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Inspection on 11/05/05 for Briar Close House Care Home

Also see our care home review for Briar Close House Care Home for more information

This inspection was carried out on 11th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Briar Close House has a number of staff who have worked at the home for many years, which helps to provide a stable and caring environment. The home is well managed and the manager and staff are approachable and keen to provide a quality service and resolve any difficulties. Service users spoken with were pleased with the service provided and stated that `nothing was too much trouble`. The physical environment was well maintained with good quality furnishings and fittings, which help to provide a comfortable and welcoming atmosphere. The garden and outside areas are also well maintained and provide a pleasant outside sitting area, which is appreciated by both service users and their visitors. A good choice of well cooked meals are provided that cater for specialist diets.

What has improved since the last inspection?

A wider range of activities has been organised from games and outings to cooking and painting. A new greenhouse has been purchased to enable those service users interested in gardening to maintain their interest. Better information is available on staff files as required by the Care Homes Regulations 2001.

What the care home could do better:

Information on care plans must be more specific to individual needs and information about risks to service users must be updated regularly. Prompter responses to identified repairs must be undertaken. Better information must be kept on service users` files to ensure that the home meets its obligations under the Care Homes Regulations 2001.

CARE HOMES FOR OLDER PEOPLE Briar Close Borrowash Derby DE72 3GB Lead Inspector Janet Morrow Unannounced 11th May 2005 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. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Briar Close Address Borrowash Derby DE72 3GB 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) 01332 718310 01332 718311 Derbyshire County Council Linda Trigg Care Home with personal care 40 Category(ies) of Old Age - 65 years and older registration, with number of places Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 3rd November 2004 Brief Description of the Service: Briar Close is a 40 bedded home for older people situated in the village of Borrowash, near the city of Derby. Three places are available for respite care and three places for day care each day. The property was purpose built and is owned by the local authority, Derbyshire County Council. Service users’ bedrooms are situated on the ground floor. The first floor is used for staff facilities only and is accessed by stairs. There are no en-suite facilities. All bedrooms are attractively decorated and personalised. Communal areas are bright and décor is of a good standard. The home is divided into four units for ten people, each having its own kitchenette, and dining and lounge area. In addition, there is a large lounge at the entrance to the building. There is a garden area with outdoor seating. Support services are in place with a choice of General practitioners, and visiting district nurses, chiropodist, dentist and optician. Community psychiatric nurse, occupational therapist, physiotherapist and dietician are accessed as required. Staff training takes place to inform and enable staff to care for service users appropriately. Transport is arranged for those service users wishing to go out and in-house entertainment is arranged. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place over 7.5 hours. Staff and care records were examined. A tour of the environment took place. Seven members of staff, twelve of forty service users, two relatives and one visiting professional were spoken with. One visiting professional was contacted by telephone following the inspection visit. The personnel department of the Local Authority was contacted by telephone following the visit to ascertain some information kept on staff files. What the service does well: What has improved since the last inspection? A wider range of activities has been organised from games and outings to cooking and painting. A new greenhouse has been purchased to enable those service users interested in gardening to maintain their interest. Better information is available on staff files as required by the Care Homes Regulations 2001. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 6 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. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 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 Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 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, 4 and 5 The home was able to provide relevant care and meet service users needs based on the assessment information provided on admission and offered service users and their relatives the opportunity to assess the suitability of the home. EVIDENCE: Three service users’ files were examined and there was assessment documentation in place in each that provided sufficient information over a range of needs for staff to provide care following admission. Those service users interviewed stated that their care needs were met and visiting professionals interviewed during and after the inspection visit also confirmed that needs were met. One service user interviewed confirmed that they had visited the home prior to admission and visiting professionals also confirmed introductory visits to assess the suitability of the home were available. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 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 Health care needs were met but additional interventions to ensure better consistency of care and response to risk assessments was required to improve care. EVIDENCE: Care planning and assessment information were available on three files examined. Risks identified in assessment documentation were not always followed through into interventions to minimise the risks and not all care plans had been revised following a review of care. For example, in one file examined a moving and handling risk assessment had not been reviewed since July 2003 and a review of the care plan stated a new plan was needed in January 2005 but this was not available. Signatures were available on those care plans seen, indicating that consultation about care took place. Service users interviewed confirmed that they had access to dentists, opticians and chiropodists and this was verified on records seen. All service users spoken to stated that they were treated in a respectful way and that staff were ‘very kind’. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 10 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) 12, 13 and 15 Social activities and meals were both well managed and provided daily variation and interest for people living in the home. EVIDENCE: A range of activities was on offer including plant growing, movement to music, cooking and painting. Meals out and visits to places of interest also occurred. Some service users visited local facilities such as the pub. A visiting professional stated that service users received ‘excellent’ stimulation. Meals were enjoyed by service users. One service user stated that the home provided ‘lovely food’ and that it was ‘well cooked’. Those visitors spoken with confirmed that they were able to visit when they liked and were made to feel welcome at the home. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 11 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 Complaints were handled objectively and service users and relatives were confident that their concerns would be listened to. EVIDENCE: The home had a clear complaints procedure, which was included in the service user guide and on display in the entrance area of the home. However, the copy on display did not have the correct name of the Commission for Social Care Inspection included. The procedure included whether or not the complainant was satisfied with the outcome of their complaint and the records examined confirmed that this was included. Those relatives and service users spoken with were confident of a courteous response from the manager. There had been no complaints received at the Commission for Social Care Inspection office during the previous twelve months. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 12 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, 20, 21, 22, 23 and 24 The home was well maintained and provided safe, comfortable and homely accommodation for service users. However, there was one outstanding matter which would further improve the environment. EVIDENCE: A tour of the building showed that the home was bright and cheerful with good quality furnishings and fittings. However, remedial work to flaking paint on the exterior had not been undertaken and made the exterior look shabby. This was raised as an issue at the previous inspection in November 2004. There was sufficient equipment to deal with those service users with disabilities, including Parker baths, raised toilet seats, wheelchairs and handrails. There was a small lounge and dining area on each of the four wings and one large lounge where special events and activities were able to take place. Three bedrooms were seen and all were personalised to individual taste. Records were available to show that service users had been consulted about the furniture they wanted in their rooms. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 13 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, 29 and 30 There were sufficient staff on duty to meet service users’ needs. The procedures for the recruitment of staff were robust and provided the safeguards to offer protection to people living in the home. Staff training was sufficient for staff to be competent at their jobs. EVIDENCE: Staff rotas for the day of the inspection were examined and showed that there were sufficient staff on duty that included flexibility to cover peak periods of activity. Those staff interviewed stated that an increase in staff hours had been beneficial and enabled them to be more involved in activities. Three staff files were examined and the personnel department of the Local Authority was contacted following the inspection and this confirmed that all had identity information, two written references and Criminal Record Bureau checks in place. Staff training records showed that a range of courses had been undertaken including loss and bereavement and adult protection. All staff interviewed stated they were undertaking or had achieved National Vocational Qualification training. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 14 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) 37 and 38 The health and safety of all involved in the home was upheld but improvements to some records were required to ensure that service users rights and best interests were safeguarded. EVIDENCE: Three service users’ files were examined and did not contain all the information required by Schedule 3 of the Care Homes Regulations 2001. For example. one file did not contain a photograph of the service user and there was no date of admission recorded on another file. Some care information, as detailed earlier in the report, was missing. Staff interviewed stated that health and safety training was undertaken and this was confirmed by staff training records. Maintenance records also showed that equipment was serviced regularly. Accident reports were up to date. Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 15 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x 2 3 Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 16 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard op19 Regulation 23 (2)(b) Timescale for action Identified external areas must be 1/8/05 repainted Previous timescale of 1/5/05 not met. Care plans must be revised 1/9/05 where reviews have indicated that this is required. Risk assessments must have up 1/9/05 to date interventions detailed. All service users files must 1/9/05 contain a photograph of the service user and full care information. Requirement 2. 3. 4. op7 op8 op37 15 (2)(c) 13 (4)(c) & 13 (5) 17 (1) (a & Schedule 3) 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. 3. Refer to Standard op3 op34 op16 Good Practice Recommendations Consideration should be given to completing assessments and care plans at the time of admission. A business and financial plan should be available This recommendation was not assessed on this occasion.. All copies of the complaints procedure should have the correct details of the Comission for Social Care Inpsection included.. C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 17 Briar Close Commission for Social Care Inspection South Point Cardinal Square Nottingham Road, Derby DE1 3QT 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 Briar Close C02 C52 S35731 Briar Close V229060 110505 Stage 4.doc Version 1.30 Page 18 - 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!