Inspection on 23/10/06 for Brimington Care Centre

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brimington Care Centre 12/12/05

Brimington Care Centre 20/06/05

Brimington Care Centre 28/02/05

Brimington Care Centre 09/11/04

Brimington Care Centre 16/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brimington Care Centre Manor Road Brimington Chesterfield Derbyshire S43 1NN Lead Inspector Nancy Bradley Unannounced Inspection 23rd October 2006 09:30 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 Brimington Care Centre DS0000019946.V316133.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. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 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 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) Southern Cross Care Homes Limited Mrs Josephine Teresa Jackson Care Home 45 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (39) of places Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. The registered person will only admit residents 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 residents can only be accommodated in the specialist unit, which has keypad locks and is located to the left of the main entrance. 12th December 2005 Date of last inspection 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 residents, 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, 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 DS0000019946.V316133.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over five hours. The inspector spoke with the members of staff on duty. The Registered Manager was on leave at the time of this visit, subsequently the inspector has held a telephone conference with the Registered Manager. During the visit the inspector made a tour of the home, spoke with several residents and their families. The inspector observed throughout the visit how the staff were meeting residents immediate and long-term needs. Records were examined relating to the residents and the running of the home. At the time of the visit there were forty-two residents in the home, with three on respite and six on day care. The home weekly fees have recently been reviewed and are as follows: Low rate, £295.20 Medium rate, £322.55 High rate, £340.10 Private £400.00 to £430.00. Additional charges are made for hairdressing, newspapers and podiatry. What the service does well: What has improved since the last inspection? What they could do better: All staff must receive training in the safeguarding of adults. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 6 Repairs to the flat roof must to be attended to immediately. In discussions with the staff this matter has been outstanding for a few months All staff must have a Criminal Records Bureau check to the required level. 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. Brimington Care Centre DS0000019946.V316133.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 Brimington Care Centre DS0000019946.V316133.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): Standard 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that potential residents needs are fully assessed and met prior to admission. EVIDENCE: The records of four residents were checked. The majority of the residents who are admitted to the home have their needs assessed through Social Services care management system, and from hospitals. The Registered Manager or senior staff assess residents prior to admission to the home. The care plans seen contained evidence of assessments and reviews annually by social workers or care management. The home also reviews their assessments annually. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. There is a care planning and review system in place, which ensures that the resident’s individual needs are met. The residents privacy and dignity is respected and maintained Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the visit care plans of four residents were examined. The care plans have been compiled by the staff on each resident and evidence was seen of care plans being reviewed on a regular basis. Care plans included services users individual lifestyle preferences and choices; the interventions prescribed by outside healthcare professionals were appropriate. Daily record and evaluations of care plans are also maintained on each resident. Detailed risk assessments were in place and these included actions to be taken by staff. All residents have access to the Advocacy service should this be required. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 10 The personal care and health needs of the residents were recorded in care plans. Information relating to visits from health care professionals such as G.P, dentists, podiatrists and opticians were recorded. All the required documents had been completed particularly assessments about areas of risk affecting the welfare and safety of the residents with pressure scores or falls. The home operates and monitors residents medication has none of the residents are able to administer their own medication. All staff have received training on medication training procedures. Boots Pharmacy inspects the home medication procedures once very three months. Medication records were checked and one occasion staff had not witnessed the signature after medication had been administered. The deputy manager agreed to address this and inform the Commission for Social Care Inspection of the outcome. The home has since confirmed that this has been attended to. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. There was a clear audit trail of all medication used at the home. The staff were observed routinely knocking on residents bedrooms and bathrooms before entering. The residents spoken with considered that the staff working at the home were good and that their privacy and dignity was respected. Conversations between residents and staff were appropriate and respectful taking account of any communication difficulties the residents may have Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 13 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities and stimulation in line with the wishes and recreational interests of the residents. Contact with family and friends is encouraged and seen as a priority. The meals offer both choice and variety, catering for any special dietary requirements. EVIDENCE: The residents spoken with during the inspection were very positive about living at the home. The daily routine is flexible and they were able to make decisions about how they spend their time during the day. The home has an Activities Co-ordinator who is employed to work for twenty hours per week, mainly Monday to Thursday but is flexible and can work at weekends. On the day of the visit the residents were having a domino match, colouring and a sing-a-long. The co-coordinator keeps a record of who has taken part in activities. The residents are able to visit accompanied by the staff or relatives. Residents are encouraged to take part in daily activities and stated that the staff respected their wishes if they choose not to take part. From records examined and discussion with the care staff residents are supported in maintaining links with the local church and the church conducts a service at the home each month. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 12 There are no restrictions on family and friends visiting the home and visits are recorded in care plans. Family and friends call-in and maintaining links with their family is given priority. Family spoken too during the visit confirmed they are made welcome and they could visit any time. The residents are all encouraged to personalise their rooms as they wish and bring in their own possessions. Residents confirmed they were happy with the meals provided. Resident’s individual preferences were considered and condiments are routinely offered. Residents are made aware of menus, and have a choice. Catering staff indicated that they had sufficient knowledge to meet individual residents dietary needs Menu records were seen showing a balanced diet. In discussions with the catering staff the inspector was informed that the menus were going to be changed. From examination of the menus the inspector noted that on Sunday’s on three out of the four weeks the residents were offered the same meal. The catering staff informed the inspector that this was not the case. Any variation to the menus must be recorded. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 13 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): Standards 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure in place with evidence to show that resident’s views are listened to and acted upon. The staff had a working knowledge and understanding of the procedures for safeguarding of adults. EVIDENCE: The home complaints’ policy and procedures was reviewed in January 06 and this includes a timescale for resolution of 28 days. The procedure contains the current address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wish to do so. As discussed at the visit, the policy will need amending to reflect the change of procedure by the Commission for Social Care Inspection when dealing with complaints. The complaints procedure is displayed in the main entrance. The complaints records were examined and there were no outstanding complaints. Residents and relatives spoken with during the inspection would have no hesitation in putting their concerns to the Registered Manager or the referring agency. The Commission for Social Care Inspection has received no complaints in respect of this service. The homes policy on the protection of adults was examined. This needs to be reviewed and updated to reflect the change of emphasise to the Safeguarding Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 14 of Adults. The majority of staff have completed training on the safeguarding of adults, however from training records examined there are still several staff who have yet to complete this training. There have been no safeguarding issues raised since the last inspection visit. The staff confirmed they would report any concerns to the manager. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in comfortable, pleasant and safe surroundings. The home generally was well maintained and clean. EVIDENCE: There is evidence to support on going investment in the home, and the tour of the home highlighted the areas of improvement. The home currently does not have an annual maintenance programme for renewal of the fabric and decoration of the premises. As discussed with the care staff the flat roof over the dining area needs immediate attention. The staff noticed a water leak, which left unattended, may affect the running of the home. Resident’s bedrooms where decorated to a good standard and contained personal belongings and reflected their individual preferences and wishes. On the day of the visit the home was clean and there were no unpleasant odours. There were sufficient rooms for a variety of activities to take place and an area were residents could meet family and friends in private. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 16 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): Standards 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. The home has robust recruitment procedures and practices in place which ensure the safety and protect the residents. However these require further strengthening to ensure residents are fully protected. Importance is given to staff training. EVIDENCE: During the visit a sample of staff rotas were examined that indicated the home was staffed according to the assessed needs of the residents with an appropriate skills mix. The home has a good percentage of staff who hold a NVQ level 3 or equivalent. The home has a recruitment and section procedures in place to protect residents from potential harm. Southern Cross Care Homes Limited require all applicants to provide two references, and have a clear Criminal Records Bureau check in line with Schedule 2 of the National Minimum Standard Care Homes for Older People. However from staff records examined staff had only had a Criminal Records Bureau clearance to a standard level not enhanced. All staff had been checked on the Protection of Vulnerable Adults First List (POVA First List). This was discussed with the Operations Manger who agreed to address this issue immediately. Also a recently employed member of staff had been appointed on one reference. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 17 Gaps in employment must be explored and formally recorded, and part of providing a full employment history applicants should provide the day date month and year. The home has a range of staff training to include moving and handling, fire training, safeguarding of adults, food hygiene, and specialist training on working with Dementia Care. All staff have a Personal Development Plan. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 18 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): Standards 31,33,35,36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was generally well managed, and regularly seeks the views of the residents on the running of the home. Arrangements are in place to safeguard the residents’ financial interests and handling of their money. EVIDENCE: The Registered Manager is suitably qualified and has a number of years experience running this home and has undertaken a recognised registered managers award. The residents and family spoken with during the visit stated that the manager was approachable and the atmosphere within the home was relaxed and friendly. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 19 The home operates to the Company’s quality assurance systems. The next review is scheduled for 15th Nov 2206. The Registered Manager confirmed that they have residents and family meetings. The Registered Manager confirmed that staff receive formally supervision in line the requirement under the National Minimum Standard. The records and monies held on behalf of the residents were crossed referenced with records and found to accurate. Where family maintained responsibility for residents monies this was clearly identified in the residents care plan. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Systems were in place for monitoring and maintaining the hot water temperatures. Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2. Standard OP15 OP18 Regulation Schedule 4 18 Requirement A record of all food must be maintained. This also includes any variations to the set menu The registered person must ensure that all staff must receive training on the Safeguarding of Adults. The registered person must ensure that the flat roof is repaired to a satisfactory standard. An annual maintenance programme for renewal of the fabric and decoration of the premises needs to be produced and implemented with records kept. All staff employees must have a Criminal Records Bureau check to the level required under the National Minimum Standard. Timescale for action 30/11/06 30/11/06 3. OP19 16 30/11/06 4 OP19 23 30/11/06 5 OP29 19 Schedule 2 30/11/06 Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 22 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 Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Brimington Care Centre DS0000019946.V316133.R01.S.doc Version 5.2 Page 24 - 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!