Inspection on 29/06/07 for Brinsworth House Residential And Nursing Home

This inspection was carried out on 29th June 2007.

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... 13/12/05

Brinsworth House Residential And... 19/07/05

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 Residential And Nursing Home 72 Staines Road Twickenham Middlesex TW2 5AL Lead Inspector Simon Smith Unannounced Inspection 29th June 2007 11:15 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 Brinsworth House Residential And Nursing Home DS0000026246.V336073.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. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brinsworth House Residential And Nursing Home Address 72 Staines Road Twickenham Middlesex TW2 5AL 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) 0208 894 1351 0208 894 0093 www.eabf.org.uk Entertainment Artistes` Benevolent Fund Mrs Sheila Gould Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability over 65 years of age of places (36) Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2005 Brief Description of the Service: Brinsworth House provides residential and nursing care for a maximum of 36 residents. The home provides care to people with a past involvement in the entertainment industry or to their dependants. The current fees are £600 per week for residential care and £750 per week for nursing care. Brinsworth House is a large detached property set in its own grounds and located close to local community facilities and public transport networks. The home is owned and operated by The Entertainment Artistes Benevolent Fund. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a range of sources when making judgements about the home. These included a visit to the home and discussion with the manager, residents and staff. A sample of records was examined, including residents’ files. Surveys were available to residents, relatives, staff and professionals who visit the home. Five residents, ten relatives and seven members of staff returned surveys to the CSCI. All residents said they get the care they need and that the home provides activities that they like to participate in. Residents spoke highly of the staff and said that they provide excellent care. One resident said, “This is a marvellous place” and described the care as “second to none”. Another resident said that the staff are “outstanding” and “always available when you need them”. Residents’ families said that they are made welcome when they visit and that they are kept well informed about events affecting their relatives. Comments made by residents’ families included: “They encourage visitors”. “They always contact me if there is any concern about my mother”. “My sister is well cared for at the home. Her appearance and presentation is always a very high standard“. “The staff are nice and caring and genuinely care about the people who live at the home”. “The staff are wonderful no matter what their role is”. “I think the bar is a wonderful meeting place and there is plenty of entertainment”. “In my opinion Brinsworth House is a perfect home for my mother – I cannot find any fault whatsoever in the care she is given”. Staff were positive about their roles at the home and said that they get good support and supervision to do their jobs. What the service does well: Residents are able to ‘test drive’ the home before deciding to move in. Residents benefit from a stable staff team and management team. Residents’ healthcare needs are managed and monitored well. Residents receive good support for residents to maintain links with friends, families and the local community. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 6 Residents have opportunities to attend a range of events, activities and outings. Staff provide high quality care. The home provides an attractive, safe and welcoming environment. The home provides good quality food, which is enjoyed by residents. The home investigates all complaints thoroughly. The home seeks residents’ views about the service they receive. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Brinsworth House Residential And Nursing Home DS0000026246.V336073.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 Brinsworth House Residential And Nursing Home DS0000026246.V336073.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): Standards 1, 2, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is available to residents. Residents have a written contract setting out their terms and conditions. Residents are able to ‘test drive’ the home before deciding to move in. Residents’ individual needs are effectively assessed at the time of admission. EVIDENCE: Residents’ surveys confirmed that they had been given good information about the home before deciding to move there. The manager said that she carries out assessments on all prospective new residents, visiting them in their own Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 9 homes where possible. The manager also said that she contacts healthcare professionals if she needs additional information before making a decision regarding admission. Comprehensive assessments were in place on all residents’ files examined. The assessment addresses communication, mobility, moving and handling, nutrition, continence, tissue viability, pain management, friends and families and social interests. New residents have a trial stay. There is a formal review after three months, although the manager said, “we try and resolve any issues if they crop up prior to the review”. Residents’ files contained either service agreements (for placements funded by a local authority) or contracts (for those who pay for their care privately). The home does not admit residents for intermediate care. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ care plans reflect their needs and preferences. Residents’ healthcare needs are managed and monitored well. Residents’ privacy and dignity are respected and maintained. EVIDENCE: Each resident has an individual care plan. Three of these were examined. All contained evidence of regular review and demonstrated that residents and their representatives are involved in the development of care plans. Staff carry out moving and handling assessments for all residents, which are regularly reviewed. Care plans also contained risk assessments where Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 11 necessary, for example regarding the use of equipment such as bed rails. Records of care in areas such as tissue viability were good and also contained evidence of regular review. All accidents and incidents are recorded. The inspection provided evidence that the home acts appropriately on any themes or concerns that emerge from this information. For example one resident had suffered a high number of falls in recent months. The deputy manager provided evidence that the home had taken appropriate action to address this issue. Care plans also contain information about residents’ interests, hobbies, family background and personal history. Whilst the quality of information in this area was good on some care plans, others were lacking in detail. One senior member of staff is responsible for the management of medication and only registered nurses administer medication. Medication is stored in a locked room and is dispensed from lockable medication trolleys. There are appropriate arrangements for the disposal of unused medication. A sample of medication administration records for five residents contained two errors. Staff spoke to residents with respect and promoted individual choice during the inspection. Personal care needs were met promptly and with discretion. Comments made by residents confirmed that they are consulted on issues that affect them at the home. Residents also confirmed that they are able to spend time in private whenever they wish. A number of residents chose to spend time alone in their rooms during the inspection. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 12 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 programme of events and activities is stimulating and varied. Residents receive good support to maintain links with friends, families and the local community. Residents receive good support to make decisions about their lives. Residents enjoy the food provided and are consulted about the menu. EVIDENCE: The home holds two large events each year for residents, one during the Summer and one at Christmas. There is also an annual Residents and Relatives Day. There is a good programme of activities, events and occasional outings. The programme included two boat trips, a visiting farm and visiting shows and entertainment. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 13 Bingo took place in the lounge during the inspection, which was popular with residents, and some residents visited a local circus during the evening. One resident had celebrated her 100th birthday the day before inspection with a well-attended party. One resident produces a regular magazine about the home that gives details of events and contains articles and photographs about the local community. Several residents said that they go out regularly to visit shops, churches or friends. One resident said that she visits friends to play bridge and hosts bridge evenings at the home. Church leaders visit the home regularly and the manager said that the home would arrange appropriate religious leadership for any residents who needed it. Residents are able to bring personal items with them when they move in and to personalise their private space. Residents are encouraged to manage their personal affairs, including finances, for as long as possible. Residents are able to access the information held about them by the home if they wish to do so. The inspector shared lunch with three residents. All residents said the food provided by the home was good. One resident asked the home to prepare some of her own food, which they did. Two residents said they were vegetarians and that the home catered appropriately for their needs. The inspector spoke to the home’s chef and examined the kitchen. The chef said that he aims to be available to residents and to get to know their individual preferences. Residents said there are always alternatives to the advertised menu. Standards of hygiene and food storage in the kitchen were good. The last Environmental Health inspection took place in January 2007. The subsequent report made six recommendations, which the chef advised had all been actioned. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear Complaints procedure. Complaints receive an appropriate response. There is a commitment to protecting vulnerable adults. EVIDENCE: The home has a Complaints procedure and records all complaints received. The most recent complaints were related to individual dishes served at mealtimes. No complaints about the home have been made to the CSCI. The volume of complaints is low and there is evidence that complaints received are addressed appropriately by the manager. There is a commitment to ensuring that all staff attend training in the Protection of Vulnerable Adults. Staff are encouraged to use the Whistleblowing policy to report any concerns they have about poor practice. Brinsworth House Residential And Nursing Home DS0000026246.V336073.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, 20, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is attractively decorated and well maintained. Communal spaces are welcoming and well used by residents. Residents’ bedrooms reflect their individual tastes and interests. Standards of hygiene are good. EVIDENCE: The home is situated close to Twickenham Green and town centre, which provides a good range of shops and services. A high standard of decoration Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 16 has been achieved throughout the home and there is a well-maintained garden. The communal rooms are welcoming and homely. These include two lounges, a conservatory, dining room and bar on the ground floor. Residents’ bedrooms vary in size and layout. The bedrooms seen were personalised and reflected the tastes and preferences of their occupants. Residents are able to bring personal items with them on admission and are to install a private telephone line should they wish. The home uses a contract cleaner. All areas of the home were clean and hygienic at the time of inspection. There is appropriate training and guidance for staff in the control of infection. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 17 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. Staff are available in sufficient numbers to meet residents’ needs. Residents are happy with the care provided at the home. Residents are protected by the home’s recruitment practices. Staff attend induction and training appropriate to their roles. EVIDENCE: Residents benefit from a stable staff and management team. Although some long-term staff had recently left the home, many staff have worked there for some time, which ensures good continuity of care for residents. Communication amongst the staff team is good. Night staff hand over to the deputy manager at 7.45am each day. The deputy manager reports to the day staff at 8am and allocates responsibilities for the shift. Staff work in teams, each of which has a team leader. Support at night is provided by an registered nurse and two carers. There is a commitment to Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 18 ensuring that all staff attend appropriate training, including NVQ qualifications. New staff have a structured induction to the home. The manager said that staff do not work unaccompanied with residents until they have completed their induction. Three staff files were checked. These contained evidence of induction and completion of probationary period. Staff files also contained proof of identity, references and Criminal Records Bureau disclosures. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, 37 and38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a motivated and experienced manager. The home has a strong management team. There is a commitment to seeking residents’ views about the home. The health and safety of residents and staff is maintained. EVIDENCE: Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 20 The home’s manager is experienced, enthusiastic and involved with residents and staff. A registered nurse, the manager has worked at the home for many years and has an excellent knowledge of the service and individual residents. Staff spoken to during the inspection confirmed that the manager is approachable and supportive. The manager works closely with the deputy manager and this alliance forms a strong management team. There is a commitment to valuing staff and their contribution to the home. The manager said, “If they’re happy, they’re going to keep the residents happy”. There is a commitment to effective Quality Assurance and seeking the views of residents and other relevant people. The home carried out a survey in January 2007, addressing areas including care, food and the environment, which provided much positive feedback. The manager said that residents’ meetings take place approximately every two months. Systems of recording and administration within the home are clear and well organised. The home keeps small amounts of monies for residents. Appropriate records of residents’ income and expenditure are maintained and monthly statements are provided to residents and their next of kin. The last fire drill took place in January 2007. The fire alarm system was checked by an engineer in June 2007. The system had an annual service in October 2006. The alarm system is checked by staff each week using different call points. Whilst standards of health and safety were good, the home does not conduct or record a regular health and safety check. It is recommended that this be considered to identify any hazards and demonstrate that appropriate action is taken should a hazard be identified. Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 21 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 3 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 X 3 3 Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 22 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. 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. 1 Refer to Standard OP7 Good Practice Recommendations Ensure that all care plans contain good quality information about residents’ interests, background and personal history. Carry out a regular health and safety audit. 2 OP38 Brinsworth House Residential And Nursing Home DS0000026246.V336073.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Brinsworth House Residential And Nursing Home DS0000026246.V336073.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. 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