Inspection on 20/08/08 for Brierfield House Care Centre

This inspection was carried out on 20th August 2008.

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

Brierfield House Care Centre 15/07/09

Brierfield House Care Centre 19/03/08

Brierfield House Care Centre 13/08/07

Brierfield House Care Centre 11/10/06

Brierfield House Care Centre 27/04/06

Brierfield House Care Centre 24/11/05

Brierfield House Care Centre 12/10/04

Brierfield House Care Centre 06/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Brierfield House Care Centre Hardy Avenue Brierfield Nelson Lancashire BB9 5RN Lead Inspector Pat White Unannounced Inspection 20th August 2008 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 Brierfield House Care Centre DS0000022499.V366494.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. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brierfield House Care Centre Address Hardy Avenue Brierfield Nelson Lancashire BB9 5RN 01282 619313 01282 698477 brierfield@ashbourne-homes.co.uk 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) Ashbourne Homes Ltd Care Home 42 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (26), of places Physical disability (1) Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to provide personal care for a maximum of 42 service users A maximum of 41 service users who fall into the category of OP (Older People) One named service user who falls into the category of PD. A variation application must be submitted to the CSCI to remove this category when this person no longer resides in the home. 19th March 2008 Date of last inspection Brief Description of the Service: Brierfield House is a residential care home registered to provide care and accommodation for 27 older people and 15 older people with dementia. The 27 older people occupy the ground floor and part of the first floor. They have the use of a lounge, a dining area and a conservatory on the ground floor. The residents with dementia related needs reside in a self -contained unit occupying the rest of the first floor. The dementia unit has its own dining area, lounge and separate staircase access to the outside grounds, part of which was adapted for exclusive use of the residents in the unit. A passenger lift provided access between the two floors. The home is purpose built, in its own grounds, on the outskirts of Brierfield. All bedrooms are single and en suite. There were 6 WCs, 3 bathrooms and 2 shower facilities, all with equipment and adaptations to assist people with restricted mobility. Fees were given as £412 - £472 per week and cover all aspects of care, accommodation, food and laundry. Hairdressing, chiropody, papers, magazines and some trips are not included in these fees. The home has a Statement of Purpose and Service User Guide that provide residents and relatives with written information about the home, including about staff and the services and facilities. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means that people who use the service experience Adequate outcomes. This inspection site visit to Brierfield House was carried out on the 20th August 2008. The site visit was part of an inspection to determine an overall assessment on the quality of the services provided by the home (see above). This included checking important areas of life in the home that should be checked against the National Minimum Standards for Older People, and checking the progress made on the matters that needed improving from the previous key inspection on 19/03/08 and that had been the subject of an on going Improvement Plan submitted to the Commission. This inspection undertaken on 20/08/08 included: talking to residents, visitors and staff, touring the premises, observation of life in the home, looking at residents’ care records and other documents and discussion with the manager and operations manager (the “management team”). Eleven residents were spoken with and seven gave their views on the home. In addition survey questionnaires from the Commission were sent to residents, relatives and staff, asking them for their views of the home. At the time of writing this report, 3 residents, 1 relative and 5 members of staff had returned completed questionnaires. Some of the views of these people are included in the report. In addition the home provided the Commission with written information prior to the site visit about the residents, staff, services provided, and it’s own assessment on the quality of the services. Some of this information is also included in the report. What the service does well: People’s needs were assessed before they were admitted to the home so that a decision could be made about whether or not the home could meet their needs. The written records of resident’s needs were in general well written, and covered most of the important matters regarding health and personal care needs. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 6 The care plans included detailed information about most aspects of care and this information had been updated. Medication systems and procedures were overall safe and residents received their medicines correctly and at the right time. There was an activities organiser in the home and there were varied and interesting activities. The home provided pleasant, bright and modern accommodation for the residents. It was attractively furnished and decorated. All the bed - rooms are single and en suite. The building, the services and the facilities were well maintained and safe. There was a good programme of staff training, and staff had opportunities to attend training according to their own needs and the needs of the residents (see below). The management team regularly carried out its own checks to find out how good the care and services provided in the home are. What has improved since the last inspection? The written information about the residents had been reviewed, up dated and made clearer, so there was more accurate information about what care and support people needed. The cabinet used to store controlled drugs had been secured to the wall in accordance with the legislation and this had made storage of these drugs safer. The way residents were treated by staff had improved. Residents said that their care, and staff attitude towards them had improved. People said that staff “were nicer”, and that they didn’t have to wait as long for attention. The staffing problems that had been ongoing for some time had been improved (see above). Some staff had left, and new ones had been recruited, and this had encouraged a better attitude and a better team spirit with staff working together more. The management of the home had improved, and a well - qualified and experienced manager had been recruited since the previous inspection. Senior Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 7 managers from Southern Cross Healthcare frequently and regularly supported the manager. 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. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 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 Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 4. Standard 6 was not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedures assisted residents and relatives to make a choice of whether or not the home would be suitable. EVIDENCE: The home had a Statement of Purpose and Service User Guide to give people information about the home, the staff and facilities. Service User Guides were seen in the residents bedrooms. The Service User Guide had been updated since the previous inspection and had been made more specific to Brierfield House. There was a specific brochure for the dementia unit describing the services and facilities for people with specific needs relating to dementia. There had been some recent admissions to the home which showed that thorough admission procedures had been followed, including a pre admission assessment to help determine whether or not the home could meet people’s Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 10 needs. This involved the manager meeting the prospective resident and /or familiy. The needs of some residents had been reassessed to establish whether or not the home could still meet these needs. The records of some of these records, were incomplete at the last inspection. They were therefore assessed again at this site visit and were found to be improved, with the information being updated and made clearer as required. This meant that there was more accurate information about people’s needs and the support required, including mental health and nutrition needs. The residents spoken with at this inspection and who were able to give their views indicated that there had been an improvement in the way they were looked after and how their needs were met by the care staff. Two relatives spoken with also felt that the home had improved and was better able to meet the needs of the residents. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans contained sufficient up dated and accurate information in most matters relating to health, personal and social care. Residents’ health care needs were met and medication management and procedures were in general safe and helped to maintain residents’ health. Residents felt that staff treated them more respectfully than in the recent past. EVIDENCE: The care plans of seven residents were viewed, including 1 in the dementia unit and including 3 that had been looked at previously to check progress made. These care plans were generally well completed and there were appropriate risk assesments and plans covering different areas of care to help staff look after people safely. There was evidence of care plan reviews to which relatives were invited. Also the care plans had been updated when needed. Details about mental health, nutrition and moving and handling that were missing or inaccurate on these plans at the previous inspection, had been completed. However on some care plans viewed there were insufficient details Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 12 about previous interests and hobbies, and on one care plan there was contradictory information about nutrition so that it wasn’t clear whether or not the person was at risk. Another care plan did not have details about whether or not the resident concerned was being encouraged and assisted to get up from bed. These details were necessary to avoid misunderstanding. Records, discussion with people, and the questionnaires, showed that residents’ health care was monitored and addressed. There was evidence of ongoing contact of some residents with psychiatric services for older people. Risk assessments on vulnerability to pressure areas were undertaken which linked to recorded preventative measures and district nurse involvement. Falls risk assessments were also carried out with information about management strategies recorded in the care plans. However the position of an alcohol based gel dispensor for hand washing in some residents’ rooms had not been assessed for any risk to the residents concerned. The 3 residents who completed the questionnaires and those spoken with felt that their care and support was “usually” available when needed, and medical support was sought as required. The inspection included looking at the records of medicines’ receipt, administration and disposal, and the ones looked at were detailed and accurate. Medicines records were checked against current stock and it was found that most medicines were usually given correctly, ‘as prescribed’ (see below). Medicines were stored securely and the cabinet used to store controlled drugs had been secured to the wall according to the regulations. In general there was good detailed information to help support the use of medicines prescribed as ‘when required’, but there was insufficient written guidelines on when to give the food supplements prescribed as “when required”. Having clear written plans is important to ensure residents have their medicines administered correctly. Also on one occasion one resident had received a tablet from another residents’ supply, because the medication was the same and the names were similar. On this occasion the right medication was given. However such a mistake could have serious consequencies, as it could result in a resident taking the wrong medication. Residents spoken with felt their rights to privacy were upheld, and several appreciated that they could spend time in their bedrooms if they wanted. Also on this site visit residents felt that the way staff treated them had improved and that in general staff were more respectful and patient. One said that the new staff “were nicer and that things were better”. However one felt that though things had improved “there was still room for improvement”. Relatives also thought that staff attitudes had improved. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient varied leisure activities to suit the individual needs and preferences of the residents, and they were enabled to maintain contact with their relatives and the community. Most residents felt they had sufficient choices in their everyday life. Mealtimes and the food served did not always suit the preferences of the residents. EVIDENCE: The inspection methods used, including discussions with residents, information supplied by the home, the questionnaires and records, showed that there were suitable and varied leisure activities. There was an “activities organiser” employed in the home and residents were seen on an individual basis to try and establish suitable activities. Activities were discussed in residents meetings and after listening to residents views more trips out had been organised. Ministers from different denominations visited the home to help residents maintain their religious interests. Relatives who were spoken with felt that communication between the home and themselves was satisfactory and that they were kept informed of Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 14 important matters affecting the residents and that overall this had improved . Visitors were made welcome at any reasonable time, according to the home’s visiting policy. Relatives were encouraged to attend activities and events, and residents’ reviews. Visitors were seen coming in and out of the home. Some residents spoken with felt they had enough choices in their everyday lives and could spend time in their rooms if they wished and could rise and retire when they wished. One resident was assisted to smoke when she wanted to. Residents could manage their own finances if appropriate. People were allowed to bring small personal possessions with them to personalise their rooms. The menus viewed indicated that the food served should be nutritious and varied. There was a choice of two main (cooked) meals and desserts. There was also a choice of a second cooked snack meal. Assistance was given to those who needed it and food was served in a suitable form for those with eating difficulties. However on the day of the site visit there was a shortage of kitchen staff and there were a number of problems. Lunch was served later than usual and residents were waiting too long at the table. Some residents were irritated and imaptient by this. Also the meal served was not the one on the planned menu and was not enjoyed by a number of residents who were spoken with. These matters were discussed with the management and the Commission was confident that this would be addressed and was not a usual set of circumstances. Drinks and biscuits were served at times throughout the day. Three residents who completed the questionnaires said they “usually” enjoyed the food Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaints procedure was accessible to residents, and residents and relatives knew who to speak to if they had any concerns. There were policies and procedures to help protect people from abuse but these were not always followed rigorously enough to ensure people were protected. EVIDENCE: The home had a complaints procedure that was used by relatives. Records and information supplied by the home to the Commission showed that 2 complaints had been made since the last inspection in March, and were still under investigation. None had been made to the Commission. The three residents who completed the questionnaires knew who to speak to if they were not happy with something and said they knew how to make a complaint. However not all residents spoken with said they knew how to make a complaint and one relative also said they did not know the process. Since the previous key inspection in March 2008, and up to the site visit, there had been 2 further allegations made against staff of potential abusive nature. One was an allegation of theft of money and the other concerned a member of staff using a residents’ lap top computer for their own purposes and without the resident knowing. This latter incident was dealt with properly and appropriate action was taken. However with respect to the allegation of theft Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 16 of money the police and the Social Services were not notified as soon as they should have been. Therefore the correct procedures were not followed and there was the possibility that this incident was not investigated as effectively as it could have been. Also there was no evidence in the home of the action taken following previous incidents of theft so it was still not clear how people’s money was being protected. Staff, were undertaking Protection of Vulnerable Adults Training as part of a rolling programme, and which is intended to help protect residents from abuse. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 17 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): 19, 20, 23, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was maintained and furnished to a good standard and provided pleasant, clean and comfortable accommodation, including the bedrooms, which were personalised and suited residents’ needs. EVIDENCE: Brierfield House is a purpose built care home. The premises were maintained to a good standard, were light and airy, comfortable, pleasantly decorated and furnished, and complied with fire regulations. Maintenance and refurbishments were carried out when required and according to a programme of maintenance. A handy man was employed in the home so that smaller jobs could be completed quickly. The outside grounds at the back of the home had a seating area with tubs of plants. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 18 The rooms viewed were clean and well furnished, and the bedrooms were personalised. A number of bed room carpets had been replaced, some with easy to clean floors to help eliminate unpleasant odours. However some rooms still had alcohol based hand wash gels attached to the wall in the ensuite toilet and there was no risk assessment to demonstrate that this was safe. Some parts of the home had been recently re-decorated and refurbished including bedrooms, corridors, the kitchen and the downstairs bathroom. Further improvements were planned for the near future. There was a housekeeper in the home responsible for the laundry and the standards of cleanliness. At the time of the site visit all parts of the home seen were clean and there were no unpleasant odours. The three residents who completed the questionnaires were satisfied that the home was fresh and clean. One person said that there had been changes that had improved the environment, with more fresh flowers, for example, in the home. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 19 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): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff were developing the right skills and attitude to meet the needs of all the residents, and residents were safer than they had been, though some training could be improved. The home’s recruitment procedures were sufficiently thorough to help protect residents from unsuitable staff. EVIDENCE: At the time of the site visit the home had enough staff on duty to meet the needs of the residents. There was evidence through discussion with residents, relatives and staff that there had been an improvement in the skills and attitude of the staff. Poor practices, evident over a number of inspections, were being dealt with in an ongoing way and a number of staff had left and been replaced. Residents and relatives said that there had been noticeable improvements in the care practices and attitude of the staff team. A relative said, “All the staff are friendly and seem to do their job OK”. However one resident said that some staff were better than others. Staff spoken with at the site visit and those who completed the questionnaires felt that there had been a big improvement in the staff attitude and morale. The general feeling was that the staff were working more cooperatively as a team than they had been previously. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 20 Information provided by the home at the time of the site visit showed that about 25 of care staff had achieved at least NVQ level 2. Others were currently studying for NVQs. Staff had satisfactory training opportunities and some training was compulsory such as moving and handling and fire safety. Since the previous inspections staff training had been reviewed to ensure that staff had opportunities for training in some specific matters, such as some aspects of mental health, challenging behaviour and raising awareness in other sensitive matters relating to one resident. However at the time of the site visit only a small proportion of staff in the home had training in dementia and only just over a quarter of staff had training in “challenging behaviour”. This was discussed with the manager who stated that this was partly because some qualified and trained staff had left and new staff had been appointed without qualifications. Further training should be scheduled with priority to ensure that previous requirements continue to be met. The staff records viewed showed that the home’s recruitment procedures were in accordance with the Care Home’s Regulations and guidance, and should help to protect residents from unsuitable staff. Appropriate checks had been undertaken and appropriate references received. At the time of the site visit there was no record available in the home of the Criminal Records Bureau (CRB) check for one member of staff having been received. The Commission was subsequently provided with information that indicated that the CRB check was obtained prior to this person commencing work and this appeared to be an isolated error in the documentation of information in the home. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 21 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): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A well qualified and experienced manager managed the home with the support of senior managers and this had improved the care practices in the home. Quality assurance policies and procedures took into account the views of residents and relatives. The health and safety of the residents and staff was promoted. EVIDENCE: A new manager had been in post for about 5 months who was well qualified and experienced. Senior managers in the company - the operations manager and a project manager - were supporting the manager in the light of the problems the home had faced. Together they formed a strong management Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 22 team that had addressed staffing issues referred to in previous reports, and improved the care practices in the home. Individual staff supervisions were being undertaken and this was contributing to the improvement in staff morale and team working. Staff spoken with felt that the new manager was effective, organised and supportive. According to the information supplied to the Commission the home had a number of internal quality monitoring measures. There were weekly and monthly audits to highlight areas of concern and to ensure the smooth running of the home. Action plans would be put in place to improve problem areas identified. Annual survey questionnaires sent to residents and relatives. Regular staff meetings and meetings with residents and relatives were held. This assisted with communication and helped to ensure that the views of residents and staff were used to develop the care and services provided in the home. The records of residents’ spending money and the balance of the cash kept in the home showed that money handed over to staff for safekeeping was managed properly and safely. However there were still concerns that the money kept by individual residents was not as safe as it should be (see Complaints and Protection). The home’s policies and procedures helped to promote the health and safety of the residents and staff. Records and staff spoken with confirmed that there was a continuous programme of moving and handling training, fire training and Protection of Vulnerable Adults training. However only a small number of staff had undertaken training in first aid training and infection control and not all staff working in the kitchen had training in safe handling of food. The fire precautions were satisfactory and the fire equipment was serviced appropriately. According to information supplied by the home, the gas installations, the central heating system, portable appliances, electrical wiring and the water supply, all had current certificates of testing. Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 23 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 2 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 X X 3 2 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 2 Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 24 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 OP18 Regulation 13 Requirement The correct procedures must be followed following any allegation of abuse and when an allegation of theft is made the police and Social Services must be notified immediately. Staff who work with people with dementia must have appropriate training for their roles and responsibilities and including suitable training in dementia and “challenging behaviour” Staff must have appropriate training in first aid, safe handling of food and infection control. Timescale for action 19/09/08 3 OP30 18 30/11/08 4 OP38 13 30/11/08 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 OP7 Good Practice Recommendations The care plans should contain all relevant and accurate details in health personal and social care, including hobbies and social interests, nutrition and when the DS0000022499.V366494.R01.S.doc Version 5.2 Page 25 Brierfield House Care Centre 2. 3. OP9 OP15 4. 5. OP24 OP28 resident identified is asked and encouraged to get out of bed. There should be clear written instructions to support the administration of all when required medication including food supplements. Meal times should be organised efficiently so that residents don’t have to wait at the table for an unacceptable length of time, and also ensure that the food served always suits the residents’ preferences. The use of alcohol based hand wash gel in people’s bedrooms should be the subject of a risk assessment to establish whether or not there is any risk to the occupant. The home should achieve the target of at least 50 of care staff being qualified to at least NVQ level 2 as soon as possible Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG 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 Brierfield House Care Centre DS0000022499.V366494.R01.S.doc Version 5.2 Page 27 - 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!