Inspection on 15/02/06 for Brighton House

This inspection was carried out on 15th February 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 10/10/06

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 Announced Inspection 15th February 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.V278639.R01.S.doc Version 5.1 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.V278639.R01.S.doc Version 5.1 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.V278639.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 Dementia (DE) Both - Minimum age 50 years on admission Date of last inspection 9th March 2005 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. 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 linvolved include Occupational Therapists, Physiotherapists, Social Worker and other professionals. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this announced inspection there were 18 permanent residents, 4 on respite care and 4 reablement. A planned admission due to take place the following day. The home provides a range of residential provision and also has a team of staff working in the community (not subject to this inspection). A pre-inspection report was provided by the home and provides a basis for information in this report. There was good written feedback directly to the Commission from 9 relatives, 3 residents and the GP responsible for the home. Fifteen residents were spoken to mainly individually and in private. This included a group discussion with 3 residents on the reablement unit and a visiting relative. A total of 3 visitors were spoken to individually. All staff on duty were seen and spoken to during the inspection day and there was an inspection of all communal areas and a sample of bedrooms. All relatives and residents indicated a high level of satisfaction in the written feedback to the Commission. Comments included “Brighton House is marvellous”, “Every member of staff has been wonderful to my mother over the past 5 years” “The standard of care is excellent staff very helpful and it is The Best” These comments were replicated in discussions on the day with residents and visitors. Two visitors of relatives with severe dementia commented about the commitment and patience of staff in dealing with the needs of their relatives and were highly satisfied with the service and care. They were kept informed of all events affecting the health and welfare of their relatives. The GP responsible for the home commented upon the excellent care provided and the understanding and cooperation of staff in meeting health care needs. This home has consistently provided a very high standard of care and the environment meets all the National Minimum Standards. It is not surprisingly a home in great demand with a waiting list. No requirements are made in this report. Three recommendations are made. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? There has been considerable work carried out to improve fire protection measures. The fire detection system has been replaced. Work has given added protection in relation to the roof space, in the interests of fire safety. Some gaps in signatures on MAR sheets seen at the last inspection were not evident on this visit. Medication records were correctly signed and there were no errors or omissions. Incomplete living will seen on the last inspection has been completed accurately to meet legal requirements in conjunction with the GP. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 7 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.V278639.R01.S.doc Version 5.1 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.V278639.R01.S.doc Version 5.1 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 Standards relating to Choice of Home were found to be met. EVIDENCE: The statement of purpose has been updated recently to include staffing changes etc providing a well informed and concise document outlining the objectives of the home and the services and facilities provided. A copy was seen to be available in the home for residents and visitors and a copy has been sent to the Commission. A copy is provided also in all bedrooms. There is an accompanying service users guide. Most residents have contracts provided by the funding Local Authority. Self funding residents are provided with a similar contract (not seen). Admissions are generally subject to Care Management Assessment, even in cases of self-funding. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 10 Additionally the home carries out an assessment prior to admission in al instances and prospective residents always seen in their current environment e.g. hospital. A large proportion of people admitted to Brighton House have had prior introductions on respite periods of care. All prospective residents are invited to the home prior to admission. The records of 2 people recently admitted to the home each contained a Care Management Assessment and a pre-admission assessment carried out by the Manager. One lady had been to Brighton House for respite periods prior to admission and therefore knew the home well. The other was admitted from an assessment placement in another home and a preadmission visit was arranged to enable her to make a decision about possible admission. There are 5 re-ablement places in the home and admissions are through multidisciplinary assessment but also subject to assessment by the home prior to admission to confirm suitability and the homes ability to meet assessed need. The 5 re-ablement places are provided for people requiring rehabilitation, usually following hospital care and 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. 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. Staff at Brighton House work closely with other professionals involved in the decision making processes. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 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 – 11 The home works in close partnership with the primary health care team. GP responsible for the home indicates and excellent standard of care and cooperation. Health care needs are adequately documented to ensure they are fully met. There is a safe system of medication in use in the home. One matter arising will be further discussed with the GP. All residents confirmed they were treated with respect and privacy upheld. Previous issue relating to living wills has been resolved. Standards relating to Health & Personal Care are met. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 12 EVIDENCE: Care plans of recently admitted and a long-term resident were reviewed. The Local Authority care planning format is good and comprehensive. Care plans are reviewed in the home on a monthly basis for all residents. At the time of the last inspection some care plans had been amended over a period of years and actions to provide care were not always clear. Some parts of plans have been re-written to provide clarity and there is in place a monthly summary of care written and signed by the Manager/Care Team Leader and defining any changes in assessed need and actions required to meet those changes. Many plans remain unchanged and this is stated in the monthly summary. There is also an ongoing monthly dependency scoring which also indicates any changes. Risk assessments were in place in both instances. These were clearly defined risks outlining potential outcomes and the required actions to reduce risk. The risk assessments are reviewed monthly as part of the total care plan. Health care needs are clearly recorded in care planning information. All interventions by health care professionals are recorded chronologically and provide a means of monitoring ongoing appointments and interventions. There are no pressure area management problems in the home at this time. Any concerns are immediately referred to the District Nursing Service who are reported to provide a good service to the home. Nurses are visiting currently only for ongoing blood checks and monitoring of minor treatments. All residents with the exception of those on respite care are registered with the local village surgery and a good service is reported by the home. The senior GP partner provided feedback directly to the Commission prior to the inspection expressing his view about the “excellent care” provided at Brighton House and good partnership of working between the practice and the home. There are at least annual health checks for all residents and this is invariably for most on a more regular basis as residents are seen by the GP and Nursing Service. There the usual mixed dependency level in the home. 7 people require dementia care 5 have mental health needs, 9 have continence care needs and 9 required wheelchair use in the home. Four people are hoisted/use standaid and required 2 staff for personal care. There are 6 people who are considered to be in the higher dependency range for care. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 13 Medication is provided to the home by village pharmacy in MDS form (Nomad). Records/MAR sheets indicated that medication was accurately recorded and kept appropriately and securely. All returns to the pharmacy are listed and countersigned by the pharmacy. The local authority provides very comprehensive procedures and training for staff administering medication. Only senior staff administer medication and all have received appropriate training. Eyedrops, creams etc were stored in the medication fridge and were dated when opened. A stimulant laxative prescribed for a resident was discussed and the home will carry out a review with the GP to ensure complete safety for continued prescription. One 102 yr resident part self-medicates following risk assessment. Where possible people on respite and re-ablement programmes can continue selfmedicating when safe to do so, the importance of continuity being understood. Personal care giving was observed during the inspection to be given with respect and dignity. This was discussed with several residents who comfirmed that privacy is always safeguarded when personal care is given – they had no reservations about this issue. All said that staff treated them with the utmost respect at all times. At the time of the last inspection “living wills” completed by some residents were seen and in one instance this had not been properly completed and dated. A requirement was made and the matter addressed swiftly with the involvement of the GP. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 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 Discussions with both residents and relatives confirmed that chosen lifestyles were accommodated and promoted by the home. Resident said their expectations and preferences prior to admission were matched and often exceeded. There is an excellent internal and external activities programme which is being further developed. Residents confirmed the high standards of food provision in the home. Standards relating to Daily Life & Social Activities are met. EVIDENCE: Chosen lifestyles are a basic philosophy of the local authority in provision of care for older people which includes Brighton House. A copy of the Local Authority document is available to all residents/relatives outlining the principles of choice and lifestyle. All residents were seen and a large proportion spoken to during the inspection. All confirmed their choices were known and acted upon. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 15 This included daily routines of care and examples were discussed and given by residents including rising, retiring and bath-times and daily routines and preferences including their wishes relating to social and recreational activity. There were several clear examples of chosen lifestyle. - One 102 year very independent resident has all meals served in her room where she has high physical needs but is still in control of the routines for her daily care. Another resident similarly spends all time in his bedroom, persuaded to move fleetingly to the nearby lounge area once a week so that his room can be extensively cleaned. A resident admitted some months ago was seen in her room where she prefers to spend most of her time, going only to the dining room for her mid-day meal. She is quite positive in expressing her preferred lifestyle and the home readily and easily accommodates her choices. Residents were seen to arrive in the dining room for breakfast up to 11 a.m. The process is staggered and offers complete choice to fit preferred rising times. An activities worker is employed 8 hours per week in the home, she also works as carer. Her hours for activities are totally flexible and will include evening/weekend input. She provides some time for activities organisation but all care staff are involved in activities which are considered an integral part care needs. Staff work well together in this area and the activities have been extended over the past year, both internally and externally. Previously fund raising was carried out by a League of Friends Committee but now carried out by staff and provides a residents comforts fund. Monies are raised for equipment, internal entertainment and external visits. External visits have been extended this year (the home has its own mini-bus) there have been many visits to local garden centres, shops, pubs and places of interest. Residents plan outings and had requested trip to Blackpool – five were taken for the day and enjoyed the day immensely. Residents are involved in all fund raising which has an occupational and social benefit for all. Contacts with family and friends are promoted - confirmed in discussions during the inspection with 3 visiting relatives. An external entertainer visiting during the inspection had most residents in the large lounge area singing and involved in the event. The positive enjoyment was clear for all and nonetheless for several residents with dementia who were singing and dancing. Visiting relatives took part too and a relative was so pleased with the clear enjoyment it provided for residents that she insisted upon paying for the entertainer to make another swift visit. This scene captured the excellent activities being developed at Brighton House and the direct involvement of relatives/visitors in the process. Volunteers, staff and relatives work closely together in several projects. Relatives meetings are held regularly in the form of a cheese & wine evening. Senior staff and Head of Hotel Services attend to ensure any matters raised can be discussed. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 16 Food provision in this home has been traditionally good. This was further confirmed during this inspection in discussions with residents. All felt that the quantity and quality of food was excellent and there were choices at all mealtimes. Residents confirmed their food choices were known and acted upon. Meals are served in bedrooms at all times as required. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 17 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 and 18 Standards inspected in relation to Complaints and Protection were found to be met. EVIDENCE: The Local Authority complaints procedure is available in 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. Measures to ensure protection of residents from abuse were pursued. The local authority policy/procedures relating to vulnerable adults was in place. The Manager felt that the subject was adequately covered in induction training. The local authority has a leaflet which is given to all staff with clear and concise instructions for reporting suspected or actual abuse. The Manager confirmed this leaflet is still given to all new staff. Procedures for abuse were reported to be discussed occasionally in supervision as part of policy/procedure awareness. Residents finances were not inspected on this visit. The Local Authority auditors are due to carry out their audit of finance in the home in the near future. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 18 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 This is a high standard environment generally well maintained although the capital building programme for 2006/7 should provide agreed guarding of all radiators and redecoration of some areas particularly bedrooms needing redecoration. Awaited replacement of a hot water boiler is presently allowing complaint from residents of insufficient hot water in bedrooms. Wash hand basin taps in bathroom area to be reversed to correctly indicate hot and cold. EVIDENCE: This is a very high standard environment which is generally well maintained. All areas of the home, internally and externally are easily accessible for residents including wheelchair users. All resident accommodation is on one floor. The environment is safe. All external doors are alarmed/have keypads. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 19 Risk assessments relating to the building and equipments are in place and regularly reviewed. There is a risk assessment for the building and a fire risk assessment. The layout of the home is excellent there is a very large central lounge area with 3 wings off this area each having bedrooms, bathrooms lounge/dining facility and kitchenette. All bedrooms have en-suite facilities and are suitable for wheelchair users. All communal areas were seen. The laundry was inspected but not the kitchen area. A sample of bedrooms were seen and all found to be bright, warm, well equipped and very well personalised. Some have telephones installed most have TV. There has been past discussion and concerns regarding some remaining corridor and lounge areas not having radiator guards. The home confirm that these are included in the capital programme for the year commencing April 2006. There has been considerable work carried out in the current year relating to additional fire prevention measures on the upper floor and other areas. Fire detectors have been replaced with a new system. Further work continues into the coming financial year. Work includes redecoration and other replacements/maintenance. It was noted that some rooms in the respite wing required redecoration and particularly the shared bedroom which needs swift action. There has been a problem with the hot water system in the home and it is reported that a new hot water tank is required and to be installed soon. One resident did complain that the water supply in her bedroom was not hot enough to wash in the morning. Testing of hot water temperatures during the inspection confirmed this. A wash-handbasin in a bathroom requires the taps to be reversed to correctly indicate hot and cold water. Hot water temperatures are tested and recorded monthly but because of the present difficulties it is important that weekly tests of most hot water outlets are taken and recorded to ensure adequate service and safety. Standards of hygiene throughout the home are high with good cleaning routines in place - confirmed in discussions with domestic staff. Continence management issues are being addressed in a very positive and robust way and there were no mal-odours. The laundry was inspected and facilities for the separation and washing of infected linen were satisfactory. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 20 A recent incidence of sickness and diarrhoea and vomiting in the home affecting several residents and staff was ultimately found to be virus related. The Health Protection Agency had been informed and additional alcohol handwashing used in addition to the usual good infection control procedures in place. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 21 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 numbers and skill mix of staff is satisfactory. Recruitment procedures are robust and protect residents. The local authority training programme provides excellent statutory and professional development opportunities for staff. Standards relating to staffing are met. EVIDENCE: The staffing hours are somewhat complicated in this home. The staffing for the reablement unit is separate from the rest of the building – there is one person on duty throughout the waking day. A community care service is provided out of Brighton House into the community but community care workers on duty also provide care in the home. The total staffing hours for the home with maximum of 28 residents is 521 care hours per week (this includes the reablement unit). Additionally the Care Team Leader is responsible for managing the care staff and works predominantly hands-on. Her hours are additional therefore to the 521 hours mentioned above. The Registered Manager is not on the staffing rota and Manages all staff. Three relatives in written feedback to the Commission stated that there were not always sufficient staff on duty. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 22 In consideration of the current dependency levels of residents and the geography of the building the inspector feels that the staffing levels are adequate. There is probably always a case for increasing staff but based upon the Department of Health guidelines for staffing levels and the average staffing levels of similar homes the current level is satisfactory. Additionally there is a Head of Hotel services post responsible for the management of 165 domestic hours, 56 catering hours and 56.5. gardener/handyman hours per week. There are 8 hours of clerical support and 8 hours per week for activities. This leaves care staff free of non-care duties. There are 22 care staff and all undertake the full time 2 week induction programme. All staff are involved in NVQ training and the home exceeded the required 50 of NVQ trained staff prior to the required date of 2005. NVQ training continues. Additionally all catering staff have completed NVQ2 training. The home is presently piloting a scheme for modern apprentices which is a government funded scheme for 18 – 24 year old trainees who progress to NVQ2 training in 12 months this is overseen the Social Services Training Unit. Two people are presently engage on this scheme and specific time allocated for study over the 12 month period. Since the last inspection there has been staff training in: Medication administration, blind/deaf awareness, moving & handling, violence & aggression, first aid, blood borne diseases and fire safety. The Manager has completed a recruitment & selection course and Manager and senior staff completed a course on disciplinary/grievance/capability procedures. Training is planned in February for 6 staff in Dementia Care. Senior staff are awaiting allocation for places on management courses (NEBSM) The local authority training programmes are comprehensive and offered to all staff. As always in this home staff were welcoming of visitors, there was a very relaxed atmosphere and whilst providing a high level of professional service to residents and their relatives, staff always show a warmth and friendliness edged with appropriate humorous exchanges. Many staff are long serving and very positive relationships are established. Staff files were inspected and those seen had required pre-employment references and checks with all documentation required under Schedule 2 of the Care Home Regulations. Recruitment procedures are good and overseen by the social services personnel section. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 23 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 and 36 - 38 Standards relating to Mangement & Administration were found to be met. EVIDENCE: Sharon Mewis was appointed by the Local Authority as Manager of Brighton House in June 2005. She was interviewed and approved as the Registered Manager of the home in October 2005. She has considerable experience in managing a service for older people. She commenced studies for the Registered Managers Award in January this year. There are clear lines of communication within the home and a structure of supervision in place for all staff. The Registered Manager brings and open and positive management style into the home. She has high standards and the necessary people/management skills to achieve and maintain those standards. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 24 There are regular management meetings (2 weekly) which include the Head of Hotel Services and Care Team Leader (Deputy). There are quarterly meetings for all staff and regular meetings for ancillary staff. There are two staff meetings for all care staff – one for day staff and one for night staff. The Registered Manager is supervised directly by the responsible individual who visits the home on at least a monthly basis and provides a report to the home and the Commission on the visit. A quality audit is now to be carried out by a senior member of the social services adult care section on an annual basis. This will replace the previous reviews carried out by Service Development Managers. Accounting and financial procedures and residents finances were not inspected on this visit. The Local Authority Auditors were due to carry out their usual audit process of financial procedures. Staff of all levels have regular recorded supervision in the home. Records seen indicated a high professional standard of recording in relation to care plans and daily recording of resident activity. The Local Authority comprehensive policies and procedures are in place in the home and were spot checked in relation to: Continence promotion, disposal of clinical waste, moving and handling and the Protection of Vulnerable Adults. All were satisfactory. In relation to safe working practices: Moving & handling training is provided for all staff at the point of induction. All Senior staff are approved moving & handling trainers. Fire records were inspected. All required checks of the alarm system, emergency lighting and fire fighting equipment had been carried out as required. There are regular fire drills for all staff and there has been staff training in fire safety since the last inspection. All staff have undertaken food hygiene training. All hot water outlets in resident areas have fail-safe valves fitted. The problems currently evident in hot water supply to those areas indicate weekly and not monthly checking of temperatures. The premises are secure. All external doors fitted with keypads or alarms. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 25 There are risk assessments relating to the building and there a fire risk assessment was reviewed in June 2005. Risk assessments relating to all resident activity were sampled with care planning information. They were all in detailed and comprehensive and were regularly reviewed. All required notifications under Regulation 37 have been notified to the Commission. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 26 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 3 10 3 11 3 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 x 18 3 2 3 3 3 3 3 2 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.V278639.R01.S.doc Version 5.1 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP25 OP19 OP25 Good Practice Recommendations The problem of supply of adequate hot water to bedroom areas must be resolved as soon as possible. Redecoration is planned but the shared bedroom used for respite care is an example of early redecoration required. Taps to wash hand basin in bathroom area to be reversed to correctly indicate hot and cold. Brighton House DS0000028865.V278639.R01.S.doc Version 5.1 Page 28 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.V278639.R01.S.doc Version 5.1 Page 29 - 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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