Inspection on 10/10/06 for Brighton House

This inspection was carried out on 10th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brighton House 29/10/09

Brighton House 29/09/07

Brighton House 15/02/06

Brighton House 24/08/05

Brighton House 09/03/05

Brighton House 18/09/04

Brighton House 26/11/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Brighton House Sneyd Terrace Silverdale Newcastle under Lyme Staffordshire ST5 6JT Lead Inspector Peter Dawson Key Unannounced Inspection 10 October 2006 09:00 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 Brighton House DS0000028865.V312458.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. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brighton House Address Sneyd Terrace Silverdale Newcastle under Lyme Staffordshire ST5 6JT 01782 717484 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) Staffordshire County Council, Social Care and Health Directorate Mrs Sharon Mewis Care Home 28 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (19), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (6), Old age, not falling within any other category (4), Physical disability over 65 years of age (12) Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 Dementia (DE) Both - Minimum age 50 years on admission Date of last inspection 15th February 2006 Brief Description of the Service: Brighton House is a local authority home accommodating up to 28 elderly people requiring care. Categories of registration include limited numbers of people with dementia care needs, or a physical disability or people with mental health needs. The home provides a very high standard environment which is well maintained. Furnishings, fittings and equipment are to an excellent standard. A capital works programme spanning several months to upgrade areas of the home and improve fire-safety were completed in October 2006. All bedrooms have en-suite facilities and there are spacious and high standard communal areas. There is only one shared bedroom which is used for couples only. The home has 3 separate wings off the main central lounge/dining area each with 9 bedrooms and each having separate lounge and kitchen facilities, assisted bathing etc. One of the wings is used to accommodate 4 people requiring respite care and 5 involved in the re-ablement programme. The re-ablement unit is staffed separately from the remainder of the home and personnel involved include Occupational Therapists, Physiotherapists, Social Worker and other professionals. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection. A pre-inspection questionnaire was provided by the home. Written feedback was received from 8 Relatives, 1 resident and a visiting GP. Most residents were seen during the inspection and around 50 spoken to individually and in small groups. One inspector carried out the inspection from 9 am – 3pm. There was an inspection of the building, including all communal areas and a sample of bedrooms. Records were seen relating to the inspection process including samples of care plans, risk assessments, medication and other records. All staff on duty were seen and several spoken to individually. At the time of this inspection there were 16 permanent and 5 re-ablement residents. There were no respite care residents. Respite care not provided during the current capital works, due to the potential disruption. The extensive refurbishment programme and ongoing works to comply with fire safety have continued over several months and at the time of this inspection were due for completion within approximately 2 weeks. The work has caused major disruption requiring all parts of the home to be vacated at varying times to accommodate the work. This has been well planned and carried out with minimum disruption to residents, who confirmed this when spoken to and outlined in written feedback from a relative. There is always an extremely relaxed and positive welcome for visitors in this home and the atmosphere created is friendly and homely. All residents spoken to expressed very positive views about the high standards of care provided none had any complaints or concerns. The inspector is always impressed with the excellent engagement in this home between staff and residents/visitors. In written feedback a resident said “following two respite visits, I decided I would like to stay here permanently, the meals are very nice and I am very happy now at Brighton House”. Relatives made similar positive comments summarised by one who said “Brighton House is a quality establishment, run by quality staff who are very kind and very caring. I could not wish for my mother to be other than in Brighton House, looked after by marvellous staff”. One relative made positive comments about care but questioned why her mothers bedroom had not been carpeted in the refurbishment programme. This was referred to the Manager who intends to ensure the re-carpeting of the room as soon as possible. One GP practice provides a service to the home including a contract relating to care of re-ablement residents. The home report an excellent service from the practice. In written feedback to the Commission at the time of the last Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 6 inspection and again prior to this inspection the GP expressed total satisfaction with the arrangements for the health care of residents and the good established channels of communication with staff on all matters of health care provision. Four relatives did say in feedback that there were “not sufficient staff on duty”. This has been stated previously by relatives and was again reviewed on this inspection. The inspector feels that the staffing levels in the home are adequate for the perceived needs of the current resident group and this will again be reviewed on future inspections. A resident who is registered blind and admitted to the re-ablement wing on the evening prior to the inspection outlined the special consideration given by staff to her particular needs. She was already very positive about the home and felt safe and supported. This home meets all the national minimum standards in relation to the environment and provides an equally high standard of care. Weekly fees at Brighton House are defined in the pre-inspection questionnaire as £439 for permanent care and £134 for respite care. What the service does well: What has improved since the last inspection? Considerable works to improve the fire detection and alert system. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 7 A major refurbishment programme enhancing further the presentation of the home. The supply of a safe hot water system has been improved with installation of new boiler system. Early redecoration in some areas identified in the last report has been carried out as part of the refurbishment programme. 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. Brighton House DS0000028865.V312458.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 Brighton House DS0000028865.V312458.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1–6 The quality of this outcome is good. This judgement is made using the available evidence and a visit to the service. Adequate information is available for choice of home and pre-admission assessments ensure needs can be met. Five reablement beds provide a good service for people discharged from hospital prior to returning home. EVIDENCE: The statement of purpose and service users guide are regularly updated and amendments sent to the Commission. The last update was August 2006. These documents are readily available in the home for existing or prospective residents and their families. There is a copy in all bedrooms. All residents regardless of funding base are subject to assessment by Care Management personnel. Additionally the home carries out their own assessment prior to admission in the persons current setting. Wherever possible introductions to the home are arranged prior to admission although Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 10 this is not always possible. Many permanent residents have spent periods of respite care in the home prior to admission. Due to the capital works programme over the past months, permanent admissions have been suspended. Re-ablement residents have continued to be admitted and they are all assessed by the homes staff prior to admission to ensure that needs can be met. The 5 re-ablement places in the home are allocated with a multi-disciplinary assessment. This is usually following hospital care and is provided to enable people prior to returning home. A specialist team of professionals are involved in assessments, reviews and discharges. A wing of the home is dedicated to providing this service together with 4 places for respite care. The unit has good facilities and includes a training kitchen and self-contained lounge/dining areas. Currently a new, larger kitchen area is being provided to improve the training facilities as part of the assessments and skill enhancement. Staffing hours are allocated throughout the waking day for this group. All bedrooms have en-suite facilities and there is an assisted bathing facility on the unit. Brighton House staff work closely with other professionals involved in the decision making process. Brighton House DS0000028865.V312458.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 10 The quality of this outcome is good. This judgement is made using the available evidence and a visit to the service. Care plans are comprehensive reflecting health, personal and other needs, although some updating required and in progress. There is close positive working with health professionals. There is evidence of respect for privacy and dignity. EVIDENCE: The Local Authority care planning format is in place and provides the necessary comprehensive information to meet assessed needs. A sample of care plans were seen. Some information requires updating for long-term residents and some plans need to be re-written for clarity. This is being done on an ongoing basis by the Care Team Leader. There are regular and good monthly reviews of care plans. There is a summary of the care for the month including any changes in dependency needs. Risk assessments are in place for moving & handling and daily living. These are to a good standard and reviewed monthly as part of the care Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 12 planning information. The recording of health care needs and information is good with a chronological summary of interventions by health care professionals – providing clear monitoring of health care status. There are no pressure area management issues in the home at this time. A visiting District Nurse was seen routinely visiting two residents to monitor and provide dressings relating to non-pressure area wound care. The home work closely with the Nursing Service and the local GP surgery provides a service to all residents, including those on re-ablement programmes. A good service is reported by the home and the GP provided written feedback to the Commission on this and the last inspection expressing a high level of satisfaction with health care support and the positive close working relationships in relation to health care issues. A resident in written feedback commented “medical support is excellent”. All residents are weighed monthly and weekly if there are any concerns about weight loss. There are no nutritional concerns at this time. Annual health checks are provided for all and invariably on a more regular basis. A CPN is involved with residents as required and on the day of inspection had arranged a hospital appointment with Consultant Psychiatrist. This followed some areas of concern discussed with the home and the relative. Staff are aware of the need to monitor the condition and motivation of the person to ensure good socialisation and quality of life. This is an example of the homes pro-active approach to physical and psychological well being. Five re-ablement residents were seen and gave individual accounts of their circumstances and needs. All had settled well, were complimentary about staff support and very positive about the objectives to improve their functioning and skills prior to returning home. There was a very relaxed atmosphere on this unit with good open rapport and very positive engagement between the residents and staff. They were able to talk openly together, express their views and there were many affectionate and humorous exchanges. One person who is registered blind, was admitted the previous evening after a long ambulance wait at hospital. She said that she was warmly welcomed, provided with an excellent meal and her mobility needs discussed in detail when shown around the home and to her bedroom she felt safe and comfortable in her new environment “thanks to the very helpful staff”. Medication is supplied to the home by the village pharmacy (Cornwells) in MDS form (Nomad). Reablement residents have bottle to person medication initially provided from home or hospital. This is later included in the Nomad system. Immediate checks of medication upon admission are carried out with the GP surgery. Self medication is risk assessed. A 102 year lady part self-medicates and where possible people on respite and reablement programmes continue if safe to do so in the interests of continuity. The home has a good record in relation Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 13 to safe medication administration. On this visit it was noted that there was no count of Haloperidol provided on a variable dose PRN basis and the actual dose given had not always been recorded. Additionally the triggers for giving Haloperidol PRN should be discussed with the prescriber and recorded. Staff should know and record the reasons/circumstances of their decision. A count of all medicaton should be kept to ensure the audit trail of medication in the home is complete. The Local Authority policy/procedures for medication administration are comprehensive and clear. Only Senior staff administer medication and have appropriate training. Personal care was seen during the inspection to be given with respect and dignity and this was confirmed in discussions with residents and staff. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 14 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 – 15 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. There is evidence of chosen lifestyles and individual choices being made. Many regular visitors are seen in the home and involved in care and daily life. Activities are many and varied both internally and externally. Residents make decisions about those activities. Food provision is good, confirmed by residents and seen on inspection. EVIDENCE: Most residents were seen and many spoken to individually. Additionally there was a group discussion with all 5 residents in the reablement lounge. All residents spoken felt that their individual preferences and lifestyle were known to staff and were accommodated. There was talk of flexible mealtimes, rising, retiring and bathtimes. Several resident prefer to spend a large (in some cases all) proportion of their time in their bedrooms. Two have all meals served in their bedroom, others have some meals served there and also choose to spend time in the lounge areas socialising. Choice is clearly available to all residents as to how and where they may spend their time. Visitors are welcomed very positively into the home, this was seen and confirmed in discussions with them. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 15 Relatives meetings are held regularly and the fund-raising and social activities arranged by the Comforts Fund group includes residents, relatives, staff and other helpers. Social events organised involve and include residents and relatives. A recent charity night held in the local community centre was attended by 15 residents and their relatives/friends – the event raised £600 for the homes comforts fund. The non-financial rewards were also clear. An activities organiser works in the home several hours each week promoting individual, group and fund raising activities. The involvement of residents, staff and relatives is considerable. Other social occasions have been arranged at a nearby church centre e.g. hire of hall for coffee mornings etc. The home has its own min-bus available for any transport needs. Entertainment is provided on a very regular basis from external sources and financed from the comforts fund. All residents have visitors most visiting on a very regular basis. In the absence of this the home would seek the services of the independent advocacy service. Food provision is reported to be good. All residents spoken to were highly satisfied with choice, quantity and presentation of food. The mid-day meal was seen served in the reablement lounge. Choices had been made earlier and meals were extremely well presented and appealing. Special diets are catered for as required, currently for diabetic and vegetarian food. An interesting observation is that staff sit and have meals with residents and engage in friendly social interactions. All residents have allocated key workers. Roles have recently been redefined and the key worker role now rotated within the units to allow all staff the opportunity to have detailed personal knowledge of the needs of all residents. Two hairdressers were busy in the salon on the day of inspection. One is regular weekly hairdresser available to all, the other had been hairdresser to person whilst in the community, there are also others who visit and use the facilities of the salon. There was good communication between hairdressers and residents with good humoured exchanges being enjoyed by all. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 - 18 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. The complaints procedures comply with regulation 22 and are readily available in the home. Staff training and awareness of abuse is satisfactory. EVIDENCE: The Local Authority complaints procedure is available the home and includes the process for referral of complaints to the Commission. A copy of the procedure is available in all bedrooms and the reception areas for visitors. No complaints have been received by the home or by the Commission since the last inspection. The protection of residents from abuse is secured by induction training and written information given to all staff outlining the procedures for reporting suspected or actual abuse. A copy of the vulnerable adults procedures is available in the home. Staff spoken to had a clear understanding of the various forms of abuse and the procedures for reporting them. The procedures are discussed in supervision as part of the policy/procedure awareness checking. Brighton House DS0000028865.V312458.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 – 26 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. Work and upgrading in the home has been carried out sensitively and enhances the established good facilities already provided. Replacement carpet in bedroom identified by a relative will be replaced. There is a safe, well maintained environment with good access to all parts of the home and suitable equipment in place. The surroundings are comfortable, clean and hygienic. EVIDENCE: Brighton House was purpose built 12 years ago by the local authority and has provided a high standard environment, with good maintenance. Some upgrading in certain areas was needed as mentioned in the last report. But an extensive programme of works has been carried out over the past Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 18 months to upgrade some areas. Considerable work has been carried out in relation to the fire safety of the building over a 12 month period to improve fire prevention and detection systems. Other work has been completed alongside that. There have been regular site meetings with the Fire Officer and County Council personnel to plan and review the ongoing work. There are 3 wings of the home which have each had to separately vacated to allow the work to be done. This has been completed with minimum interruption for residents. The re-abelment service was transferred to a nearby home whilst the work there was completed and respite care places not allocated for the relevant period. Residents spoken to said that they had not been directly affected/inconvenienced by the work, in fact some residents and staff had enjoyed the smaller group experience together. Written feedback from a relative said “My congratulations to the Head of Home and staff for the efficient way in which they have coped with the disruption during the recent refurbishment” At the time of this inspection the final work was being completed with the central lounge area out of use with major work being completed including new ceiling with re-enforcement of the floor, electrical, fire and other work in the upper area of the home. Residents were using the smaller lounge/dining areas ( and dining room) for eating and communal use. The Fire Officer has arranged to visit and review and approve the completed works on 17th October 2006. Many areas have been redecorated and re-carpeted. This includes the main corridor areas and some bedrooms. Obviously certain areas most affected by the work have been prioritised. One relative in written feedback expressed some disappointment that her mothers room had not been re-carpeted, this was discussed with the Manager who intends to arrange replacement. The relative mentioned did say that she was entirely satisfied with the care provided for her mother at Brighton House over the past 2 years and that “staff were wonderful”. Pipework and radiators in the corridor areas mentioned in previous reports, which required covering to protect residents from the hot surfaces, have all been appropriately covered as part of the capital works programme. A sample of bedrooms inspected were well furnished, clean and comfortable with good personalisation. In each bedroom there is a photograph album or photos on walls recording the activities and events in the home, personalised to the particular resident. All bedrooms are for single use and have en-suite facilities. Problems with the hot water system identified on the last inspection appear to have been resolved with installation of new heating system. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 19 Standards of hygiene throughout the home were high, as usual with good cleaning routines in place. Continence management issues known in the home are dealt with swiftly and adequately by staff and there were no mal-odours. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 20 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 – 30 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. Although questioned by some relatives, the staffing levels appear adequate to meet the needs of the current resident group. Induction and training processes provided by the local authority are good and well evidenced. Recruitment policies and practices ensure the safety of residents. EVIDENCE: Four relatives in written feedback felt that there were not sufficient staff on duty. Staffing levels in this home are complicated - Staffing on the reablement unit is separate from that provided in the rest of the home. There is one person on duty in that unit throughout the waking day. Night cover is integral with the rest of the home. The total staffing hours are 521 per week which includes care assistants and Care Shift Leaders – it does not include the Care Team Leader (Deputy) who works on the rota and the Registered Manager who is not on the rota but responsible for managing all staff. There is always a Care Shift Leader on duty and care assistants provided for the 3 shifts on the basis of 5:4:2 – that number includes one person on the re-ablement/respite unit and staff who provide a community care service outside the home. The home is registered Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 21 for a total of 28 people and includes 5 reablement beds and 4 respite care beds. Taking this into account the staffing levels of the home for the remaining 19 people (maximum) is adequate. The inspector feels in consideration of the geography of the building (one floor -easily supervised) and the dependency levels of the current resident group, that staffing levels are adequate. This obviously needs to be continually reviewed in the light of any changes. Apart from care staff there is a Head of Hotel Services post responsible for the management of 165 domestic hours, 56 catering hours and 56.5 gardener/handyperson hours per week. There are 8 hours of clerical support and 8 hours per week for activities co-ordinator. This leaves care staff free of non-care duties. Staffing has been quite static in this home. Many are long-serving staff. There has been one vacancy since the last inspection, which has been filled. The Local Authority arrangements for training of staff are particularly good. There is a thorough induction process and all statutory and training automatically provided for all staff. There has been staff training over the past year in: Handling of medication, Moving & Handling, Dementia care, Attendance at work, Management of Violence & Aggression, First aid (2 day course), Health & Safety, Fire and Recruitment & Selection training. Training planned in the future includes Infection Control (new policies), Audiology training, Health Emergency Deaf/blind awareness – some in-house, Social Care & Health, some external. All external to Brighton House. NVQ training continues for all. There are 27 care staff 19 have NVQ2 or above (70 ). There is one person on a modern apprentice scheme (18 – 24 years) with guaranteed training to NVQ standard and study time allocated over the 12 month contract period. The person involved was clearly enjoying the work and study and felt she was making a positive contribution in the home (confirmed by Manager). Recruitment procedures are good and overseen by the Social Services Human Resources Section. Records relating to recently employed staff evidenced that all checks and references had been obtained as required under Schedule 2 of the Care Home Regulations, with the exception only of the absence of proof of qualification. This should be obtained in all instances. A recently appointed member of staff stated that she had received an appropriate induction. She has previous care experience and NVQ2 training but had received moving & handling training relevant to the new setting. She stated she had settled well, had received required supervision (record seen) and was very positive about her decision to move from another similar setting. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33 & 36- 38 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. The home is well run by a competent manager who leads in a positive way. The home is run in the best interests of residents who are protected by the homes procedures and attention to health and safety detail. EVIDENCE: The present Manager has been in post for sometime and was approved by the Commission as the Registered Manager 12 months ago. She has considerable experience in managing a service for older people and keen to maintain and improve standards wherever possible. She takes a positive lead and there is an open and relaxed atmosphere. Communication between all levels of staff are open and positive. Supervision is in place for all staff. The home is run in the best interests of the residents and gives the impression of a well run and managed home. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 23 Visitors spoken to said that they were always welcomed into the home, were kept informed of all events affecting the lives of their relatives and “felt able to approach staff concerning any matter”. The positive close working between staff, residents and visitors is reflected in the very positive work done by the group managing the comforts fund who meet regularly, raise funds and sponsor events and activities. There are regular management meetings which include the Manager, Deputy, and Head of Hotel Services. There are quarterly meetings for all staff and regular meetings for ancillary staff. Staff meetings are held at times to include both day and night staff. A quality audit is carried out by a senior member of the social services adult care section on an annual basis (not seen). A Service Development Manager is responsible for overseeing the operation of the home to required standards and provides support and supervision to the Manager. Regular monthly unannounced visits are made by the SDM. Accounting and financial procedures and residents finances were discussed but records not inspected on this visit. The Local Authority auditors continue to carry out their usual audit process of financial procedures. Records seen indicated a high standard of recording in relation to care plans and daily recording of activity. Safe working practices Moving & Handling training is provided for all staff at the point of induction by senior staff who are all approved manual handling trainers, who complete annual updates as required. Fire records were not inspected. Considerable work to improve fire safety is about to be completed. The process has been overseen by the Fire Officer who is due to confirm satisfactory completion at a meeting on 17th October 2006. All senior staff have received first aid training and complies with the requirement to have a trained person on duty at all times. Risk assessments are in place and inspected, relating to all resident activity and the building. The Fire Risk Assessment is updated regularly and will be further reviewed upon completion of the work mentioned. All staff have received training in Food Hygiene. Infection control procedures are being changed and training for all staff being arranged. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 24 All required notifications under Regulation 37 have bee notified to the Commission. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 25 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13(2) Requirement The actual dose given of variable dose medication, must be recorded. There must be count of all medication received and administered. Timescale for action 11/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP29 OP19 Good Practice Recommendations Documentary evidence of qualifications of staff must be obtained as required in Schedule 2. Negotiate replacement bedroom carpet with relative. Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brighton House DS0000028865.V312458.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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