Inspection on 10/05/05 for Brinton Care Home

This inspection was carried out on 10th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brinton Care Home 06/06/07

Brinton Care Home 09/06/06

Brinton Care Home 02/12/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Brinton Care Home 103-104 Stourport Road Kidderminster Worcestershire DY11 7BQ Lead Inspector Penny Wells Unannounced 10 May 2005 11:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brinton Care Home Address 103-104 Stourport Road Kidderminster Worcestershire DY11 7BQ 01562 825491 01562 825491 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) Minster Pathways Limited Care Home 4 Category(ies) of LD Learning Disability - 4 registration, with number of places Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: In addition to those referred to on the previous page, the following condition applies: 1. One person with an additional physical disability and one person with an additional mental disorder Date of last inspection 21 September 2004 Brief Description of the Service: Brinton Care Home is a detached, four bedroomed house, conveniently situated on the Stourport Road in Kidderminster. The interior of the building has been upgraded to a good standard, to provide individual accommodation for 4 service users. The home has been registered for 4 service users who have a learning disability, which may include challenging behaviour. In addition, one person has a physical disability and one person has mental health problems. The stated aim of Brinton Care Home is to foster an atmosphere of care and support, which both enables and encourages service users to live as full, as interesting and as independent a life-style as possible; within which to encourage positive choice and personal development, and to achieve the full potential of each service user. The home is owned by Minster Pathways Ltd and Mr Surendra Patel, who is the Operations Director, is the Responsible Individual for Brinton Care Home. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced inspection that took place during the day of 10th May 2005. The home had been open for ten months. Neither of the inspectors had visited this home previously and spent time preparing for the inspection and four hours at the home. The registered manager had left the home earlier in the year and an application from the acting manager (previous deputy), Ms Susan Wilcox, to register as the manager is awaited. Ms Wilcox was on leave at the time of this visit. This was a positive visit and the inspectors appreciated the co-operation and time of the service users and staff. What the service does well: What has improved since the last inspection? The service users and staff have settled in. All aspects of the service have been developed as the service users have moved in. Staff have written guidance and training opportunities to assist them in appropriately supporting and caring for each individual. The majority of the previous requirements and recommendations from the first inspection visit and report have been implemented. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 6 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. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-5 Suitable information was available for service users and their representatives to make an informed choice about the service and the care provided. EVIDENCE: The home had developed the statement of purpose and service user guide, which had been shared with the service users and their families. This information gave a good picture of the home and service provided. Consideration could be given to having the service user guide and other documents in different formats, where appropriate, to meet individual needs. These documents will need updating with the new manager’s details and staffing arrangements. The home had introduced and used a detailed assessment document to compliment the information received from the social worker and family. Staff had ensured that the service was suitable and could meet the individual needs of the prospective service user, prior to admission. Also there was a planned introductory period. The home do not accept emergency admissions Each service user had a service agreement but it needed to be updated to include details outlined in NMS 5.2, 6 & 16.11. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,10 The individual needs and choices of the service users were respected and well documented which ensured there was consistency in the delivery of the care and support to service users. EVIDENCE: Detailed service user plans and risk assessments were in place and had been reviewed and updated, when necessary. Service users, families and other professionals had been involved in this process. Service users had key workers. Staff used the plans as working documents and also kept a daily record of events for individual service users. Service users were involved in making decisions about their daily routines which the staff demonstrated. The staff were aware of the local advocacy service and a service user attended an advocacy group. The service had a policy on confidentiality which now included a statement for partner agencies. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11-17 There were opportunities for personal development and a range of activities in and out of the home. Individual’s daily routines were respected. Service users were provided with a varied menu. EVIDENCE: There were opportunities for service users to access college, day centres and local amenities such as shops, cafes, pubs, the library, the gym, and parks. In house activities included computing, walking, board games, jigsaws, listening to music and watching television. The home had a people carrier and the service users enjoyed day trips, with a trip being planned to Welshpool. Also a holiday was being discussed for this year. Service users were being supported to meet regularly with their relatives. The individual service user’s daily routine was respected and planned. Service users were able to have a key to their bedroom but not to the front door because it had a keypad. Staff talked and addressed service users with respect. Brinton had ‘golden rules’ (in symbol format) to ensure that the rights of each individual in the home were respected. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 11 A variety of meals and drinks were provided and recorded for the service users. Snacks such as fruit and cake were available as well. Consideration could be given to involving service users in the preparation of their snacks and meals. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 The personal and healthcare needs of two of the service users were being met. EVIDENCE: Staff were available to assist with personal care needs and did so discreetly. Personal care needs were clearly recorded in the sample service user plan that was viewed. The staff group consisted of both male and female workers and there was a keyworker system. Some of the service users were able to attend to their own personal care. Appropriate healthcare support was given to the service users by staff and healthcare professionals which was clearly recorded in the plans. Advice had been sought by staff from specialists with regard to epilepsy and a service user spoke positively about the support received from another specialist. The home had a suitable medication system for administering service users’ medicines which will be viewed in detail by the pharmacist inspector very soon. Staff were planning to commence a ‘safe handling of medication’ course in May 2005. Staff had received training in administering an invasive treatment. Staff had also received a talk from a funeral director about dying and further training for staff in respect of the ageing, illness and death of a service user was being considered. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 13 Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The systems in place helped to ensure the service users were being protected and a service user indicated that they were listened to. EVIDENCE: The home had a complaints procedure (in two formats) included in the statement of purpose and service user guide. A service user said that they felt able to raise comments or concerns with the acting manager. There was a book for recording complaints and the outcome but there had been no complaints since the home opened. Procedures were in place to safeguard service users. The home had monies in safe keeping for the three permanent service users in the office. Separate tins and records were being kept. Consideration should be given to the service users managing and retaining their personal monies, with support. The company ensured that all staff were suitably vetted (see NMS 34). Records were kept when there had been incidents of aggression. NMS 23 will be discussed in detail with the manager at the next inspection. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-30 The premises were suitable for the purpose and current permanent service users. EVIDENCE: The home consists of a lounge/dining room, kitchen, utility room, bathroom and four en suite single bedrooms. The premises are domestic in nature and suitable as a small care home. It was accessible, warm, clean and safe. However the rooms had been furnished to meet the needs of those with challenging behaviour which meant that some rooms did not appear homely. The television in the lounge had a small screen and was encased. Both inspectors and a relative considered that a larger screen would be easier for viewing. The home was being used by three permanent service users and a fourth on a sessional basis without separate facilities as recommended in NMS 24.5. The home had good access to local amenities by walking, bus and car. The premises were suitable on the ground floor for one service user with mobility problems. There was a programme for general maintenance. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 16 At the time of registration the home met the majority of requirements of the local fire service (also see NMS 42). The environmental health officer had visited in August 2004 and had confirmed that the kitchen facilities were satisfactory. The four, single, en-suite bedrooms were suitable and had basic furnishings. The wardrobes had been secured to the walls, as previously recommended. The main window in the ground floor bedroom had been replaced with clear glass so that the service user could look out. There was one communal bathroom on the first floor and an en suite bathroom and toilet in the ground floor bedroom. The other three bedrooms had en suite toilets. Privacy locks had been fitted to some of en suites, communal bathroom and toilet. Consideration still needed to be given to appropriate window coverings in the bathroom and en suites with windows. There was communal lounge/dining room. The proposals for the garage to be converted to a games room and an all weather conservatory to be built, were still being considered and would be welcomed. There was an office for the manager and staff. The existing provision was suitable for the current service users and, except for the ramped access, there were no other aids or adaptations. The home did not have a call bell system, which should be considered as the home accommodates a service user with physical disability and others who may have challenging behaviour. A listening in device was being used for one service user and a call bell system would be more suitable. The home appeared clean and hygienic. There was a separate laundry in a shed in the garden. However it was being accessed through the kitchen which is not acceptable. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33 & 35 The service users were being supported by a staff team who had relevant experience, skills and were developing their knowledge through training. The staff group was settled and there were sufficient staff to support the service users appropriately. EVIDENCE: The three staff on duty, on the day of the visit, were clear about their roles and responsibilities with the focus being on supporting the service users. The staff did not seem familiar with, or have copies of, the code of conduct and practice set by the General Social Care Council (GSCC) for care workers. The staff team consisted of both male and female workers with a variety of skills and experience. There were three senior care staff, three care staff, four night staff and an acting manager. All these staff had been at the home since it opened and the vacant post was about to be filled. The rotas indicated that there were three staff on duty during the day, and at night there were two waking staff. Two of the staff, on duty, were working double shifts which was a long working day – 6.45 am to 9.15 pm. Staff said that they liked to work these long days. However this should be monitored to ensure staff do not become stressed or tired as the work can be demanding. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 18 Another member of staff on duty had transferred from days to nights and was enjoying working with the service users. The staff on duty spoke enthusiastically about the training opportunities they had. It was pleasing to note that the staff were able to access courses locally run by the North Warwickshire Trust, which specializes in caring and supporting service users with learning disabilities. The home had also established contact with specialist healthcare workers and the communication team of the Trust. The care staff undertake the laundry, cleaning and gardening as no ancillary staff are employed except for a maintenance person. No relief or agency staff were being used, nor volunteers. Staff meetings took place regularly. More than 50 of the staff team had a NVQ in care, level 2, with two senior staff having obtained level 3. Two other staff were undertaking NVQ level 2. It was pleasing to note that the majority of staff had undertaken training in safe working practices (see NMS 42) and attended courses relating to the special needs of service users with learning disabilities. New staff would benefit from undertaking the induction course of the Learning Disability Award Framework (LDAF) and all the staff would benefit from training in managing challenging behaviour. The arrangements for the recruitment, supervision and support of staff will be discussed with the manager at the next inspection. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,41,42 The home had suitable systems in place, of which staff were aware, to ensure that service users’ rights and best interests were being safeguarded. Staff were familiar with safe working practices. EVIDENCE: The registered manager had left earlier in the year, which was disappointing. The deputy was acting manager and her application to register as the manager is still awaited. The acting manager was on sick leave so the management of the home could not be discussed with her. However one service user said that she was approachable and always listened. The company had introduced a quality assurance policy and the questionnaires needed to be concluded and findings made available to interested parties. The company’s policies and procedures were in the home and been introduced to the staff. The next step would be to introduce them to the service users, in suitable formats, if possible. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 20 The home were maintaining appropriate records to indicate the needs of individual’s and the smooth running of the home. It was pleasing to observe that senior staff were familiar with the policies, procedures, recording systems and in the absence of the acting manager were able to access them easily. The company’s Area Manager was visiting the home regularly although reports did not appear to have been submitted to the CSCI on a monthly basis, as required. The standard on Safe Working Practices is wide ranging and could not be discussed with the acting manager therefore it was not scored. However the following was noted: • The home had the company’s health and safety policy. • Staff had undertaken training in safe working practices – basic food hygiene, moving and handling, fire safety and first aid. It was unclear whether the four staff who attended first aid training were qualified first aiders and more staff need to do this training to ensure there is a first aider on duty at all times. Staff should also have training in infection control. • A risk assessment of the premises had been carried out and documented for each room. Also risk assessments for service users, where needed, were in place. The fire safety risk assessment could not be located. • There were records of checks on the water, fridge and freezer temperatures and cleaning programmes in place for the cleaning of kitchen equipment. • The microwave was said to be used only for defrosting meat. Good practice would be for meat to be defrosted naturally. The microwave could then be used by the staff and service users for cooking purposes. • All the equipment in the home was new and annual servicing would be introduced. • Any accidents were being recorded in an appropriate format. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 3 2 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 2 x 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brinton Care Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x 2 3 2 x x E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 22 Yes 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 5 Regulation 5 Requirement A contract/statement of terms and conditions, that includes all of the information detailed in Standard 5.2 and in a format appropriate to the service users’ needs, must be provided for all of the service users. Locks with appropriate override device must be fitted to the doors of all the en suite facilities. (timescale of 31.12.04 partially met) Suitable window coverings must be fitted in ensuite facilites. (timescale of 31.12.04 not met) A call bell system must be fitted A review of the access to the laundry must be undertaken. Monthly reports must be submitted to the CSCI of the visits to the home on behalf of the Responible Individual. All the staff must receive training in managing challenging behaviour and infection control There must be at least one member of staff on duty at all times, day and night, who is qualified in first aid i.e. First Aid at Work. Timescale for action 31.08.05 2. 27 12 30.06.05 3. 4. 5. 6. 27 29 30 41 16 12,13,23 13,16 26 31.07.05 30.09.05 30.09.05 30.06.05 7. 35, 42 13,18 30.09.05 8. 42 13,18 30.09.05 Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 23 9. 10. 42 37 13,23 9 The fire risk assessment must be located, reviewed and available in the home. The home must have a registered manager 30.06.05 31.08.05 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. 3. 4. 5. 6. 7. 8. 9. 10. 11. Refer to Standard 1 11,17,23 21 24 24 28 31 33 35 39 42 Good Practice Recommendations The statement of purpose and service user guide should be updated with the new managers details and staffing arrangements, with a copy sent to the CSCI. Consideration should be given to further developing independent living skills. Training for staff in respect of ageing, illness and death of a service users should be provided. A larger television screen should be provided in the lounge. The arrangement of permanent and sessional service users using the same facilities should be reviewed. Consideration should be given to further development of the premises to include the provision of a games facility and an all weather conservatory. The code of conduct and practice produced by the General Social Care Council should be provided to all staff. The long days worked by staff should be monitored by the company. New staff should undertake the induction training of LDAF The questionnaires should be collated and findings available to interested parties. A review of the use of the microwave should be undertaken. Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 24 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. Extracts may not be used or reproduced without the express permission of CSCI Brinton Care Home E52 S59942 Brintons V226594 100505.doc Version 1.30 Page 25 - 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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