Inspection on 10/07/07 for Briarwood Nursing & Residential Home

This inspection was carried out on 10th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Nursing & Residential... 18/07/06

Briarwood Nursing & Residential... 14/11/05

Briarwood Nursing & Residential... 07/02/05

Briarwood Nursing & Residential... 24/05/04

Briarwood Nursing & Residential... 20/10/03

Briarwood Nursing & Residential... 21/07/03

Briarwood Nursing & Residential... 29/08/02

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

CARE HOMES FOR OLDER PEOPLE Briarwood Nursing & Residential Home Normanby Road Eston Middlesbrough TS6 6SA Lead Inspector Jane Bassett Unannounced Inspection 10th July 2007 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 Nursing & Residential Home DS0000000149.V344987.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 & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Briarwood Nursing & Residential Home Address Normanby Road Eston Middlesbrough TS6 6SA 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 456222 01642 454777 Premier Nursing Homes Limited Mrs Gaynor Mallaby Care Home 49 Category(ies) of Dementia - over 65 years of age (49) registration, with number of places Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To allow the admission of service users aged 60 years plus. Date of last inspection 18th July 2006 Brief Description of the Service: Briarwood is a 49- bed care home providing both personal and nursing care to older people with dementia. It is a three-storey purpose built home providing 49 single bedrooms on the ground and first floor all with ensuite toilet facilities. There is a passenger lift giving access to the upper floors. The home provides two lounges and dining facilities on each floor accommodating residents. There is a garden area situated at the front of the building. The home is situated close to local amenities, shops and public transport. There are car-parking facilities for use of visitors to the home. Information in the pre inspection questionnaire indicated the homes fees range from £453. 08 per week depending on assessed need. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection report includes information obtained from a pre inspection questionnaire. An unannounced visit to the home was carried out. During the visit, which lasted five and a half hours the inspector walked around the building and looked at documentation including staff records and residents files. The inspector spoke to four relatives, four staff members and the manager. As the inspector walked around the home she carried out indirect observation of interactions between residents and staff. Whilst it was difficult for the inspector to obtain the views of the residents all appeared settled and comfortable in their surroundings. Two relatives returned surveys to CSCI. Four residents completed surveys with the support from staff at the home. What the service does well: What has improved since the last inspection? What they could do better: Some documentation in the home requires further development to promote the safety and wellbeing of the residents. This includes the continued development of the care planning records to ensure there is a consistent approach. All Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 6 residents’ records must reflect their current needs, how these are to be met, and the individual’s abilities and preferences. Documentation in relation to medication should include the appropriate signatures for hand written instruction on MAR sheets and medication returned to the pharmacy. The registered person must ensure that CSCI are notified of all incidents affecting the well being of service users. The registered provider must ensure that any issues in relation to safe guarding vulnerable adults are referred to the appropriate authority. Information contained in the complaints policy should be developed to include details of authorities funding the care of the residents. 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 & Residential Home DS0000000149.V344987.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 & Residential Home DS0000000149.V344987.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): Outcomes for standard 3 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective people to use the service and their representatives have the information needed to choose a home, which will meet their needs. EVIDENCE: During the inspection the inspector looked at two files of residents recently admitted to the home. Files seen were found to contain information obtained by the home prior to the residents admission. Evidence seen indicated that staff from the home carried out an assessment of need prior to the admission of the resident. Family members of a resident who had recently been admitted spoke to the inspector. They told her they had the opportunity to visit the home prior to their relative being admitted. During this visit they were given information about the home and the service provided and were given the opportunity to discuss the needs of the prospective resident. The home does not offer intermediate care. Briarwood Nursing & Residential Home DS0000000149.V344987.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): Outcomes for standards 7, 8, 9, & 10 were looked at. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Individuals and or their representatives are involved in decisions about their lives, and play a role in planning care and support received. EVIDENCE: During the inspection the inspector examined four resident files. These were found to contain assessments of activities of daily living, nutrition, waterlow, falls risk, general risks, and mental health assessments. Information about the residents also included life histories, some of which were written by family members. Files contained plans of care, however one file examined contained evidence that the person was incontinent. The file did not contain a plan of care in relation to this. Other plans of care lacked detail as to that persons specific needs. Due to the residents frailty and capacity it is not possible for them to be directly involved in care planning, however evidence was seen that indicated Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 10 families have discussed and agreed plans of care and have been involved in reviewing the care given. Families who spoke to the inspector confirmed this. Other records seen indicated residents have input from GP’s, district nurses, speech and language therapists, dieticians and other health professionals as necessary. The home operates a key working system and an additional team working process has been introduced on the nursing unit. Staff who spoke to the inspector were able to describe in detail the needs of individual residents and how these are met. Staff described how individuals are encouraged and enabled to be as involved in decisions as they are able. Due to the resident’s frailty and capacity it was difficult to ascertain their opinions, however one resident gave the inspector a thumbs up when asked about the home. Relatives who spoke to the inspector expressed their satisfaction with the care given one person said ‘it is excellent’ another said ‘ staff are really good, they know my relative well’. Comments in surveys returned to CSCI included ‘ I and all the family are very pleased and grateful for the wonderful care they give’. The inspector observed good interaction and rapport between staff and residents, needs were seen to be addressed with respect. A sample audit of medication identified no major issues with storage and administration of medication. However it was seen that the returns book is not always countersigned by the collecting pharmacy. Handwritten entries on the MAR charts were not always signed, dated and countersigned to reduce the risk of mistakes when copying information from the pharmacy label or prescription. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 12, 13, 14, & 15 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities meet individual’s expectations. People who use the service are encouraged and supported to make choices about their lives where able. EVIDENCE: Whilst it was difficult to ascertain the resident’s views and opinions the inspector did observe good interaction between staff and residents. All residents seen during the inspection appeared settled and comfortable in their surroundings. Staff who spoke to the inspector were able to describe how they promote choice and independence where possible. All spoke of respecting the privacy and dignity of residents. The home employs an activities coordinator who works with residents individually and in groups. Evidence was seen of various activities that have taken place, including entertainments, sing a longs, games and crafts. Relatives who spoke to the inspector confirmed there was usually something happening every day. Plans of care contained information as to individuals preferred activities. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 12 Relatives also confirmed there were no restrictions on visiting and people were always made to feel welcome. The inspector was told that meals were ‘tasty’, ‘ well cooked’, ‘really good’ and there was a good variety, however some concerns were raised regarding the teatime menu. A number of people mentioned that the variety of choices was sometimes limited. The manager told the inspector that menus were under constant review and alterations are made as necessary. Staff told the inspector the cook spends time talking to the residents about the meals and their preferences. The lunchtime meal in the first floor dinning room was observed. The surroundings were found to be pleasant and the meal unrushed. Staff were seen to give assistance to residents as necessary. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 16 & 18 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to an effective complaints procedure and have their rights protected. EVIDENCE: The home has a policy on handling complaints; this was seen to be available to residents, visitors and staff. This should be developed further to include details of those local authorities funding placements as recommended at the previous inspection. The manager told the inspector that relatives had been given this information. Relatives who spoke to the inspector confirmed they were aware of the policy and knew who to contact if they had a concern. Relatives who spoke to the inspector told her they felt that they were listened to and things were done, no one had any current concerns. Information in the pre inspection questionnaire indicated the home has not received any complaints in the last 12 months. Previous complaints were seen to be recorded appropriately. Staff who spoke to the inspector told her they have received training in the protection of vulnerable adults and prevention of abuse. All were able to describe how they would raise any concerns identified. Evidence seen by CSCI indicated that the majority of concerns are reported appropriately. However during the inspection visit the inspector was told of a concern that had not been referred to the local authority, adult protection coordinator. The inspector was given information that the issue had been Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 14 investigated by the provider and the provider felt that it was not necessary to refer the issue at the time. Briarwood Nursing & Residential Home DS0000000149.V344987.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): Outcomes for standards 19 & 26 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment. EVIDENCE: The home is purpose built providing single room accommodation with ensuite toilet facilities. On the day of inspection the home was found to be clean, tidy and odour free. Resident’s rooms seen by the inspector were found to be personalised to taste with pictures, ornaments and personal possessions. Relatives who spoke to the inspector commented on the pleasant environment. Information in the pre inspection questionnaire indicated the home is maintained as required. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 27, 28, 29, & 30 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained and in sufficient numbers to support the people who use the service. EVIDENCE: During the inspection the inspector examined four staff files. One of which was of a care staff member who had recently been recruited. This contained evidence of application form, references, criminal record bureau checks and induction training. Staff who spoke to the inspector confirmed they had been asked to supply all information prior to employment. Relatives and staff who spoke to the inspector said there was generally sufficient staff to meet the needs of the residents, however there were times when it was extremely busy. Comments received from relatives included ‘ the staff are very good’, and ‘ the staff are committed and friendly’ Information in staff records and the pre inspection questionnaire indicated staff have received the necessary training in relation to fire safety, moving and handling, prevention of abuse, first aid and safe handling of medication. A number of staff have undertaken dementia care training. Staff who spoke to the inspector told her that training was encouraged and available. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 17 Information received from the home indicated all care staff have achieved NVQ level 2 or above. The manager told the inspector further training in dementia care and palliative care was planned. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 18 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): Outcomes for standards 31, 33, 35, 36, & 38 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect, and has quality assurance systems. EVIDENCE: The registered manager is a first level nurse, has a management qualification and has experience of managing care services. Staff and relatives who spoke to the inspector told her there was an open door policy, and the manager is approachable. One relative told the inspector ‘ the manager always listens to what I have to say, she acts on things’. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 19 Comments received in surveys returned to CSCI included ‘ The care home Briarwood is really very good’ and ‘ the staff are always ready to help our family with any issue’. Regulation 26 visits take place and reports were available. Staff receive regular supervision and this is documented. Evidence seen on the day of inspection and information in the pre inspection questionnaire indicated fire alarms are checked weekly, there are regular fire drills, and hot water temperatures are checked as required. Information given indicated that the home and equipment are maintained and serviced as required. Accidents were seen to be recorded. It was seen during an examination of the accident / incident book there had been incident relating to a medication error. Records seen indicated that staff at the home had acted appropriately in relation to the safety and wellbeing of residents, however this incident had not been reported to CSCI as required in regulation 37. The manager carries out regular audits on care plans, medication and recorded accidents. The manager told the inspector the home does not handle any personal monies for residents, all expenditure is invoiced. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 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 Standard No Score 16 3 17 X 18 2 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 2 X 3 3 X 3 Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15 (2) (b) Requirement Work must continue to ensure plans of care reflect all the identified needs, how these are to be met, and reflect the individuals abilities and preferences. Timescale for action 01/10/07 2 OP18 13 (6) The registered provider must 01/09/07 ensure that any issues in relation to safe guarding vulnerable adults are referred to the appropriate authority. Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 22 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. Refer to Standard OP9 OP9 Good Practice Recommendations The registered person should ensure that records of returned medication include a signature to confirm collection by the pharmacy. Handwritten entries on the MAR charts should be signed, dated and countersigned to reduce the risk of mistakes when copying information from the pharmacy label or prescription. The written complaints policy should be developed further to include the details of those authorities funding the care provided by the service. 3 OP16 Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Briarwood Nursing & Residential Home DS0000000149.V344987.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!