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Inspection on 31/01/06 for Briar Court Nursing Home

Also see our care home review for Briar Court Nursing Home for more information

This inspection was carried out on 31st January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Service users are encouraged to make decisions about their lives. Service users are helped to keep appropriate relationships with family members and friends. Service users are offered a healthy diet. Personal support is given to service users in a way that they are happy with. Arrangements are in place to meet service user physical and emotional health needs. Service user views are generally listened to. The home has a range of strategies in place to protect service users from harm. The staff working at the home are offered training that helps them to do their jobs properly. The home appears to be well managed. The home has lots of things in place to monitor the quality of care provided at the home. The health, safety and welfare of service users and staff is taken seriously within the home.

What has improved since the last inspection?

The dining room, entrance, staircase and bathrooms and toilets have all been redecorated since the last visit.

What the care home could do better:

The manager should find out from service users how they could be more involved in decision making within the home. Service users` requests for low fat desserts should be taken notice of when planning menus. Furniture and fittings such as the use of pictures andornaments in the dining room could be better to make it more attractive and homely for service users. The home could improve how it records responses to service user concerns and views.

CARE HOME ADULTS 18-65 Briar Court Nursing Home 59 Hutton Avenue Hartlepool TS26 9PW Lead Inspector Jean Pegg Unannounced Inspection 31st January 2006 10:15 Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 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 Briar Court Nursing Home DS0000000148.V271238.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 Adults 18-65. 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 Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Briar Court Nursing Home Address 59 Hutton Avenue Hartlepool TS26 9PW 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) 01429 224442 01429 275800 lizwhite@castlebeck.com Castlebeck Care (Teesdale) Limited Mrs Elizabeth White Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: Briar Court is a registered care home with nursing. The home provides accommodation for eleven younger adults with a learning disability. Briar Court is a detached house in a private residential area in Hartlepool. The home is within easy walking distance of the town centre and local amenities. There is good access to public transport. The home provides single bedroom accommodation, two lounge areas, one dining room, kitchen, laundry and a garden to the rear of the house. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted for 8 hours. Information to help the inspection was got by spending time with and speaking to service users and staff and by looking at different documents held at the home. Overall this was a positive inspection although some recommendations have been made as to how the service could be improved. At the time of writing this report, 3 service users have returned written comment cards. These comment cards indicate that they are satisfied with the care at Briar Court. What the service does well: What has improved since the last inspection? What they could do better: The manager should find out from service users how they could be more involved in decision making within the home. Service users’ requests for low fat desserts should be taken notice of when planning menus. Furniture and fittings such as the use of pictures and Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 6 ornaments in the dining room could be better to make it more attractive and homely for service users. The home could improve how it records responses to service user concerns and views. 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 Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: None of these standards were assessed. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 Service users are encouraged to make decisions about their lives and agreement is reached as to how much assistance is required and given. EVIDENCE: 2 care plans were looked at to see how far service users were encouraged to make decisions within their lives. Each service user has a programme in place that is aimed at promoting independence in accordance with each individual service user’s needs and capabilities. There was evidence of consultation and agreement with each service user as to how this would be achieved. Risk assessments were also in place to show how risks and responsibilities were balanced and the reason for restrictions being made where appropriate. There was also evidence that these plans and risk assessments were reviewed. Discussion with service users also indicated that they were given assistance and guidance to make decisions within their lives. Of the 3 service users who returned comment cards, all 3 said that they would like to more involved in decision making within the home. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 & 17 Service users are helped to maintain appropriate relationships with family and friends. Service users are offered a healthy diet but their suggestions for low fat desserts has not been responded to. EVIDENCE: It is clear from what service users said and by what was written in service user files and in the visitors’ book, that service users are helped to keep in contact with their families where appropriate and possible. Discussion with staff confirmed that guidance and workbooks on maintaining personal relationships produced by the British Institute for Learning Disabilities (BILD) are used with service users as part of the day services programme. Lunch was eaten in the dining room with service users and staff. The dining room has been redecorated since the last inspection with service users choosing the colour scheme. The furniture looks tired and some of the chairs are in need of reupholstering. The dining room would benefit from some dressing to make it look more homely as the presentation of it is fairly basic at Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 11 the moment. There was a good choice of food available that was nicely cooked. From discussion with staff it is evident that healthy eating is promoted, however, it was also evident from speaking to service users and by looking at resident meeting records that desserts and sweet things are not offered despite requests being made for them. The chefs confirmed that cultural and religious dietary requirements could be met by the home. 2 of the 3 service users who completed comment cards indicated that they liked the food, 1 indicated that they sometimes liked the food. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Personal support is offered to service users in a way that they are happy with. Arrangements are in place to meet service user physical and emotional health needs. EVIDENCE: Care plans show the level of support that each service user requires with their personal care. This support differs with each individual and is dependant upon his or her individual capabilities. Discussion with some service users confirms that routines for getting up and going to bed are fairly flexible. Everyone at the home appeared to be very individual in his or her appearance. One service user had a hairdressing appointment that day at a salon in town. General health care needs are met by community health services for example GPs, dentists and opticians. Castlebeck Care consultants and specialist healthcare staff provide services to meet the emotional and behavioural needs of service users. As stated above, general health care needs and advice is accessed through the National Health Service (NHS) community health services. A service user who had just been to the GP confirmed this. Staff members make daily observations and recordings of service user health needs and annual health Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 13 checks are offered. All 3-service users indicated on their comment cards that they felt well cared for. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service user views are listened to but it is not clear if all are fully acted upon. The home has a range of strategies in place to protect service users from harm. EVIDENCE: The home has a complaints procedure in place. The complaints procedure could be improved by using formats that are more appropriate for service users. The use of Plain English should be encouraged as well as pictures where appropriate. Font size and choice of font should also be considered to aid visual presentation. The complaints book was seen and there have been no complaints recorded since February 2004. The majority of service user concerns are discussed during the residents meetings and recorded in the minutes. From the records seen, it was not easy to see if all of the suggestions made by service users had been responded to. All 3-service users who completed comment cards said that they knew who to speak to if they had any concerns about their care. The manager has made a Protection of Vulnerable Adults (POVA) referral since the last inspection visit. The actions taken by the manager indicate that the procedure had been followed correctly. The home has a lot of policies and procedures in pace to help protect service users from harm. Staff members spoken to were able to correctly identify the actions that should be taken should they suspect abuse within the home. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: None of these standards were fully assessed. A general tour of the building confirmed that some redecoration work has taken place since the last visit. The woodwork in the entrance has been lightened and walls have been painted. The dining room, bathroom and toilets have been redecorated. The decorator was still working on the back staircase. Staff confirmed that there were plans to erect an outside shelter for smokers to use and that money had been budgeted for this. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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 Staff are offered training appropriate for their work. EVIDENCE: Copies of training planned for staff through the central training department were seen. Staff are able to access a wide variety of training including the Learning Disability Award Framework (LDAF) accredited training. Staff confirmed that training was “pretty good” and “excellent in fact”. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The home appears to be well managed. The home has a range of systems in place to monitor the quality of care provided at the home. The health, safety and welfare of service users and staff is taken seriously within the home. EVIDENCE: Although the manager was not present during the inspection, information provided by staff and previous inspection reports confirm that the manager has experience and qualifications that exceed the national minimum standard. Staff saw the management of the home as being good. The home has a range of different things in place to monitor the quality of care within the home. Periodic Service Reviews are carried out that measure the environment and some clinical areas. The results are used to improve standards within the home. A service user survey has just been carried out and Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 18 staff were still busy collating the results. Staff reported that senior management visit the home regularly and plans for development of the home include the provision of a smoking shelter and a new fitted kitchen. Service users were familiar with the job of the inspector and appeared to be very relaxed and comfortable when speaking about their lives in the home. Staff are offered a range of training that helps them to work in a safe manner. Staff were also able to produce evidence of regular maintenance checks being undertaken to make sure that equipment remains safe within the home. Risk assessments are in place and accident books are maintained. Staff perceive that Health and Safety is taken seriously within the company. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Briar Court Nursing Home Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 4 X 3 X X 3 X DS0000000148.V271238.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action 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 4 5 Refer to Standard YA7 YA17 YA17 YA22 YA22 Good Practice Recommendations The manager should find out how service users wish to be more involved in decision making within the home. The dining room environment should be improved to make it a more congenial setting for diners. Service user requests for low fat puddings at meal times should be taken account of when planning menus. The complaints procedure should be produced in a format that is simple and easy for people to use. Clearer records are needed to show how service user concerns and views are acted upon and if they are, then the reason should be shown. Briar Court Nursing Home DS0000000148.V271238.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Court Nursing Home DS0000000148.V271238.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. 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