Inspection on 29/09/07 for Brighton House

This inspection was carried out on 29th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brighton House 29/10/09

Brighton House 10/10/06

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 Mr Berwyn Babb Key Unannounced Inspection 29th September 2007 14:00 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.V348021.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.V348021.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.V348021.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 10th October 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 that 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 was completed in October 2006. All bedrooms have en-suite facilities, and there are spacious and well appointed communal areas. There is only one shared bedroom, and as this contains a double bed, it is used only for couples, or one person who does not want to sleep in a single bed. 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 and other usual services. 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.V348021.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out during the afternoon of Friday the 29th of September 2007 by one inspector working alone. The Registered Care Manager had tendered her resignation, and the providers had identified the person in charge of the home as the person entrusted with its management, and until a replacement could be registered as a Fit Person with CSCI. (She herself was one of the applicants, with an interview the following week.) The inspector carried out a visual examination of the exterior and grounds of the home, and toured the interior, including the majority of the private bedrooms. He spoke with senior management, (both in the home and by telephone to their headquarters) care staff, people who use the service, and visitors to the home. He reviewed care plans and other documents relating to the proper ordering of this service, and this report is founded upon what he saw and heard. This home, which is in the heart of its local community, was clean, well ordered, well maintained, warm, light, airy, and free from odours throughout, and people living in the home and their visitors, were extremely positive about the service it provided. The Home offers permanent care, for which the providers (the County Council Social Service department) charge £439 per week, and respite care for £138 60 a week. Re-ablement care (rehabilitation) is fully funded, with no charge been made to people who use this service. What the service does well: This home provides an excellent service to frail and elderly people in need of permanent care, providing them with the opportunity to experience periods of respite before they relinquish independent living, and also enables people who have been in hospital to undergo intensive rehabilitation to enable them to return to their own homes. It does this in a modern establishment that was built for the purpose, and is situated in the heart of its local community. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 7 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.V348021.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service have the information they need to ensure that the home can meet their personal choices and assessed needs, and they are able to visit the home as part of that process. Those admitted for rehabilitation can expect dedicated input directed to reviving their independence. EVIDENCE: People who use this service told the inspector the history of how they had come to be admitted, and from this, it was possible to deduce that they had had not only a comprehensive statutory assessment of their needs and individual choices, but that with the exception of a lady who was admitted as an emergency, they had had a graduated programme of introductory visits to the home, and were in possession (with their relatives and supporters) of all the information they needed to help them make an informed decision about moving in. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 9 Members of senior staff described how they visited people (sometimes when they were in hospital) in order to tell them about the home, and to gather assessment information so that they could reach a conclusion as to whether they would be able to meet that persons needs and individual choices. A sample of the care plans of people who use this service was examined, and in one was an expression by family and friends that they wish to be involved in care plans, and to participate in carers meetings, and there was also a list of the dates on which this person had visited the home prior to their admission. This type of information about pre-admission visits was repeated in all but one of the care plans reviewed, and in that case, the person who uses the service had been totally dependent on a carer who themselves had been admitted to hospital as an emergency, leading to her admission to the home also as an emergency. Contracts were seen in all of the care plans reviewed. People admitted for rehabilitation were magnanimous in their praise of what staff had done to return them to a level of health that would allow them to consider returning home. One lady said to the inspector: My shoulder was so badly damaged that they had to do as much for me as they would do for a newborn baby, and thanks to their devotion and care, I can now do this. (She then grasped the arms of her chair, and pulled himself up to her feet without any difficulty.) Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In spite of the need to repeat the requirement relating to PRN medication, the way the health and personal care needs of people who use this service were recorded and met was extremely commendable. They reported how their privacy and dignity was upheld, how well they were cared for by experienced and loving staff, and how highly they regarded the home. EVIDENCE: People who use this service were seen to have their needs and choices recorded in assessments and reviews that formed the basis for the delivery of their care. A sample of their care plans was reviewed, and was seen to set out in detail the action needed to be taken by care staff to ensure that all aspects of their health, personal, and social care could be met in the most dignified manner, with the intention of maximising and enhancing their independence. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 11 An example seen in one care plan of this was that when a carer noticed a person struggling to finish her lunch, she went and talked to her and obtained her permission, before assisting her to complete this task. In another care plan it was recorded that somebody admitted as an emergency in an advanced state of confusion, was able to express her wish to have her hair cut, when she observed the visiting hairdresser attending to other ladies in the home. A third care plan contained comprehensive lists of that persons likes and choices, including religious observation and sporting fan club memberships. In the sections on health care, in addition to a record of assessed and the emergent needs, there were details of relevant contacts for each individual (Hospital consultants, clinics, nurse specialists, GP services,) and records of forthcoming appointments, together with arrangements that would need to be made to enable the person to keep these. Examples from the care plans reviewed, and from discussion with people who use the service and care staff included written details on the care of a person who had been fitted with a pacemaker, attendance at a stroke club, contact with the doctor to discuss appropriate response to changes in behaviour (leading to a reduction in that persons medication) links with the Parkinsons disease specialists, appropriate use of a Nebuliser, regular appointments with chiropodists, dentists, opticians, and hearing specialists, arranging for, and responding to, the information generated by blood tests, appropriate ways of moving and handling, responding to deluded behaviour, ensuring correct diet and body mass, and provision of, and the correct use of, and servicing, aids (such as a wheelchair). During the review of the storage and Administration and recording of medications, it was unfortunately revealed that the discrepancies in M. A. R. sheets that led to the requirement of the previous report, had not been rectified, and that there were still two systems being operated in relation to how it was recorded that a PRN medication had not been necessary. Some people were marking the sheet with an R for refused, and other people had been leaving the space blank. The requirement will be repeated in this report. In all other respects matters relating to medication were satisfactory. The home uses a monitored dosage system, receiving their medication from the pharmacist in dispensing boxes divided up into columns for every day of the week, and rows corresponding with early morning, lunchtime, teatime, evening, and (if necessary) and extra row for night-time. These were stored in appropriate, hospital styled, metal cabinets, one of which was a mobile unit for taking to each of three separate areas of the home, and which was padlocked to the wall was not in use, and the other of which was appropriately bolted to the wall, and contained reserve supplies, and a second further locked inner compartment for the storage of any controlled drugs. There was also a separate medication fridge in the room for such things as insulin, and this was fitted with an external digital temperature display. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 12 Examination of such things as eye drops and topical creams revealed that the dates they were opened had been clearly written on the container, in line with current best practice advice. There was nobody recorded in the home at this time administering their own medication. Examination of the training records of care staff demonstrated that everybody undertaking the administration of medication had undertaken an appropriate course, and had received a certificate confirming this. The file in which the MAR sheets were kept opened with a list of people so authorised, and a sample of their signature. When discussing with people who use this service their experience of receiving care, they were all at great pains to impress the diligence, dignity, and sensitivity that they would have been treated with, by people working in this home. In the words of one lady: They have treated me like the Queen since I have been here . Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service said they were satisfied with the routines and activities of the home, with how their dietary needs were met, with how they were able to pass the time, and with the visits they received from friends and relatives. In one persons care plan, details were seen of meeting their need to observe their religion. EVIDENCE: During the tour of the home, people who use this service spoke of how happy they were with the way the home was run for their benefit, and talked about some of the things that they did during the day. A particular feature of this home appears to be its physical location in the absolute centre of its community, and some knowledge, that many people seen during the afternoon had of each other, prior to them being admitted. In one of the lounges, two ladies were energetically exchanging information about the current situations of other local people known to both of them, and expressing their own views on the propriety or otherwise, of what they had just heard. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 14 Elsewhere, a member of staff employed to promote activities, was being assisted to produce a database of photographs of people who use this service for respite, so that when they enter the home, their picture will be on the door of the room that it are to occupy, to welcome them and help them identify which room is theirs. Relatives and friends were visiting the home regularly throughout the afternoon, and in conversation with the inspector, they also spoke extremely highly of the care and attention provided by the staff. In one of the care plans reviewed, the indication from the group of relatives was that they wish to be included in reviews of the care of their relation (with her permission) and attend relatives meetings. Another example of community contact was discovered when a visit was made to the kitchen, where a large box of foodstuff was been made up into hampers for distribution in the community, and it was learned that this was a gift from a local school, who historically, have always donated produce from their harvest festival service to the home. The visit to the kitchen also confirmed the wide ranges of choice available for people in the home, and the quality and quantity of the goods held in store to achieve this. Such things as cleaning rotas, fridge temperatures, food temperatures, freezer temperatures, and the overall cleanliness of the environment were noted, as were the health and safety directives posted on the walls, together with a large white board containing information regarding the dietary requirements and personal choices of individuals, and any specific utensils needed to assist them in enjoying their diet. The Cook confirmed that she had adequate cutlery and crockery to serve the meals that she produced, and sufficient and appropriate utensils to make them with. She confirmed that all people who work in the kitchen have received training in relation to food and hygiene. The menu for the cooked meal on this particular day had been fish, or an alternative of poached egg, both served with chips and peas, and followed by either fruit crumble and custard, or tapioca pudding. People who use the service told the inspector that their meal had been delicious, and that they were able to make a cup of tea (or other warm drink) in the kitchenettes attached to each lounge at any time they wanted (and the senior member of staff confirmed that this was after a risk assessment had taken place). Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, and 18. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are enabled to make comment on any concerns that they may have, both through the formal complaints procedure, and through Residents meetings. Discussion with staff would suggest an extremely high level of commitment to protecting them from abuse. Arrangements were seen in care plans concerning exercising the right to vote. EVIDENCE: A member of the care staff was engaged in a formal interview during which the subject of complaints and abuse were discussed in some depth. She was correctly able to identify from whom the vulnerable people in this home were at risk of abuse, what forms this might take, and what the agreed procedure was that she should follow, if ever she suspected anyone was being abused. She was able to confirm the commitment of staff to the complaints procedure (copies of which had been seen in the care plans that had been reviewed), and details of how to go about making complaints were displayed prominently in the public area near to the door. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 16 In one care plan the involvement of adult protection was recorded, after a senior member of staff had recognised that there was an issue following conversations with the lady. Discussion with the managers on duty expanded on this, and established their ongoing role in the protection of this vulnerable adult. In one of the care plans being reviewed, it was stated that the person using the service would need assistance to enable her to exercise her democratic right. (Vote). Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service live in a well maintained environment with comfortable indoor and outdoor facilities, sufficient and suitable lavatories and washing facilities, specialist equipment that they need, safe and comfortable bedrooms, and a clean, pleasant, and hygienic ambience. EVIDENCE: A visual examination was made of the exterior of the premises, and both these, and the grounds, appeared to be in good order with out any need of attention. Car parking is provided at the side of the way up to the front door, where a double entrance helps security, and reduces heat loss. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 18 A full tour of the communal and service areas was undertaken, and visits made to the majority of bedrooms. Everything was seen to be in good order, with a high level of maintenance to the fabric and decoration of the premises, reflecting the capital works programs completed in October 2006, that had spanned several months, in order to upgrade areas of the home, and improve fire safety. There are three separate wings, and in addition to the main lounge, there are two further lounges, nominally dedicated for the use of people on respite, and those undergoing rehabilitation (Re-ablement). This wing is staffed separately from the remainder of the home, with personnel that include occupational therapists, physiotherapists, and social workers, in addition to a dedicated member of care staff. Good-quality and substantial furnishings and fixtures were seen at all locations, with such things as piano, music centres, and televisions being available to the occupants. The home was well provided with bathrooms and lavatories, with all bedrooms having ensuite facilities, and was being both domestic and assisted baths, and a separate shower room. In the bathroom with an Arjo Malibu hoist, the overall ambience of the room had been improved by the provision of full height wall tiles, in shades of sage and beige, picked out with the occasional tile decorated with flowers. The device for operating the emergency call could safely be left floating in the bath, as well as having sufficient tubing to enable it to be used from the toilet. There was a thermometer to test the temperature of the water, and a set of sit on scales. Those bedrooms examined were tastefully and comfortably furnished, and reflected the individual personality of their occupants. Many (predominantly the permanent rooms) had extensive collections of photographs and ornaments, and some small pieces of furniture, in addition to appropriately guarded heating radiators, accessible emergency call points, wash basins, and ensuite toilets. In one room a lady had a collection of ornaments and plaques reflecting her love of the Royal family, and in another room a persons religious commitment was reflected in a beautiful miniature Icon. Each room had a Perspex leaflet holder containing such commendable information as an advocacy guide, the Service Users Guide, and a letter from the chief executive of the council thanking people for their contribution to the recent consultation exercise over the future of direct services. There were also other documents informing people about the services that they were receiving In the room of one person there was a Trixie hoist for this lady, as she needs assistance with all transfers undertaken in the room, and in addition to the normal pillows on her bed, there was a special V. shaped pillow to help her support herself when she sits up. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 19 Hand rails to assist mobility were seen in all the corridors of the home, and other aids included a perching stool, and a device used to assist moving a person around keeping them steady, which the acting manager said was less mauling for them than having to be moved into and out of a wheelchair when going to the toilet. Many of the rooms were fitted with television aerial boosters, because reception was otherwise unacceptable. The home was light and airy, with good natural light as well as artificial, and as has been mentioned in several places previously, all radiators were covered with a metal guard to protect anybody from being burnt if they fell against it. All artificial lights were domestic in character, and touch lights were observed on bedside cabinets, something that makes it much easier to obtain illumination during the night, than fumbling for a switch. The laundry was provided with a sluice unit and complimentary Belfast sink, and both of the washing machines and both of the dryers were of substantial industrial design. The walls were tiled from floor-to-ceiling, and the flooring was both impervious, and of an easy to clean construction. There were separate receptacles for each individuals room, and plastic baskets in these to convey the clean laundry back to that person. The home was clean and tidy throughout, with no hint of mall odour, and policies and procedures were seen for both regular and the cleaning, and for the disposal of both clinical and general waste. Brighton House DS0000028865.V348021.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have their needs and choices met by an appropriate number of skilled staff who are competent to do their jobs, and who have been employed through policies and practices that were designed to protect them. EVIDENCE: A formal interview was undertaken with a member of care staff during which verification was given that the recruitment procedure used had been based on equal opportunities and that it ensured protection for the people who use this service. In particular she had been required to provide two written references and clear police checks. The job had been advertised in local newspaper, and after filling in an application form, she had been invited for an interview. During a substantial two-week induction period she was not allowed to work on the floor of the home, in a caring capacity, but nevertheless net those people using the service at that time, and learn the layout of the home in between formal training sessions. She confirmed that supervision was both formal and open ended in that she could approach a senior member of the team at any time with confidence, if she had anything that concerned her. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 21 She stated, and this was later confirmed by observing the records, that she had undertaken all mandatory training, and that a matrix was kept so that the managers knew which members of staff would need to renew their training within any given period. She had qualified to NVQ level 2, and was of the opinion that there were sufficient staff employed in the home to be able to meet the assessed needs and personal choices of the people who use this service with both safety, and with the capacity to ensure that their privacy and dignity were upheld. Both visitors, and people who use this service, made extremely positive comments about the quality of care provided by the staff of this home. The establishment of the home includes a head of hotel services, domestic and catering staff, a gardener/handyperson, and eight hours of clerical support and eight hours of activities coordinator support, all of which leaves care staff free from non-care duties. Brighton House DS0000028865.V348021.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service benefit from robust management, commitment to quality assurance, and to their financial interests, and from an enterprise that works to ensure the promotion and protection of their health, safety, and welfare. EVIDENCE: The current Registered Care Manager for the home had resigned with effect from the day following this key unannounced inspection. Her line manager immediately informed CSCI of the measures put in place to ensure the smooth running of the home until she could be replaced, and interviews were due to take place the week following the inspection. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 23 The person in charge of the home at the time of the inspection was one of those to be interviewed, and was the person named as acting manager in the interim. CSCI consider that the immediate action taken by these providers to ensure continued good management of the home, to be sufficient proof of their bona fides, and there will be no requirement in this report concerning the registration of a new fit person as manager, as this is expected to take place within a matter of weeks. In several of the care plans reviewed, detailed observation was made of the substantial questionnaire that had been completed by the person using the service, and which mirrored the standards on which this report is based. (All responses read at this time were of a positive, or of an extremely positive nature in relation to this home.) Residents property account was checked and nothing discovered to be out of order, and it was established that the comforts fund is audited annually, and that arrangements have been made for its disbursement should the outcome of current deliberations by the county council, be the closure of this home. Personal allowances. First one checked, the amount kept in the wallet tallied exactly with what was recorded in the documentation. Second checked, and here again the amount recorded in the paperwork tallied exactly with the cash in the wallet of that name. Current fees. County council standard fee of £439 per week for permanent accommodation in an elderly home. The fee for respite care is £138 60 To ensure that the safety, welfare, and health, of people who use this service and the staff looking after them are promoted and practised, observations were taken both of the physical environment, and of the dynamics existent in the home. Discussion took place with management, care staff, and people who use the service and their visitors, and a review was made of relevant documentation to ensure compliance with good practice. Amongst other things looked at to confirm that people who use this service lived in safety, were the menus, the staff rota, the MAR sheets, the general and deep cleaning programs, training schedules, service certificates for such things as hoists, and electrical and gas installations, and financial records, as noted above. Nothing seen or heard calls the inspector concerned for the safety, health, or welfare of people who use this service. Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 24 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 4 4 4 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 4 3 3 3 4 4 X 4 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 X 3 X 3 X X 3 Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 A review should take place of the policies relating to the administration of medication. In practice, this refers to ensuring that the actual dose given of variable dose medication must be recorded. Timescale for action 11/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Birmingham Local Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brighton House DS0000028865.V348021.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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