Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 09/10/07 for Brindley Court Nursing and Residential Home

Also see our care home review for Brindley Court Nursing and Residential Home for more information

This inspection was carried out on 9th October 2007.

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 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

The home provides good healthcare for individuals who live there. The involvement of outside healthcare professionals was evident. Nursing care is also delivered well and there were no individuals accommodated in the home with pressure sores at the time of the visit.The planning and delivery of the activities and entertainment programme was good. The activities co-ordinator is very enthusiastic and keen to ensure that all the people who live in the home are fulfilled socially. Most of the residents and both sets of visitors who were spoken to at the time of the visit were happy with the care and attention they received at the home.

What has improved since the last inspection?

There has seen some refurbishment and redecoration, which has, improved its appearance. The home now has a registered manager in place, which has been lacking over the last few inspections.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Brindley Court Nursing And Residential Home Station Street Longport Stoke-on-trent Staffordshire ST6 4ND Lead Inspector Mrs Yvonne Allen DRAFT Unannounced Inspection 9th October 2007 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 Brindley Court Nursing And Residential Home DS0000026941.V351089.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. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brindley Court Nursing And Residential Home Address Station Street Longport Stoke-on-trent Staffordshire ST6 4ND 01782 828428 01782 828429 brindley.court@ashbourne.co.uk 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) Modelfuture Limited, Mr David Forrester Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (13) of places Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 13 PD 35 to 65 years Date of last inspection 9th May 2006 Brief Description of the Service: Brindley Court Care Centre provides personal and nursing care for up to fiftytwo male and female persons. The home provides accommodation for mainly older people but can accommodate up to thirteen people, aged between 35 and 60 years on admission who have a physical disability. The home is a two-storey purpose built brick building. It has fifty-two single bedrooms and each of them has an en-suite comprising of a toilet and wash hand basin. The home has lounges and dining facilities on each floor. A passenger lift that is accessible to service users allows easy access around the home. There are appropriately adapted bathing facilities to each floor. There is a central kitchen and laundry. Externally, the home has pleasant secure gardens for service users to enjoy and there is ample parking space. The home is situated close to the A500 and is within easy access of local shops, bus service, a train station and road networks. The fees charged by the home at the time of the inspection visit ranged from £337.00 to £612.00. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection visit was carried out over two days by one inspector. A second inspector attended on the first day and observed the care of residents in the dining room over a period of one and a half hours. The Registered Manager was present on both days and feedback was left with him including immediate requirements. Feedback was also given to the Regional Manager over the telephone following the inspection visit. This inspection examined all the key standards and outcomes for the residents who live at the home. The following methods were used in order to obtain the evidence required to make judgements – Direct observation of the care of residents and of the interaction of staff and residents, over a period of time. Discussions with residents, staff and visitors to the home. Discussions with the Registered Manager of the home and telephone discussion with the Regional Manager of the Company. Examination of relevant records and documentation. A tour of the home including all communal areas and a random sample of bedrooms. Outcomes for the people who live at this home are varied – some are good, some adequate and some poor. Requirements have been included at the end of this report to ensure that improvements are made in the outcomes which have been identified as poor. What the service does well: The home provides good healthcare for individuals who live there. The involvement of outside healthcare professionals was evident. Nursing care is also delivered well and there were no individuals accommodated in the home with pressure sores at the time of the visit. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 6 The planning and delivery of the activities and entertainment programme was good. The activities co-ordinator is very enthusiastic and keen to ensure that all the people who live in the home are fulfilled socially. Most of the residents and both sets of visitors who were spoken to at the time of the visit were happy with the care and attention they received at the home. What has improved since the last inspection? What they could do better: The morning routine was seen to be poor with individuals not receiving the care and attention they should have. There appeared to be several reasons for this, which were evident during the visit. Residents were waiting for a very long time for their breakfast (some up to 2 hours). As a result of this residents were becoming agitated. Four staff members spoken to during the visit stated “It’s nearly always like this in a morning” and “There just isn’t enough staff”. The knock on effect of the late breakfast meant that residents were back sitting at dining tables an hour and a half after breakfast. The administration of medication was also unacceptable as individuals were not receiving their medication on time – some were two hours late and eye drops were administered in whilst residents were eating their food. The home was very cluttered - in the small ground floor lounge and both shower rooms – with furniture and other extraneous items. So much so that the two shower rooms were not fit for purpose. There was also concern over the safety of the stairs between the two floors – and a need for key code locks in the stairwells to prevent residents from falling. One of the bathrooms had been left in an unacceptable state of cleanliness with a soiled mattress and a dirty soiled bath. This was contravening infection control guidelines. Two of the care plans seen did not confirm that the individuals involved had received regular baths and/or showers. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 7 There was also little evidence of service users and/or their representatives being involved in the evaluation of care plans. Dignity and respect was not always promoted for the people who live in this home. 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. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 8 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 Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 9 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): Standards 3 and 4 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals have their needs assessed before being offered a place at the home, and can be assured that the staff who work there have the necessary skills and expertise to be able to meet their assessed needs. EVIDENCE: We examined a random selection of individual care plans where it was identified that each individual had undergone an assessment of their needs before being offered a place at the home. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 10 Discussions with the registered manager confirmed that he usually carried out these assessments and often, for individuals with complex needs; another nurse would accompany the manager on his assessments. There was also evidence contained within individual plans of pre admission assessments having been carried out by funding bodies such as Social Services. Discussions with the manager confirmed that he only offers placements to individuals who fall into the categories of care for which the home is registered with CSCI. The manager possesses the skills and experience necessary to run the home. Examination of staff training records and discussions with the staff who work at the home confirmed that the staff team have the required skills and expertise to be able to meet the needs of the residents. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 11 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 were assessed. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although health care needs were monitored and met, care practices were not tailored to meet individual needs and dignity and respect were compromised. EVIDENCE: Further examination of the same individuals plans identified that each resident had a full plan of care in place, which had been developed from the initial assessment of their needs. Individual risk assessments had been developed and a plan of care put in place for each need identified. These had then been regularly evaluated - at least monthly and any changes documented. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 12 There was little evidence of the involvement of individuals in their own plan of care and the input of relatives/representatives was also limited. The “relatives’ communication record” in one of the plans had a last entry as 20/06/06. Two of the four plans examined also indicated that general baths/showers had not been offered/given on a regular basis. One individual had only received 1 general bath in 17 days. For another resident there was no documentation of any bath or shower having been given. This was discussed with the manager during feedback where he stated that he thought this was more likely to be a lack of documentation and that residents did receive baths and showers regularly in the home. There was good evidence of visits by healthcare professionals including GPs, district nurses and optician. The foot care assistant seen visiting at the time of the inspection. She explained that she comes in in-between visits from the podiatrist and that residents at the home receive a good chiropody service. Discussions with the manager identified that there were no individuals with pressure sores in the home at the time of the inspection visit. The Company monitor the development and treatment of pressure sores on a regular basis. The nurse was observed administering the morning medication in the dining room on the nursing unit. This was carried out as per policy but took a very long time as residents were coming and going and she did not finish this until 11.30am. Examination of the Medication Administration Record (MAR) chart identified that medication, which was prescribed to be administered at 9am, was not being given until two hours later. Some individuals then had more medication prescribed for 1pm and therefore not enough time lapse inbetween. It was also observed that eye drops were being administered in the dining room whilst residents were eating. This is not good practice and is undignified. The period of observation of residents identified that individuals were not always treated with dignity and respect. A care assistant was overheard speaking sharply to a resident who wanted to go back to her room as she had been waiting in the dining room “since 7.30am” and it was now 11am. She was told that she would have to sit and wait for her tablets. This lady asked three times to be taken back to her room she then became upset and started to cry. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15 were assessed. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There was a good programme of activities and entertainment at the home. However the arrangements for taking meals was chaotic, undignified and did not meet the needs of individuals. EVIDENCE: We met with the activities co-ordinator on the second morning of the inspection visit. Discussions were held with her about the activities and entertainment, which she organises on a regular basis. There is a planned programme of activities and entertainment and there was plenty of evidence of this – photographs and documentation. Also discussions with residents confirmed that they considered that their social and therapeutic needs were met. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 14 One lady was sitting in the “meeting/training room” on the second floor, making Christmas present tags out of old Christmas cards. She said that she enjoyed doing this and liked to come and sit in this room as she had a table to work at and it was “nice and quiet”. There was also evidence of the residents having been on trips out. These were limited, however, as the home does not have its own minibus to call on and has to rely on taxis. It is a recommendation that the home provides its own minibus or shares with another home. Discussions with the activities co-ordinator identified that she likes to treat each resident as an individual with different needs, preferences and abilities. Activities are recorded for each individual. The activities co-ordinator is very enthusiastic and this is an area where the home has good outcomes for the residents. There is open visiting at the home and visitors were observed coming and going at the time. We spoke with one visitor who was happy with the care provided for her relative at the home. She said – “This is a really good home” and she had “no complaints”. The home provides three main meals per day plus drinks in between. Light snacks can be provided if required. As highlighted previously, the arrangements for the serving of breakfast on the morning of the first inspection day were chaotic. Residents were brought to the dining room on the ground floor from 7.30am onwards and left sitting with nothing to eat and drink – some waited until 10.30am for breakfast. One individual had to wait until 10.55 am for breakfast. Individuals were becoming uncomfortable and agitated and staff (who were busy) were unable to provide the attention required to meet the needs of the residents during this time. A number of individuals required assistance to eat and drink and it was observed that there was a very young inexperienced member of staff (later identified as a student from college), feeding a resident. This resident had an advanced degree of dementia and, as such, was unable to communicate verbally with the student. However, the resident was attempting to communicate through facial expressions and this was not picked up on by the student – the student being unaware of what to do and how to react to this. It was observed that there was not enough break time between breakfast and lunch. Residents were brought in for lunch - some back sitting at the dining tables at 12 .30pm - an hour after breakfast had finished. On the second day of the inspection visit, the dining room on the ground floor was much more settled and the process of breakfast time flowed much better. All the residents had been given their breakfast by 10.00am. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 15 However upstairs on the second floor, on the same morning (second day), it was noted that, although this dining room was very calm, once again individuals had been brought to the dining room and left sitting at the tables for a long time before being served breakfast. They were observed at 9.15am, where there were a number of residents sitting at the tables, some having been brought down to the dining room well before 9am and breakfast was just starting to be served at 9.50am. Discussions with staff members at the time identified that part of the reason why breakfast was late being served was that the hot trolley had broken down and food was having to be sent up from the kitchen on the dumb waiter. The staff were having to wait for the food to be sent up. Discussions were held with the deputy manager, manager and other staff members about arrangements and routines in the morning. It was identified that there were some good ideas for changing the working routine in the mornings and that it was not necessary to bring all the residents down for breakfast – only those who preferred to. Others could be served breakfast in their own rooms and then personal care and bathing could be carried out during the remainder of the morning. Some staff stated that part of the problem was that there were not enough staff on duty to cope with the needs of the residents during the early morning. Certainly this appeared to be the case to inspectors at the time. Immediate requirements were left at the time of the visit to review and improve the routine in the mornings and to ensure that the needs of individuals were met. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 16 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 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at the home can be assured of their safety and welfare and that concerns they might have about the home are listened to and taken seriously. EVIDENCE: Discussions with the manager identified that a log of complaints is maintained and complaints are dealt with as they arrive – ensuring that the 28-day timescale of the complaints policy is adhered to. There was a clear and accessible complaints policy on display in the foyer to the home. This included the details of the CSCI. The CSCI had not received any complaints directly since the last inspection but had attended 2 Vulnerable Adults meetings with Social Services relating to 2 separate incidents/individuals in the home. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 17 Discussions with the residents, and two sets of visitors in the home confirmed that they knew who to go to should they have any concerns and any that they had had in the past was dealt with efficiently. The policies and procedures adopted by the home help to ensure that residents are kept safe and protected from harm or abuse. There is a policy on abuse and Protection Of Vulnerable Adults (POVA) in place at the home and the staff spoken to at the time of the visit were aware of this. Staff had also received instructions and training on the recognition of abuse. Before being offered employment at the home staff are carefully selected and a check is carried out to ensure that their name does not appear on the POVA list. 2 references are obtained and a Criminal Records Bureau (CRB) check is also carried out. These were seen contained in employee files. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 18 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, 21 and 26 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a warm homely environment, which was purpose-built to meet their needs. Infection control procedures must be tightened up in order to avoid crosscontamination and more provision is required for storage purposes. EVIDENCE: We walked around the home and inspected all communal areas, a selection of bedrooms, the kitchen and the laundry. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 19 It was identified that the assisted shower rooms on both floors were cluttered with extraneous items and were unsafe to use. As these rooms were registered bathrooms this was contravening the registration details of the home. The shower room on the second floor had a sign in place, which read – “Do not use as a storeroom”. There had been a blatant disregard for this. The small ground floor lounge was also cluttered with bedroom furniture. We were informed that this furniture was being moved out and was awaiting the maintenance person – who was on holiday at the time. There appeared to be other extraneous items left around the building and there was a distinct lack of storage facilities. This was discussed with the manager at the time and other potential areas, which could be used for storage, were identified. Another of the ground floor bathrooms was very poorly presented with a dirty stained mattress propped up against the bathroom wall and a bath, which was very dirty and contaminated with faecal matter. We were informed that an incident had happened with one of the residents that morning and that the carers had not yet had the opportunity to clean the bathroom. The bathroom should not have been left in that state as this was contravening infection control guidelines. It was identified that the stairs between the two floors were accessible to residents and posed a health and safety risk, especially for those individuals who might be unsteady on their feet. As a precaution it is a requirements that key code locks, of the type authorised by the fire safety officer, be provided on these stairwells. There had been some redecoration and refurbishment since the last inspection and this now needs to be continued through the home as there were areas remaining, which were showing signs of wear and tear. On the second floor the lounge was very attractive and homely with numerous paintings and pictures. There was an information board upstairs informing residents what day it was and the weather etc. Unfortunately the board had not been changed for that day and was not up to date. Bedrooms were personalised and residents had brought in personal effects to help the room look more homely. The kitchen was visited and appeared clean and tidy. The home had received a visit from environmental health since the last inspection and the recommendations of their report had been addressed. It was noted that the afternoon drinks were being prepared with cups but no saucers. When the cook was asked about the saucers she stated that most of Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 20 the residents preferred not to use them. This does not promote dignity for individuals and residents should be served cups with saucers unless they request otherwise. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 21 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, 29and 30 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people who live at the home can be assured that the staff who look after them are carefully selected and possess the required knowledge and skills. However staff are not always provided in sufficient numbers in order to be able to meet all of their care needs. EVIDENCE: At the time of the inspection visit there was a total of 50 residents accommodated in the home. This was divided into 2 units – ground floor and second floor. There were 35 individuals accommodated with nursing needs and 15 with personal care needs. The staff on duty included the Registered Manager – who was working supernumery, two trained nurses – one on each floor and 7 care staff in total. There was also domestic staff on duty including a housekeeper, domestic assistants and a laundry assistant. The head cook was on duty together with a kitchen assistant. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 22 The practices observed at the time of the inspection visits, together with discussions held with 4 different staff members and with residents raised serious concerns and identified that there was a shortage of care staff at this home particularly on the ground floor over the busy morning period. It was also identified that there were only 2 care staff on duty during the afternoon on the second floor unit, and again this was insufficient to deal with the needs of the residents. The Regional Manager had forwarded to CSCI her assessment of the dependency levels of residents in the home together with her plans for a change of morning routine and practices. A change of working routine would help but would not eliminate the need for an extra member of care staff over the morning period on the ground floor and the afternoon period on the second floor. There was a staff training and development programme in place at the home. Examination of four staff files identified that regular training courses had taken place including mandatory health and safety training. NVQ training is on going at the home. Discussions with staff members confirmed this and they all felt supported with their training needs. Examination of the same four staff files identified that the recruitment process was robust. There was evidence of interviews, health check questionnaires, and 2 references had been obtained. Enhanced CRB and POVA checks had been obtained and gaps in employment history had been explored. Staff members spoken to confirmed that they had undergone induction training and had been satisfied with this. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 23 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 were assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed well but improvements are required in other outcome areas in order to ensure that the home is run in the best interests of the people who live there. EVIDENCE: The registered manager was present throughout both inspection visits and for feedback at the end. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 24 The manager is very experienced in nursing, care of the elderly and management. He is supported by a deputy manager who is also experienced and suitably qualified to run the home. Discussions were held with both managers. The deputy stated that he felt very well supported by his manager and that he is approachable and runs an open door policy. Residents, staff and visitors all commented on the support they receive from the manager of the home. The residents knew who he was when he accompanied us around the home and were at ease with him – some of them took the opportunity of thanking him for various things he had done for them. The manager, in turn, is supported by the Company Regional Manager. There is a quality assurance programme at the home. The Company carry out Regulation 26 visits to the home every month the reports of which are sent to CSCI. The views of residents and relatives are sought in surveys - but the response to these is not always good and very few are returned. Residents’ meetings are held on a regular basis where individuals are encouraged to air their views together with any thoughts and suggestions for the running of the home. The minutes of these were seen at the time of the visit. Staff meetings are also held regularly and minutes of these were seen. There is also a suggestion box in the main foyer. The manager stated that he tours the home most days and meets and chats to the residents. He commented that many concerns were dealt with at this stage and did not develop into complaints. He was advised to record this as proof of daily auditing. Accidents, incidents, pressure sores and dependency levels are all audited regularly as well as other areas and services in the home. The manager was advised to audit the morning routine including the serving of breakfast. The maintenance of residents’ personal allowances was inspected and found to be in order. There was a clear audit trail and receipts and invoices were kept as proof of expenditure. Money was available to individual residents whenever they needed it. Staff received regular supervision sessions and these were seen recorded at the time of the visit. The manager had overall responsibility for the health and safety of the residents, staff team and visitors to the home. There was a health and safety policy statement in place. All staff received regular update training sessions in mandatory health and safety such as moving and handling, infection control, fire safety and other areas. Records of these were seen and staff confirmed that this training took place. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 25 Equipment used at the home was regularly serviced and maintained and records of this were seen. Risk assessments had been carried out on the environment and working routines and these were regularly reviewed. Fire risk assessments had been carried out for individuals in the home and this, too, was regularly reviewed. Routine checks were carried out fire detecting, fire fighting and fire preventing equipment. This included the regular testing of the alarm system. These checks were recorded. Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 26 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 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x 2 x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 2 Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 27 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. Standard OP27 Regulation 18(1) Requirement 1 more care assistant must be provided on the ground floor unit during the morning period and on the second floor unit during the afternoon period. The extraneous items must be removed from the shower rooms and these must be made fit for purpose. Key-Code locks must be installed on the stairwells between the floors. The morning routine must be reviewed and improved upon so that the needs of individuals in the home can be met and dignity promoted. Residents must not be left sitting in the dining room for long periods of time. Medication must be administered at the time for which it is prescribed. Individuals must be offered showers and/or baths (whichever they prefer) on a regular basis throughout the week and these must be recorded in the care plan. DS0000026941.V351089.R01.S.doc Timescale for action 10/11/07 2. OP21 23(2)(1) 10/11/07 3 4 OP38 OP7 13(4) 12(4)(a) 10/11/07 10/11/07 5 6 7 OP15 OP9 OP7 13(7) 13(2) 12(1)(a) 10/11/07 10/11/07 10/11/07 Brindley Court Nursing And Residential Home Version 5.2 Page 28 8 OP38 16(2)(j) 9 OP10 12(4)(a) Infection control guidelines must be adhered to in relation to ensuring the cleanliness of bathrooms. Attention must be given to improving and promoting dignity for the people who live in the home. 10/11/07 10/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP15 Good Practice Recommendations It is a recommendation that care plans be reviewed with the service user/representative. PREVIOUS RECOMMENDATION It is a recommendation that the kitchen assistant start duty at 8am each morning. This should help to ensure that breakfast time is more flexible and geared to suit all the service users in the home. PREVIOUS RECOMMENDATION It is recommended that the redecoration programme be continued through the home. It is recommended that saucers be provided with cups. 3. 4. OP19 OP15 Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Birmingham Local Office 1st Floor, Ladywood House 45-56 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brindley Court Nursing And Residential Home DS0000026941.V351089.R01.S.doc Version 5.2 Page 30 - 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!