Inspection on 10/05/07 for Briarfield

This inspection was carried out on 10th May 2007.

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.

Other inspections for this house

Briarfield 13/02/06

Briarfield 04/07/05

Briarfield 14/03/05

Briarfield 14/07/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 Briarfield 42 Stainburn Road Workington Cumbria CA14 1SN Lead Inspector Liz Kelley Unannounced Inspection 10th May 2007 12:30 Briarfield DS0000022538.V334667.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 Briarfield DS0000022538.V334667.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. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Briarfield Address 42 Stainburn Road Workington Cumbria CA14 1SN 01900 66733 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) West House Miss Beverley J Steele Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of PD (Adults with physical disabilities) up to 6 service users in the category of LD (Adults with learning disabilities) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 13th February 2006 2. Date of last inspection Brief Description of the Service: Briarfied is a residential care home providing accommodation for six people who have a learning disability. West House, who have a number of similar homes, operates the home. The home is large detached bungalow, situated in a residential area on the outskirts of Workington. There is ramped access to the front and rear of the building. Garden areas are to the front and rear. There is also a large patio area to the rear of the home. Residents have access to a wide range of both in-house and community based activities. The home has a wheelchair accessible vehicle for residents use. West House is a voluntary organisation providing a range of community based support services and residential homes to people with learning disabilities living in West Cumbria and Carlisle. The full range of West House services are open to residents, and includes day services, art, craft and music workshops, work placements and a wide social network. The current scale for charging is £756.62 per week. A Handbook is available for prospective residents, and the latest Commission for Social Care Inspection report is made available on request. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 hours. All five residents were at home across the afternoon and were spoken to, and three staff and the manager were interviewed. A partial tour of the premises took place and staff records and residents files were examined. To help the inspector to write this report the home provided a self-assessment report/questionnaire. Information was also used on past information CSCI had about the home. The overall picture gained by the Inspector was that residents were being offered an individually tailored service that promotes a good quality of life for people living in the home. What the service does well: What has improved since the last inspection? Healthcare plans and medication files have been reviewed and these now provide very good, up-to-date information that assist in maintaining and promoting residents well-being and health. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 6 Residents live in a well kept and safely maintained home with a continuous programme of renewal, for example a new lounge carpet and dining room flooring of a good quality had recently been fitted. 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. Briarfield DS0000022538.V334667.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 Briarfield DS0000022538.V334667.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): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Introduction to the home is well managed and planned in a way that ensures compatibility with other residents and that needs can be met, which has led to residents settling successfully in the home. EVIDENCE: The Statement of Purpose and Service Users Guide contain relevant details to assist residents, relatives and professionals in making an informed choice on the appropriateness of the home. The Service Users Guide is available in different formats and is user friendly having symbols, pictures and photographs to illustrate and promote understanding. All new residents receive a full comprehensive needs assessment before admission this is carried out by staff with skill and sensitivity. The service is highly efficient in obtaining any assessment undertaken through care management arrangements, and insists on receiving a copy of the care plan before admission. Individuals are supported and encouraged to be involved in the assessment process. Information is gathered from a range of sources including other relevant professionals, and with the individuals agreement, carer’s interests are taken into account. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 9 Before agreeing admission the service carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Prospective people who use services are given the opportunity to spend time in the home. These sessions are carefully recorded and included input from family and social workers. This ensures that all relevant information and assessments are available to increase the likelihood of a successful of placement. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 10 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. This judgement has been made using available evidence including a visit to this service. Developing individual plans that promote choice and encourage personal development is a notable strength of the staff team. EVIDENCE: Care plans are in a style termed “Person Centred Plans” and staff use a variety of skills and ways to engage residents in planning their care and setting goals. Residents are involved through picture work, symbols, charts, graphs and are encouraged to take ownership of their plans by writing in their files and amending their care plans. Individuals plans are regularly up-dated and revised when goals have been attained. This leads to care plans that are dynamic and evolving documents that encourage significant personal developments for residents. Care plans contained very detailed and useful risk assessments which are designed to encourage and promote a good quality lifestyle. For example one residents was able to go swimming and another horse ridding. Briarfield DS0000022538.V334667.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): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assisted to have a good quality of life and access to a variety of life experiences through a skilled and committed staff team. EVIDENCE: Central to the home’s aims and objectives is the promotion of the individual’s right to live an ordinary and meaningful life, both in the home and in the wider community. For example residents have individual hobbies and interests. They are assisted to plan and chose their own holidays. Recent examples were trips and holidays to Blackpool and day trips to local places of interest. Residents were observed interacting in a positive manner with staff and other residents. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and specialist. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well supported to lead healthy life styles and have their medical needs attended to by good links with local health care professionals. EVIDENCE: Health care plans were identified as an example of good practice. Recording in these plans was in good detail making it easy to identify contacts and outcomes from health care professionals and to ensure that regular appointments and checks were carried out in all health areas, such as dentist appointments drugs reviews, chiropody and well persons clinics. Residents were registered with a GP of their choice and had access to other members of the Primary Health Care team. A GP feedback card commented “I have been attending Briarfield since 1991 as a GP and the present staff provide excellent care and always respect the needs and wider well-being of people living at Briarfield.” For example regular meetings take place with allied professionals to look at behaviour management strategies to improve the quality of resident’s lives. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 13 Staff were able to demonstrate comprehensive records and systems to monitor residents health care needs. Resident’s health care needs were thoroughly documented and reviewed. The staff team has sensitively handled the ageing process and offered good support to minimise any impact on independence, and to reduce the impact on health. Any personal care was delivered in resident’s own bedrooms and staff are aware of issues of dignity and privacy. Interactions between staff and residents was observed to be carried out in a sensitive and respectful manner, by giving prompts, suggestions, and guidance about personal care. Medications in the home are well managed, with an orderly medicine cabinet and well-ordered and accurate medication charts. Staff have completed accredited training in the care and dispensing of medications and this was an area well managed by the home. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to protect the rights and well-being of service users. EVIDENCE: The manager conducts thorough induction training that covers adult protection issues and the various forms of adult abuse. Staff had received training in the use of physical intervention procedures, which focused on diversion tactics rather than physical restraints, which were not used. Staff are encouraged to look for triggers and distraction measures and only when these fail is medication used to calm people down. Polices and practices are in place to safe guard the handling of residents monies. Personal monies and records were examined and found to be correct, with the signatures of staff and routine checks by the manager. Residents have good and varied links with outside organisations and advocate groups which ensures they have channels to express views and concerns if necessary. These areas, and training in Adult Protection safeguarded residents rights and protect them from abuse. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a well maintained home and benefit from one that is well designed and adapted to meet their needs. EVIDENCE: A programme of planned maintaince and renewal was available and areas recently up-graded were bedrooms and the lounge. Staff and residents work together to keep the home tidy and clean. There is a large lounge that has recently been redecorated with new furniture. Bedrooms are all large enough to have easy chairs and televisions and are individualised to each persons tastes and interests. This gives ample communal space and choice of for residents. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff recruitment, training and work practices in the home are well developed which ensures that residents’ well-being is promoted by staff that have the qualities, aptitudes and skills to work in social care. EVIDENCE: Briarfield has a stable workforce with a good mix of skills, experience, and age, which reflects the profile of the residents. All staff are clear on their role and what is expected of them. The staff team support each other and share skills and knowledge with colleagues. This leads to good levels of confidence and satisfaction from relatives and professionals with the care that is delivered. The manager follows the recruitment procedures of West House. The service sees induction and any probation as vital to the success of staff recruitment and retention. A recent example of using the probation period as an extension of the selection procedure was demonstrated that ensured that only those with the best aptitudes are given permanent contracts. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 17 The content of the induction and probationary periods are seen to be very robust, detailed and service specific. The service only confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their high standards. Staff files are held in the home, and contained all the relevant documentation being clearly sectioned and well-organised. The selection procedure includes obtaining two written references, a formal interview and an informal interview involving residents, wherever possible. All staff had CRB disclosure checks and applications are subject to equal opportunities monitoring. Upon appointment staff were issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. West House has a code of conduct and all members of staff have a statement of terms and conditions. A member of staff interviewed confirmed these practices. These are all good practices and ensure that residents are supported by a carefully selected and vetted staff team. The manager has a framework for supervisions and appraisals, and these have been carried out to good standards; staff reported that these are helpful and they feel well supported by the manager and the organisation. Management of the organisation prioritise training and facilitate staff members to undertake external qualifications beyond the basic requirements. The service ensures that all staff within its organisation receives relevant training that is targeted and focused on improving outcomes for people who use services. Staff training continues to have a high profile in the home and staff are keen to gain new knowledge and skills that will assist them in supporting residents. For example all staff have recently completed a Safe Handling of Medication training course, and have had a number of specialist courses to promote residents health and well-being. These include training in pressure care, positive communication, epilepsy and autism. All staff now have a qualification in care, either NVQ 2/3 and the manager has the Registered managers award and NVQ 4 in care. Staff also receive regular updates in mandatory training and a rolling programme includes first aid, abuse and neglect, fire wardens, moving and handling, health and safety and physical intervention training. The manager has identified that staff would benefit from person centred training to formalise the approach they are already putting into practice. Staff consistently report high levels of satisfaction about the employer. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 18 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): 37,39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed by an experienced and competent manager who in turn is supported by a committed staff team who together run the home in the best interests of residents. EVIDENCE: The manager has the required qualification and experience, is highly competent to run the home and meets its stated aims and objectives. The manager promotes an open, positive and inclusive atmosphere in the home through a variety of ways: regular staff meetings; regular supervision; and by encouraging participation in West House service users groups, and encouraging participation and use of advocates. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 19 Staff had received all of the required training to ensure the health and safety of service users and themselves. The administration systems within the home were found to be up-to-date and in good order, ensuring the home was run in an efficient and effective manner. West House ensures that the home has as appropriate effective and regular support from the organisation, via a named line manager and access to senior professional support. There are clear lines of accountability. Working within these systems the manager demonstrates effective financial planning and budgetary control skill, and the home provides value for money. Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 20 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 4 32 4 33 X 34 3 35 3 36 X 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 4 3 X 4 X 3 X X 3 X Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 21 NO 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. Refer to Standard Good Practice Recommendations Briarfield DS0000022538.V334667.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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