portions were of a good size and the meal was well presented. The menu on display matched meal that was provided, residents chatted during the meal saying how much they enjoyed the food available at the home. One resident had spaghetti bolognaise as an alternative, which was home made, well presented and of ample quantity. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 13 The kitchen area was viewed during the inspection; the kitchen appeared clean and tidy, and well organised, cleaning schedules were in place and there were records of fridge and freezer temperatures and policies for the prevention of cross infection. Staff were observed wearing protective clothing when entering the kitchen and food preparation areas. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 14 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): 16 There is an informal complaints system in place, this system needs to be more formalised to ensure that service users are confident that their complaints will be taken seriously and acted upon. EVIDENCE: Within the statement of purpose, there is a paragraph on how the home aims to respond to any complaints, however the information provided for existing and prospective residents, does not include the stages and timescales for the process, to ensure there is a prompt and effective response from the provider. There was no copy of a complaint procedure on display, for residents or their representatives to access if the need arose. There were no records available of any complaints that had been raised by residents or their representatives. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Residents are provided with a homely place in which to live, the décor and furnishings are traditional and the standard of hygiene was good. EVIDENCE: The home is situated in a rural location, set within pleasant grounds and gardens; there are single and double rooms within the original house and in the single storey extension. The communal areas of the home seen were well maintained and furnished to an acceptable standard. A shared bedroom was viewed which was pleasantly decorated and contained items of personal belongings, privacy screens were available Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 16 Residents who were sitting in the conservatory which faces onto the rear car park, said that they liked spending time there as they could see people coming and going, one resident who was sitting in the conservatory was looking forward to her daughter collecting her, as they had arranged to go out for a pub lunch. The residents and staff lavatories looked at were clean and tidy, however the staff lavatory did not have any running hot water in the wash hand basin. Specialist pressure relieving equipment is prescribed through the district nurse, and there is such equipment in use, however there is no record within the care plans of the equipment being in use. There is a stair lift to rooms situated on the first floor. On the day of inspection there was intermittent heavy rain showers, the roof outside the managers office, was leaking, the registered individual was attending to this with the maintenance worker, and a contractor was being contacted to come to the home to repair the roof. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 The staffing levels and skills mix is satisfactory in meeting the needs of residents. The homes recruitment policy and practices need to be improved to ensure that residents are in safe hands at all times. EVIDENCE: On the day of inspection there was twenty-two residents within the home, two care assistants, one activity co-ordinator, two cleaners, one cook, one kitchen assistant, one maintenance worker and the deputy manager on duty. The registered individual was also available within the home. Some staff training has taken place on dementia care, one member of staff has completed a distance-learning course in dementia care and the deputy manager was planning on undertaking the same course. One of the care staff is qualified as a National Vocational Qualification level 2 Assessor; in order for the member of staff to fulfil this role, and to support staff in achieving their National Vocational Qualification Level 2.the registered individual provides time off duty Two staff recruitment files were looked at; the files did not contain all of the information required by schedule 2 of the regulations. One issue discussed with the registered individual was in relation to obtaining written references prior to staff taking up employment. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 18 One recently appointed member of staff spoken with confirmed that they had received induction training on fire and health and safety. They confirmed that they had been instructed that they were not to attempt any moving and handling of residents until they had received moving and handling training. There were praising comments for the home, from staff that have recently been employed such as “the staff really do care for the residents”, “the home has a lovely homely feel about it” and “residents seem very relaxed and at home”. The staff morale appeared to be high, interactions observed between staff and residents were light hearted and friendly. The deputy manager confirmed that the home does not make use of any staff from care agencies. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 19 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): 31,32,33,36,37 & 38 Residents live in a home were they are cared for by a loyal and dedicated staff team, however the health, safety and welfare of residents is placed at risk due to the unsatisfactory care plans currently in place. EVIDENCE: The management approach is open and positive and staff morale appears to be high, The deputy manager confirmed that she conducts individual staff supervision sessions, however no records of these one to one meetings were looked at during this inspection. There is dependability on staff being verbally updated on the changing needs of residents. The requirement that each resident has an individual care plan which is generated from the assessments of their daily living and longer term, health, emotional and physical care needs, was discussed with the registered Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 20 individual and the deputy manager. Who agreed that meeting this requirement, was to be treated as an area of high priority. The deputy manager had arranged a meeting with the team of four senior carers employed at the home, with the purpose of address this requirement and utilising the skills of the team, she was confident that there would soon be progress in bringing the care plans into daily use. Residents and their representatives views are sought through a quality assurance system to identify where the home can improve the quality of service provided. Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 21 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 2 3 2 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 2 2 Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 22 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 1 Regulation 6 (a) (b) Requirement The registered person must keep under review the statement of purpose and service users guide and notify the commission and service users of any such revision within 28 days. Comprehensive needs assessments must be drawn up with each resident, to provide the basis for the care to be delivered. Residents care plans must be formulated for all identified needs, to include specific guidance on how these needs are to be met. The plans must be made in conjunction with the residents or their representative. (Previous timescales of 07/11/04 and 30/09/05 not met) Moving and handling assessments must be carried out for all residents (previous timescales of 07/11/04 and 30/09/05 not met.) There must be a simple, clear and accessible complaints procedure that includes the DS0000012716.V255229.R01.S.doc Timescale for action 13/11/05 2 7 14 (1) (2) 30/11/05 3 7 15 30/11/05 4 38 13 (5) 30/11/05 5 16 22 31/12/05 Brackley Fields Country House Version 5.0 Page 23 6 29 19 7 27 18 timescales for the process. The registered person shall supply a written copy of the complaints procedure to any service user and to any person acting on their behalf if that person so requests. The registered person must have 31/10/05 the staff recruitment information required by schedule 2 of the regulations, on each staff file. (Previous timescales of 01/06/04 and 30/09/05 not met) Dementia training must be 31/01/06 provided for all care staff. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Brackley Fields Country House DS0000012716.V255229.R01.S.doc Version 5.0 Page 25 - 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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