Inspection on 02/11/06 for Briarwood

This inspection was carried out on 2nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Briarwood 30/10/08

Briarwood 01/02/06

Briarwood 26/08/05

Briarwood 14/12/04

Briarwood 08/06/04

Briarwood 03/03/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Briarwood 12 Station Avenue Bridlington East Riding Of Yorks YO16 4LZ Lead Inspector Mr M. A. Tomlinson Key Unannounced Inspection 2nd November 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 Briarwood DS0000019651.V318167.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. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Briarwood Address 12 Station Avenue Bridlington East Riding Of Yorks YO16 4LZ 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) 01262 679233 F/P 01262 679233 jacquiblower@aol.com Mrs Jacqueline Vera Blower Mrs Jacqueline Vera Blower Care Home 7 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (7) of places Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Briarwood is a detached three-storey property located in a residential area of Bridlington. It is conveniently situated for all of the main community facilities including the public transport network. On and off-road parking is available. The home provides accommodation and personal care for a maximum of seven (7) older people some of who may have dementia. Nursing care is not provided. Should such care be required on a short-term basis, the community health care team will provide it. The home also provides accommodation and personal care on a respite care basis. The service users accommodation is located on the ground and first floors. A stair lift provides access to the upper floor. The registered providers private accommodation is on the upper floor. There are three double bedrooms and one single. All of the bedrooms are currently being used for single accommodation. The bedrooms have en suite facilities consisting of a toilet and a wash-hand basin. The service users have the use of a lounge and dining room on the ground floor. There are some internal steps on the ground floor. The home has a large pleasant garden with an aviary. The garden is accessible to the service users. The current fees are £307.80 a week. Additional charges are made for hairdressing, chiropody, newspapers and some outings. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit formed part of the annual Key Inspection process of Briarwood undertaken by the Commission for Social Care Inspection (C.S.C.I.). The inspection included discussions with the service users, the home’s manager and those staff on duty. The premises were inspected and several statutory records examined. Telephone discussions were also held with the relatives of some of the service users. Written comments were received from two Placement Officers. Feedback on the findings of the inspection visit was provided for the registered provider at the conclusion of the visit. This report also incorporates information received on the home by the C.S.C.I. prior to the inspection visit. What the service does well: What has improved since the last inspection? The registered provider has continued to look at ways of making the lives of the service users more meaningful. She has encouraged the service users, for example, to become involved in a project supporting under-privileged people in Africa. The staff continue to be provided with training opportunities to ensure that they maintain their skills and knowledge. Since the previous inspection several areas of the home have been redecorated and new furniture provided for the lounge. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 6 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. Briarwood DS0000019651.V318167.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 Briarwood DS0000019651.V318167.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 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission and follow-up assessments undertaken on the service users ensure that a considered decision can be made regarding the appropriateness of the proposed placement. EVIDENCE: Since the previous inspection visit, the local authority had placed two new service users, one male and one female, in Briarwood, thereby increasing the total to four. The registered provider had only received basic information on the service users prior to their admission into the home from the Local Authority and consequently she had undertaken her own assessment of their needs. One of these assessments was examined. It was very comprehensive and covered a range of needs that included health and personal care needs. It also included a general and a ‘falls’ risk assessment of the service user as well Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 9 as a nutritional, behavioural and hearing assessment. From these assessments a holistic picture of the service user’s needs, abilities and preferences had been established which enabled the registered provider to develop a meaningful care plan. Intermediate care is not provided at Briarwood. Briarwood DS0000019651.V318167.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are provided with care plans that enable the staff to meet their assessed needs. EVIDENCE: The registered provider had developed and implemented comprehensive care plans for the service users. It was evident from an examination of these plans that they had been based on the assessment of the service users. The care plans not only identified the service users’ physical needs but also their emotional and social needs and preferences. Through this approach the registered provider was able to tailor the service to each individual. The records also included evidence that the care plans had been regularly reviewed and amended as necessary thereby ensuring that they remained meaningful and relevant. Whilst the service users were aware of the records maintained on them, they did not express any desire to become involved in the Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 11 development of their care plans. From a telephone discussion with a relative (next of kin) of a service user it was apparent that they had been kept informed of the respective service user’s progress and/or deterioration and the action taken by the home in response to this. This relative had also been provided with the opportunity to view the most recent assessment of the service user undertaken by the placing authority. This person commented, “We’re very happy with the care provided, she (service user) is well looked after”. It was apparent from an examination of the records and discussions with the staff and the service users’ relatives that the service users had been provided with good support from the healthcare services including input from an optician and a chiropodist. They had also been provided with annual medical reviews. They had all retained the medical practice of their choice following their admission into the home. One of the service users confirmed that an appointment had been arranged for her to attend a hearing clinic so that she could be issued with a digital hearing aid. All of the service users had received an influenza injection. The registered provider had previously been a registered nurse and consequently had a sound knowledge of healthcare services. The records provided evidence that medical problems experienced by the service users had been promptly and effectively addressed. The relative of a service user, who said that they were kept informed of the relevant service user’s health and of their medical appointments, also confirmed this. The aforementioned information meant that the service users’ health and personal care needs were being met. The home continued to use a monitored dosage system for the administration of the service users’ medication. The medication was appropriately secured. The medication records were complete and up to date. The staff had received training in the administration process. None of the service users had been assessed as being capable of safely self-administering their medication. Briarwood DS0000019651.V318167.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are provided with an opportunity to participate in a range of social activities that take into account their needs, abilities and wishes. EVIDENCE: There was not a set programme of social activities but the registered provider had placed emphasis on promoting activities that were appropriate to the individual and were preferred by them. Several examples were given by the registered provider and were observed during the inspection visit. These included several of the service users knitting ‘squares’ to be made into blankets to be sent to Africa. The registered provider had a direct link with a clinic in Kenya and intended to personally deliver the blankets. This had provided these service users with a purposeful activity and it was evident that they had developed a considerable interest in the recipients of these blankets. In addition to this, knitting assisted the service users in keeping their hands supple and maintained their dexterity. One service user had never had the skills to knit and they confirmed that the registered provider had taught them. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 13 There was a range of board games available and evidence was provided that specific activities were arranged in conjunction with annual festivals such as Halloween and November 5th. It was apparent that the service users had access to magazines and newspapers of their choice. One service user read the newspaper to the other service users and then they discussed the news items. From this approach the service users had stayed up to date with current affairs. One service user continued to attend a day centre each week. They confirmed that the registered provider regularly took them out shopping and to the hairdresser. Since the previous inspection the number of service users accommodated at Briarwood had increased from two to four and included one male. The outcome of this appeared to be that the service users were less apathetic than during the previous inspection visit and had discovered a new enthusiasm for life. It was also evident from the information available that the service users were encouraged to retain a degree of independence and where possible make choices and decisions for themselves. It was evident that the service users had been encouraged to retain good links with their family and several had relatives that visited them on a regular basis. This was confirmed through a telephone conversation with two relatives of service users who confirmed that they could visit whenever they wanted and were always made to feel welcome by the staff. The menus indicated that the service users were provided with a balanced and nutritious diet that endeavoured to take into account their personal preferences. The service users commended the quality of the meals. The records indicated that since moving into Briarwood the newest service users had put on weight, which in one case was extremely important due to their very low body mass index. The main meal of the day was taken at lunchtime and eaten in the dining room. The service users confirmed that mealtimes were unhurried and that if they could have an alternative to the meal on the menu if they wished. Briarwood DS0000019651.V318167.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The internal and external network of support provided for the service users should ensure that any concern or issue is quickly identified and acted upon. EVIDENCE: The home had an appropriate complaints procedure that was readily available to the service users and visitors to the home. The registered provider said that they attempted to minimise formal complaints by encouraging the service users and visitors to the home to make known and discuss any concerns. The more able service users and a relative of a service user confirmed this. The registered provider demonstrated a sound understanding of the Adult Protection procedure and the types and indications of abuse. The service users had a good network of internal and external support and consequently it was concluded that any concern would be quickly identified and acted upon. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 15 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, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users are provided with an environment that not only meets their needs but also enables them to live comfortable lives in pleasant surroundings. EVIDENCE: The premises continued to be maintained, decorated and furnished to a high standard. To the visitor it presented as being an informal and domestic environment. The lounge and dining room were enhanced through the use of ornaments, pictures and flowers. The lounge looked out onto the main road leading into the town and consequently there was always something to look at for the service users. Traffic noise had been eliminated through the use of double-glazing. The service users looked relaxed and at home in their environment. They all expressed satisfaction with their accommodation. The Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 16 premises were exceptionally clean and were free of any unpleasant smells. The service users and visitors to the home confirmed this high standard of cleanliness as being the norm. The service users had their own bedrooms that all had en suite facilities consisting of a toilet and a wash-hand basin. These facilities were seen as being important by the service users as it provided a good standard of privacy for them. There were also communal toilets and a bathroom available. An in-bath hoist was available to assist those service users with mobility problems. A stair-lift enabled the service users to have access to the upper floor. This had been the subject of a risk assessment and it was observed that the service users only used it when accompanied and assisted by a member of staff thereby minimising the risk of an accident. The service users had personalised their bedrooms by furnishing them with personal belongings and memorabilia. This gave them a degree of ownership over their environment. As far as could be ascertained from the home’s records, the premises met with the specific requirements of the Fire and Environmental Health Departments. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are supported by competent and experienced staff who have a good understanding of the service users needs. EVIDENCE: In essence, the staff team consisted of the Registered Provider, her family and two full-time members of care staff. The Registered Provider and her family lived on the premises and consequently provided on-call support outside of normal working hours. On the day of the inspection visit there were two staff on duty. According to the staff rota this level of staffing was the norm during the day. The staff confirmed that there was a degree of flexibility built into the staffing arrangements to take into account the needs of the service users at any particular time. The home’s records provided confirmation that the staff had received appropriate training that was considered commensurate with the size and aims of the home and the assessed needs of the current service users. The records confirmed that all of the staff, including the registered provider’s family, had been appropriately vetted by undergoing a CRB/POVA check. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 18 It was evident from discussions with, and observation of, the staff on duty at the time of the inspection visit, that they had a good understanding of the service users’ needs and treated them with patience and respect. The service users also commended the staffs’ efforts to provide a comfortable and pleasant environment for them. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are provided with good support from the manager who has clear aims to promote the welfare of the service users. EVIDENCE: The registered provider, Mrs Blower, has had over thirty years experience in running and managing a care home. In addition to this she was a registered nurse and worked in a hospice. Taking her experience and age into account, Mrs Blower has decided not to pursue formal management qualifications. During the inspection visit she demonstrated appropriate management skills in the way she instructed and supervised the staff. From discussions with her, Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 20 and the service users, it was apparent that she had the skills and abilities to fully discharge her duties as a registered manager. It was also evident that the ‘homely and friendly’ personality and attitude of the registered provider had a direct effect on the ambience of the home. It was evident from discussions with the staff, the service users and visitors to the home that the home was run in the best interests of the service users with particular emphasis being placed on the promotion of their independence and ‘self-worth’. The registered provider had taken a positive decision not to become directly involved in the service users financial affairs. She had encouraged the service users or their representative to retain this responsibility. This was seen as being good practice and minimised the risk of allegations of financial malpractice being made against the registered provider. It was evident from an inspection of the premises and an examination of the records that the registered manager had taken appropriate action, including the training of the staff, to ensure a safe environment for the service users. Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 21 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 3 3 4 4 4 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 4 4 X 3 X X 3 Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 Briarwood DS0000019651.V318167.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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