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Inspection on 26/10/05 for Brimley

Also see our care home review for Brimley for more information

This inspection was carried out on 26th October 2005.

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.

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

Residents at Brimley live in a busy family home where routines are flexible, where they choose what they like to do and which is run in their best interests. They are well supported by a suitably trained, experienced and sensitive workforce who work hard to help residents achieve their rights whilst being aware of their own responsibilities as citizens and as house mates. Residents are obviously relaxed in the company of staff and have a degree of confidence that is heartening. Staff and residents clearly enjoy each other`s company. Care plans help staff to provide a consistent high standard of care and to ensure that residents` needs are understood and met. These documents demonstrate that residents` health and personal care needs are well met. Medication records show that safe working practices are in place. Mealtimes are enjoyed by residents as a time to get together and talk about what they have been doing or what they plan to do. It is also a time when visitors often come and meet with residents and staff. Staff and residents carry out meal planning, preparation and shopping together. On the day of this unannounced inspection one resident said she would like to bake a cake. Residents would that evening enjoy cup cakes and bread and butter pudding.

What has improved since the last inspection?

Since the last inspection the method for recording residents daily events and activities has been altered to comply with Data Protection. Those people attending fire drills are recorded to ensure all staff and residents attend. Procedures in relation to the recording of medication have been improved. Training in the protection of vulnerable adults continues and this issue is openly discussed to promote residents understanding of abuse and their confidence in reporting anxieties or abuses. Substances hazardous to health are being safely stored.

What the care home could do better:

No requirements or recommendations to improve practice were identified on this occasion.

CARE HOME ADULTS 18-65 Brimley 1 Read Close Pound Lane Exmouth Devon EX8 4NP Lead Inspector Teresa Anderson Unannounced Inspection 26th October 2005 10:00 Brimley DS0000021893.V251093.R01.S.doc Version 5.0 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 Brimley DS0000021893.V251093.R01.S.doc Version 5.0 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. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brimley Address 1 Read Close Pound Lane Exmouth Devon EX8 4NP 01395 265775 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) Devon & Cornwall Housing Assn. Normanlea Society Limited Mrs Linda Williams Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Brimley provides residential care for up to 6 people with learning disabilities who may have a physical disability. The property is a purpose-built detached bungalow located in a residential suburb of Exmouth, a short walk from the centre. There are six single bedrooms for residents, a lounge/dining room and a conservatory. There is a pleasant garden with seating areas. Car parking is ample. The home has the use of a mini bus which it shares with the sister home - 29 Albion Hill, also in Exmouth. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This second inspection was undertaken as part of the normal programme of inspection and this report should be read in conjunction with the report written in July 2005. This inspection took place between 10.00am and 3.00pm when the inspector saw all communal areas of the home and three of the six bedrooms. The inspector spoke with four of the five residents, with the manager, two carers and the cleaner. Records in relation to care planning, training and medication were inspected. The manager completed a preinspection questionnaire. No comments cards from residents or relatives were received by CSCI. The inspector would like to thank all the residents involved in this inspection for allowing her to come to their home and for being so hospitable and helpful. and hospitable. What the service does well: What has improved since the last inspection? Since the last inspection the method for recording residents daily events and activities has been altered to comply with Data Protection. Those people attending fire drills are recorded to ensure all staff and residents attend. Procedures in relation to the recording of medication have been improved. Training in the protection of vulnerable adults continues and this issue is openly discussed to promote residents understanding of abuse and their Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 6 confidence in reporting anxieties or abuses. Substances hazardous to health are being safely stored. 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. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 7 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 Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 8 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 inspected in July. EVIDENCE: Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 9 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 and 10. Residents’ benefit from confidential care plans which reflect their preferences and needs. EVIDENCE: Two care plans were inspected. These plans are contained within three main systems. A system for storing old information that is still pertinent to the resident, one for current information and guidelines/observations and a daily diary. All are kept safely and in confidence and contain the information staff need to provide continuity of care. Risk assessments are undertaken. Staff demonstrated an excellent understanding and knowledge of residents, which matched the information contained within care plans. Residents spoken to were not familiar with their care plans (this is not unusual) but expressed their conviction that they are cared for in the way they prefer. The manager said that she feels the format/system for recording plans could be improved and is currently working on this and on developing the extent to which risk assessments are undertaken. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 10 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): 16 and 17. Residents benefit from an ethos that promotes and safeguards the rights of residents and encourages residents to be aware of and take seriously their own responsibilities. Residents enjoy flexible meal planning and a nutritious diet which they help to plan and prepare. EVIDENCE: When the inspector arrived at the home three residents were on their way out – going shopping or to the cinema. The residents had chosen these activities and they were clearly not restricted by any routines imposed by the home. Whilst these residents were out, the other two residents went about their business doing what they wanted. This included knitting, making tea, watching TV and videos and making cakes. All these activities were spontaneous as opposed to planned and it was clear that staff would have responded and supported residents to do what they chose to do. The inspector saw many examples of how residents’ rights and responsibilities are upheld. For example, one resident entered the bedroom of another resident without permission. A short gentle and sensitive discussion helped the Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 11 resident to appreciate that although she has the right to live freely at Brimley, she also has a responsibility to uphold the privacy rights of other residents. (All bedroom doors have locks but residents choose not to use them). Residents said they choose what they want to do although this has been severely restricted by the decision not to allow people who live in residential care to have access to clubs and activities set up for people with learning difficulties in the community. Residents are very much involved in meal planning, choosing and preparation and discussed this with the inspector. Shopping is done with those residents who wish to be involved and some residents really enjoy helping with cooking. Fresh fruit and hot and cold drinks are available at all times. During this inspection one resident asked to make a cake and was supported to do this. Other residents also joined in. That evening residents would enjoy cup cakes and a bread and butter pudding. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 12 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): 18, 19 and 20. Residents’ personal care, emotional and physical needs are well met and systems for administering medication ensure safe procedures are in place. EVIDENCE: Care plans show that appropriate referrals are made to allied health professionals as needed and that preventative medicine is practiced. For example one resident sees a chiropodist regularly and an extra appointment was made when this was needed. Another resident has benefited from a referral to an occupation therapist with a resultant improvement in her mobility and level of independence. Annual health checks are undertaken and residents are supported when for example smear checks are due. One resident talked of her poor health and it is clear that staff support this resident to live with this on a daily basis and ensure that the correct medical support is in place. One resident has been supported to move to another care home because her health care needs could not be adequately met at Brimley (residents talked of how they continue to visit with this resident). Residents report they get up when they like and go to bed when they like. They choose what to do with their days, where what they like and generally live their lives within the normal (but flexible) routines of daily life. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 13 Medication records were examined and are in order. Appropriate procedures are in place for ordering, storing and administering medication and staff receive appropriate training. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 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): 23 Procedures and training ensure that residents are well protected from abuse. EVIDENCE: All staff receive training in the protection of vulnerable adults and those spoken with are familiar with the procedures to be followed. The newly appointed cleaner is scheduled to receive this training in the near future. Residents are clearly confident and relaxed in the company of staff and obviously enjoy their company. Following the last inspection, the issue of abuse and reporting was discussed at a residents meeting. The manager feels that having open discussions about abuse will help residents to feel confident about reporting any incidents or anxieties. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 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 inspected in July. EVIDENCE: Brimley DS0000021893.V251093.R01.S.doc Version 5.0 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): 35. Residents’ benefit from the support of a well trained and experienced workforce. EVIDENCE: The training needs of staff who work at Brimley are clearly mapped against the needs of residents. For example, induction training covers the mandatory training required and further training is decided through staff supervision, matching staff training to resident’s needs and the needs of the service. Recent training has included assertiveness training, a team-building day, autism, learning disability and mental health, infection control and risk assessment. Staff demonstrated a sound knowledge of the residents and any associated issues and health conditions. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 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): 39 and 42. Residents’ benefit from living in a home which is safe, which is run in their best interests and from an ethos which puts residents at the heart of home life. EVIDENCE: Residents told the inspector that they attend regular home meetings where they can talk about what they like. They also said that Brimley is their home and that they enjoy living here. Changes are suggested by both staff and residents but are only carried through if the residents agree. The manager told the inspector that formal questionnaires are not sent out to supporters, relatives or allied professionals who visit the home. She feels that the staff create an atmosphere which encourages visitors to make suggestions or to air their views. Frequent meetings, open days and events are organised to which families are encouraged to attend. At the last inspection, safe working practices were inspected. Since then fire drills have continued and records have been kept of all those who attend. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 18 Residents confirmed they attend fire drills and were able to tell the inspector what they would do if the fire alarm sounded. The cupboard containing substances hazardous to health was locked. Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brimley Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000021893.V251093.R01.S.doc Version 5.0 Page 20 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. Refer to Standard Good Practice Recommendations Brimley DS0000021893.V251093.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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. 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