Inspection on 24/04/08 for Briarfield House

This inspection was carried out on 24th April 2008.

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

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 House 15/05/07

Briarfield House 05/02/07

Briarfield House 02/10/06

Briarfield House 11/04/06

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Briarfield House 8 Easson Road Redcar TS10 1HJ Lead Inspector Mrs Sue Lowther Key Unannounced Inspection 09:00 24th April & 20th May 2008 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.V363138.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 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.V363138.R01.S.doc Version 5.2 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 F/P 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.V363138.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 12 The maximum number of service users who can be accommodated is: 12 15th May 2007 2. Date of last inspection 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. The manager told inspectors that it costs £ 421:14p per week for a resident to stay at Briarfield House. This does not include the cost of personal newspapers, hairdressing or chiropody. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection of Briarfield House took place on the 24th April and 20th May 2008. Records were examined and a tour of the building took place. Time was spent talking to people living at the home, staff and visitors. The manager supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for home’s to provide information about their service. The inspection focussed on key standard outcomes for people living at the home. We also checked whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection? Most of the requirements and recommendations made at the last inspection have been met. New care plan documentation has been implemented and reviews are carried out for each specific identified need. All of the radiators have now been guarded. A keypad lock has been fitted to the laundry area and cleaning products are now stored appropriately. Bolts Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 6 have also been removed from bedroom and bathroom doors. These changes were required to maintain the safety of the people who live in the home. The home have appointed an approved contractor for the removal of clinical waste. Staff spoken to said that when they are involved in catering and domestic duties, this does not detract from their care hours. Surveys have been introduced and the manager said that comments are acted on and improvements made wherever possible. 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 House DS0000000079.V363138.R01.S.doc Version 5.2 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.V363138.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience adequate quality outcomes in this area. Assessment procedures are in place to ensure that the home can meet the needs of the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Everyone is assessed prior to living in the home. In addition to social services assessments the manager normally visits the person in their current place of residence. Three assessments were viewed. Assessments provide staff with basic information about how people’s needs will be met by the home. Some of the assessments viewed had gaps in the recording of information these should be updated. One person who had been admitted to the home recently said, “I Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 9 was given lots of information and I have settled well.” Another said, “ I was able to look around before moving in.” The home does not admit people for intermediate care. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. People who use the service experience adequate quality outcomes in this area. Documentary evidence within care plans needs to be improved to ensure people’s health and personal care needs are met fully. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Three care plans were viewed. They contained varying levels of detail and although they contained some assessments to determine risk they did not contain assessments for the risk of pressure damage to the skin or nutritional assessments. These should be carried out on a monthly basis. Where these assessments identify a potential risk, a care plan must be available to make sure these needs are met. Social assessments were blank in some files. There was some evidence of input from people living at the home with regard to their care plans. One person said, “Care plans, yes I know I have one”. One relative wrote on the survey, “They look after my relative with care and consideration taking into account age and disability”. One member of staff wrote on a Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 11 survey, “We help clients keep their independence and aim to help them out as much as possible with any other assistance they may need”. Evidence was seen in files of involvement from other people for example district nurses, doctors, and care managers to confirm that other professionals are involved. One person said, “We are well cared for and always have nice clean beds. We can see people like GP’s, as we need them”. The medication records of three people were checked. All controlled drugs were checked, the amounts tallied with the Controlled drugs book. A drug fridge must be available to ensure that drugs requiring this facility are stored safely. The policy and procedure in relation to the procedure for administration of medication must be specific to the home. The dispensing chemist had supplied the information available at the time of the inspection. People spoken to during the inspection said that they were treated with dignity and respect. They said that staff always knock on bedroom doors and call them by their preferred name. Staff also gave examples of ways in which people’s privacy and dignity were being maintained. One person said, “Privacy and dignity is great no problems they are they are all very good to us”. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use the service experience good quality outcomes in this area. People would like further opportunities to be involved in social activities. Records should demonstrate how people are able to make choices and decisions about their lives. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Activities are tailored to individual need as far as possible. An extra member of staff is available for a few hours each day to provide this. Comments about the activities being provided were generally good. Everyone spoken to at the time of the inspection said that they were appropriate. Some people said that they did not wish to join in and that staff accepted this. Activities include bingo, sing a longs, quizzes and trips out. People also said that they were able to sit outside when the weather was nice. People were asked about visiting arrangements, which are flexible. One of the comments from a visitor included, “We are made welcome to the home, its Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 13 lovely”. Visitors can see people in their own rooms or in any of the communal areas available throughout the home. Comments about the food were good. The looked appetising and people said that it was tasty. Specialist diets are catered for and include menus for diabetics and soft menus. Staff supported those who needed help during mealtimes in a sensitive manner. One person said, “The food is good, no complaints”. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use the service experience good quality outcomes in this area. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. One person said, “If I had a problem I would tell the manager”. One relative said, “I would approach any member of staff at any time”. The home had received one complaint since the last inspection. This was recorded along with the action taken. The manager says that she has an open door policy. One person said, “I could tell someone if there was a problem as the manager is very pleasant”. The home had a basic adult protection procedure to support staff in making a referral should this be required. The manager said that all of their policies were being reviewed and updated. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell the manager or make a referral themselves. Training is provided for all staff in adult protection. One member Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 15 of staff said, “I would have no hesitation in reporting any concern. I am here for the residents”. Another wrote on a survey, “We always put residents first”. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. People who use the service experience good quality outcomes in this area. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: There have been a number of positive changes to the premises. All of the radiators have now been guarded. A keypad lock has been fitted to the laundry area and cleaning products are now stored appropriately. Bolts have also been removed from bedroom and bathroom doors. These changes were required to maintain the safety of the people who live in the home. All bedrooms that were seen were personalised with people’s own items. There was a range of equipment seen around the home to support people with bathing and mobility. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 17 During the tour of the building, the inspector found the building to be clean, tidy and free from offensive odours. Since the last inspection the home have appointed an approved contractor for the removal of clinical waste. However the registered person should consider more appropriate procedures and facilities for the sluicing of soiled items. This will reduce the risk of cross infection. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. People who use the service experience good quality outcomes in this area. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. Training is provided for all staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. Staff spoken to said that when they are involved in catering and domestic duties, this does not detract from their care hours. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with many of the staff having an NVQ at level 2 or above. Training is provided for staff. As well as mandatory training, recent training has also taken place in adult Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 19 protection and health and safety. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments from staff included “Morale is good and there are lots of opportunities for training” and “Good training, we are able to support each other”. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. People who use the service experience good quality outcomes in this area. The home’s registered manager provides clear leadership, support and guidance to those living and working at the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager has previously obtained the Registered Manager Award and has enrolled to undertake an NVQ (National Vocational Qualification) level 4 in care in September 2008. She promotes equal opportunities. There was an open and friendly culture between the management team and staff working at the home. Staff said that they felt well supported in their work. There was evidence in staff files to show that supervision was taking Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 21 place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are well supported. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Regular meetings are held and the home has a number of systems in place to consult with people living at the home. The manager confirmed that monthly Regulation 26 audits by the owner take place. Surveys have also been introduced and the manager said that comments are acted on and improvements made wherever possible. The owner said that the home do not hold personal finances on behalf of the people who live there. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 22 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? In Part 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 Care plan documentation must be developed further to include assessments for pressure care and nutrition. Individual plans of care must be available where a risk is identified. This will ensure that all health care needs are fully met. A drug fridge must be available to ensure that drugs requiring this facility are stored safely. The policy and procedure in relation to the procedure for administration of medication must be specific to the home. (The requirement in the previous report with regard to this has been partially met). Timescale for action 31/08/08 2. OP8 15 31/08/08 3. 4. OP9 OP9 13(3) 13(3) 31/08/08 31/08/08 Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 24 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. 3. Refer to Standard OP12 OP26 OP31 Good Practice Recommendations A more suitable area should be found for the hairdresser. The registered person should consider more appropriate procedures and facilities for the sluicing of soiled items. This will reduce the risk of cross infection. The manager should continue to pursue a qualification to NVQ Level 4 in Care, or an equivalent. Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Briarfield House DS0000000079.V363138.R01.S.doc Version 5.2 Page 26 - 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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