Inspection on 28/01/08 for Brightlands

This inspection was carried out on 28th January 2008.

CSCI found this care home to be providing an Good service.

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

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Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Brightlands 77 Main Road Hoo Nr Rochester Kent ME3 9AE Lead Inspector Marion Weller Key Unannounced Inspection 28th January 2008 10:00 Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 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 Brightlands DS0000070514.V353200.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 Adults 18-65. 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. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brightlands Address 77 Main Road Hoo Nr Rochester Kent ME3 9AE 01634 250 592 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) Clearwater Care (Hackney) Ltd Mrs Annette Brightman Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) 2. The maximum number of service users to be accommodated is 13. Date of last inspection New Registration. Brief Description of the Service: Brightlands is a residential care home providing accommodation and support to adults with a learning disability. The house is a large detached property providing bedroom accommodation over three floors. All bedrooms are for single occupancy. Some people with a physical disability can be accommodated and there is equipment in place to help with their mobility needs. The home has their own transport that can accommodate wheelchair users. The home is conveniently situated for local shops, library, churches, post office, pubs and a sports complex. It has easy access to the Medway Towns. A wide range of ‘in house’ and community based day activities are provided. The home also provides some day activities for people with disabilities who do not live at the home. There are staff on duty 24 hours a day to meet individuals needs. The staff are trained to carry out their jobs and most have an NVQ qualification. The staff are supported and supervised by the Registered Manager who is in the home every day. The current fees charged for this service range from £648.05 to £1461.32 per week depending on people’s individual needs. Anyone interested in moving to the home will have his or her individual needs assessed before a fee is agreed. Please contact the manager for further details. Brightlands DS0000070514.V353200.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 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of Brightlands. The Manager did not know we (the Commission) were coming to inspect the home. As part of the inspection, surveys were sent out before the visit to some people living at the home who were asked to give their views about the service. Surveys were also sent to some relatives of the people living at the home. The feedback regarding the service from all surveys was very positive. The inspector was in the home from 10.00 am to 4.00 pm and spent some time looking at records and documents, observed how the home was run and how staff were supporting people and also looked around the home itself. Brightlands was recently purchased by Clearwater Care (Hackney) Ltd. The new owner for the service was registered with the Commission as the Registered Provider on 3rd September 2007. The previous owner/ manager continues to manage the home on a day-to-day basis. In purchasing Brightlands, Clearwater Care (Hackney) Ltd took over an established service, which previously offered excellent standards of care. A quality judgement of ‘excellent’ can once again be attained by the service when the new providers have demonstrated sustainability. It should be noted that the new owners demonstrated throughout the registration process a firm commitment to offer a good quality service at Brightlands and over time to re-establish the home’s sustained track record of high performance. What the service does well: The people living at the home enjoy busy and interesting lifestyles. They are supported to take part in the activities they enjoy and to develop their own skills and abilities. A very full programme of activities is regularly organised in the home and outside in the community. One survey respondent said, ‘My ……… is always busy, occupied and stimulated, simply brilliant attention to detail and effective planning goes into making sure everyone in this home spends their time productively.’ The Manager and senior staff are very focused and innovative in supporting people to communicate in a way that best suits them. The Manager checks the quality of the service regularly and asks people who live in the home what they think. Relatives are encouraged to visit the home Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 6 when they wish and to give their views. All comments, concerns and suggestions are taken seriously and given proper consideration. There was evidence of clear feedback being given to people about the issues they raise. One survey respondent commented, ‘I feel very happy with how the home is run, as a parent, they listen closely to me.’ and a resident said, ‘‘I know who to tell if I am unhappy – they always do something about it.’ The house is kept very clean and pleasant and was seen to be comfortable for the people that live there. Each person has their own room, which is their own private space. One resident said, ‘The carers knock before they come into my room’ The people in the home enjoy the meals provided and there is a lot of choice. A resident said, ‘I always have choices at meal times’ a survey respondent commented, ‘The food at Brightlands is excellent. Lots of it is grown on their own allotments and residents are involved in the growing and the preparation of food.’ The people living at Brightlands are supported by a sufficient number of caring staff that are well trained to do their jobs. The staff follow the care plans that are in place to support people with their everyday skills and to ensure they meet all their other needs. A parent said, ‘They understand and treat clients as if they were their own family here.’ What has improved since the last inspection? New systems for supporting people to communicate have been introduced at Brightlands and have recently been further developed. There is a large touch screen computer in the home’s dining area that allows people to use symbols and pictures to tell staff how they are feeling and what they want to do. The home has also introduced ‘Facebook’ to enable service users, family and friends to exchange information and photographs on a daily basis. There is a new computer system (easy log) for keeping records about the wellbeing of the people living at the home. This helps staff keep accurate records and to be able to use the information to give people the support they need. Staff have hand held recording devices, which they update regularly. Medication records have been included on this system and the identification and monitoring of premises maintenance issues. All service users have their weekly activity plan converted into symbols to ensure good communication. The home routinely converts placement contracts into symbols. In this way, all service users have a good awareness of their rights and responsibilities when they decide to move in. The Home has recently arranged one major holiday at service users request and two weekend breaks, all of which were greatly enjoyed. A second lift has Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 7 been fitted into the Home’s Mercedes mini bus to allow for easier service user access during community-based activities and outings. Menu’s for the summer months have nutritional values listed against each item to help service users make better dietary choices and maintain a healthy lifestyle balance. The manager intends to extend this work to the next set of seasonal menus. 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. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1. 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are confident that the home can support them. This is because service users needs and aspirations are assessed before they move to the home to ensure their needs can be met. They are also given sufficient information to help them make an informed decision about moving in. EVIDENCE: Significant time and effort are spent in planning to make admission to Brightlands personal and well managed for prospective service users. The home has developed a comprehensive statement of purpose and service users guide that is clear, informative and made available in formats appropriate for each persons needs. This ensures that prospective service users and their families and representatives have enough information to make an informed choice about moving in. Both information documents are regularly reviewed and updated by the manager. They would further benefit from the Commissions correct title being used throughout the documents to avoid any confusion. Detail could be added now in relation to the new owners of Brightlands. This would fully inform people of the new lines of accountability Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 10 for the service offered at the home. The manger stated her intention to fully address both these minor areas of improvement discussed. Prospective service users have a full assessment of their needs in which they are fully involved before they are offered a place at the home. The Manager carries out all pre admission assessments herself and includes information obtained from other professionals to help in the decision making process. The assessment covers people’s emotional, physical, social and psychological needs. It also addresses any cultural or specific needs they may have. If the assessment shows that the home is able to meet the person’s needs, they are offered a place at the home. The assessment is then used to develop a care plan for how these needs will be met. One service user was clear about how much their personal choice had played in their admission to the home. They said, “I asked to come to Brightlands – I liked it.” Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6789 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have individual care and person centred support plans that ensure their needs are identified and met. They are supported to take assessed risks as part of an independent lifestyle and to make decisions in their lives wherever possible. EVIDENCE: People who live in the home all have a care plan that is based on a full assessment of their needs and is compiled by staff in consultation with them. Plans of care clearly direct staff how they need to support the person in each area of their life. Each plan is kept under review and updated as needed. Service users have a key worker who works closely with them to ensure their views are clearly reflected in the plan. Service users confirmed that had been involved in care plan formulation and reviews. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 12 In addition to the care plan, each person has a person centred plan and a health plan. Service users meetings are held every few months to help people living at the home have a say in how it is run. The minutes of these meetings are produced in a standard, pictorial and symbol format for information and reference. The home also organises an annual quality assurance audit in which service users views are sought. Service users are supported to be involved in the day-to-day running of the home. This includes taking turns helping with cooking, working on the homes allotments and cleaning their own rooms. There is a domestic assistant in post to do the heavier chores. Service users have been involved in interviewing new staff where possible. The home encourages people to be as independent as they can be. Sufficient risk assessments are in place to minimise risks to individuals in their daily activities Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 16 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to take part in the activities they enjoy and which meet their needs. People who live in the home have numerous opportunities for personal development and are well supported to maintain contact with their family and friends. They have their rights promoted and respected but are also aware of their individual responsibilities and are supported to meet these. Service users are offered a healthy nutritious diet and enjoy their meals. EVIDENCE: The people who live at Brightlands enjoy busy lifestyles that reflect their interests. There is an excellent programme of activities in place that has been designed with service users involvement. One relative said ‘ people have a better leisure and social life here than I do!’ Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 14 Service users are supported to do the things they wish to each day. This includes swimming or hydrotherapy, sailing, gym and spa, golf, horse riding, trampoline, pottery, cookery, work on the home’s allotments, photography, climbing, computers, sensory sessions and adult education classes. Another respondent to our pre inspection survey request said, ‘The number and quality of activities offered to clients at Brigtlands is fabulous.’ There are activities arranged in the home during the evenings that people can choose to participate in. Examples of these include, relaxing watching TV or a DVD, listening to music, helping in the kitchen, games, painting or using computers. Records maintained in the home clearly show that everyone is supported in doing the activities they personally enjoy. Service users are supported to be as independent and safe in their choices as possible. A good example of the home’s emphasis on this was evidenced in the pictorial ‘discussion projects’ displayed in and around communal areas. Staff use these to initiate conversation, educate and raise awareness of the potential dangers service use may encounter when out in the community. Current themes are, ‘Understanding the Green Cross Code’, ‘Who are Safe People’ and ‘We must say no to strangers.’ The home made a recent investment in the purchase of a flat touch, large screen computer system. This is being constantly developed to service users benefit. It is used as a communication tool for people that find verbal communication difficult. There are pictures and symbols that can be used by touch to help a person communicate their needs, wishes and feelings. A good example was shown, with the service users permission, of a saved conversation held recently between them and a family member. This would not have been possible for either individual without the availability of the equipment and had clearly brought pleasure to them both. There is a section in the computer programme that helps people plan their day and the activities they wish to do. The programme has been designed around the preferences and activities of the service users. There is also the facility to for service users to send symbol e-mails and pictures to relatives and friends. The Manager is looking to develop the system further by adding switches that people with physical disabilities can use and by the addition of more photographs to the picture bank. Service users right to privacy within the home is respected and they have each been offered a key to lock their room. Staff respect the views of the people living there and support them to express these effectively. Service users, in turn, are made aware of the responsibilities that have through their contract and the routines of the home. Service users responsibilities include respecting each other and the property. Cleaning their own rooms and doing their own laundry. Helping with meal preparation. An individual’s involvement in these activities is based on their own abilities and staff support is given where necessary. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 15 Staff said that service users family and friends could visit when they wished. This was confirmed by the survey responses received from both service users and their relatives. One respondent said, ‘They always make me feel so very much at home when I’m visiting’ and another who said, ‘I feel very happy with the home as a parent and I am welcome to visit at any time’ Food is planned around service users dietary needs and preferences. There are choices available for each meal and individual needs are catered for. The planned menu is nutritious and includes fresh vegetables, which staff and service users have grown in the home’s four allotments nearby. One survey respondent stated, ‘The food at Brightlands is excellent. Lots of food is grown on their own allotments and residents are involved in the growing and the preparation of food.’ The Manager has begun to develop the home’s seasonal menu plans to include nutritional information for each meal. This helps service users make healthy and informed dietary choices. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and they can be confident that their health care needs will be met in full. EVIDENCE: Service users health and personal care needs are clearly addressed within their plans of care. The plans inform and direct staff exactly how to support the person and what their preferences are. Equipment has been provided to help with personal care where it has been assessed as required for individuals. Tracked ceiling hoists are fitted for those with identified needs. The home can also provide portable tracking and hoists if required. Other equipment such as shower chairs, toilet frames etc are all in situ where needed. The home’s new computerised monitoring and recording system highlights to staff when regular health care appointments are due for people living in the home and produces reports of health issues and interventions where needed. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 17 Staff have held electronic monitoring devices, which assist them to record daily information that informs the home’s regular review of service users health and care needs. The local GP surgery is almost next-door to the home. The manager states the home enjoys excellent links with healthcare professionals including the GP, speech and language therapists, dieticians and physiotherapists. Survey respondents were very confident that the home dealt effectively with the health needs of the people who live there. One survey respondent said, ‘The home will pursue every investigative option and will not stop until they have found out what is wrong and what can be done to help someone.’ Medication Administration in the home is well managed. The home uses a monitored dosage system for medication administration and provides both manual medication administration records and computerised records as a way of double-checking administration. Records inspected of medication administered to service users evidenced no gaps in recording. Staff that administer medication have all had certificated training. Each service user has an individualised homely remedy list agreed with their GP. Service users medication and potential side effects have been recorded in their care and health documentation to further inform staff and safeguard the individuals involved. Two good practice issues in relation to medication storage were discussed with the manger. Where minor good practice shortfalls currently exist, we are confident they will be quickly resolved. Good practice recommendations have been made in relation to these in this report. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are protected from abuse and have access to a clear complaints procedure which they or their representatives understand and know how to use. EVIDENCE: There is an updated complaints procedure in place that service users are aware of and which is produced in formats that people who live in the home understand. Service users said they knew whom to talk to if they had any concerns, as did relatives surveyed and spoken with. No complaints or allegations have been received by the home or by the CSCI since the home was registered. All staff are trained in safeguarding vulnerable adults. There are updated policies and procedures in place to keep service users safe and for staff to follow if they have any concerns about a persons care. The home has an open visiting policy. One relative said, ‘Brightlands is one big family – they offer a special kind of quality, one where you are confident that people are safe and secure’ The owner/Manager is in the home every day to monitor the quality of care provided. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 19 Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a safe, clean and comfortable environment, which is well maintained. There are good standards of furnishings that largely meet the needs and tastes of the people who live there and which encourage independence. EVIDENCE: There is a spacious lounge area on the ground floor with a large screen TV, piano and comfortable seating. The manager stated that some chairs in this area are due to be changed within the next 12 months. Service users also have the use of a conservatory with additional seating and a separate dining room. There is a quiet room/library area upstairs. Visitors are able to use this space or service users can take visitors to their own rooms if they wish. The home has a very well equipped laundry and large modern kitchen. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 21 Most bedrooms have ensuite bathrooms. The two bedrooms that do not have their own allocated bathroom located nearby. All bedrooms reflect service users personal tastes and interests and are comfortable for them to use. Staff respect the privacy of service users rooms and service users reported that staff knock before entering their bedrooms or bathrooms. One service users bedroom did not evidence the provision of a lockable storage space, although the room was furnished to a very high standard in all other respects. Some topical prescribed medicines, i.e. ointments/creams belonging to the service users had been left on view directly opposite the entrance door. It was discussed that medicines should be locked away when not in use to ensure the provision of a safe environment for all service users. It is recommended that the home audit NMS standard 26 against the facilities they provide in each bedroom to meet individual service users needs. Equipment to help people with mobility difficulties is in place, including shower chairs and an overhead tracking hoist system. Textured panels have been fitted to some doors to help a service user who has a visual impairment to find their way around the home. One service user has a switch in the room to operate their TV and radio. The manager stated there is a rolling programme of refurbishment and redecoration in place. Plans are currently being discussed with the new owners to further extend the home to provide a games room for service users in the near future. The home is kept very clean and hygienic. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 34 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by sufficient numbers of trained, competent and qualified staff. They are also protected by the home’s robust recruitment procedures in which service users are encouraged to be involved. EVIDENCE: The manager confirmed there is a minimum of 12 staff on duty throughout the day. Staff work in shifts based around service users activities. There is one waking night staff and one sleep in night staff. The registered manager lives nearby, as do supervisory/ maintenance staff that can return quickly to site in an emergency. There are clear lines of accountability and staff are aware of the demands of their role and the home’s expectations of them. A comprehensive staff-training plan is in place, which covers all core competencies. The home has a trained trainer in The Mental Capacity Act and will be organising awareness sessions for all staff to ensure they can evidence compliance around decision making for those who lack capacity. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 23 The home exceeds the 50 standard for trained staff. The manager confirmed her intention to ensure that all staff are either qualified or working towards an NVQ qualification in Care at Level 2 over the next year. New staff undertakes an induction programme that involves completion of training courses and completing a workbook. The induction is very detailed and gives staff the knowledge and skills they need to support service users. Content is in line with the demands of Skills for Care. Staff are well supervised, directed and supported. Recruitment procedures are robust with all the correct recruitment checks being made before employment is offered to an individual. Service users are routinely involved with the recruitment of new staff. Survey response in relation to staff were very positive and included, ‘ Staff are excellent, I can’t think of anything that can be improved’ and ‘The staff they have at Brightlands to care for my relative are excellent, you would think the service users were members of their own family’ Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 40 41 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home and a person in charge that provides clear direction and leadership. The manager is qualified and competent and aims to consistently improve and develop the service and the outcomes for the people who live there. To this end, service users and their representatives are regularly consulted about their views of the service. The health, safety and welfare of service users are given a high priority in the home, which ensures they are protected. EVIDENCE: Brightlands was recently purchased by Clearwater Care (Hackney) Ltd. The new owner for the service was registered with the Commission as the Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 25 Registered Provider on 3rd September 2007. This is the first Key unannounced inspection following that event. The previous owner/ manager is now the registered manager and continues to operationally manage the home on a day-to-day basis. The manager is well qualified, an excellent role model for staff and is experienced in supporting this service user group. Prior to the sale of the home, she managed the service to a very high standard and continues to be held in high esteem by service users, relatives and staff. The way the home is run shows an excellent understanding of peoples needs in respect of gender, age, sexual orientation, race, religion or belief and disability. The new owners of Brightlands have undertaken both formal and informal visits since their purchase of the home. They have visited informally to meet with service users and their families and more formally, to undertake checks to ensure themselves of the continuing high quality of the service provided. The manager stated that the owner’s representative prepared a written report on the conduct of the home during visits. A copy of the reports had not however been provided to the manager and were therefore not available for inspection. It is recommended that reports compiled in line with the demands of regulation should be maintained in the home to evidence good practice. The people who live in the home or their family members raised no financial concerns. Service users finances are managed competently and to a high standard. Accounts have recently been externally audited, with excellent results. The home has a full time administrator to assist and support the registered manager. Service users are consulted on their views of the home through meetings and general feedback. There is a good quality assurance system in place that allows the owner to assess the quality of the service against the National Minimum Standards. Service users and their families or representatives are actively involved in this process. The most recent exercise was viewed during this site visit. It was noted that a high number of survey returns graded the home as ‘Excellent’ from a choice of poor, adequate, good and excellent. Relevant polices have been produced in symbol format for service users and the home’s emergency fire procedure has been produced in pictures and symbols. These have been regularly reviewed. An ‘Easy log’ system has been introduced for the storage of service users information and daily notes. This is a computerised system that logs all events, which occur in relation to a service user, including medication administration. It also triggers health appointments and health and safety checks as a reminder for staff. The system produces reports for monitoring and review and it is backed up by more detailed paper records. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 26 There is a call system in all bedrooms that links to a pager which staff carry and a door alarm system that alerts staff if service users wander during the night. The safety of people who live in the home takes a high priority. Equipment in the home has been regularly serviced as needed and risk assessments have been completed for the general environment/ individual activities. This includes manual handling, participation in external activities, day care service users and fire safety. Above all things, there is clear evidence that this home is operating as a safe service and to the clear benefit of the people who live there. Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 2 27 4 28 4 29 4 30 3 STAFFING Standard No Score 31 3 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 4 4 3 X Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? New Service Registration. 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 YA20 YA26 Good Practice Recommendations It is recommended that service users oral medicines be separated for the purposes of storage from topical preparations. It is recommended that furniture and fittings in each service users bedroom be checked for compliance with the provisions of the National Minimum Standards (NMS 26.2 (ii)) Non-provision of items listed in the standard should be supported by fully documented consultation and/or risk assessment in the service users care plan. It is recommended that reports compiled by the Registered Provider in relation to the demands of Regulation 26 be copied to the manager and maintained in the home for inspection purposes. 2. YA41 Brightlands DS0000070514.V353200.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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