Inspection on 16/09/08 for Briardene Care Home

This inspection was carried out on 16th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Briardene Care Home 30/06/09

Briardene Care Home 03/06/09

Briardene Care Home 01/05/09

Briardene Care Home 16/02/09

Briardene Care Home 11/06/07

Briardene Care Home 08/06/06

Briardene Care Home 06/09/05

Briardene Care Home 14/12/04

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Briardene Care Home Newbiggin Lane Westerhope Newcastle upon Tyne NE5 1NA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Thompson     Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Briardene Care Home Newbiggin Lane Westerhope Newcastle upon Tyne NE5 1NA 01912863212 01912866820 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Audrey Margaret Alderson Type of registration: Number of places registered: Windmill Hills Ltd care home 59 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Briardene is a care home with nursing providing care for older people with physical and mental health needs. The home is owned and managed by Windmill Hills Limited that is part of a larger group, which provides care services for a variety of client groups. The home is staffed by registered general nurses supported by care staff. The philosophy of care is to support the residents in their activities of daily living and to provide for their physical and mental health needs. The home is situated in Newbiggin Lane in the west of the city of Newcastle upon Tyne fairly close to local shops and public transport links. The building is comprised of three floors, the top floor being staff accommodation. The lower two floors are resident accommodation with 62 single bedrooms all with en-suite facilities. On each of these floors there are a number of bathrooms, toilets, lounge and dining rooms. The home has a visitor coffee room and Care Homes for Older People Page 4 of 27 Over 65 31 28 0 0 Brief description of the care home hairdressing room. There is also a kitchen and laundry room. To the rear of the home there is a very nice garden and patio area. Fees in the home vary and are available on request from the organisation. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced inspection. The manager was not present at the time but the Care Homes for Older People Page 6 of 27 operations manager represented her. How the inspection was carried out: Before the visit we looked at: Information we have received since the last inspection visit. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The manager’s views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received 18 responses from questionnaires. During the unannounced visit we: Talked with people who use the service and some of the staff. Looked at the information about people who use the service and how well their needs are met. Looked at other records the home is required to keep. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, comfortable and safe. Checked what improvements had been made since the last inspection visit. Feedback was given to the operations manager at the end of the visit. What the care home does well: What has improved since the last inspection? What they could do better: Some areas of the home were not tidy or clean enough. These were generally places that residents did not use. This has an impact on the ability of staff to thoroughly clean these areas to prevent the spread of any infections. Some shower and bathrooms were also cluttered with things that did not belong there. The manager of the home carries out various checks on staff before she employs them. This is to help protect residents from potential abuse. Some of the records relating to those checks were not properly completed. Some of the criminal records checks were Care Homes for Older People Page 8 of 27 not returned and there was no indication that they had been followed up. Some of the health and safety checks were not up to date or had not been done at the required intervals. These were mostly the internal checks made on fire systems and window restrictors. The manager should have systems in place to audit these checks and ensure that they are carried out. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: Three pre admission assessments were checked. They contained enough information to enable staff to meet peoples needs on admission. The assessments covered all areas of health and social care. The different and diverse needs of people were reflected. Two residents spoken to could remember coming to the home for a look around. One said she chose the home because it was clean. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. Evidence: Five care plans were examined and three were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. All three case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. One of the carers was asked to describe the care given to a very dependent resident who was nursed in bed. She did this very well. The care she described matched the care needs written in the care plan. Residents looked clean and well cared for. One of the more frail residents was cared for in bed. She looked comfortable and had suitable Care Homes for Older People Page 12 of 27 Evidence: pressure relieving equipment in place. Residents said staff tried to respect their privacy when carrying out personal tasks. Residents needing medical attention were given this in their own bedrooms. Relatives told us that they thought the nurses were excellent. They also said they were confident that health matters were attended to promptly. Medication ordering, administration, storage and disposal were examined. All medicines were accounted for and all those administered were signed for. Five amounts of controlled drug were checked and were correct. One resident requires her medication at different times to the rest of the residents. Her tablets were packed into a dosette by her relative and administered by the nurses on duty. This is secondary dispensing and nurses are not allowed to do this. The nurse on duty agreed to seek advice from a pharmacist. There was not a regular medication audit carried out. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: The home has appointed two new activities organisers who are starting to improve the range of activities and social events that people have access to. People were seen having manicures and even the gentlemen were enjoying this. One member of the staff team plays the piano for people who enjoys music and likes to dance. The Mountain Ash Audio/Visual programme visits the home every six weeks. The programme includes hour long sessions on Old Benwell, Old Scotswood, Rowing in Durham, the Saxons in Morpeth and other titles. Their Christmas Special has already been booked to take place on the 28 November. Other events include a ‘Pink Day’ for Cancer Research, a Halloween event, and the National Help the Aged ‘Lets Dance’ greatest dance event. The ‘Spider Man’ visited recently and brought snakes, insects Care Homes for Older People Page 14 of 27 Evidence: and other reptiles for residents to meet. Everyone said they really enjoyed this and can’t wait for him to return. One person is regularly collected by friends from their Church so that they can go out to a service. Staff were seen spending time with residents both on a one to one basis and in groups. Conversation in the lounge was bright, humorous and relevant to what people were watching on the television. People were seen being helped in a sensitive way to have their morning coffee and a biscuit. Staff did this in a pleasant and unhurried way, taking time to talk to people at the same time. We sampled lunch which was tasty and fresh. The choice on the day of the inspection was steak pie, potatoes and mixed vegetables or cheese omelette and fries, followed by rhubarb and custard. The omelette was particularly light and tasty. Residents told us that they usually enjoyed the food. They did say that sometimes the tea served from the trolley was not hot enough and they were not sure if they could have a hot drink at lunch time. The drink offered at lunchtime was usually juice or water. The operations manager agreed to take immediate action on this. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. Evidence: Staff follow the home’s policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date with information and training. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to. One resident said she had made a complaint and she was happy with the outcome. The complaints record in the home showed that six complaints had been received in 2008. These were about missing items, long response times to a nurse call and poor attitude of a staff member. The documentation showed that each complaint had been addressed to the satisfaction of the complainant. CSCI recently received a complaint which contained information that was referred to the Safeguarding Adults Team at Newcastle. The organisation worked with the team to resolve the issues. Disciplinary action was taken as a result of the complaint. The matter has been resolved and all agencies involved were happy with the outcome. Care Homes for Older People Page 16 of 27 Evidence: Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe comfortable home that is generally pleasant and clean. Evidence: The home was generally clean. There were some slight odours on the first floor. We were told that this was coming from the carpets and that new carpets were on order. The furniture and general decor provides residents with a comfortable homely environment. They said the home was warm enough and clean enough. One resident said the cleanliness of the place was what had made her decide to move in. Bedrooms were well personalised and looked comfortable. Generally the atmosphere was homely and comfortable, there were a number of ornaments and pictures around that contributed to this feeling. Some areas of the home were not tidy. On the ground floor the sluice was cluttered with decorating equipment, boxes and shoes. There was a plastic garden chair in a bathroom. There were three sponges in the shower room. Sponges should not be used at all for resident bathing as it is impossible to keep them germ free. The grouting in the shower room was black and the walls scuffed and stained. There did not appear to be enough assisted bathing facilities. Some of the baths are designed for residents who can climb in themselves and are not now used. We stated that we would be happy Care Homes for Older People Page 18 of 27 Evidence: for one of these to be used as storage if other assisted facilities were provided. Some of the bins in the home do not have lids that are operated by foot. This is essential to limit contamination and the spread of infection. Records show that the water in some staff hand washing sinks is as hot as 50-52 degrees. This means that good hand washing techniques cannot be followed, as staff cannot wash their hands under running water. The bench in the visitors room was stained. The external grounds were tidy and well maintained. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported through staff numbers, skill and ability. They are not fully protected through good recruitment procedures. Evidence: The home was adequately staffed. There was a senior and five care staff on duty on the first floor, and two nurses with five cares staff on the ground floor. At night there is one nurse, one senior and four carers. During the inspection a resident on the first floor had a fall and the response of the staff team was quick, professional and sensitive. Staff told us and records confirmed that they had received mandatory training. There was some further training requested by staff. This related to topics covering care of the elderly. Three staff recruitment files were examined. Records showed that staff complete an application form, provide references and undergo an interview. One of the staff files indicated that some issues from a previous employer had not been followed up, or if they had, had not been documented. The interview scoring form was not always fully completed and had not been signed as accurate by both interviewers. Care Homes for Older People Page 20 of 27 Evidence: There were some gaps in the record of nurses PIN checks though it did look as though these were up to date. Staff had been checked using vulnerable adults procedures but some criminal records checks had not been returned. The staff induction form for these staff was not always fully completed. This would indicate that staff were not given immediate instruction in the homes policies, procedures and values. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are not fully protected through reflective management which takes account of the diverse needs of the service. Evidence: The home has an experienced registered manager. She has been assessed as having the competency and skills to run the home. There have been recent complaints from staff indicating that the management of the home is not open, positive or inclusive. The provider has investigated these complaints and taken some action to resolve them. The situation does seem to have improved and residents told us things like laundry and food were better in the home now. There have been some requirements made about issues which are affected by the management of the home. There was not enough evidence that there is a clear sense of direction and leadership. This would be demonstrated through thorough, auditing, monitoring and quality review. The home does seek the view of residents and their relatives. This is in the form of Care Homes for Older People Page 22 of 27 Evidence: questionnaires which are sent out every three months. Servicing and maintenance agreements are in place for facilities and equipment. These appeared to be up to date. Internal health and safety checks were carried out on window restrictors, fire fighting equipment and beds. These were not fully up to date. The checks on window restrictors showed that some faults had been identified. There was no indication of any follow up action. Weekly fire alarm tests had only been done three times in July and did not appear to have been done at all in August. Hot water temperature checks are carried out weekly but none were recorded for September. A health and safety meeting takes place on he first of every month but there were no records of these at all for 2008. There were no obvious trip hazards in the home. Fire exits were clear of obstruction. Residents personal monies were well accounted for. Records were examined and showed that two signatures were obtained for all transactions. Three amounts of money were counted and were correct. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 9 13 Commence regular audit of medication. Ensure that secondary dispensing does not take place. Residents receive the correct medication in the correct dose. All medication is accounted for. 21/12/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 13 Replace bins with foot 21/12/2008 operated ones. Ensure all areas of the home are clean and tidy. Ensure that staff can follow good hand washing practice. The premises are kept clean and hygienic. The spread of infections can be controlled 2 29 19 Ensure staff are sufficiently screened and checked before recruitment. Residents are protected from harm by secure staff screening. 01/12/2008 Care Homes for Older People Page 25 of 27 3 38 13 Ensure that all health and safety checks are kept up to date at all times. Residents are protected by good health and safety practice. 01/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 21 32 37 Reassess the bathing provision in the home. Management of the home must promote good standards and provide clear direction. The standard of record keeping must improve to demonstrate that residents and other users of the service are protected. Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 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. 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!