Inspection on 06/12/06 for Briardene

This inspection was carried out on 6th December 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Briardene 16/01/06

Briardene 29/04/05

Briardene 04/11/04

Briardene 19/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 Briardene 63 East Parade Harrogate North Yorkshire HG1 5LP Lead Inspector Mrs Maggie Coxon Key Unannounced Inspection 6th December 2006 10:30 Briardene DS0000007817.V322902.R01.S.doc Version 5.2 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 Briardene DS0000007817.V322902.R01.S.doc Version 5.2 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. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Briardene Address 63 East Parade Harrogate North Yorkshire HG1 5LP 01423 562667 01423 524441 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) Appleview Homes Limited Mrs Josephine Ann Ross Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (2) of places Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 13 service users with a Learning Disability some or all of whom may have physical handicap Category (LD(E)) refers to two named service users over the age of 65. Date of last inspection 16th January 2006 Brief Description of the Service: Briardene is a care home registered by Appleview Homes Limited to provide personal care and accommodation to up to thirteen adults with learning disabilities including two identified people who are over 65 years of age. The home consists of a large, late Victorian property developed from a previously semi-detached house and one storey of the adjoining semi, now connected together. The home is situated in the centre of Harrogate town and has good access to all the towns facilities. All thirteen bedrooms are for single accommodation and are sited on several floors. Whilst the home does not have a passenger or stair lift, all areas are accessible to those residents currently living there. The home does not have level or ramped access. Current information about services provided at Briardene in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Information provided by the manager on 27th October 2006 indicated that the current weekly fee for the home ranges from £595 to £650. Additional costs include toiletries, hairdressing, college courses, holidays and leisure activities and transport costs. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report: • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the visit, this is called a pre-inspection questionnaire. A visit to the home that they didn’t know was going to happen. This lasted for seven hours and included talking to all thirteen residents, care staff and the trainee deputy manager about how the home is run. Most areas of the home were seen and records that the home has to keep were checked. Residents’ medication was also checked to make sure that it was being properly looked after for them. Thirteen comment cards were sent to residents all of which were returned. Twelve comment cards were sent to residents’ relatives seven of which were returned. • • People living in the home have expressed a preference to be known as residents. What the service does well: Residents and staff get to know each other very well and staff are kind and friendly so residents can be confident that they will get good help. Residents can have lots of contact with friends and family and see them at any time. Staff also spend a lot of time talking to the residents. This means that they can have company whenever they like. Residents meet with the manager to talk about the help they need and to find out about the home before they move in. They can also visit the home to see if they like it. This means that residents can decide whether or not they move into the home. The home is well run and staffed so residents are well looked after. They have plenty of activities both inside and outside of the home and spend lots of time out and about in their local town as well as visiting places further away. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 6 Residents are helped to be as independent as possible and to make as many choices as they want to regardless of their age, gender or needs, they are all treated equally, they are also all treated respectfully by the staff. Residents see their GP, dentist, optician and chiropodist whenever they need to. This means that they can stay as healthy as possible. Residents have a good choice of food and drinks at mealtimes. This ensures that they have a varied diet of their choosing and can enjoy their meals. Residents are asked to say what they think about the service they get at Briardene. This gives them the chance to ask for any changes and to have a say in planning services in the future. 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. The summary of this inspection report can be made available in other formats on request. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 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 Briardene DS0000007817.V322902.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 4. Quality in this outcome area is good. Information about the service provided is available to anyone who wants it although this now needs updating. A detailed needs assessment process ensures that the diverse needs of residents are identified and planned for before they move into the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has produced a statement of purpose and service user guide, which are both produced in a user-friendly format. This information is also available via audiotape on request. Every resident is given a copy of the service user guide. Both documents however are now in need of some amendment and updating. An assessment had been taken of each resident before they moved in. Three admissions have been made in the last year and detailed assessments had been undertaken of these individuals before they moved in. The deputy manager explained that any such admissions are arranged via planned introductory programmes including visits to the home and trial placements prior to being made permanent. People currently living in the home are also asked for their views.. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. Residents make as many decisions and everyday choices as possible and have an active say in the running of the home. They can be confident that staff can meet their needs and are keen to give them the chance to be as independent as possible. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Case tracking confirmed that residents’ individual personal plans are very comprehensive and well organized and are being regularly reviewed. They contain sufficient detail to ensure that staff know how best to meet the diverse needs of the individual resident in a way that promotes their independence wherever possible. Residents’ records, comments made by residents both when surveyed and during the visit and observations at the visit show that individuals are able to make many choices and decisions in their daily lives including how their rooms Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 10 are to be redecorated, whether or not they want their own bedroom door key, and choices about activities and meals. Residents can also take reasonable risks subject to negotiation and agreement with the manager and to a well recorded personal risk assessment signed where possible by the resident concerned. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area is good. Residents enjoy lots of activities that they have chosen themselves. They are supported to develop and maintain relationships with family and friends. Meals are home made and nutritious so residents can enjoy good, healthy food. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Residents have a wide variety of activities that they participate in both locally and further afield. Several of them attended activities in town during the visit. The registered manager, staff and residents have planned activities so that everyone has a busy and interesting lifestyle geared to suit them and so that they have a real presence in their local community. Residents said they are also allowed personal space when they want it. Residents have regular meetings with support from staff. Here they can put forward views and suggestions and they are then helped to work towards Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 12 achieving personal as well as group goals. Conversations with residents and staff during the visit show that each resident is given certain responsibilities, such as by looking after their own bedrooms and is expected to contribute to the running of the home on a planned and agreed basis. They are however also able to make choices and decisions in their daily lives and can take reasonable risks after a risk assessment has been undertaken and recorded. Residents also said they are supported to keep in touch with family and friends and were busy buying presents and making Xmas hampers for their relatives. Surveyed relatives said that they are made welcome at the home at any time and are kept well informed about their relative should they need to be. Residents are able to go away on holiday if they want to and are helped to do so by staff. They also go out on trips they have chosen either by themselves or with other residents. Staff cook all the meals using quality, fresh ingredients. Residents said that they choose what they want to eat and come up with suggestions during their meetings. Records of meals eaten show that meals are varied and nutritious and provide residents with a healthy diet. Lunchtime was very relaxed and informal and drinks and snacks were available on a regular basis. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. Residents are able to stay as healthy as they can by being helped to attend regular health appointments and by being helped to take their medication although the procedure and training of staff in this area could be made better. Residents get good support to manage their personal care well. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff were seen to provide all support, including that concerning personal care needs, in a way that promoted the residents’ privacy and dignity. Case tracking identified that each resident has a detailed health assessment and is registered with a GP. They have regular health checks and attend regular appointments with opticians, chiropodists and dentists. Residents’ health records are well kept. All of the residents have their medication administered by staff. Most medication is dispensed via a monitored dosage system although a small amount is dispensed in boxed strips. All medication is securely stored. Administration is generally well recorded although incoming stocks of boxed Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 14 medication were not being booked in or counted down and audited on the current medication sheet. This shortfall was discussed with the trainee deputy manager who agreed to improve the recording in this area. He also explained that whilst staff had had training on the monitored dosage system in use only he had undertaken more detailed medication training which is to an acceptable level. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Systems are in place for dealing with concerns or complaints and for safeguarding residents from abuse although the procedure and the training of staff in this area could be improved to ensure the protection of residents as much as possible. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A comprehensive complaints procedure is followed and is made available to residents in easy read and pictorial form. Residents also have regular meetings in which they can express any dissatisfaction. There have been no complaints since the last inspection. One relative surveyed wrote “We are pleased with the care given to our relative with the understanding if we had any cause for concern or complaint we are able to sort them out between ourselves”. There is also an adult protection procedure in place. This currently states that the management team in the home will decide what action is to be taken should an allegation of abuse be made. This does not reflect the agreed multiagency adult protection procedure currently in operation North Yorkshire. This states that the NYCC adult protection team lead on all adult protection investigations. The trainee deputy manager said that the procedure would be amended forthwith to reflect this. Staff have had in-house adult protection training but none from a professional trainer. They were however aware of the Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 16 need to report to their managers any witnessed or suspected abuse of a resident. Residents’ monies are checked after every transaction by staff to make sure no mistakes have been made. Staff explained that physical restraint is used only in extreme circumstances to protect one of the residents. All staff have had appropriate training in this area. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28 and 30. Quality in this outcome area is good. The standard of the environment is good and provides residents with a clean, comfortable and safe home in which to live. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Communal areas are well maintained and very pleasantly decorated and furnished. The kitchen has recently been redecorated, re-floored and refurnished. Residents had helped staff to put up Xmas decorations throughout the home. Residents’ bedrooms are well maintained, decorated and furnished. Several of they said that theirs have been decorated and furnished to their personal taste and they are very happy with them. There are sufficient well-equipped bathrooms and toilets that are situated on various floors throughout the premises. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 18 The home was clean, warm and tidy throughout. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. Quality in this outcome area is good. The home is well staffed by individuals who are experienced and trained so residents can be confident of getting good help and support. This judgement has been made using available evidence including a visit to the service EVIDENCE: There were sufficient staff on duty to help residents at the time of the visit and staff rosters indicate that the home is well staffed at all times. Staff confirmed this to be the case. Staff were seen to interact very well with the residents and provide them with help in a friendly and professional manner. One relative surveyed wrote “Very good staff and my son’s looked after very well”. Personnel records checked for the one person employed since the last visit showed that whilst a CRB check had been undertaken in this country before they started work no check had been undertaken with the authorities in their country of origin from where the individual had newly arrived. The trainee deputy manager agreed to follow this up if possible. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 20 New staff undertake the learning disability award framework induction and foundation training prior to enrolling on NVQ training. Eleven of the twenty two care staff have already completed an NVQ and a further six are currently undertaking NVQs to level 2 or 3 whilst the trainee deputy manager and a senior carer are completing NVQs to level 4. Staff have recently also completed training in dementia care. Other training was up to date. Staff said that they have regular supervision from the registered manager who also holds regular staff meetings. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 and 42. Quality in this outcome area is good. The home is well managed so residents can feel safe and be confident that the manager and staff are always looking for ways to improve the service and thus improve residents’ quality of life. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The registered manager is very experienced in the management of care services. She has been the registered manager of Briardene for a number of years. The trainee deputy manager explained that the registered manager has completed part of the required qualification but has yet to finish the whole award. Staff say that the management team provides good leadership, guidance and support in an open and inclusive style. Staff said they have regular supervision Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 22 from the registered manager and are encouraged to contribute fully to team meetings. The Responsible Individual for the home undertakes monthly quality audits. Residents’ views are ascertained through day-to-day informal chats, through regular meetings facilitated by staff and residents have also been surveyed. Relatives’ and health care professionals’ views are also surveyed. Information gleaned from all sources has been collated and is to be fed back to residents at their next meeting with any changes being actioned. One relative surveyed wrote, “Briardene is like a normal family home. The residents are not institutionalised but are encouraged to retain their individuality. The standard of care, cleanliness and overall efficiency is very high”. Monthly health and safety checks of the building are undertaken and fire safety is well maintained including regular fire safety training for all staff. The fire procedure is also discussed with residents who are involved in regular fire drills. Other health and safety systems and records are also well maintained. The trainee deputy manager explained that he had not known that hot water stored in the home should be done so at a minimum of 60°C in order to reduce the risk of Legionella. He said that he would seek professional advice and make sure that the system is safe for use. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 3 X X 2 X Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No. 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 YA23 Regulation 13(6) Requirement The registered person should amend the adult protection procedure to state that any allegations of abuse be reported immediately to the adult protection team within the local authority who lead on all investigations. Timescale for action 26/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA20 Good Practice Recommendations The registered person should amend and update the home’s statement of purpose and service user guide so that they give accurate information. New stocks of medication dispensed outside of the monitored dosage system should be booked on to the current medication sheet as they are commenced and then counted down to produce an audit trail. All staff should have appropriate medication training. Staff should be given more detailed adult protection training. The registered manager should complete an appropriate DS0000007817.V322902.R01.S.doc Version 5.2 Page 25 3. 4. Briardene YA23 YA37 5. YA42 qualification. The registered person should ensure that hot water stored in the home is done so at a minimum of 60°C. Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Briardene DS0000007817.V322902.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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