Inspection on 14/12/05 for Brenalwood Care Home

This inspection was carried out on 14th December 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

Brenalwood Care Home 11/06/08

Brenalwood Care Home 20/06/07

Brenalwood Care Home 24/08/06

Brenalwood Care Home 21/09/05

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

CARE HOMES FOR OLDER PEOPLE Brenalwood Care Home Hall Lane Walton On Naze Essex CO14 8HN Lead Inspector Ray Finney Final Unannounced Inspection 14th December 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 Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brenalwood Care Home Address Hall Lane Walton On Naze Essex CO14 8HN 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) 01255 675632 01255 679245 R.W. Care Homes Ltd Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 36 persons) 22nd September 2005 Date of last inspection Brief Description of the Service: Brenalwood is a home providing care and accommodation for 36 individuals over 65 who have dementia. The premises consist of a large detached property, offering accommodation on two floors, with a passenger lift to the first floor. There are three double rooms. All rooms have en suite facilities. The home offers a range of communal areas available for the use of all service users. Brenalwood is situated within walking distance of all the local amenities of Walton-on-theNaze. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place on 16th December 2005 for a total of 7 hours. The inspection process included discussions with the deputy manager, acting manager and three members of staff. The inspection also included a tour of the home, observations of interactions between service users and members of staff and evidence gathered from samples of records. The atmosphere in the home during the day of the inspection was relaxed and welcoming and the inspector was given every co-operation from support staff, the acting manager and the Responsible Individual of R.W. Care Homes Ltd. What the service does well: What has improved since the last inspection? What they could do better: Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 6 Although the environment had improved, further work remained outstanding to make the home more suitable for those with dementia. The acting manager informed the inspector that clear signage to assist with orientation was in the process of being prepared. The quality assurance programme needed to be implemented and the information from quality assurance questionnaires should be collated and presented as a report. 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. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: No evidence was examined for these standards at this inspection. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Individual plans of care were in place to ensure service users’ health, personal and social care needs were met. The home met the healthcare needs of service users. EVIDENCE: Samples of service user care plans were examined. Many had been improved and updated since the last inspection and contained greater detail. Files examined contained records of risk assessments on aggressive behaviour, dehydration, pressure sores, urinary tract infections, MRSA and risks around service users who were unable to make choices. A member of the care team spoken with showed knowledge of the health care needs of service users. There was a good awareness of procedures around oral hygiene and the home enlisted the advice of the District Nurse for those service users who were frail. A dentist visited the home when requested. The home used input from health care professionals where appropriate, including district nursing services, optician and chiropodist. One service user with a pressure sore was receiving treatment from the District Nurse and a special ‘pressure mattress’ had been purchased. Service users were assessed around Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 10 their continence needs by the Continence Advisor. The home supported service users around difficulties with psychological health such as depression or anxiety by referral through the G.P. to hospital consultants or Community Psychiatric Nursing Services. Staff spoken with said that the home offered a variety of games and ‘Music and Exercise’ to help with general fitness. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 The home was able to meet the interests and needs of the service users, but would benefit from making information about activities available. Service users were helped to exercise choice and control over their lives within the limitations of their dementia, but would benefit from having accessible information about advocacy services. EVIDENCE: The acting manager informed the inspector that the programme of activities offered by the home had been improved since the last inspection. Activities included ‘music and movement’, giant dice and hobbyhorses, coffee mornings and 1:1 reminiscence work. A visiting choir from the local community entertained service users. Although available activities were improving, there were no notices or information on display to inform or remind service users of events that were happening. The home would benefit from ensuring activity planners or programmes were readily available in a format that would be attractive and suitable for the service users in the home. The acting manager said that service users in the home who had dementia were supported to make choices by family members. None of the service users in the home were able to manage their own finances and some had solicitors to act on their behalf. Information around advocacy services was not Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 12 readily available for service users or families. The acting manager showed the inspector that a new glass covered notice board had recently been installed. He said that information such as advocacy services would be able to be displayed and would not be taken down or destroyed by service users who were confused, as had happened in the past. During a tour of the premises, evidence was seen of personal possessions in service users’ rooms. Records examined showed that service users had an inventory of personal possessions on file. Service users had access to their records; however, none had the capacity to examine files. Information was made available to families who came to reviews. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home ensured that complaints were listened to and acted upon. Overall the homes policies and procedures ensured that services users were protected from abuse, although they would benefit from ensuring further staff training around abuse awareness was provided. EVIDENCE: The home had a complaints procedure in place that was made available to service users and their representatives in the Statement of Purpose and Service User Guide. The complaints procedure was also seen to be displayed in service users’ rooms. The policy contained timescales for responding to complaints and it had been updated in July 2004. Records examined showed that the home documented complaints appropriately. Records examined showed that there was a whistle blowing policy in place. The acting manager said that the home provided staff training around abuse awareness. However, staff spoken with said that the last abuse awareness training that had been arranged was cancelled and it was going to be rescheduled. A tour of the premises showed that service users had lockable drawers in their rooms for safe storage of valuables. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 The home provided a safe, well-maintained environment for service users who lived there. Service users lived in safe, comfortable surroundings and overall the home was clean, pleasant and hygienic, although sluicing facilities were not in place. EVIDENCE: A tour of the premises showed that the programme of re-decorating was almost complete and the home was well maintained throughout. The laundry room had had an additional washing machine installed. New furniture had been provided in many of the rooms and the through lounge and dining room had been redecorated and new tables and chairs were in place. The communal area was light, airy and pleasant. The member of staff responsible for maintenance was spoken with and records examined. Evidence was seen that regular checks on water temperature were carried out and recorded. Records showed that a weekly Health and Safety audit of the premises was carried out covering fire doors and alarms, Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 15 emergency lighting, extinguishers, boilers, smoking and housekeeping maintenance. COSHH and infection control records were examined and found to be in order. The member of staff in charge of maintenance kept records meticulously. The acting manager informed the inspector that an Environmental Health check had been carried out on 20th September 2005. The grounds were seen to be tidy and well maintained and a ramp was in place to ensure service users were able to access the grounds. The home had CCTV cameras but these did not intrude on service users privacy. Since the last inspection the requirement to install thermostatically controlled valves to water outlets had been completed. Although the home did not have a sluicing facility, overall the standard of cleanliness throughout the home was much improved since the last inspection. A member of the cleaning staff spoken with was satisfied that the home was being thoroughly cleaned and the inspector would find ‘no cobwebs’. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 The needs of service users were met by the numbers and skill mix of staff. Overall the home’s recruitment policy and practices ensured service users were protected and supported, although CRB enhanced checks also needed to be carried out for staff moving from other countries. Staff received training to ensure they were competent to do their jobs. EVIDENCE: Staff spoken with felt there were sufficient staff on duty to meet the needs of service users. The staff rota was examined and showed that staff were rostered on flexibly to cover busy periods. Staff roles were identified on the rota and specific staff were allocated for activities. Information provided by the Registered Individual and acting manager showed the Residential Forum was used to assess required staffing levels. The acting manager confirmed that all members of staff providing care were over 18 years old and no one under 21 years was left in charge. A tour of the premises showed domestic staff kept the home clean and odour free. The home had a policy on Selection and Recruitment of Staff and an Equal Opportunities policy that were reviewed in July 2004. Staff records examined showed appropriate references were obtained. Criminal Record Bureau enhanced checks were in place for most members of staff but staff coming from abroad to work in the home had not all had CRB checks completed. The acting manager gave assurances that these checks were being processed and until they were completed, staff without an enhanced CRB certificate would not Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 17 work unsupervised. All members of staff were given the General Social Care Council Code of Conduct and a statement of the terms and conditions of employment. Members of staff spoken with said they received statutory training such as fire, Manual Handling and Health & Safety. Abuse awareness was also provided, although the last planned session had been cancelled; the carer spoken with said it was going to be re-arranged in the New Year. One carer spoken with said that the induction received six months previously had been basic and “could have been better” but recently there had been “vast improvements”; standards had improved, there were staff meetings and staff felt supported. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 At the time of the inspection the home did not have a Registered Manager in post, however the interim arrangements put in place by the providers ensured service users lived in a home that was receiving appropriate management. On the whole the home was run in the best interests of the service users, although more work needed to be done on quality assurance and monitoring systems. The home ensured that the financial interests of service users were safeguarded. The health, safety and welfare of service users and staff were promoted and protected by the home’s policies and procedures. EVIDENCE: Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 19 The responsible individual of R.W. Care Homes Ltd was overseeing the management of the home with the support of the Registered Manager of Blenheim House and an assistant manager. The home had a quality assurance system in place. At the time of the last inspection questionnaires had been sent to relatives and some were returned to the home. However, the information had not been collated and the results made available to current and prospective users, their representatives and other interested parties. The acting manager said that although no further action had been taken to develop and collate information through the quality assurance system, more work was planned now that the environmental improvements were completed. At the time of the inspection no service users were able to manage their own finances. The home had a policy in place around service users’ property and money. Service users’ monies were kept in separate wallets in the home’s safe and receipts were kept. Admin staff spoken with and records examined showed appropriate recording of income and expenditure. Service users had lockable facilities in their rooms for safe storage of valuables. The home had policies and procedures in place around Health & Safety and safe working practices. Staff spoken with said they received statutory training and there was evidence of this on records examined. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 2 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 21 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 OP26 Regulation 13(3)16(2 )(j) Requirement The registered person must ensure they make suitable arrangements for maintaining satisfactory standards in respect of sluicing and provide a rationale for dealing with infection control and continence issues. This is a repeat requirement. The registered person must ensure that CRB checks are carried out for all new members of staff. The registered provider must appoint an individual to manage the care home. The registered person must ensure that information obtained through the home’s quality assurance system is collated into a report, which is made available to service users and a copy of which is sent to the Commission for Social Care Inspection. This is a repeat requirement. Timescale for action 31/03/06 2. OP29 19(4)(c) 31/03/06 3. 4. OP31 OP33 8(1)(a)(b) (i) 24(2) 31/03/06 31/03/06 Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 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. 2. Refer to Standard OP12 OP14 Good Practice Recommendations Up to date information about activities should be made available to service users in a format suited to their capacities. The home should ensure information on external agents such as advocacy services is made available. Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Brenalwood Care Home DS0000062892.V267124.R01.S.doc Version 5.1 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. 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