Inspection on 04/07/05 for Briarfield

This inspection was carried out on 4th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Briarfield 10/05/07

Briarfield 13/02/06

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 Gordon Chivers Unannounced 04 July 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Briarfield Address 42 Stainburn Road Workington Cumbria CA14 1SN 01900 66733 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) West House Beverley Steele Care Home 6 Category(ies) of Physical disability registration, with number Learning disbility of places Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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) 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 14 March 2005 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. Service users have access to a wide range of both in-house and community based activities. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six and a half hours between 09.30 and 16.00 hours. The inspection took place in the presence of the home’s manager, Ms. Beverley Steele. The inspection focused on those standards against which a requirement or recommendation had been made by the last inspection, and those standards which were not assessed during the last inspection. Four of the service users were in the home throughout the inspection, and three members of staff were interviewed. The inspector would like to thank the service users and staff for their welcome and cooperation throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The care management system appears to be somewhat fragmented, resulting in difficulty in tracking case files from assessment through care plan, action and review. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 6 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. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 standard(s) 5 Service users have signed contracts of residency which provides them with security of tenure and support. EVIDENCE: In response to the recommendation made by the last inspection, all of the service users’ contracts/terms and conditions of residency have now been signed on their behalf by family or independent representative and by an officer of the care provider. Copies of these contracts are retained in their personal files. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 standard(s) 6,9 The needs of the service users are thoroughly assessed and reviewed when necessary. Service users benefit from plans of care which are developed and implemented based upon this information. Service users are enabled to undertake a range of activities within the context of the assessed risks and actions taken to control and minimise those risks. EVIDENCE: Service users’ assessed needs are fully identified and actions to meet these needs are found in their person centred plan and care plan. These actions are reviewed as and when necessary but at least every six months. The PEG feeding procedure and strategy in respect of one service user is reviewed every three months (more frequently if necessary) as recommended by the last inspection, and the records of those reviews are now up to date. The home is developing a new communication strategy with and for the service user. The risk assessments on each service user are comprehensive. Risk assessments relating to day trips and journeys in the home’s minibus have been strengthened according to the recommendation of the last inspection. Key information about the service users, contact names and numbers and journey details is taken on each and every trip. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 standard(s) 11,16,17 The home provides service users with a lot of opportunities to gain or retain skills. The rights of service users are respected; and meals are balanced and varied. EVIDENCE: The staff and the activities organiser arrange for the service users to undertake a range of activities inside and outside of the home. Appropriate activities are identified with reference to the person-centred and care plans. Staff record some of the activities and the service user’s reaction and response. Staff provided examples of how they attempt to support service users to gain or retain skills and competencies. However, the case files do not reveal a clear recorded linkage between care plans, activities, reviews and the outcome for the service user. The Statement of Purpose and the staff handbook contain the care provider’s principles of care and support which include respecting and enhancing the rights to privacy, dignity and as full a life as possible for the service users. These are also found in the staff’s code of practice. Interviews with staff and direct observation of their interaction with the service users provided evidence Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 11 of the importance which staff attach to this principle and some of the ways in which they put it into practice. Menus are worked out in advance a week at a time. The main meal, which includes vegetables, is different for each day of the week. Fruit is introduced in a number of ways such as in drinks. Two of the service users contribute to the cooking through their activities. Presentation and consistency of the food is dictated by the dietary notes, risk assessments and speech therapist guidance for individual service users. Some service users have to have personalised meals/menus. Service users indicate choice by accepting or refusing food, although staff get to know their likes and dislikes over time. The lunchtime meal was observed with service users supported by staff. The home uses a special table cloth which stops the plates from moving around the table. The four service users taking lunch certainly appeared to be enjoying their food. Most service users take their meals in the communal dining room which is well furnished and decorated. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 standard(s) 19 Staff place a high importance upon meeting the service users’ health needs. EVIDENCE: The staff pay a lot of attention to the physical health of the service users. The assessments of need and care plans contain a lot of references to their physical health. Some of these will be reviewed quite frequently because of the critical nature of the need. It can be difficult to gauge whether a service user is upset and for what reason. Familiarity and communication developed by staff with service users over time is the only way to detect emotional upset and provide support and understanding. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 13 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 standard(s) 23 Staff have procedures and are given training to prevent the abuse of vulnerable adults. EVIDENCE: The home keeps a record of the CRB check in respect of each member of staff. The home has policies and procedures in respect of the protection of vulnerable adults and whistle-blowing. All staff have had some training in these issues through LDAF Induction and NVQ. Staff are also trained in-house as part of monthly team meetings, and can receive ‘outside’ training arranged by Westhouse, depending upon demand and supply of specific training courses. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 14 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 standard(s) 25,27,28,29 The home’s bedrooms, bathrooms and communal rooms are spacious, well decorated and well furnished. The home is clean and well kept. There is plenty of specialist equipment. EVIDENCE: Each service user has their own bedroom. All the bedrooms are spacious, well decorated and well furnished. Each bedroom is different and is personalised to reveal the tastes of the service user. Each room has a washbasin, radiator with guard, ventilation and sufficient cupboard space. The home has a bathroom and a shower room, each with a toilet. Both are well decorated and have hoist chairs and non-slip flooring. All the service users require support with washing and toileting. Because of an incident when a service user was scalded, the manager is insistent that the procedures for using these facilities are framed and displayed on the wall, despite the institutional nature of such practices. The home has a large lounge and a slightly smaller dining room. Both are well decorated and well furnished. There is also a large patio area and an even larger garden to the back of the house. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 15 There is a range of specialist equipment in the home. The service users benefit from the five thera-posture beds, the hoists and other bathroom equipment, as well as the purpose built sensory room. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 The service users are supported by a competent, qualified and effective staff team. EVIDENCE: All staff have qualified to at least NVQ level 2 in care, with the exception of a new member of staff who has undertaken the LDAF Induction and Foundation course. The manager arranges for some training to be undertaken in the home, and Westhouse also arranges training courses for staff. All staff undertake annual, mandatory, refresher training on a range of basic health and safety issues. Training checklists are now maintained by the manager and in each staff member’s file of the training undertaken, as recommended by the last inspection. All the staff interviewed considered that the staff worked well together and that morale was good. The last inspection required the home to review its staffing input, especially during the weekends. This was done by the manager and agreed by CSCI at a meeting on 7/4/2005. On Saturdays two of the service users visit their families and so no additional staff are rostered in. Two additional staff are rostered in on alternate Sunday afternoons except for July and August when staff and service users are away on holidays. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39 The home is well run and the manager is producing a Development Plan based upon service user views. EVIDENCE: The manager, Ms. Beverley Steele, has many years experience working with people with learning disabilities. She has a NVQ level 4 in care and has just completed the Registered Managers Award. She was the Senior Support Worker in the home for ten years before becoming the manager. In her opinion the current staffing levels and structure are appropriate for Briarfield, even though there is no longer a Senior Support Worker post. The staff interviewed described her style as approachable, inclusive and fair. The manager is in the process of putting together a Development Plan for the home which she intends to present to CSCI by 1/9/2005. Some relatives have returned the questionnaire sent to them and the staff are devising strategies to get the other families to give feedback on the service. It is obviously very difficult to ascertain the views of the service users directly because of their communication difficulties. The manager is intending to enlist the help of Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 18 family and advocates in this exercise. The manager understands that ascertaining service user views as the basis of the Development Plan is a requirement. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 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 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 x 3 3 3 x Standard No 11 12 13 14 15 16 17 2 x x x x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Briarfield Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x x x F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 11 Regulation 14,15 Requirement Activities must be clearly linked to the care plan and their effectiveness in meeting the objectives reviewed The manager must provide CSCI with a Development Plan which is based upon the views of the service users, as required by the last inspection. Timescale for action Immediate. 2. 39 24 1/9/2005 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 27 37 Good Practice Recommendations The home should find alternative, less institionalised ways to ensuring that service users are not scolded or endangered in any other way in the bathrooms. The manager should provide CSCI with a copy of the Registered Managers Award when she receives it. Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith CA11 9BP 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 Briarfield F58 F10 s22538 briarfield v234622 040705 ui stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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