Inspection on 27/02/06 for Brewster House

This inspection was carried out on 27th February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brewster House 05/11/08

Brewster House 17/01/07

Brewster House 21/11/05

Brewster House 04/03/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Brewster House Oak Road Heybridge Maldon Essex CM9 4AX Lead Inspector Kay Mehrtens Final Unannounced Inspection 27th February 2006 10:30 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 Brewster House DS0000017780.V286722.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. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brewster House Address Oak Road Heybridge Maldon Essex CM9 4AX 01621 853960 01621 857847 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) Runwood Homes Plc Ms Allison Squires Care Home 62 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (62) of places Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 62 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 25 persons) The total number of service users accommodated in the home must not exceed 62 persons The registered person must not admit persons subject to the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 21st November 2005 Date of last inspection Brief Description of the Service: Brewster House is a large purpose built unit in the village of Heybridge near the town of Maldon in the county of Essex. The home accommodates 62 service users who are over the age of 65 years. All of the accommodation provided is on a single room basis spread over two floors. A large majority of the rooms have en-suite facilities. There are no double rooms. Outside of the home there is a central courtyard and gardens. There is a car park to the front of the property with ample spaces. The home is situated near to shops and is on a public transport route to Maldon, Witham and Colchester. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place on the 27th February 2006, lasting 6.5 hours. This was the second statutory inspection of the year and focussed on the remaining key standards not inspected at the last inspection, as well as a review of the requirements and recommendations from the last inspection. The inspection process included: discussions with the manager, staff and residents. There were 60 residents accommodated at the time of the inspection. The fees range from £358.54 to £525.00 per week. There are additional charges for hairdressing, newspapers, personal items and outings. The premises were inspected, including the grounds. The provider has made an application to the commission for an increase in the registered number of residents from 62 to 64. The provider has sought the change of a room, previously used by the day care services, to become a shred bedroom. The inspector used the opportunity of the unannounced inspection visit to make a site visit of the proposed room, as part of the registration application. Any comments regarding the application will be made, as appropriate, at the next inspection visit. Samples of records and residents care plans were inspected. The inspector had the opportunity to meet many residents and would like to thank them for their time and hospitality. The inspection covered nine key standards. The home was clean and well maintained. The staff were observed to be very respectful and caring with residents. What the service does well: Care plans are well written and contain detailed information to enable the staff to deliver a service that meets the assessed needs of the residents. The approach and attitude of the manager and staff is very much on resident and family input into the care planning process. The home has built up very good working relationships with health care professionals. Positive feedback was given to the inspector, about the care provided at the home, from a local doctor. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 6 The manager and her staff team came across as caring, professional and keen to provide a good standard of care for their residents. 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. Brewster House DS0000017780.V286722.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 Brewster House DS0000017780.V286722.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): EVIDENCE: These standards were not inspected at this inspection. Brewster House DS0000017780.V286722.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, 8 and 10 Care plans provided good information to assist staff in meeting the needs of residents. The general and specialist health care needs of residents were well met. EVIDENCE: One care plan was sampled and was of a good standard. The care plans addressed all the identified needs as stated in the pre-admission assessment and from discussion with the resident concerned. It was well written and provided detailed information so that new staff would know exactly what to do to meet the needs of the resident. The plan included clear information with regard to the individual health care needs and difficulties. It was very detailed and a lot of work had been done to ensure the physical frailties of the resident were addressed and included in every aspect of their care. The inspector was impressed by the approach taken by the key worker to include the resident and their family in the care planning and reviews. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 10 The care plans were regularly reviewed and amended as required. Risk assessments regarding falls and manual handling were also reviewed and amended to reflect any changes. The only shortfall noted with this care file and others what that the daily recording tended to comment more on physical than social and emotional issues for residents and so lacked a balanced view. Risk assessments and monitoring of residents’ pressure areas and nutritional needs were clear and were regularly reviewed, as were all the care plans for each resident. Records of specialist health appointments and outcomes were well maintained. There was detailed information regarding medical interventions, outcomes of hospital visits and advice sought from relevant health care professionals. The monitoring records on residents’ nutritional, dietary and weight needs were well maintained. There was good evidence of input and advice from health care professionals with regard to pressure care, diabetes, Parkinson’s and falls prevention. Residents commented positively about the staffs’ attitude towards them. They felt that their dignity and privacy were respected. The inspector observed good practice with regard to staff ensuring residents privacy. For example, they were observed to knock on doors before entering a room and ensured that doors were closed when attending to residents’ personal care needs. The staff were observed to sit and chat with the residents in a respectful and pleasant way. Residents were seen smiling and laughing with the staff and clearly enjoyed their company. The inspector was very impressed with the manager and staff response to an incident when a resident fell and required emergency assistance. They were very caring and reassured the resident. They acted professionally and so ensured positive response and worked well with the emergency service when they arrived. Brewster House DS0000017780.V286722.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): 14 Residents’ choice is respected in many aspects of their life in the home. EVIDENCE: The standard with regard to activities (12) was not fully inspected, at this visit. However, the manager informed the inspector that she had recently employed a new activity worker and hoped that the level of meaningful activities for residents with dementia would improve. This will be monitored at the next inspection. The inspector noted several bedrooms where it is evident that residents are supported to bring their own possessions with them when they moved in. There was information available to residents with regard to accessing advocacy services, if required. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not inspected at this inspection. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 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 the following standard(s): 26 Residents are provided with a safe, well maintained and pleasant home. EVIDENCE: The inspector visited during the morning and there was no evidence of any odour throughout the home. The inspector did a tour of the premises and the standard of hygiene was very good. The home was warm and bright. The laundry area was tidy, efficiently run and well-equipped area. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 14 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 and 29 Staffing levels are sufficient to meet the needs of the residents. Staff recruitment practices are sufficient to ensure residents’ protection. Staff are trained to do their job in a competent manner. EVIDENCE: The use of agency staff had greatly reduced since the last inspection. The manager had worked well, with the providers’ support, in recruiting new staff. The inspector had the opportunity to meet some new staff, as they were busy doing some individual training on fire awareness. The manager informed the inspector that all new staff only does “shadowing” with other staff until their employment checks and induction is completed. The inspector observed good practice when a senior member of staff checked with the manager to see if the new staff had done their manual handling training before allowing them to move residents. The staff spoken to informed the inspector that this was so and said that they were enjoying the training and support provided by the rest of the staff team. They also said that they were looking forward to doing more training and starting their National Vocational Qualification level 2 courses. The staff rotas showed that there was 2 senior staff and 8 care staff on duty for the morning shift reducing to one senior and 8 care staff for the evening Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 15 shift. There are then 3 care staff and one senior on duty during the night. In addition, the manager and deputy are on duty during office hours with sufficient catering and domestic staff employed. The inspector did comment upon the “dependency level assessment tool” currently being used by the home as it focused on the physical difficulties of residents. Brewster House accommodates up to 23 residents with dementia. An assessment tool that takes their needs and difficulties into account would be more appropriate and useful, especially when considering any review of staffing levels to meet assessed need as is required in the regulations and standards. The staff files were well organised. All required checks were undertaken prior to staff working in the home. Though one of the files checked did not contain a current photograph of the staff member. The commitment to National Vocational Qualification training is good as several members of staff have achieved level 2 and many more were currently doing the course so the home is well on target to meet the 50 requirement and more. The manager has also been very pro-active in seeking out other sources for training including links with Connexions for information and advice about “modern apprenticeships”. The inspector looks forward to hearing about her progress at the next inspection. The manager informed the inspector that training with regard to the Protection of Vulnerable Adults which was highlighted, as a requirement at the last inspection, had not yet been achieved. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 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 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): 35 Residents’ finances were well managed. EVIDENCE: Records examined showed that residents are encouraged to maintain their own finances with support provided when required. Records were well maintained. The inspector advised the manager to undertaken risk assessments with residents should they choose to manage their own affairs. The manager is not an appointee for any residents. The local social service department will act on behalf of some residents should this be required or appropriate. Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 18 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 OP12 Regulation 12 Requirement The registered person must ensure that appropriate activities and are provided for those residents with dementia. The staff must be trained and competent in understanding and providing relevant activities for residents with dementia. This standard was not fully inspected and will be monitored at the next inspection. The registered person must ensure that staff are trained with regard to understanding adult abuse, polices and procedures in the Protection of Vulnerable Adults. This is a repeat requirement. Timescale for action 21/04/06 2. OP30 18 21/04/06 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 Good Practice Recommendations DS0000017780.V286722.R01.S.doc Version 5.1 Page 19 Brewster House Standard Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 20 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 Brewster House DS0000017780.V286722.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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