Inspection on 11/04/06 for Briarfield House

This inspection was carried out on 11th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 House 24/04/08

Briarfield House 15/05/07

Briarfield House 05/02/07

Briarfield House 02/10/06

Briarfield House 21/02/06

Briarfield House 26/07/05

Briarfield House 29/09/04

Briarfield House 14/04/04

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

CARE HOMES FOR OLDER PEOPLE Briarfield House 8 Easson Road Redcar TS10 1HJ Lead Inspector Shaun Common Unannounced Inspection 11th April 2006 09:30 X10015.doc Version 1.40 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 House DS0000000079.V289751.R01.S.doc Version 5.1 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 Older People. 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 House DS0000000079.V289751.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Briarfield House Address 8 Easson Road Redcar TS10 1HJ 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) 01642 488218 Mr Stephen Metcalf Miss Louise Metcalf Mrs P Creed Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Briarfield House is a large detached two-storey house, built in 1902. It is a mellow building, which blends well with the surrounding properties and has an enclosed garden. The home is situated in a quiet residential road near to the racecourse. There are shops and a large supermarket within walking distance, and a nearby bus stop provides access to the town centre and sea front. The home provides accommodation for twelve elderly service users, in ten single rooms and one double room with en-suite shower, wash basin and lavatory. Bedrooms are comfortably furnished, and service users are able to personalise their rooms by bringing some possessions with them when they move into the home. Downstairs there is a bathroom/shower room, and separate lavatory and upstairs there is a bathroom and separate lavatory. There is a large spacious lounge, and a pleasant dining room, and a smokers room is provided to the rear of the house. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to Briarfield House by the Lead Inspector, who was made to feel welcome by residents and staff. The inspection started on a Tuesday morning and lasted a total of five and a half hours. The inspector spoke to several residents and observed how the home was running. The inspector spoke to staff, the manager and the joint proprietor, as well as looking at records, sampling a meal and looking around the home. One resident state ‘The owner and his wife are really good to me, they’re all good’. What the service does well: What has improved since the last inspection? What they could do better: Care plans and a record that shows how the home makes things safe for residents, called a risk assessment, are not up to date and do not record all of a resident’s needs. They are not looked at and updated regularly enough. Staff are not trained in how to protect residents and keep them safe and hot water is not controlled so it comes out of taps at a safe temperature. The home has not got in place good ways of showing that they listen to the views of residents, their relatives, friends and other important people in how the home is doing and how it could be better. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 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 House DS0000000079.V289751.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Resident’s needs are assessed. Care plans are developed and in place from these assessments that identify individuals needs. EVIDENCE: Two residents files were examined and the home had in place assessments for each resident. Plan’s of care for daily living were in place and were developed from the assessment. Briarfield House does not provide intermediate care. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Care planning, risk assessment and reviewing are not sufficiently robust. Residents’ health care needs are met, medication systems are appropriate and residents are mainly treated with dignity and respect. EVIDENCE: Two residents’ files examined contained care plans that were different in format and quality of content. The last inspection report of February 2006 determined that care planning and risk assessments were not robust and care plans were not reviewed as appropriate. It was evident that work was underway to further develop care planning and risk assessment processes, however there was clearly still work to do in order to provide robust systems. The manager assured the inspector that the work would be completed in the allocated timescales as set out in the last inspection report. Nutritional screening remains an outstanding matter, however the manager advised that this would be undertaken in line with the above tasks, as will staff training in nutrition. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 10 File information contained details of health professionals involved with residents and records of visits/appointments undertaken. One resident who spoke to the inspector stated ‘I have my own GP and I like them’. They also told the inspector that staff always treat people with respect and dignity and they knock on doors before coming into your room. Observations made by the inspector supported this viewpoint. The homes medication storage and administration systems were examined and were noted to be appropriate and clearly recorded. It was noted that in one room where two residents share, that there was no screening provided if they wished to have privacy. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Resident’s preferences and social needs are provided for and contact arrangements are in place and flexible. Residents are provided with a varied diet. EVIDENCE: Observations made by the inspector at the time of the visit evidenced a relaxed, flexible routine for residents. Although activities and interests were not very well documented and evidenced at the home, one resident told the inspector that, ‘staff offer activities, but people don’t want to do them’. ‘If it’s a nice day, I go shopping or for walks’. ‘I go out all the time’. One resident was asked about visitors and stated ‘my niece comes to see me’. ‘She sees me in my bedroom’. The resident also clarified that this was in private and that there were no restrictions. One resident told the inspector that they manage their own money and records were noted to be kept appropriately in the home for managing residents finances. The manager and owner advised that most residents relatives help them manage their finances and retain their monies for them. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 12 A varied menu was in place that recorded alternatives taken by residents and catered for their individual choices. The inspector sampled a meal and this was of good quality. Two residents told the inspector that the food was fine and that alternatives were available. One resident said ‘they sometimes offer, cheese on toast, beans on toast, bacon sandwiches, soup and other things’. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents know how to complain and the home has an appropriate procedure in place. Lack of staff training and absence of an appropriate adult protection procedure leaves residents vulnerable. EVIDENCE: The complaints record was examined and there have been no complaints made to the home. The complaints procedure was in place and available in a predominate place in the home. A resident who spoke to the inspector said she knew how to complain if she needed to and felt safe at the home. No one at the home has yet received training in ‘No Secrets’ regarding the protection of vulnerable adults and neither does the home have in place a procedure for staff. The manager stated she is attending a course shortly and has received advice that appropriate training courses for staff are not available at the moment, however the home will be advised when they do become available. The manager stated she would be training staff after she has completed her course until formal training is accessible. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Briarfield House is homely, comfortable and well maintained. EVIDENCE: The inspector undertook a tour of the home. The home was well decorated, furnished and comfortable. Residents told the inspector they were happy with the home. The home was also noted to be clean and hygienic throughout. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The home appears appropriately staffed, however this cannot be evidenced. Staff are trained and qualified and relevant information that safeguards residents’ is in place. EVIDENCE: The home had in place a recorded rota, however did not have in place a recorded system that demonstrated the numbers of staff required in relation to the assessed needs of residents. There is a total number of seven care staff at the home as three have recently left and three new staff are about to start work. Of the seven staff present, four are qualified to NVQ Level 2 or hold an equivalent qualification. The manager stated that of the three new staff, all are qualified to NVQ Level 2 or equivalent. The recruitment processes and files of the home have been examined at previous inspections and there were no new staff in post at the time of inspection. Staff training records included induction and foundation training recorded on an old system as was available at the time of their employment. The manager stated that she has obtained the new documentation from Skills for Care and this will be implemented for new staff. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 The manager is experienced, however not yet qualified. Quality assurance is lacking. Residents’ finances are protected and most health and safety matters are managed well, however lack of hot water controls place residents at risk. Staff supervision is lacking. EVIDENCE: The manager is currently undertaking the Registered Managers Award and hopes to complete this shortly. She is also registered to start NVQ Level 4 in Care in September 2006. The home does not have a quality assurance system in place. The manager discussed this with the inspector and advised that she has just completed work on this area in her Registered Managers Award and will be working with the owner to develop a system to implement a system shortly. One resident who spoke to the inspector said ‘they don’t ask about my views’. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 17 One resident told the inspector that they manage their own money and records were kept appropriately in the home for managing residents finances. The manager and owner advised that most residents’ relatives help them manage their finances and retain their monies for them. Two staff files examined demonstrated that supervision was lacking and not to the standard. The inspector noticed that warning signs were in place about very hot water at basins and water temperature checks demonstrated they greatly exceeded the required regulated temperature of 43C. The manager was required to take action quickly to prevent potential injuries/accidents to residents. Other health and safety matters were examined such as maintenance of boilers; PAT (portable electrical appliance) testing, Fire maintenance, tests, drills etc and all were appropriate. The homes’ accident record was appropriate and fully completed. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 1 Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement The registered person must ensure residents care plans include written information in the form of a risk assessment about the risks, which have been identified, will be managed and minimised. The registered person must ensure the residents care plan sets out in detail the action which needs to be taken by care staff to ensure the health needs of the resident are met. The registered person must ensure the residents’ care plan is reviewed by care staff in the home at least once a month and updated to reflect the changing needs and current objectives for health and personal care and actioned. Appropriate screening must be provided in bedrooms where residents share, in order to afford privacy. The home must be able to evidence that varied activities are offered both inside and out of the home. DS0000000079.V289751.R01.S.doc Timescale for action 01/08/06 2. OP7 15 01/08/06 3. OP7 15 01/08/06 4. OP10 16 01/06/06 5. OP12 16 01/05/06 Briarfield House Version 5.1 Page 20 6. OP18 13 7. OP18 13 8. OP27 18 9. OP33 24 10. OP38 13 The home must have in place an adult protection procedure in conjunction with the Department of Health Guidance, ‘No Secrets’. The registered person must ensure all staff receive the Department of Health’s ‘No Secrets’ training. The manager must ensure that there is a record in place, that is regularly review and up to date, that demonstrates the dependency levels of residents and the number of staff needed to provide appropriate and safe care. Effective quality assurance and quality monitoring systems must be in place to measure success in achieving the aims, objectives and Statement of Purpose of the home. The home must make immediate arrangements to ensure that hot water outlets that residents have access to unsupervised, deliver hot water at a temperature close to 43C. 15/05/06 01/05/06 15/05/06 01/08/06 13/08/06 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. Refer to Standard OP8 Good Practice Recommendations The registered person should ensure that residents nutritional screening is undertaken on admission and subsequently on a periodic basis, a record is maintained of nutrition including weight gain or loss and appropriate action taken. The manager should be qualified to NVQ Level 4 in Care and Management, or an equivalent qualification. All staff should receive formally recorded supervision at DS0000000079.V289751.R01.S.doc Version 5.1 Page 21 2. 3. OP31 OP36 Briarfield House least 6 times per year. Briarfield House DS0000000079.V289751.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 House DS0000000079.V289751.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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