Inspection on 19/07/05 for Brinsworth House Residential And Nursing Home

This inspection was carried out on 19th July 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.

Other inspections for this house

Brinsworth House Residential And... 29/06/07

Brinsworth House Residential And... 13/12/05

Brinsworth House Residential And... 17/01/05

Brinsworth House Residential And... 27/09/04

Brinsworth House Residential And... 22/01/04

Brinsworth House Residential And... 26/09/03

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Brinsworth House 72 Staines Road Twickenham Middlesex TW2 5AL Lead Inspector Jon Fry Unannounced 19 July 2005 10:15 am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brinsworth House Address 72 Staines Road Twickenham Middlesex TW2 5AL 0208 894 1351 0208 894 0093 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Entertainment Artistes Benevolent Fund Mrs Sheila Gould CRH Care Home 36 Category(ies) of OP Old Age (36) registration, with number PD (E) Physical Disability - Over 65 (36) of places Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: One specified male aged 59 years of age until he reaches the age of sixty five years. Date of last inspection 18/01/05 Brief Description of the Service: Brinsworth House is a care home for thirty-six residents, providing both residential and nursing care. It is a spacious detached house set in large grounds and is located close to local facilities and transport. The home provides care exclusively to residents with past and present involvement in the entertainment business or to their dependants. Brinsworth House is operated by the Entertainment Artistes Benevolent Fund (E.A.B.F). The home is decorated and furnished in a particular style reflective of the entertainment business. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 19th July 2005 over six hours. During the course of this visit the inspector had the opportunity to speak with thirteen residents, two visitors and the registered manager of the home. Records and the environment were additionally examined. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that staff maintain fully up to date and accurate records relating to the administration and management of medication. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 6 Maintenance work must be completed to ensure all hot water outlets accessed by residents are fitted with thermostatic valves. A Requirement from the Fire Officer regarding smoke seals fitted to fire doors must also be actioned by the 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. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5. The needs of residents are fully assessed prior to admission to which ensures that the home is able to meet their needs. EVIDENCE: The inspector identified that an appropriate assessment procedure is in place at the home to ensure that it can fully meet individual needs of residents once they are admitted. This was evidenced by fully completed assessment documentation as examined for two residents. Thirteen residents were spoken to individually at the time of inspection and all reported that they enjoyed living at the home. One resident reported that they had moved in within the last month and commented that they were ‘looked after so well’ and the service was ‘very good’. Another newer resident stated that the staff were ‘great’ and had ‘helped them tremendously’. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. The changing needs of residents are fully addressed by the home. Care plans in place are fully completed and subject to a recorded process of monthly review. Residents benefit from good access to health practitioners as required. The records / systems maintained to ensure the safe administration of medication to residents require minor improvement. EVIDENCE: Feedback from residents spoken to was very positive regarding the commitment of the home to keeping residents as well as possible. Comments included ‘the medical service is excellent’, ‘the GP visits very promptly’ and ‘the staff arrange my health appointments for me’. Care documentation for two residents was examined and these were observed to set out a plan of care to meet individual needs. The documentation was subject to a recorded monthly review process that ensures they are current and up to date. Areas of need addressed included communication, mobility, hygiene and nutrition. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 10 Potential risks to residents are assessed by the home to ensure that they are acceptable. Self-medication, use of cot-side equipment and mobility were three areas of risk to individuals seen to be addressed by the home. All residents spoken to reported that they were treated with dignity and respect by staff at all times. Feedback included ‘excellent’, ‘wonderful’ and ‘always polite’. The home had sent out questionnaires as part of its own quality assurance audit in early 2005 - twenty two responses were received and all rated the care given by staff as either excellent or very good. Medication administration records were observed to be generally well maintained but further improvement is required to fully ensure the safe administration of medicines to residents. Four instances were identified where the administration record had not been signed as required. One instance was observed where the receipt of a medication had not been accurately recorded and two other instances noted where a variable dosage was given but these were not being accurately recorded. One further instance was observed where a medication prescribed for one resident was not being administered according to the record maintained but a number of the tablets were missing. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Residents are given opportunities to engage in appropriate activities and are able to maintain contact with relatives and friends. Visitors are welcomed to the home. The dietary needs of residents are well catered for. EVIDENCE: The inspector observed that Mass was taken by a visiting Priest on the day of inspection. A music and movement session had also been facilitated for residents and one resident was heard to be playing the new piano as provided in one lounge area of the home. One resident was additionally seen to have friends visiting whilst others were observed to be reading or watching television at the time of inspection. The home has its own bar where a number of residents were observed to enjoy a pre-lunch drink. The home has a programme of activities with the registered manager reporting that imminent trips planned were for a river cruise and a flight on the London Eye. All residents spoken to reported that they were able to receive visitors. All but two of the residents spoken to stated that they were satisfied with the activities available in the home. Comments included ‘there’s something going Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 12 on everyday’, ‘happy with current level’ and ‘well satisfied’. Two residents reported that ‘they would like a bit more going on’ and ‘too quiet at times’. The inspector took lunch with residents on the day of inspection. A choice of food is available for each meal with residents asked for their preference for the following day. Comments regarding the food were generally very positive and included ‘excellent’, ‘very good’ and ‘terrific’. One resident stated that it was ‘not the greatest’. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. Residents and relatives feel listened to and that any concerns they have will be taken seriously. EVIDENCE: All residents spoken to reported that they knew how and who to make a complaint to. The majority of residents spoken to stated that they had never had cause to complain but felt confident that if they did the manager would listen to what they had to say. One resident reported that they felt satisfied with the way a recent concern had been handled by the home. Systems are in place to record any complaint received by the home along with actions taken and outcomes. This ensures that a record of any investigation is retained. The record of complaints evidenced that there had been four complaints since the previous inspection had taken place in January 2005. All had been logged with actions taken by the home also fully recorded. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 and 26. Residents at Brinsworth House enjoy a homely and comfortable living environment. The premises are well kept and maintained to a good standard of cleanliness. EVIDENCE: As stated within previous inspection reports, the communal lounge and dining areas provide a very high standard of living environment to residents. There are two spacious lounges; a conservatory, bar area and a large dedicated dining area. A very attractive garden area is also available for residents use. New carpeting had been provided in communal hallways throughout the home since the last inspection took place. Comments from residents regarding the home environment included ‘beautiful’, ‘comfortable’ and ‘I’m very happy with my room’. Two bedrooms were seen on the day of inspection – each was personalised to the individual with one of the rooms having been beautifully decorated with a collage of pictures by the resident accommodated. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 15 Toilet and bathroom facilities were observed to be sufficient to meet the need of residents. An additional shower facility has also been provided for residents in recent months. Laundry facilities were seen to be satisfactory – the registered manager reported that new machinery was due to be fitted in the near future to update the systems in place. Maintenance work was ongoing at the time of this inspection visit to ensure that all hot water outlets were fitted with fully operational thermostatic mixer valves. This essential work further ensures the safety of residents accommodated at the home. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30. Sufficient staff are employed to meet resident’s needs. A programme of training is in place to ensure that individual needs are met by competent staff. EVIDENCE: Feedback from residents regarding the care staff was very positive on the day of inspection. Typical comments received included ‘the staff always do their best’, ‘very caring’ and ‘marvellous’. All residents spoken to reported that they felt there were enough staff on duty to meet their needs. Training records examined evidenced that staff had received recent training in areas such as Food Hygiene, First Aid, infection control, wound care and abuse awareness. The registered manager reported that Fire Safety training was now being provided as an in-house provision and future training was planned for staff regarding challenging behaviour. NVQ training for staff continues despite problems with ongoing support from local colleges / providers. Four staff members have successfully achieved this qualification at Level two with a further three staff commencing study shortly. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38. Resident’s benefit from a well managed home. Residents are consulted on the way the home is run. The health and safety of residents is protected by regular checks being carried out within the home. Work needs to be completed to fully ensure the safety of hot water systems. EVIDENCE: The registered manager has been in charge at the home since 1990 - feedback obtained from residents was positive regarding the way the home is run and included ‘charming’, ‘great’ and ‘helpful’. The home had sent out questionnaires to residents and their representatives as part of its own quality assurance audit in early 2005 - twenty two responses were received and collated results published. These were observed to record positive responses in all areas including choice of menu, access to health professionals and the maintenance of the premises. Individual comments made were seen to be typically very positive and included ‘Brinsworth is such Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 18 an excellent place’, ‘could not wish for a more caring atmosphere’ and ‘all staff work so hard to ensure that the residents are happy’. Staff carry out regular checks on the building, furnishings and equipment to ensure the Health and Safety of residents and visitors to the home. A report from a visit in 2005 from an Environmental Health Officer was seen to have described the catering at the home as ‘a very well managed food operation’. Issues identified on the day of inspection included the observed ongoing work being carried out to ensure that all hot water outlets are fitted with functional thermostatic valves to restrict temperatures. The registered manager additionally reported that the Fire Officer has required all doors in the nursing wing to be fitted with satisfactory smoke seals – this has been included as a Requirement within this inspection report. The inspector identified that a risk assessment for Legionella had been carried out for the premises. The registered manager reported that major works were being planned with regard to the replacement of water storage tanks located in the roof of the building. Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 4 2 x 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x x x x 2 Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 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. 1. Standard OP9 Regulation 13 (2) Requirement The Registered Persons must ensure that the administration of all medication to residents by care staff in the home is fully and accurately recorded. Variable dosages administered must be accurately recorded at all times. 2. OP9 13 (2) The Registered Persons must ensure that all medication is administered to individual residents as prescribed by the GP. The Registered Persons must ensure that intumescent strips and cold smoke seals are fitted to fire doors in the nursing wing as required by the Fire Officer. The Registered persons must ensure that all hot water outlets accessed by residents are fitted with thermostatic valves to prevent risks from scalding. 01.09.05 Timescale for action 01.09.05 3. OP38 13 (4) 01.01.06 4. OP38 13 (4) 01.10.05 Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Brinsworth House G54-G04 S26246 Brinsworth V240730 190705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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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