Inspection on 24/08/05 for Brighton House

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 15/02/06

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 Unannounced 24 August 2005 09:00 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 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 E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 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 Irene Merricks Care Home 28 Category(ies) of 3 DE registration, with number 19 DE(E) of places 6 MD(E) 4 OP 12 PD(E) Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 3 Dementia (DE) both - Minimum age 50 years on admission Date of last inspection 09 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 are 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 people involved 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 as required. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced inspection there were 18 permanent residents, 4 respite and 4 reablement. The home provides a range of residential provision and also has a team of staff working in the community (not subject to this inspection). The Care Team Leader (Deputy) has recently been appointed as the Head of Home, an application is in process to the Commission for approval of that person as the Registered Manager. The Head of Home was not on duty at the time of this unannounced inspection. There were actually 3 Shift Leaders (Senior Care) on duty and the inspector was able to spend very useful time with those 3 people and also other care staff on duty. The inspector was involved in the 9 am handover and able therefore to have a summary view of current residents. All residents were seen and the majority spoken to. Several visitors were seen and some spoken to. All spoke highly of the care provided at Brighton House and the usual high commitment of staff. The relative of a recently admitted resident said her mother had settled very well with the help of staff and that she was “delighted” with the home, environment and care. She felt confident that her mother was safe and monitored closely at Brighton House. Some residents had had breakfast at 9 am, other were seen to rise later, some quite later in the morning. Several had had breakfast provided in their bedroom. This is an excellent physical environment and the lounge is central to the home, the majority of people using this area throughout the day and is a meeting point for relatives and visitors. There is a very relaxed atmosphere, staff in this home have the natural skill of making visitors feel welcome and although care is provided in a very sensitive way, staff have humorous exchanges with residents, visitors and each other which creates a friendly and homely atmosphere. The inspection focussed on health care issues and care planning information. There is high staff awareness of health care matters, care planning has been generally good in this home but some plans require updating and more formal review. The care and chosen lifestyle of a 102 yr lady was reviewed during the inspection and found to be excellent. She has high physical dependency needs Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 6 but totally alert and gave a detailed account of the care she received and spoke highly of the work of care staff. A resident with complex continence needs presented some management difficulties, mainly in relation to odour management, but the home were dealing with the issues in a definite and positive way. The recording in relation to this issue though needs to be improved. As always at Brighton House there was a warm welcome and an open discussion with the inspector, this included residents, staff and visitors. This summarises the positive impression the home creates. There are high standards of care. What the service does well: What has improved since the last inspection? 10 bedrooms have been redecorated, some refurbished as necessary. Residents spent time outside the home enjoying the summer weather. Utilising the excellent seating and patio areas with gazebo erected to protect from sun etc. NVQ training continues and the home exceeds the required 50 of NVQ trained staff required by 2005. A permanent Head of Home has been appointed by the Local Authority, soon to be interviewed by the Commission. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 standard(s) 1 - 6 The statement of purpose requires some additional information. Good pre admission assessments were seen and introductions to the home completed appropriately A good intermediate care service (re-ablement) is provided home staff working closely with other professionals. EVIDENCE: The statement of purpose/service users guide has been updated to include recent changes in the home, however there are were some omissions to the original statement of purpose did not include all information as required under Schedule 1 of the regulations and should be added. This will be further discussed on the next inspection. Copies of the statement of purpose are given to all residents and copy in their bedrooms. Copies are also available in the home for visitors. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 10 Most residents have contracts provided by the funding Local Authority; self funding residents are provided with a similar contract. Admissions generally are subject to Care Management Assessment. Additionally the home carries out an assessment prior to admission in all 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. Admissions to the re-ablement unit are through multi-disciplinary assessment but are also subject to assessment by the home prior to admission to confirm suitability and the homes ability to meet assessed need. Five places are provided for people requiring re-ablement/rehabilitation usually following hospital care and prior to returning home. A specialist team of professionals are involved in assessments, reviews and discharges. One of the wing of the home is dedicated to providing this service to those 5 people and 4 others needing respite care. The unit has good facilities and includes a training kitchen, and self-contained lounge/dining areas. Staffing hours are allocated throughout the 24 hour period specifically for this group. All bedrooms have en-suite facility and there is an assisted bathing facility on the unit. Staff at Brighton House work closely with other professionals involved in the decision making process. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 standard(s) 7 - 11 There is good awareness of health care needs with swift referrals to health care professionals where necessary. The home should review the care planning information provided, which although comprehensive does not give a concise and up to date account of staff actions required to meet needs. The system for reviewing plans could also be re-considered. Care plans must be revised in response to changing needs to allow accurate monitoring. There is a safe system of medication in place, omissions seen were unusual for this home. The principles of dying and death are positively applied. The documentation relating to living wills must be reviewed in all cases immediately. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 12 EVIDENCE: Care plans were sampled for 2 long term residents. The Local Authority care planning format is very comprehensive. Plans seen contained many additional dated notes to plans which had originated 2-3 years ago; it was difficult to get a swift picture of some of the current needs as amended. Perhaps some long term plans should be re-written to provide clarity. The home are dealing well with the complex continence needs of a resident having involved other professionals, however this aspect of the care plan had not been revised to provide clear instructions to staff on meeting the need and monitoring outcomes. The system for reviewing care plans changed over 12 months ago. Previously each aspect of care need was reviewed and signed. There is now a monthly summary signed by staff indicating changes, but again this did not reflect current care needs, relevant sections not always being revised. The home should consider ways of improving the system to provide a current and concise working document outlining actions required by staff to meet specific need. Evidence seen support the fact that health care professionals were contacted appropriately and to ensure preventive health care. Local GPs provide a good service to the home, respond swiftly to requests for visits/assessment and there is a good working relationship with the local Practice, confirmed in recent feedback form received from one of the GP’s involved. There are no pressure area problems in the home at this time. District Nurses visiting only 2 residents to supervise prescribed treatment by the GP. A reablement resident with acute cellulites had been referred swiftly to the GP and joint treatment regime being followed, the home dealing with the resultant discomfort of the person in a sensitive and reassuring way. A resident with severe dementia who had surgery for cancer would not allow the wound to heal, advice sought from the nursing service and staff seen to deal with the ongoing problem in a diplomatic, caring and reassuring way. The care provided to a 102 yr old very dependent and fiercely independent lady was reviewed by the inspector. Her wish to be cared for in the privacy of her bedroom was respected, also her wish to sleep in a reclining chair, not bed was respected. This had been her preferred option prior to care, a bed introduced but not appropriate/used was removed, her bedroom providing good space resembling a sitting room and allowing adequate space for hoist which was necessary for her continued care. The lady spoke highly about staff care and attention to her needs, she was very satisfied with all aspects of care which she discussed in detail. Her personality is such that she would very positively have indicated if she had been dissatisfied. The care provided to this person was excellent. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 13 Medication records and the MDS (Nomad) system were inspected. The home has a good record of safe medication administration, the local authority has very comprehensive procedures and provides a good standard of training in medication for senior staff who administer medication. It was noted on this occasion that some medication had not been signed for appropriately at the point of administration. This must always be done. Self medication is promoted where possible, it is particularly important for respite and re-ablement residents in this home to continue self-medication to continue the process which will be necessary upon discharge. There were examples of this. Medication is stored in locked facility in bedrooms where residents self-administer. Observations and discussions with residents supported the view that they were treated with respect by staff and that they received personal care in total privacy. Previous deaths in the home have indicated that the principles of dying and death are practised; there are thank-you cards for relatives of deceased residents outlining this. Inspection of records on this visit showed that some residents had completed “living wills”. In one instance this had not been properly completed and it had not been dated. This of course, negates the validity of the document. The home must review urgently the documentation in all cases where this document exists, ensuring simultaneously that relatives are consulted where necessary and appropriate. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 standard(s) 12 - 15 Choices of lifestyle are respected and accommodated. This is a very popular home with both residents and visitors. There are many requests for vacancies which cannot be met and therefore many disappointments. The home meets all the standards for Daily Life & Social Activities. EVIDENCE: Chosen lifestyles are a basic philosophy of the local authority in provision of care for older people and specifically for Brighton House. Examples were seen during the inspection supporting this principle and example given in the previous section above. All residents were seen and many spoken to during the inspection. All indicated satisfaction with the routines and services provided at Brighton house. There is an activities worker employed for 8 hours per week, but all care staff are involved in activities. Previously there was a League of Friends group which provided some activities and considerable monies raised to provide additional comforts in the home. The League of Friends has now ceased to Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 15 operate and the home has a comforts fund which involves staff, residents and relatives in fund raising events. The Fund provides monies for residents social needs in the form of providing entertainment, outings to local pubs, garden centres etc. purchase of birthday and Christmas presents and additional comforts throughout the home e.g. TVs, furniture etc. Summer and Christmas Fairs, raffles, car washes etc. provide dual benefits – resident involvement and tangible financial benefits too. There have been recent visits to Trentham Gardens, Brampton Museum etc. A mini-bus is provided to the home from the proceeds of past and present fund raising too. Contacts with family and friends are promoted. Several visitors were seen visiting the home during the inspection. People clearly feeling relaxed and free to sit either in the lounge area or privacy of bedrooms as they wish. Friendly, warm and humorous exchanges were noted between visitors and staff, several children and a dog accompanying visitors provided a central point of interest and discussion for all. Visiting relatives were spoken to by the inspector, one whose mother had been recently admitted stated that she had settled quickly and well, “staff were excellent” and she was “relieved that mother is happy and safe” The very large and attractive main lounge area opens out from the foyer of the home and is very inviting and homely. There is a very large and attractive dining area resembling a good restaurant and used as a social meeting place too. Food is to a high standard, all residents spoken to confirmed this. Mealtimes are flexible, residents seen arriving for breakfast over several hours. There are good food choices at all mealtimes. Meals are served in bedrooms as required. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 standard(s) 16 - 18 Standards relating 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 reception area for visitors. There is no complaints book or file in which complaints are recorded (no chronological record) but the home report that no complaints have been received in the period since the last inspection. No complaints have been received by the Commission. A policy/procedure is available in the home informing staff of the procedures for reporting suspected or actual abuse. This is reinforced in induction training and also supervision. All staff receive individual copies outlining the procedures to be followed in the event of suspected or actual abuse. All staff have received training in the management of violence and aggressions. Physical interventions are not required in this home. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 standard(s) 19 - 26 This is a high standard environment which is very well maintained. All standards in relation to the environment were found to be met. EVIDENCE: This is a very high standard environment which is also well maintained. All areas of the home, internally and externally are easily accessible for residents, including wheelchair users. The environment is safe. All external doors are alarmed/have keypads. Risk assessments are in place relating to the building and equipments. These are all regularly reviewed. There are excellent seating areas surrounding the home, which resident can access from various points within the home. The good summer weather has been maximised by residents sitting outside with appropriate seating and shade. A see-through gazebo set over a patio area at the rear allows some Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 18 protection for resident who can see the garden area and can be easily monitored by staff. The comforts fund allows additional provision. A very large flat-screen TV has been purchased for the lounge are and TV’s replaced in bedrooms and 2 lounge areas. All bedrooms have en-suite facilities. There are 2 assisted bathrooms and a walk-in shower area, one of these located on each of the 3 wings of the home. All have good access for wheelchairs and people with physical disabilities in general. All relevant areas have grab rails fitted. The call system is available in all resident and communal areas (sample tested). There are extension cords to call systems where required. All resident accommodation is on one floor and there is excellent easy access to all parts of the home for all residents. A random sample of bedrooms were seen. All were bright, well furnished and have good standard furnishings and fittings. All bedrooms were well personalised reflecting the individuality of residents. All have TV either provided by the resident/family or the home. Telephones are installed in some bedrooms – 102 yr resident has telephone installed – used regularly. There is good ventilation and natural light in all areas of the home. All windows have restrictors. Radiator guards have been fitted in all bedroom areas and some communal areas. Remaining corridor and some lounge areas required guards to be fitted and this is planned in the current Local Authority financial year. At the time of the inspection major work was being carried out to extend and improve the fire alarm and warning systems in the home. Fail safe devices are fitted to hot water outlets in all resident areas and maintained by local Company. The hot water in one area sampled seemed high, this will be further checked. Regular weekly checks of water temperatures are taken and recorded. Standards of hygiene in the home are high with cleaning routines in place. An ongoing continence management problem relating to particular residents present some difficulties but were being adequately addressed with regular carpet and upholstery cleaning carried out. Some lounge carpet has been replaced to ensure good odour control and the home are considering specialist flooring in a bedroom to assist with the management of the problem. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 19 A requirement was made on the last inspection for removal of incontinence waste bins from the laundry area in the interests of good hygiene. This has been done and they have been removed to the bathroom/toilet areas. They are only removed/replaced weekly by the LA Contractor. The inspector had some concerns about the regularity of this and it was discussed with the Head of Hotel Services. The preferred option must be a large outside container which would allow daily/regular removal of this waste from the interior of the home. A requirement made in relation to cleaning routines in the laundry has been actioned. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 28 The staffing levels are adequate to meet the needs of the current resident group. The 2 standards relating to staffing were found to be met. EVIDENCE: The care staffing levels remain the same as on 1.4.02 as required. The number of care staffing hours are 531 per week (this includes community care hours). Additionally there are 165 domestic hours, 56 catering hours and 56 gardener/handyman hours. There are 8 hours clerical support and 8 hours per week for handicraft instructor. The home provides a service to people in the community for which community care hours are provided. Figures include specific staff allocated to the reablement wing. The Local Authority induction and NVQ training is available for all staff. The home exceeds the required 50 of NVQ trained staff required by 2005. This training continues. There is a fairly static staff group in the home with only one change since the last inspection. Recruitment procedures and staff records were not inspected on this visit. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 21 The inspector is always impressed with the relaxed atmosphere in the home provided by staff who show a high commitment to resident care but provide it in a friendly, homely and natural way. Staff smile readily with humour which is used positively with each other, residents and visitors providing a very comfortable and relaxed atmosphere. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 - 38. It was not possible to assess standards 31 – 33, as there is not a Registered Manager in the home at this time, although application is in process. Standards relating to finance were also not inspected on this visit. Record keeping was of good professional standard. All staff are regularly supervised. There was evidence of safe working practices being applied and reviewed in the home. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 23 EVIDENCE: The Registered Manager left the home over 12 months ago. Since that time there have been Acting Managers working in the home, who have been competent but not approved by the Commission. This situation has now been regularised. The Local Authority have interviewed and recently appointed Sharon Mewis as Manager, she was formerly Care Team Leader (Deputy). She now has to be interviewed and formally approved as the Registered Manager by the Commission. An application has been received for approval by the Commission and is now being processed with a date for interview in October 2005. There is a process of staff supervision in the home for all staff and these are recorded and carried out at least 6 times per year as required in the standards. Records seen and required by regulation were satisfactory. Individual records of residents were sampled and some action required in relation to care plans mentioned elsewhere in this report. The standards of recording met professional required standards and data protection legislation. In relation to Safe Working Practices: All senior staff receive training in moving and handling and train all other staff. The manual hoist is presently used for one resident specific training has been provided and regular servicing taken place of the equipment. A Fire Risk assessment is now in place. Fire records were not inspected on this visit. There was considerable work in progress in the home relating to fire safety changes and improvements. All senior staff receive first aid training and there is always a senior member of staff on duty. Food hygiene training is provided for all staff and is satisfactory. The Local Authority Catering Advisor regularly visits the home the last visit being 2 weeks prior to the inspection. Following requirements of the last report there have been improvements to the infection control standards in the laundry area. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 24 Risk assessments are in place relating to all resident activity and there are reassessments following all falls. All staff received good induction, foundation and ongoing training to meet required NTO standards. Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x 3 x x 3 3 3 Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 26 Are there any outstanding requirements from the last inspection? 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 7 Regulation 15(2) Requirement Care plans must be revised in response to changes in assessed need. The system for reviewing and documentaing changes to plans should be reviewed Medication must be signed for at the point of administration Completed livng will identified must be re-written, completed concisely and dated. All others checked. Timescale for action Ongoing 2. 3. 9 11 13(2) 12(1) (2) Ongoing Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Brighton House E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 Page 27 Commission for Social Care Inspection Stafford - 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 E51-E09 S28865 Brighton House V246075 240805 Stage 4.doc Version 1.40 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!