Inspection on 11/08/05 for Brecklands Nursing Home

This inspection was carried out on 11th August 2005.

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 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

Brecklands Nursing Home 13/02/07

Brecklands Nursing Home 20/09/06

Brecklands Nursing Home 11/01/06

Brecklands Nursing Home 29/11/04

Brecklands Nursing Home 25/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brecklands Nursing Home 28 Burnham Avenue Bognor Regis West Sussex PO21 2JU Lead Inspector Helen Tomlinson Announced Thursday, 11 August 2005, 10.00am, V235088 th 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 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. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brecklands Nursing Home Address 28 Burnham Avenue, Bognor Regis, West Sussex, PO21 2JU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 863218 Mrs Lynda Rehman CRH 19 Category(ies) of OP-19 registration, with number of places Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 29/11/04 Brief Description of the Service: Brecklands nursing home is a privately owned care home providing nursing care for up to nineteen residents in the category of older people. The home is a detached two-storey property in a residential area of the town of Bognor Regis. It is close to the town centre, within easy access to all local amenities and is half a mile from the sea front. Accommodation is provided in fifteen single and two double rooms. Four of the single rooms have en-suite facilities. A lounge with adjoined conservatory and a smaller dining room provide the communal space. A seating areas is available on the first floor. I Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. The inspector arrived at 10am and left the home at 4.30pm. The registered manager, Mrs Lynda Rehman, was present throughout the inspection and the care home owner, Mrs Janet Cole, was in the home for part of the time. Over the course of the inspection nine residents, five visitors and four members of staff were spoken with. Staff were observed giving support and assistance. Three residents files were examined in detail and other records were seen as was necessary. A tour of the premises took place. Staff files were examined. Eight comment cards were received from visitors/relatives prior to the inspection. Comments made included that the service by staff was “first class” and that “nothing was too much trouble”. Only positive comments were contained in the feedback. What the service does well: The environment and atmosphere was homely and comfortable. It was described by residents and visitors as “home from home” and “the next best thing to being at home when you can’t manage there any longer.” The home was clean and tidy and free from offensive odour. Residents benefit from a stable and consistent team of staff. They said this was important as they liked the continuity and knew the staff well. They praised the way the staff helped them saying they were “friendly, helpful and polite.” One resident said “it’s great to be spoiled and cared for so well.” Both residents and visitors were highly complimentary about the registered manager. They described her as “extremely caring” with “nothing being too much trouble” and described things she had done to help which were outside of her day to day responsibilities. The care plans for the residents were very comprehensive and the amount of detail gave a good picture of the resident and the care they needed. They were regularly reviewed and kept up to date. The health care needs of the residents were identified and met. Other health professionals were consulted when appropriate and advice sought. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 6 Residents were complimentary about the food served. Staff showed a thorough understanding of the residents individual likes, dislikes and preferences. 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. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 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 standard(s) 3 No new residents were admitted without an assessment of their needs having been done. EVIDENCE: The files of three residents were examined in detail. These had assessments on file which had been obtained prior to them becoming accommodated in the home. The registered manager said that all new residents were assessed by a member of staff from the home before being accommodated, unless it was an emergency. Assessments from health professionals and social services were on file as was appropriate. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 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 standard(s) 7,8, and 10 Residents benefited from having a detailed plan of their needs and abilities documented. The health care needs of the residents were met. The dignity and privacy of the residents was respected by the staff. EVIDENCE: The three files examined had comprehensive plans of care documented. These plans were drawn up from assessments of need and contained a lot of detailed information which gave a good picture of the resident. How their needs were to be met was clear and included exact actions to follow. These plans were up to date and had been regularly reviewed on a monthly basis or more frequently if needed. Staff were aware of the information in the care plans and followed this when caring for the residents. The health care needs of the residents were clearly documented and action taken to meet these needs was recorded. One resident who had entered the home in the past few weeks had had her health needs re-assessed by the Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 10 qualified nurses. This had resulted in referrals for a new hearing aid and dentures, both of which impacted on her life. Assessments of health care needs were recorded, including the risk of developing a pressure sore, risk of falls and moving and handling assessments. There were no nutritional assessments used in the home and it was recommended these be done. Bed rails were in use for some residents. A letter of agreement to their use, signed by the resident or their relative, were present on file. There was no risk assessment which identified any alternatives explored. It was recommended this be done. The bed rails seen in place did not have protectors fitted. All bed rails must have protectors fitted when in use. Staff had received training in the moving and handling of residents and equipment was present which was used as indicated in their individual assessment. Some moving and handling techniques were seen which could present a risk to residents and staff. The manager stated these methods had been included as acceptable in the training. It was recommended that the use of these techniques should be reviewed and a more safe method adopted. Residents said that the staff treated them kindly and showed them respect. They said they were polite when talking to them and very helpful. Bedroom and bathroom doors were closed when staff were assisting residents. Staff were overheard to speak to residents in a gentle and courteous manner. They addressed them appropriately, were friendly and relaxed. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 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 standard(s) 15 The food was nutritious and appealingly served with a variety and choice which suited the residents. It was served in a pleasant environment EVIDENCE: The residents said they enjoyed the food served for them at all meal times. They were unsure of what choices were on offer, but said if they didn’t like the main meal then they would be made an alternative. Choices were offered on the menu, but residents seemed unaware of this. It was discussed with the manager that residents should be aware of all choices at all meals. The main meal of the day was appealingly served and residents could choose to eat in the dining room or their own bedrooms. Those requiring assistance had this given discreetly and were encouraged to have sufficient nutrition. Hot and cold drinks were freely available and staff assisted residents where needed. Staff showed an understanding of the residents individual tastes, bringing chocolate and sweets for one resident who enjoyed sweet things. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 and 18 Any concerns or issues raised would be taken seriously and appropriate action would be taken Residents were protected from abuse EVIDENCE: No complaints had been received since the last inspection. The complaints procedure was on display in the dining room and the hallway. Residents and relatives spoken with said they would feel confident to approach the manager or any senior member of staff with any issues they needed to raise. They said the staff were approachable and they would be sure that any issues would be resolved. No allegations of abuse had been made at the home since the last inspection. The manager and other staff were aware of the correct procedure to follow should an allegation be made. The correct guidance policies were available in the home with up to date written procedures. Nine members of staff had received training in the protection of vulnerable adults. Further training for all remaining staff was booked. Staff spoken with showed an understanding of their responsibility in protecting people in their care. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19, 24 and 26 The majority of the home was tidy, clean and well maintained. Some areas of the home were in need of repair. Fire safety precautions were inadequate to protect the residents in case of a fire. EVIDENCE: The home was clean, tidy and free from offensive odours. New carpets had recently been laid in the communal areas and all but two bedrooms. Some areas had been re-decorated. The majority of the home was well maintained. One recently admitted resident said she was awaiting the new carpet to be fitted in her room and was then bringing her own furniture from home. All residents spoken with were happy with the decoration, fixtures and fittings in their own bedrooms and the communal areas of the home. The windows at the front of the house were in need of replacement. The manager stated an estimate for this work had been obtained prior to Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 14 the inspection and it was scheduled to be carried out before the winter months. The carpet from a corridor to a toilet was lifted and presented a trip hazard to staff and residents. This should be made safe. During the inspection all bedroom doors were wedged open. It was discussed with the manager that should residents wish to have their doors held open a device which meets with the guidance of the fire authority should be used. No fire doors should be wedged in the open position. This puts residents at risk in the event of a fire. The manager was advised to seek the advice of the fire authority. Staff were seen to wear protective clothing when carrying out care procedures or serving meals and drinks. All areas of the home were clean and pump soap and paper towels were in the communal hand washing areas. One bathroom was showing signs of wear and tear which resulted in damaged paintwork. This could not be adequately cleaned for infection control purposes and should be repaired. The home was clean and residents were complimentary about the level of cleanliness both in their own bedrooms and communal areas of the home. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The number of staff was adequate to meet the needs of the residents. The recruitment procedures were not adequate to ensure protection for the vulnerable adults in the home. EVIDENCE: The duty rota was examined and showed that there were adequate numbers of staff on duty to meet the needs of the residents. The files of the two most recently appointed care workers were examined. These did not have all the information required to ensure the person is fit to work with vulnerable adults. The necessary checks against the Protection of Vulnerable Adults register had not been undertaken. The manager stated there were currently four members of staff working in the home who had not had this check carried out. These staff members must not work without supervision until satisfactory checks have been obtained. The manager was given advice about the information to be obtained for any new members of staff, before they start work in the home. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,36 and 38 Residents benefit from a home which is run in their best interests. The personal finances of residents are safeguarded by the practices in the home. Staff receive support in their day to day work. Resident’s health, safety and welfare are protected EVIDENCE: The home is run in a very informal manner. Residents spoken with said they could speak to any member of staff with suggestions or concerns. They saw the manager most days who was involved in the day to day work in the home as well as the management aspects. There was no formal quality assurance system. Opportunities were given to staff, relatives and residents to comment on the quality of service offered. This was through discussion, staff meetings, Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 17 relatives questionnaires and day to day contact between staff and residents in the home. The manager stated she did not manage the finances of any residents accommodated in the home. She held small amounts of “spending money” for the hairdresser, newspapers etc. This was securely stored and accurate records were kept. The manager and other qualified staff worked with the care assistants on a daily basis. This gave an opportunity for supervision of new staff, observation of practice and discussion of any issues arising. The manager carried out annual appraisals for the staff which were recorded. It was recommended that more frequent supervision should be carried out and if this occurs informally records should be kept. All staff had received training on the health and safety within the home. Staff were seen to have an understanding of this aspect of their responsibility. As discussed in standard 19 some aspects of fire safety and one issue of a trip hazard were discussed. Three of the current members of staff had received first aid training. All staff had received fire safety training. The manager was informed the frequency of this should be increased. As discussed in standard eight the moving and handling techniques in the home require reviewing. Accident records were kept which met with the data protection guidance. Window restrictors were in place. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 3 x 2 Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 19 NO 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. 2. 3. Standard 8 19 29 Regulation 13(4)(c ) 23(2)(b) 19 and schedule 2 13(4)(a) Requirement All bed rails must have protectors fitted when in use The windows at the front of the building must be replaced or repaired All persons employed to work in the care home must have the relevant checks carried out to make sure they are fit to do so. The ill fitting carpet in the doorway of the first floor bathroom must be made safe. Timescale for action 31/8/05 30/10/05 31/8/05 4. 38 31/8/05 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 8 Good Practice Recommendations More thorough risk assessments should be done for the use of bed rails. Nutritional risk assessments should be carried out. The methods used for moving and handling residents should be reviewed. Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 2nd Floor, Ridgeworth House LIverpool Gardens Worthing, West Sussex BN11 1RY 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 Brecklands Nursing Home H60-H11 S24124 Brecklands V235088 110805 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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