Inspection on 18/07/06 for Briarwood Nursing & Residential Home

This inspection was carried out on 18th July 2006.

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 Nursing & Residential... 10/07/07

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 Key Unannounced Inspection 18th July 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 Nursing & Residential Home DS0000000149.V304946.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.V304946.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.V304946.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 14th November 2005 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 £365 to £485. Briarwood Nursing & Residential Home DS0000000149.V304946.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, five relative / visitor comment cards were received. An unannounced visit to the home was carried out. During the visits, which lasted a total of six hours the inspector carried out a tour of the environment, an audit of documentation including staff records and residents files, and spoke to four relatives, six staff members, and the manager. Whilst it was difficult for the inspector to obtain the views of the residents all appeared settled and comfortable in their surroundings. What the service does well: What has improved since the last inspection? The home continues to provide a pleasant environment with a planned programme of maintenance and redecoration. The manager has obtained information regarding current good practice and guidance in relation to nutrition in the elderly and has developed the menus to reflect this. Briarwood Nursing & Residential Home DS0000000149.V304946.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. Briarwood Nursing & Residential Home DS0000000149.V304946.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.V304946.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group is Good. This judgement has been made using available evidence including a visit to the service. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. EVIDENCE: During the inspection two files of residents recently admitted were examined. These were found to contain an assessment of need carried out by the home prior to the resident’s admission. The manager confirmed that wherever possible staff from the home would visit the prospective resident and carry out a full assessment prior to their admission. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 9 Two family members who spoke to the inspector told her they had visited the home prior to their relative’s admission, staff at the home had been helpful and had given them the information they required. They also stated they were given the opportunity to discuss their relatives needs. Briarwood Nursing & Residential Home DS0000000149.V304946.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome group is Adequate. This judgement has been made using available evidence including a visit to the service. Each resident has a plan of care that has been agreed with them or their representative, however information was not always clear as to current needs and how these are to be met. The plan also contains a risk assessment. EVIDENCE: During the inspection six plans of care where examined. Two of these were found to be confusing as to the resident’s current needs and how these were to be met. Files contained assessment documentation, plans of care, reviews and daily recordings. Areas of need identified within the assessments and other documentation did not always have a specific plan of care as to how that need was to be met. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 11 Concern was raised by the inspector that the terminology within some of the documentation could be open to misinterpretation and should be more specific. Files of the four long term residents were seen to contain that person’s life history; a number of these had been completed by the resident’s own family. Plans of care seen included evidence of discussion and agreement with resident’s representatives. Relatives who spoke to the inspector confirmed this. Evidence was seen in plans of care to indicate residents have appropriate access to GP’s, and other health professionals. Staff who spoke to the inspector were able to describe in detail the needs of individual residents and how these are met. Due to the resident’s frailty and capacity it was difficult it ascertain their opinions, however a number of relatives spoke to the inspector. Comments received included ‘very satisfied with the home’, Very happy here’, and ‘ we are pleased with the care and welcome given’. The inspector observed a good interaction and rapport between staff and residents, needs were seen to be addressed with respect. The home has a policy on the administration of medication. A sample audit of medication identified no major issues with storage and administration. Staff who administer medication have received ‘safe handling of medication’ training. Briarwood Nursing & Residential Home DS0000000149.V304946.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome group is Good. This judgement has been made using available evidence including a visit to the service. Family and visitors feel welcome. Staff resources are provided to allow time for activities and stimulation. The home provides meals that offer quality variety and choice. EVIDENCE: Whilst it was difficult to ascertain the resident’s views and opinions on their lifestyle the inspector did observe good interaction between staff and residents. All residents observed appeared to be 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 resident’s privacy and dignity, and the importance of treating people as individuals. The home employs an activities co-ordinator, who has been working with the residents in both groups and individually. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 13 During the inspection it was observed that residents were encouraged to socialise and participate in the activities. Staff and relatives who spoke to the inspector commented on the recent enjoyable trips to Albert Park and Kirkleatham. Relatives spoke of the welcome that they receive and the friendly but respectful attitude of all the staff. The home has recently developed the menus provided to reflect current good practice and guidance obtained in respect of ‘menu solutions for care homes’. All who spoke to the inspector expressed satisfaction with the quality, choice and variety of meals provided. One relative commented ‘the food is very good’ another said their relative ‘ loves’ the meals. The lunchtime meal was observed in the ground floor dining room. The surroundings were seen to be pleasant and the meal was unrushed. Staff were available to assist the residents as required. Briarwood Nursing & Residential Home DS0000000149.V304946.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome group is Good. This judgement has been made using available evidence including a visit to the service. The home has a complaints procedure that is available to all. Resident’s representatives confirmed they had a good understanding of how to make a complaint and were clear of what can be expected to happen if a complaint is made. EVIDENCE: The home has a policy on handling complaints. This is available to residents, visitors and staff. This should be developed to include contact details of those local authorities funding placements at the home. Information received in the pre inspection questionnaire that indicated the home has not received any complaints. However one complaint recently received by a local authority is currently being investigated by the home. Responses in the relative questionnaires received by CSCI indicated that people had no current concerns, and are aware of how to raise any issues. Relatives who spoke to the inspector confirmed this. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 15 Staff confirmed that they have received training in relation to prevention of abuse and were able to demonstrate through response to questions the actions they would take if a concern arose. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome group is Good. This judgement has been made using available evidence including a visit to the service. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe place to live with rooms that meet the NMS and have en suite facilities. EVIDENCE: The home is purpose built providing single room accommodation with en suite toilet facilities. On the day of the inspection the home was found to be clean, tidy and odour free. Resident’s rooms seen by the inspector were found to be personalised with pictures, ornaments and personal possessions. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 17 Visitors who spoke to the inspector commented on the pleasant environment. One relative told the inspector ‘ it is always clean and tidy’. One comment in the relative questionnaires received by CSCI stated they were ‘ very satisfied with the home’. Information received in the pre inspection questionnaire indicated that the home is maintained as required. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30. Quality in this outcome group is Good. This judgement has been made using available evidence including a visit to the service. The recruitment process IS robust promoting the safety and well being of residents. Staff are receiving training. Evidence indicates that staff have the appropriate skills and ability to meet the residents needs. EVIDENCE: During the inspection four staff files were examined. These were found to contain the appropriate documentation in relation to recruitment and supervision. Evidence from staff files seen and information in the pre inspection questionnaire indicates that staff receive appropriate training including Fire safety, First aid, Safe handling of medication, Manual handling, Food hygiene, prevention of abuse and Dementia awareness. Staff who spoke to the inspector confirmed this. Information in the pre inspection questionnaire indicated 80 of the care staff have achieved NVQ level 2 or above. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 19 Relatives who spoke to the inspector commented on the friendly but respectful attitude of the staff. Comments received included ‘the care is excellent’, ‘ we are satisfied with the care’ and ‘ staff are always friendly and welcoming’. Relatives were generally satisfied with the staffing levels, however one comment received indicated that staff appeared ‘ stretched’ especially at teatime. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome group is Good. This judgement has been made using available evidence including a visit to the service. The manager has the required qualifications and experience and is competent to run the home. She works to improve the service and provide a good quality of life for the residents. 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 that there was an open door policy and the manager could always be approached. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 21 Relatives told the inspector that they had the opportunity to attend meetings and raise issues. Comments received included ‘ the home is well managed’ and ‘we have confidence in the home’. Regulation 26 visits take place and reports are supplied to CSCI. Information within the pre inspection questionnaire indicated that equipment such as passenger lift; fire alarms, emergency lighting and hoists are maintained as required. The manager told the inspector that the home does not hold any personal allowances for residents, all expenditure is invoiced. Accidents were seen to be recorded appropriately. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 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 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 23 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 Plans of care must be reviewed and developed to reflect current identified needs and how these are met. Timescale for action 01/09/06 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 OP16 Good Practice Recommendations The Complaints policy and procedure should be developed to include details of all funding authorities. Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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. Extracts may not be used or reproduced without the express permission of CSCI Briarwood Nursing & Residential Home DS0000000149.V304946.R01.S.doc Version 5.2 Page 25 - 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. 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