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Inspection on 20/06/05 for Brimington Care Centre

Also see our care home review for Brimington Care Centre for more information

This inspection was carried out on 20th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The inspector received a warm and friendly welcome at the home, from the managers, staff, relatives and service users. The relatives and service users were satisfied with the care and service provision and shared their views with the inspector.

What has improved since the last inspection?

The company continues to invest in the home. The majority of requirements were acted upon.

What the care home could do better:

The care plans should contain an accurate, up to date record of the assessed needs of the service users. Inaccurate records may lead to inconsistencies in the delivery of care. The senior care staff should ensure that the care plans are up to date. Medications should be stored correctly and medication administration records signed.The service users should always be offered a choice of meal. All repairs and refurbishment detailed in the body of the report should receive attention. The registered person should comply with these and previous requirements.

CARE HOMES FOR OLDER PEOPLE BRIMINGTON CARE CENTRE MANOR ROAD BRIMINGTON CHESTERFIELD DERBYSHIRE S43 1NN Lead Inspector IVAN BARKER Unannounced Inspection Monday 20th June 2005 at 10:00am 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. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brimington Care Centre Address Manor Road Brimington Chesterfield Derbyshire S43 1NN 01246 559777 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) Highfield Care Homes Ltd Mrs Josephine Jackson Care Home only 45 Category(ies) of 6 DE registration, with number 39 OP of places BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person will only admit service users into the home who have: Dementia, Alzheimer`s Disease, Picks Disease, Huntingdon`s Chorea, Creutzfeldt-Jakob Disease, Korsakoff`s, Psychosis, Artereo-Sclertotic Dementia conditions, who are in the latter stages of the illness, and with present similar clinical features, as Dementia, and require personal care. 2. The Unit must have at least one member of staff trained in Dementia care on each shift. 3. 6 DE service users can only be accommodated in the specialist unit, which has keypad locks and is located to the left of the main entrance. Date of last inspection 28/02/05 Brief Description of the Service: Brimington Care Centre is a purpose built home for elderly people. It consists of two units. One providing personal care to elderly service users, the other providing dementia care with specific diagnosis, which are listed as part of the conditions of registration. The Dementia unit consists of 6 bedrooms, a bathroom, and a lounge / diner. The Elderly unit is on two floors, with bedrooms on both floors. There is a large lounge and dining room on the ground floor and a lounge / diner on the first floor. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The person present at the inspection were Mrs J Jackson, manager. Mrs T Saunders, region manager Within this inspection, which occurred over a three and half hour period, the inspector toured the building, spoke to service users, relatives and staff and examined the care plans and other documentation. He spoke with 9 service users and 3 relatives. Within this inspection and the requirements that have been listed within this report, the inspector recognised that the 3 of the 5 requirements are relating staff practice, rather than to the company. However it is the responsibility of the company, through their management systems, that they ensure that the requirements are met. What the service does well: What has improved since the last inspection? What they could do better: The care plans should contain an accurate, up to date record of the assessed needs of the service users. Inaccurate records may lead to inconsistencies in the delivery of care. The senior care staff should ensure that the care plans are up to date. Medications should be stored correctly and medication administration records signed. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 6 The service users should always be offered a choice of meal. All repairs and refurbishment detailed in the body of the report should receive attention. The registered person should comply with these and previous requirements. 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. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Intermediate care was not provided. EVIDENCE: The manager advised the inspector that the home did not provide intermediate care. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 9 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) 7,8,9 Inaccurate care plans will not contribute to the delivery of care, and may place the service users at risk. The systems for the administration of medications are poor in the areas relating to the accountability of staff signing documents and for securing the storage of drugs. The relatives and service users were satisfied with the care and service provision. EVIDENCE: The inspector established that since the last inspection, the home had reviewed the record keeping. The region manager advised the inspector that she had undertaken a training session with the staff. However on examination of 4 care plans, the inspector found that some individual needs were evaluated on a daily basis, and included a daily summary, but there had not been a monthly review, when the whole care needs of the service user had been re evaluated. Also within some of the care plans the mobility needs of service users had not been recorded or reevaluated. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 10 For example: The prescription of care identified that the service user walked with assistance, when she actually required a wheelchair. The service users who walked with the assistance of staff plus a walking aid had the aid removed from the service user by some staff, when the service user was sat down. This practice was to prevent the service user attempting to walk unaided. However this practice was not recorded within the care plan and the inspector observed inconsistencies within this practice. Regarding medications, there was no signature (ownership) of some of the hand written medication entries. Should an error occur it would be difficult to establish the individual who recorded the information. The medication room was left unlocked and unattended. The inspector received some very positive comments from the relatives and service users. The comments he received were as follows; The meals are good and we get what we like. The care is good. The staff are ‘very affectionate’. The staff keep me well informed about my mother, and give me support both emotionally and with my finances, relating to Social Services fees etc. ‘This home was my first choice as soon as I walked in the door, it’s so friendly’ BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 11 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) 15 A choice of meal at dinner had not been offered to service users. EVIDENCE: The inspector was informed that the ‘expected practice’ from the company, was to offer each service user on a daily basis a choice of meals at breakfast, dinner and tea. However on discussing meals with the service users, the inspector was informed that the meals were good, but no one could advise the inspector what was for dinner, that day. On raising this issue, with the manager, as dinner was being served, she questions the staff, and was informed that the staff had not obtained the service users requests this morning. When the manager had raised the issue, a member of staff obtained the choices for the teatime meal. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 12 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 The complaints procedure was accessible and people were confident to use it. EVIDENCE: The inspector was aware that one complaint that is still outstanding and the Commission for Social Care Inspection have been liaising with the complainant and the managers of the company. The relatives and service users were aware of the complaints procedure, and expressed to the inspector that they had confidence to raise issues with the manager of the home. No complaints were raised with the inspector at the time of the inspection. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 13 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, 21, 22, 24, 26 The registered person had met most of the requirements; the loop system is still outstanding. The environment had not been maintained to the required standard. EVIDENCE: The inspector monitored the previous requirements from the last inspection, and established the following; The region manager informed the inspector that the home was exploring the provision of a portable loop system. As the system was yet to be supplied and fitted the requirement was repeated. The floor covering had been replaced. On touring the building the following was found; BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 14 The sluice machine on the ground floor was inoperable. Rooms 3 and 18 were in need of some redecoration. The inspector did observe a decorator painting the corridors, and other areas of the home. Within room 12 there was a strong odour. On further examination it was established that the odour was permuting from the mattress. The manager instructed a member of staff to change the mattress. Within bathroom 39 the bath panel need to be affixed to the bath. The kitchen floor had a large tear in the centre. The region manager identified that the floor covering was on order, but the removal of the kitchen appliances was still under negotiation with another company. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 15 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) 0 These standards were not assessed, at this inspection. EVIDENCE: BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 16 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) 0 These standards were not assessed, at this inspection. EVIDENCE: BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 17 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x 2 2 x 2 x 2 STAFFING Standard No Score 27 x 28 x 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 x x x x x x x x x x BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 18 yes 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 Requirement The registered person must maintain accurate records which detail the up to date care needs of the service users. The registered person must ensure that the medications are secure and the medications signed within the medication administration records. The registered person must ensure that the service users have a choice of meal. The registered person must ensure that the service users needs arebeing met by the provision of appropriate equipment, ie a loop system. This was a previous requirement The registered person must ensure that all repairs, redecoration and refurbishment, listed in the body of this report are completed. Timescale for action 20th July 2005 20th JUly 2005 2. 9 13 3. 4. 15 22 12 23 20th July 2005 31st March 2004 5. 19,24,26 16 20th September 2005. 6. BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 19 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 BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Cardinal Square Nottingham Road Derby DE1 3QT 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 BRIMINGTON CARE CENTRE C52 CO2 S19946 Brimington Care Centre V234514 Stage 4.doc Version 1.30 Page 21 - 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!