CARE HOMES FOR OLDER PEOPLE
Briercliffe Lodge Rainhall Crescent Barnoldswick Lancashire BB18 6BS Lead Inspector
Mrs Marie Dickinson Unannounced Inspection 10:30 7 February 2006
th 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 Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 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. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Briercliffe Lodge Address Rainhall Crescent Barnoldswick Lancashire BB18 6BS 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) 01282 816638 01282 816638 Mrs Gillian Eyton-Jones Mrs Rebecca Eyton-Jones Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Staffing levels as specified in notice of proposal to grant registration subject to conditions dated 25 October 2002 3rd October 2005 Date of last inspection Brief Description of the Service: Briercliffe Lodge is registered with the Commission for Social Care Inspection to provide accommodation and personal care for seventeen older people. The home is owned and managed by Mrs Gillian and Mrs Rebecca Eyton-Jones with the support of a deputy manager and senior staff. Staff are on duty and available twenty four hours a day. The home is a detached property set in its own grounds, with outdoor seating areas and car parking facilities. It is located in a residential area on the outskirts of Barnoldswick. Accommodation is provided on two floors in thirteen single and two double bedrooms. The upper floor bedrooms can be reached by using a stair lift. There are comfortable lounges, dining rooms and conservatory. There are two assisted bathrooms and seven bedrooms with en suite facilities. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 7th February 2006. It is the second required statutory inspection carried out this year. The inspection involved getting information from staff records, care records and policies and procedures. It also involved talking to residents, visitors and staff on duty. People who live at the home and staff on duty were asked for their views about the home and how it was managed. Consideration was also given in methods used by the owners and staff employed, to get residents and relatives views on the care provided and the home they lived in. How care was actually provided was discussed with everyone. The home was assessed against the National Minimum Standards for Older People. Not all standards were assessed and this report should be read with the inspection report dated 3rd October 2006 for the reader to have a complete overview of the home. One of the owners Mrs Eyton-Jones was on duty. What the service does well:
Information was made available for people interested in the services and facilities of the home. Before anyone is admitted, proper assessments are completed and used to decide if living at the home is in the person’s interest. This information was used correctly, making sure residents requirements for care and support by staff was provided. Information recorded in care plans gave care staff clear guidance in what each person needed day and night. Guidance was written on how to keep people safe. Staff were described as ‘wonderful’, ‘kind and helpful’. Relatives shared this view. Activities were varied and to residents liking. Good hospitality was given to visitors to the home who were made welcome by staff. Relatives were consulted and kept informed of their relatives changing needs. Everyone considered the catering arrangements to be very satisfactory. Residents living at the home expressed satisfaction about their accommodation. Bedrooms could be personalised. The home was spacious and furnished to a satisfactory standard. A good level of hygiene was maintained and observed during inspection. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 6 The numbers of staff employed helped make sure residents lived a lifestyle that suited them. Staff were trained properly to care for older people. They were supervised in their work and teamwork was evident. Staff said they enjoyed their work. Residents were given opportunities to have their say in how they think the home is run and if improvements could be made. Their views were considered important. Residents were consulted about important issues that may affect them. 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.
Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 8 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 Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 9 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): 1,2,3,4,5 Sufficient information about the home was made available for people to help them decide if the home was suitable to meet their need. Assessments of people wanting to live in the home contained enough information to plan how care needs were to be met. Trial stays were offered. Staff were trained to care for people. Advice was taken from other professionals to make sure all care needs were dealt with in a proper way. Residents were given a contract on admission. EVIDENCE: One resident said that she was currently deciding if she wanted to stay at the home. Her daughter had made the arrangements for her to stay. This home was what she chose and she was happy. Records showed an assessment had been completed before the resident came to live at the home. There was sufficient information recorded that provided a clear and detailed picture of what support was needed. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 10 Information was available about the home that included a residents guide outlining the services and facilities provided. Staff had been given training to care for older people. Records showed that staff acted upon the changing needs of residents and consulted with other professionals for advice such as the visiting district nurse. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 11 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 Care plans were used to help staff to provide the right personal care for residents. The plans had been reviewed regularly with residents. Residents were satisfied that their needs were met and they considered staff were respectful to them. Medication was managed properly. EVIDENCE: Care plans were written for the residents. These plans showed how people’s care needs had been identified. The care plan showed what help was required such as when getting up, or if help was needed for walking and bathing. In addition to this, each resident had a night care plan that showed how care was to be provided during the night. There was evidence that residents were involved in regular reviews. Two relatives visiting during inspection said they had meetings with staff to discuss their mothers care needs. They said staff explained how they would support their relatives. This was ‘appreciated’. The staff said they were involved with care planning. They work to a key worker system, which involves having extra responsibilities for a number of individual residents.
Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 12 Resident’s healthcare and mental health care needs were recorded with guidelines for staff. These included continence management and mental health wellbeing. Residents confirmed staff talked to them about their care. They liked their carer and were happy with how they helped them. They considered all the staff to be ‘nice’ and ‘wonderful people’. Daily records showed residents received personal care and additional specialist support where needed. This included help from the visiting district nurse. Other professional people visited such as chiropodist and residents doctors. Information was recorded to keep people safe. Residents said staff were mindful of their privacy. Personal care such as bathing was given in private. They also confirmed staff would knock on bedroom doors and wait to be invited in. Medication was managed properly. One visitor to the home said ‘you read about people not getting proper medication in care homes, but not here, they are so very careful’ Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 13 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 Resident’s lifestyle was to their expectations and they felt satisfied with their care in the home. Activities were provided and resident’s relatives and friends who visited were made welcome. Catering arrangements were satisfactory. EVIDENCE: Activities for residents were varied and included craftwork, exercise class, manicures, baking, trips, concerts, entertainers and going out for walks. Residents said they were happy with this provision. There had been three birthday celebrations recently. One had been a 100th birthday. These were celebrated with entertainment, music and dancing. Residents said ‘they played songs we knew, it was really lovely’. Staff generally had time to organise events and activities suitable for everyone to enjoy. Some residents said they had communion in the home. People from churches visited regularly. Residents said routines in the home suited them. They could please themselves when they get up or when they went to bed and staff were available should they need them.
Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 14 There were a number of visitors in the home during inspection. They said they ‘always feel welcome’. Residents said there were plenty of visitors. Staff were ‘very good and gave their visitors a hot drink and they were friendly’. One resident said she ‘missed her family although they do visit, staff are very kind’. One written comment said ‘staff always smile and are friendly’. Tables set for lunch were nicely presented. The food served to the residents was very good. Choices were offered and special diets catered for. Visitors to the home said ‘the meals always look and smell good’. Residents said the food was to their satisfaction. They had a menu to choose from and had a different meal provided if they didn’t want the choices offered. The meals were ‘home cooked’ and ‘very nice’. Menus were discussed with residents. Staff gave assistance to those people who could not manage to eat their meal without some help with feeding. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 15 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): 16,17,18 The complaints procedure was clear and easy to use for residents and visitors to the home such as relatives. Any concern or suggestion was listened to and taken seriously. There were policies and procedures in place to make sure any suspicion or allegation of abuse was dealt with correctly. Residents were registered to vote in local and general government elections. EVIDENCE: The complaints procedure was given to residents when they came to live at the home. A number of residents said they had no complaints against the staff, but if they did they would speak to the owners who worked in the home or any other staff member. There had been no complaints received at the Commission. When people are resident in the home they are entered on the electoral register. Abuse procedures including a whistle blowing policy were covered in training given to staff. This involved completing a workbook, and was part of induction. A condition of employment included an agreement, which prevented staff having any financial gain from residents. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 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): 19,23,26 The home was maintained to a relatively good standard, and residents lived in a comfortable and homely environment they liked. Residents were able to bring personal possessions from home when they were admitted for their bedrooms. A good standard of hygiene was achieved. EVIDENCE: Briercliffe Lodge is situated in a residential area on the outskirts of Barnoldswick. There are gardens to the side and rear that residents can walk around, and car parking space at the front. The home was furnished to a relatively good standard. Since the last inspection some rooms had been decorated. The hallway benefited from being made into a comfortable reception. Some repair work required to a bath panel and tiles remain outstanding. Comments made by residents and visitors described the home as ‘very homely’, ‘welcoming warm and clean’.
Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 17 Residents said they liked their bedrooms. One resident recently admitted said she had brought her ‘lamp, bits and pieces, television and her own chair, clock vase and picture’ when she came to live at the home. Residents had a key to lock their room if they wanted. The double rooms had privacy screens. The owner said people were given a choice to share. Records show how agreement to share this room is managed properly. A good standard of hygiene was observed throughout the home. Staff were employed for this purpose. The laundry was organised and washing machines had the right programmes for washing heavily soiled linen. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 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): 27,28,30 The level of staffing was good. Residents had confidence in the staff working at the home. Training provided and attended by staff was good which helped them to develop proper skills in caring. Staff received regular supervision. EVIDENCE: The home was properly staffed during the inspection. The residents were very happy with the staff in the home. They said they were very caring and ‘a pretty decent lot’. Relatives visiting said the staff were ‘very good’ and in their opinion there were always enough staff on duty’. There had been no new staff recruited since the last inspection. All staff had attended basic training. The percentage of staff having completed a national vocational qualification in care level 2 and above was over 50 . Staff said they enjoyed training and were helped by the owner to develop their career in care. They received supervision regularly. A supervision planner was used for this purpose. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,36, The home was managed efficiently and in the interest of the residents. Proper accounting and financial procedures protected residents. Guidance and support was given to staff, which benefited residents. EVIDENCE: Residents had regular meetings. Records of these were kept. The agenda of a recent meeting dealt with issues such as any complaints, suggestions or improvements to be made. The meeting was well attended and showed residents did influence how service was provided in the home. What they said mattered and was acted upon. Anonymous questionnaires were used as a means of seeking what people thought about the care and services given. The outcomes of these findings were made available for people to look at.
Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 20 Staff confirmed they received routine formal supervision and annual appraisals. However formal staff meetings should be held in the home to benefit staff generally as a team. Staff said they enjoyed their work in the home and worked well as a team. Residents, relatives and staff expressed general satisfaction about the home. Staff said they were given proper instructions, guidance and support. Work routines were established and flexible to suit residents. The insurance documentation for the home was up to date. Business and financial planning for 2006 showed how investment was being made to upgrade the environment. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 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 Standard No Score 16 3 17 3 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 X 2 X X Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard OP21 OP36 Good Practice Recommendations It is recommended the bath panel and tiling on the wall be repaired or replaced. It is recommended staff receive regular formal supervision. Briercliffe Lodge DS0000009479.V272195.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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