Inspection on 21/09/05 for Brenalwood Care Home

This inspection was carried out on 21st September 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

Brenalwood Care Home 11/06/08

Brenalwood Care Home 20/06/07

Brenalwood Care Home 24/08/06

Brenalwood Care Home 14/12/05

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 Unannounced Inspection 22 September 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.V251883.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. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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 Mrs Patricia Langstaff Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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) 24th November 2004 Date of last inspection Brief Description of the Service: Brenalwood is a home providing care and accommodation for 36 individuals who are 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.V251883.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 22nd September 2005 over a period of 7 hours and 45 minutes. During the day of inspection, four members of staff were spoken with and two visiting relatives. The visitors and staff spoke well of the home. 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. On the day of the inspection the registered manager was unavailable and the inspector was given every co-operation from Raymond Hughes, who was deputising in her absence, and Debbie Carson, Responsible Individual, R.W. Care Homes. What the service does well: What has improved since the last inspection? What they could do better: The environment could be improved to make it more suitable for those with dementia. The addition of aids to assist with orientation such as clear signage with pictures or symbols and different colour schemes for different areas would improve the surroundings for service users. The home should ensure that the activities available suit the service users’ needs and have been specifically Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 6 designed for people with dementia. Staff would benefit from training explicitly around the needs of people with dementia. Some areas were found to have an unpleasant odour and carpets needed to be replaced. Documentation in service users files needed to be better organised. Care plans and risk assessments needed to be more comprehensive, specific and detailed to enable staff to meet service users needs appropriately. Relatives spoken with said that if service users were admitted to hospital and it was not possible for a member of staff to accompany them, they should have more information sent with them, as service users who were quite confused would not be able to answer questions adequately. 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.V251883.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 Brenalwood Care Home DS0000062892.V251883.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): 3, 4 Service users who moved in to the home had their needs assessed. The home was unable on the day of inspection to demonstrate its capacity to meet all the assessed needs. EVIDENCE: Records examined showed that assessments were in place detailing the needs of service users. Staff spoken with were not able to demonstrate an awareness of how to meet the specialist needs of service users with dementia or to provide evidence of training in this area. Activities relating to dementia were limited. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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, 9, 10 Individual plans were inadequate to provide the basis for the care to be delivered to ensure service users’ health, personal and social care needs were met. Service users were protected by the home’s policies and procedures for dealing with medicines. Service users were treated with respect and their right to privacy was upheld. EVIDENCE: Service records sampled showed that care plans were in place but they contained insufficient detailed information to provide the basis for delivering care. Most files inspected were not well organised, although attempts had been made to update one service user file. A monitored dose medication system was in place and was examined by the inspector. Medication records examined were correctly completed and well maintained. Service users ‘Medicine Administration Record’ Sheets had photographs of service users. Controlled drugs were stored in an appropriately locked cupboard and documentation was clearly completed. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 10 Observations of interactions between staff and service users showed that service users were treated with respect. A relative spoken to was pleased with the care that had been provided. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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, 13, 15 The lifestyle experienced in the home did not fully satisfy the social and recreational needs of the service users. The home ensured that contact with family and friends was maintained. Service users were offered an appealing and balanced diet that they were able to eat in pleasant surroundings. EVIDENCE: Staff spoken with said “there are a lot of activities in the home” such as a ‘music morning’, exercise to music, jigsaws, ‘Connect 4’ and cake making. However, activities relating to dementia were limited to a flip chart referred to as a ‘word board’ and a member of staff who did ‘reminiscing’, although no evidence was produced of resource materials. Relatives spoken with said that visitors are always made welcome and they can “drop in any time”. They said there were activities “like keep fit and coffee mornings” to keep the service users occupied. Staff spoken with said that there had been a routine visit from the environmental health inspector recently and the home had already actioned the recommendations. The kitchen had a good standard of cleanliness and the inspector observed additional cleaning in progress during the inspection. Some equipment needed to be replaced and a new milk machine was on order. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 12 Menus inspected showed there was a choice of hot and cold meals available, planned on a four-weekly rotational basis. There was evidence of both fresh and frozen vegetables and fresh fruit available. Fridges and freezers that were inspected contained a variety of foods. The inspector observed drinks and snacks were available throughout the day. Meals were unhurried and one service user chose to spend a considerable time over the lunchtime meal. The acting manager said that service users only had food pureed when absolutely necessary, such as meat that may have been difficult to chew. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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): These standards were not inspected on this occasion. EVIDENCE: No evidence was looked at for these standards at this inspection. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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): 21, 22, 24, 25, 26 Sufficient and suitable lavatories and washing facilities were available for service users and they had the specialist equipment required to maximise their independence. Bedrooms were safe, comfortable and service users had their own possessions. Service users lived in safe, comfortable surroundings. On the day of the inspection the home appeared clean but with some unpleasant odours present. EVIDENCE: On the inspector’s tour of the premises, it was observed that there were en suite facilities in service users’ rooms and the acting manager said that an additional bathroom had been refurbished since the last inspection. A room had been fitted out as a hairdressing salon and a number of portable aids had been purchased so that service users who were unable to sit to have their hair washed at a traditional basin were able to have it done on their beds. A comprehensive assessment of the premises had been carried out by an independent organisation. The Occupational Therapist’s environmental report Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 15 had been received and the acting manager informed the inspector that recommendations in the report were being actioned. The inspector saw evidence of grab rails and ramps to maximise service users’ independence. Hoists were available and there was evidence that they had been serviced. A new call system had been installed in all bedrooms. There was evidence of extensive re-decoration in many of the bedrooms and the acting manager said that the work was ongoing, with a few more rooms still to have been completed. The décor was observed to be of a good standard. There were a number of new carpets in place and the inspector was informed that others were ‘on order’. Some of the bedrooms had ‘riser’ chairs. There was evidence in service user bedrooms of a variety of personal items such as photographs. All radiators were seen to be covered; many of them with ‘soft’ covers that the acting manager felt were particularly suitable for the service user group. The handyman spoken with on the day of the inspection produced evidence that weekly water checks were carried out and a ‘Legionella check’ had been carried out in May 2005. There was evidence that some thermostatically controlled valves had been put in place since the last inspection. The work had not been completed, but the inspector was informed that it was scheduled to be done within the following month. Portable Appliance Testing was carried out on the day of the inspection. Lighting throughout the home was observed to be adequate, although some areas in the lounge could have had additional lighting to avoid gloomy patches. The acting manager was looking at putting additional wall lights in the lounge and mirrors in the dining area to reflect light. Sluicing facilities were not in place, but the acting manager said that options had been and would continue to be explored to ensure the facilities met the required standards around hygiene and infection control. The linen cupboard was clean and tidy and contained a good supply of bedding. The acting manager informed the inspector that bed linen was sent out to be laundered and only service users personal items were laundered in the home. The laundry room was small for the volume of laundry being carried out and was not well ventilated; there was only one small opening window. The majority of the bedrooms were clean and odour free, although one area had an unpleasant odour. The acting manager stated that the carpet had been cleaned but this had not been sufficient to eliminate the odour. A new carpet was on order and would be delivered and fitted within five weeks. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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): 28, 30 Staff were generally trained and competent to do their jobs and to help ensure service users were safely cared for. However, training specific to caring for people with dementia is needed. EVIDENCE: Information provided by admin staff and the acting manager indicated that 50 of care staff had achieved NVQ qualifications at level 2 or level 3. Staff spoken with and records examined on the day of the inspection showed that a range of training was provided. One member of staff said “training’s great” and had completed Health & Safety, First Aid and Manual Handling training. A new member of staff had completed an induction programme, ‘shadowed’ other staff and was booked in to do Fire Safety, Manual Handling and First Aid courses the following month. Only Senior Staff who have had appropriate training gave medication. Although there was evidence of appropriate statutory training, training specific to the needs of service users with dementia was not evidenced (see evidence for standard 4 and standard 12). Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 17 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): 33 Quality Assurance systems are in place but have not been used effectively to ensure the home is run in the best interests of service users. EVIDENCE: The home had a quality assurance system in place. Questionnaires were 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. Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X 3 3 X 3 2 2 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X X Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP4 Regulation 12(1)(b) Timescale for action The registered person must 31/12/05 make proper provision for the care and supervision of service users with dementia. The registered person must 31/12/05 ensure that service users’ care plans set out in detail the actions which need to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service users as identified in their assessments are met. The registered person must 31/12/05 ensure that the programme of activities offered in the home is planned with regards to the needs of service users with dementia. The registered person must 31/10/05 ensure that thermostatically controlled valves are fitted (see detail in main body of report). This is as repeat requirement The registered person must 31/12/05 ensure that the home has DS0000062892.V251883.R01.S.doc Version 5.0 Page 20 Requirement 2 OP7 15(1) 3 OP12 16(2)(n) 4 OP25 13(4)(a) (c) 5 OP26 13(3) Brenalwood Care Home suitable arrangements to prevent the spread of infection particularly in respect of continence and sluicing facilities. This is a repeat requirement 16(2)(k) The registered person must ensure the home is kept free from offensive odours. The registered person must 31/12/05 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 6 OP33 24(2) 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 Brenalwood Care Home DS0000062892.V251883.R01.S.doc Version 5.0 Page 21 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.V251883.R01.S.doc Version 5.0 Page 22 - 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!