Inspection on 26/08/05 for Briarwood

This inspection was carried out on 26th August 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 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 02/11/06

Briarwood 01/02/06

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 Yorkshire YO16 4LZ Lead Inspector M.A. Tomlinson Unannounced 26 August 2005 9.30 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 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 J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Briarwood Address 12 Station Avenue Bridlington East Yorkshire YO16 4LZ 01262 679233 01262 679233 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) Mrs Jacqueline Vera Blower Mrs Jacqueline Vera Blower Care home only 7 Category(ies) of DE (E) Dementia-over 65, OP Old age registration, with number of places Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14th December 2004 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 whom may have dementia. Nursing care is not provided. Should such care be required on a short-term basis, it will be provided by the community health care team. The service users accommodation is located on the ground and first floors. A stairlift 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 diningroom 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. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two statutory unannounced inspections to be undertaken of Briarwood by the Commission for Social Care Inspection during this inspectoral year. The inspection took five hours including one hour of preparation time. The registered provider and one member of staff were available throughout the inspection. Only three service users were accommodated at the time of the inspection, one on a short-term respite care basis. The two permanent service users were spoken to together without staff being present. The two Social Services’ Reviewing Officers allocated to these service users were spoken to on the telephone. An inspection of the premises was carried out along with an examination of a number of statutory records. What the service does well: What has improved since the last inspection? It was apparent that action had been taken to further improve the standard of the environment through a programme of redecoration and refurbishment. The most notable improvement being the total refurbishment of the kitchen. Those requirements and recommendations identified during the previous inspection had been addressed. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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 standard(s) 3 and 6 The pre-admission assessments undertaken on the service users provided adequate information on which a considered decision could be made as to the appropriateness of the proposed placement. EVIDENCE: The care records of the two permanent service users included assessments undertaken prior to their admission into the home. The assessments were reasonably comprehensive and provided adequate information on which a decision could be made as to the suitability of the proposed placement. The assessments included a range of risk assessments and a personal profile of the service user concerned. The third service user had recently been admitted as an emergency and the registered provider was waiting for an assessment to be provided by the placing agency. An assessment was in the process of being undertaken by the registered provider of this respite care service user in order to develop a care plan. Intermediate care was not provided by the home. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 and 10 The service users’ health and personal care needs were met through good levels of input from health and social care professionals and the implementation of meaningful care plans. EVIDENCE: The two permanent service users had been provided with a care plan. As previously stated in this report, the care plan for the respite care service user was in the process of being developed by the registered provider. The service users had been assessed as not having the capability to be overly involved in the development of their care plan. The care plans were clear and unambiguous. The identified the primary needs of the service users along with the actions to be taken by the staff to meet those needs. There was evidence that the care plans had been regularly reviewed and, where necessary, amended. In addition to the home’s care plans the service users had a care plan developed by their placing agency. Both of the permanent service users had Reviewing Officers allocated by Social Services. The records confirmed that the service users have received good support from health and social care professionals. A record was maintained of visits to, and Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 10 from, medical practitioners. Both permanent service users were registered with a local dental practice. The home continued to use a monitored dosage system for the administration of the service users’ medication. The service users had been assessed as not being capable of administering their own medication. The medication was appropriately secured and the associated records were up to date. The registered provider was originally trained as a nurse and she demonstrated a good understanding of medication and of the required administration procedures. Nominated staff were responsible for administering the medication. They had received appropriate training from the local pharmacist and their competence to undertake the procedure had been assessed by the registered provider. It was difficult to assess from discussions with the service users whether they were satisfied with the level of privacy provided. They did, however, look relaxed in their environment and from their reaction appeared to have established a good relationship with the staff. They were dressed in clean and appropriate clothing, were well groomed and one was wearing makeup. The provision of single bedrooms and en suite facilities enhanced the service users’ privacy. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 and15 The service users were provided with an opportunity to maintain contact with their families and participate in community activities. EVIDENCE: The registered provider confirmed that the home did not have a ‘set’ programme of social activities but based such activities on the needs, wishes and abilities of the service users on a day-to-day basis. From discussions with the staff and service users it was evident, for example, that the service users were encouraged to remain as mobile as possible by taking frequent walks out of the home. They were regularly taken into the town shopping by using a wheelchair. They also attended a local hairdresser, which, according to the registered provider, gave them greater contact with the local community. One of the service users attended a local day centre on one day each week. A Social Services’ Reviewing Officer, who regularly visits the home, confirmed this level of social activity. The Reviewing Officer said that her client had made considerable progress since being admitted into the home approximately two years ago and was noticeably less confused. The records confirmed that the service users had reasonably regular contact from members of their families. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 12 The menus indicated that the meals were varied and provided a balanced diet for the service users. Emphasis was placed on the use of fresh fruit and vegetables. A record of food provided for the service users was maintained. The service users indicated their satisfaction at the standard of the meals. As part of their on-going nutritional monitoring, the service users had been regularly weighed. There was evidence that meal times were reasonably flexible and that the wishes of a service user not to have a meal at the planned time was respected. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The service users’ network of support workers both within and external of the home should ensure that any Adult Protection issue will be identified and acted upon. EVIDENCE: An appropriate complaints procedure was in place. Due to the level of the service users’ infirmity, reliance was primarily placed on the staff or the social and health care professionals to identify any concerns affecting a service user. A policy was in place regarding Adult Protection. The subject was discussed with the registered provider. Arrangements had been made for the staff to receive training on Adult Protection including the types and indications of abuse. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,24,25 and 26 The standard of the environment within the home is good thereby providing the service users with an attractive and homely place in which to live. EVIDENCE: The premises presented as homely and domestic. The property was decorated and maintained to a high standard. A rolling programme of refurbishment was in place and since the previous inspection the kitchen had been totally refurbished and updated. It was evident that the service users had been encouraged to furnish their bedrooms with their personal belongings. The furnishings in the bedrooms and the communal area were of a good standard. All of the bedrooms had en suite facilities consisting of a toilet and a washhand basin. There were large secluded rear gardens to which the service users had good access. There were adequate numbers of toilets. A toilet was available to the service users on each floor of the property. The bath had an in-bath hoist. A basic call system was installed in every room used by service Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 15 users. A stair-lift provided access to the upper floor. Thermostatic valves had been fitted to the hot water outlets accessible to the service users in order to maintain the water temperature within safe limits. There was recorded evidence that the temperature of the hot water had been regularly checked. The radiators had been fitted with safety guards. The property was very clean, hygienic and totally free of any offensive odours. As far as could be ascertained the service users were satisfied with their accommodation. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The staffing arrangements in place are considered appropriate for the current service users. EVIDENCE: There was no regression in the level of staffing since the previous inspection. The ‘core staffing’ consisted of the registered provider, her partner and her son plus two care assistants. A staff roster was available. One of the care assistants had been employed at the home for a considerable number of years. The registered provider and their family live on the premises and are ‘on-call’ during the night. The staff records were inspected. They contained evidence that a reasonably robust staff vetting procedure was in place including a CRB/POVA check. There was also evidence that the staff had undertaken training in both statutory and professional subjects. Three of the staff had obtained a National Vocational Qualification. From discussions with the staff it was evident that they had a good understanding of the needs of the service users. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 The service users are provided with a safe environment and their financial interests are adequately safeguarded. EVIDENCE: From an inspection of the records and discussions with the staff, it was evident that the routines of the home were tailored to meet the specific needs of the service users. The registered provider provided confirmation that the staff do not become involved in the service users financial affairs but encourage the service users or their representatives to retain that responsibility. Where purchases had been made on behalf of the service users, their families had been formally invoiced. Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 18 The records confirmed that appropriate action had been taken by the registered provider to ensure that the environment was safe for the staff and the service users. This included routine servicing of the gas, electrical and stair-lift systems. Risk assessments had been undertaken and where necessary action had been taken to reduce the level of risk such as the fitting of safety guards to the radiators. There was evidence that the staff had been provided with training and information on health and safety. Briarwood J53-J04 S19651 Briarwood V227751 260805 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 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 4 x x 3 3 4 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None 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. 1. Refer to Standard None Good Practice Recommendations Briarwood J53-J04 S19651 Briarwood V227751 260805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 4 Triune Court Monks Cross YORK YO32 9GZ 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. 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