CARE HOME ADULTS 18-65
Brigstock House 57 Brigstock Road Thornton Heath Croydon Surrey CR7 7JH Lead Inspector
Barry Khabbazi Unannounced Inspection 24th January 2006 11:00a Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 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 Brigstock House DS0000025758.V278940.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Brigstock House Address 57 Brigstock Road Thornton Heath Croydon Surrey CR7 7JH 020 8665 6369 020 8664 8254 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) Mr Cass Mohamedally Mrs Patricia Mohamedally Mrs Kay Jardine Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th August 2005 Brief Description of the Service: Brigstock House is a care home registered for eight adults with a learning disability. The home currently provides a service to a service user group with a wide range of needs including complex needs. Brigstock House is one of three similar homes owned by Mr and Mrs Mohamedally. Brigstock House is staffed throughout the day and with staff who sleep on the premises at night. Each service user has an allocated key worker to support them to identify and meet needs. The detached property is keeping with the other houses on the road. There are 8 single bedrooms. There is a communal lounge, a dining room and a kitchen. Other facilities include a laundry, staff sleeping in room and staff office. There is an established rear garden with a lawn, mature trees and bushes, a patio area. Access to the premises from the garden and front of the house are via stairs only. This home is currently not suitable for people with physical impairments affecting mobility. The home is located in Thornton Heath, within easy access by public transport and local shops. Residents of the home attend day centres on weekdays and the home has its own car. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This home currently meets {and exceeds in some cases} all of the National Minimum Standards and has demonstrated areas of good practice. All of the Commission’s service user and relative surveys have also confirmed this view, with only positive comments about the home being received to date. Where shortfalls have previously been identified, these were of a minor nature and the manager has proven committed to fully meeting all areas and exceeding them where possible. The key Standards identified throughout this report were all assessed at the last inspection, which was the main inspection for the year. Please see that announced inspection report for a full audit of all the key Standards. In addition that inspection report also refers to a pilot undertaken, where the service users conducted a large part of the inspection themselves. It is hoped that a similar service user led inspection will occur at the next inspection. This unannounced inspection therefore focused on following up on previous good practice recommendations. All of the residents were at day activities during this inspection. Please see the last report referring to the service user led inspection for a comprehensive list of service users views at that time. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 6 What the service does well:
Evidence of whole Standards exceeded presented: Standard 8, Service user inclusion, involvement and service user consultation are areas of good practice for this home, and the service users’ familiarity with involvement in the home, was one of the reasons that this home was selected for the service user inspection pilot recorded under the summary. This is reflected by Standard 8 – ‘service user consultation and participation in the running of the home’, being exceeded. Standard 21, ‘Ageing and Death’ was evidenced as exceeded. This ensures that choices and rights are held with the highest regard and that care is provided above the minimum standard at these times. Standard 36- ‘Supervision frequency’ was evidenced as exceeded both this and last year. This ensures a well guided and appraised staff group. Evidence of good practice presented: . Standard 2.3 only requires internal assessments for privately funded service users. Although the home does not have privately funded service users, it still produces an internal assessment for all its potential new admissions, including the most recent referral. This creates a higher level of knowledge of the needs of a new service user. Standard 6. The implementation of Person-Centred Planning for all service users will make them more central to the process of care provision. Standard 14, The home has contributed towards the cost of service users holidays from its own funds which facilitates more holidays. Standard 40, Although the relevant accessible documentation standards have now been met, the home continues to build on the current achievements, and to continually explore and develop access to all relevant documentation on an ongoing basis. The manager is very committed to this and has stated it as one of her aims for this year. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 7 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. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. Details of previously identified good practice that are referred to elsewhere in this report are however included below. EVIDENCE: Evidence of good practice presented: . Standard 2.3 only requires internal assessments for privately funded service users. Although the home does not have privately funded service users, it still produces an internal assessment for all its potential new admissions, including the most recent referral. This creates a higher level of knowledge of the needs of a new service user. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Plans of care contain originally assessed needs, and are updated regularly and their implementation is now recorded satisfactorily. This will help staff know all a resident’s needs and how to meet them. EVIDENCE: The last inspection report recorded the following; ‘Although daily notes were indeed recorded daily,they generally only covered sleeping patterns and continence and did not cover or reflect other aspects of the care plan, for example community use. The following recommendation is now therefore set: Daily notes should be more holistic and cover how the care plan was met on that day.’ This had been implimented by the time of this inspection. Daily notes are now recorded daily and are more detailed where required. This recommendation and Standard 6 are now fully met. Evidence of good practice presented: . Standard 6. The implementation of Person-Centred Planning for all service users will make them more central to the process of care provision. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 11 Evidence of whole Standards exceeded presented at this inspection: Standard 8, Service user inclusion, involvement and service user consultation are areas of good practice for this home, and the service users’ familiarity with involvement in the home was one of the reasons that this home was selected for the service user inspection pilot recorded under the summary. This is reflected by Standard 8 – ‘service user consultation and participation in the running of the home’, being exceeded. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. Details of previously identified good practice that are referred to elsewhere in this report are however included below. EVIDENCE: Evidence of good practice presented: . Standard 14, The home has contributed towards the cost of service users holidays from its own funds which facilitates more holidays. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. Details of previously identified good practice that are referred to elsewhere in this report are however included below. EVIDENCE: This following evidence of exceeding Standard 21 was presented: 1, During these periods, relatives can visit at any time day or night. 2, During these periods, relatives can stay over night if required. 3, If welcomed, the home maintains contact with relatives following a death of a service user. 4, Following a recent death of a service user, extra ‘over quota’ staff were brought in to provide extra support for the service users and staff. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. EVIDENCE: Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. EVIDENCE: Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. Details of previously identified good practice that are referred to elsewhere in this report are however included below. EVIDENCE: The following evidence of exceeding Standard 36 was presented. 1, Staff supervision notes sampled identified that, staff supervision frequency had exceeded the minimum annual requirement for 6 supervision sessions. 2, Themed supervisions also occur, for example shift leading competence. 3, In addition, ad-hoc brief supervision sessions were also recorded. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were all assessed as met at the last inspection and were not re-assessed at this follow-up inspection. Please see that inspection report for details. Details of previously identified good practice that are referred to elsewhere in this report are however included below. EVIDENCE: Evidence of good practice presented: . Standard 40, Although the relevant accessible documentation standards have now been met, the home continues to build on the current achievements, and to continually explore and develop access to all relevant documentation on an ongoing basis. The manager is very committed to this and has stated it as one of her aims for this year. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x x x x x x x x Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 19 NO 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. 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. Refer to Standard YA14 Good Practice Recommendations The home must provide a minimum 7 day holiday to all service users, funded by the placing authority, as a part of the contracted price. Brigstock House DS0000025758.V278940.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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