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Inspection on 31/08/07 for Briarwood Nursing Home

Also see our care home review for Briarwood Nursing Home for more information

This inspection was carried out on 31st August 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and deputy managers are skilled and well informed. The staff and management team value the residents and respect their rights. Staff deliver excellent care practice for people who have very complex mental health needs or dementia. The staff respected resident`s wishes and responded to what people needed. Briarwood has a good staffing level and the qualified nurses specialise in caring for the needs of people with dementia and mental health needs. Staff try to find ways to communicate with the least able residents. Staff have access to a wide range of training. Staff have good record-keeping skills and assessments are extremely comprehensive and informative. They readily reflect the life people have had and their current needs.Mental Health Concern have recruited a person to work in the kitchen during the afternoon. This gives additional flexibility in meal choice and frees up care staff.

What has improved since the last inspection?

Medication systems are now improved and all aspects of recording is good.

What the care home could do better:

Light levels in the corridors must be improved.

CARE HOMES FOR OLDER PEOPLE Briarwood Nursing Home Whitmore Road Blaydon Tyne & Wear NE21 4AN Lead Inspector Mr T Moody Key Unannounced Inspection 31st August 2007 10:00 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 Nursing Home DS0000018169.V350249.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 Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Briarwood Nursing Home Address Whitmore Road Blaydon Tyne & Wear NE21 4AN 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) 0191 414 8374 0191 414 7439 janetmole@hotmail.com www.mentalhealthconcern.org Mental Health Concern Mrs Janet Mole Care Home 33 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (21), Mental disorder, excluding learning of places disability or dementia (12), Mental Disorder, excluding learning disability or dementia - over 65 years of age (12) Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 2006 Brief Description of the Service: Briarwood nursing home was built in the late 1960s by the local authority to provide nursing and personal care for older people with dementia care or mental health needs. The fees at the home are £795. These fees are funded by Gateshead PCT via continuing care arrangements. Briarwood is divided into three units. The one unit upstairs and one downstairs are used for the care of those with a dementia type illness. The other upstairs unit provides long-term care of people with complex mental health needs. All of the units have communal areas as well as bathrooms, toilets and bedrooms. The administration area is all located at the front of the building. The home is situated in the heart of Blaydon close to the Blaydon Precinct and the main bus interchange linking to Gateshead, Newcastle and Hexham. A short distance away is the local library, GP surgeries and dentist. The home is close to the main road however pedestrian crossings are available to improve access to local facilities. It is enclosed in its own grounds and is surrounded by a mix of houses. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried this unannounced inspection, speaking to people using the service, staff and visiting relatives. The deputy manager was present at the time of the site visit. All of the National Minimum Standards were inspected during the last inspection and information about systems was obtained from Mental Health Concern’s headquarters. This information was satisfactory and it was judged unnecessary to repeat this process as the documentation and processes were unchanged. Several residents were identified at the home. The care they received was tracked through discussions with staff, relatives and by looking at the service user plans. Visitor’s comments were universally positive about the care their relatives received and some relatives had developed a strong bond with staff. Information supplied by the home and comment cards were not available prior to the site visit but comments, collated later, were also positive. Briarwood provides nursing care for people with a dementia-type illness and care for people with mental health needs. Some of the people have difficulty communicating their views verbally. Therefore staff practice, attitude and approach were watched and judgements made on how well staff worked with people. What the service does well: The manager and deputy managers are skilled and well informed. The staff and management team value the residents and respect their rights. Staff deliver excellent care practice for people who have very complex mental health needs or dementia. The staff respected resident’s wishes and responded to what people needed. Briarwood has a good staffing level and the qualified nurses specialise in caring for the needs of people with dementia and mental health needs. Staff try to find ways to communicate with the least able residents. Staff have access to a wide range of training. Staff have good record-keeping skills and assessments are extremely comprehensive and informative. They readily reflect the life people have had and their current needs. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 6 Mental Health Concern have recruited a person to work in the kitchen during the afternoon. This gives additional flexibility in meal choice and frees up care staff. What has improved since the last inspection? 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 Nursing Home DS0000018169.V350249.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 Nursing Home DS0000018169.V350249.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): Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service. Information is available to service user’s and their relatives in documentation and through contact with staff. This ensures people can make an informed choice about the homes The assessments are extremely comprehensive and enable staff to meet service user’s needs. EVIDENCE: Service users guide is available and relatives say they are involved in all aspects of the placement process. The deputy manager confirms that this happens when there are close relatives to consult. Care plans are well laid out and well kept. A wide range of information is recorded, as well as people’s expectations about how they are to be cared for. There is good information about life histories and about cultural and spiritual needs of service users. The assessment records accurately reflect the needs of not only the residents with complex mental health needs but also those residents who have dementia care needs. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service. Staff are able to recognize resident’s needs and make sure they receive appropriate health and social care. EVIDENCE: Case tracking, and discussions with the deputy manager and staff, showed that the staff have a very in depth knowledge of the people using the service and their needs. Risk assessments are in place. There is written evidence of clinical specialists and consultants being involved in service user’s care. There is also reference to other aspects of local health care provision. Care plans were very clear, well laid out and comprehensively kept. One relatives spoke of working with staff to write the service user plan. During the site visit, it was seen that staff sought resident’s and relative’s agreement to undertake tasks or provide services. The medication system was working effectively. Storage is appropriate and record keeping is good. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service. Staff recognise the need to make sure residents make choices about their lives and as far as possible help people remain independent. Service users are able to enjoy activities and a lifestyle suited to their needs and aspirations. EVIDENCE: During the site visit staff responded to residents and listened to their views. People were encouraged to complete activities, which reflected their previous lifestyles. The resident’s with complex mental health needs were constantly asked their view and gave them options to choose from. Service users were guided gently during activities or when making their way around the home. Case tracking showed that staff have recorded information about resident’s ability to make decisions about everyday activities as well as those around their future. Discussions with staff and deputy manager confirmed that they had an indepth knowledge of the service user’s strengths and abilities as well as their problems. Service users spoke of trips out and said the staff were “good to them”. Staff on the dementia care units constantly chatted to residents and they appreciated the conversation. Relatives said, ‘The staff are just lovely. I couldn’t be more contented ’. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 11 The home has it’s own transport and the deputy manager spoke of service users going on outings for shopping or other community contact such as trips to the local barbers to have a haircut. A part-time kitchen assistant has been employed. Although meals are provided through a cook-chill system the additional kitchen staff can now provide an increased degree of flexibility in providing snacks as well as the evening meal. The service users are also able to use community facilities and on the day of inspection a meal of fish and chips had been procured from a local shop. Service users appreciated this and enjoyed their meal. During the meal, less able service user’s were well supported by staff. Ensuring they had adequate food and drink which was given in an appropriate manner. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home’s staff deal proactively with complaints or concerns and service users are protected by this approach. EVIDENCE: The complaints procedure is made available to residents and relatives through the service user guide. Relatives said that the found the staff and manager approachable. One said, ‘the home is very flexible, I couldn’t ask for anymore’. Case tracking showed that when people had raised concerns, even if these were minor matters staff treated these seriously and took action to resolve the issue. The home has an appropriate, protection of vulnerable adults policy and they follow Gateshead Social Services Department guidance. The deputy manager and staff confirmed that they receive regular training and updates in relation to this. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Briarwood has been divided into discrete units, which provide a homely environment and met residents’ needs. EVIDENCE: Briarwood has been recently refurbished. Up to date adapted baths and showers have been installed and these are suitable for people mobility problems. The bedrooms sizes have been increased and smaller more homely units have been created for the care of all residents. One of the dementia care units is downstairs so residents can easily go out into the garden. The units are well decorated and the use of symbols and pictorial clues help people find their way around. All of the decorative works have been conducted to a high standard but the type of lighting in the corridors does not give light levels that would meet the National Minimum Standards. The deputy manager agreed that this would be addressed and spoke to a maintenance engineer on the day of the site visit. The home was clean and tidy and there were no unpleasant odours anywhere in the home. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service. There are sufficient staff available, who are suitably trained, to meet service user’s needs. EVIDENCE: The staffing levels in the home were sufficient for staff to assist service users to cope with their complex mental health needs and difficulties dealing with everyday life. Relatives from the dementia care unit were observed to come in during mealtimes to assist their loved ones to eat. Staff in the home supported them in this and ensured they were also able to have a meal at this time. Mental Health Concern has a dedicated training department. This department provides staff with opportunities to go on a wide range of training. Mandatory training such as food hygiene is being completed. 78 of care staff have completed NVQ training and the qualified staff are able to go on various courses including degrees. Staff records are kept centrally but these can be seen via an intranet link. Personnel staff make sure that CRB checks are completed, references obtained and full employment histories taken. The deputy manager stated that new staff are supervised until the induction training has been completed. There is a training “matrix” form available to show “at a glance” when training is due or who has attended mandatory training events. Staff confirmed this and said the felt the company was good at meeting their training needs. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home has an efficient manager and deputy. The company provides effective management systems for the home and the implementation of these ensures service user’s needs are met. EVIDENCE: The home manager was not present during the site visit, however the deputy manager was capable, confident and well informed. The deputy said she felt well supported by Mental Health Concern. The deputy and her staff were up to date in developments in mental health and dementia care and care is research based. The company is very effective in training all of the staff and the staff are highly motivated. The company carries out quality audits and these include customer service questionnaires. Relatives confirmed that they had received these. A team of finance staff at the head quarters look after the personal allowance records. Relatives and resident’s when they need information can get this Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 16 from the manager via the intranet system. Only small amounts of money are held on behalf of residents. Receipts are kept. There were no health and safety issues noted at the time of the inspection other than concerns about light levels in the corridors. This was starting to be addressed almost immediately. Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 17 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 2 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 X 3 3 Briarwood Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 18 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. 1. Standard OP25 Regulation 13, 23 Requirement Light levels must be maintained to the level set in the National Minimum Standards, in all areas used by service users Timescale for action 30/11/07 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 Nursing Home DS0000018169.V350249.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection South Shields Area Office 4th Floor 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. 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