Inspection on 02/12/05 for Brinton Care Home

This inspection was carried out on 2nd December 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brinton Care Home 06/06/07

Brinton Care Home 09/06/06

Brinton Care Home 10/05/05

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 Worcs DY11 7BQ Lead Inspector P Wells Unannounced Inspection 14:30 2 December 2005 nd Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brinton Care Home Address 103-104 Stourport Road Kidderminster Worcs DY11 7BQ 01562 825491 01562 824753 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) Minster Pathways Limited Mrs Susan May Wilcox Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person with an additional physical disability and one person with an additional mental disorder. 10th May 2005 Date of last inspection 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 provide individual accommodation for 4 service users. The home is 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 Surrendra Patel, is the operations director and the responsible individual for Brinton Care Home. Mr Colin Farebrother is the area manager who visits the home on a regular basis. Mrs Susan Wilcox became the registered manager on 27th September 2005. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 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 afternoon of 2nd December 2005. The home has been open for seventeen months and had full occupancy. Time was spent preparing for the inspection reading the pre inspection questionnaire, and four hours at the home. The focus of this visit was to meet with the newly registered manager (who was not on duty at the last inspection) to hear how the service was being established. Also to meet the service users and staff on duty. The inspector appreciated the co-operation and time of the service users, staff and manager. What the service does well: What has improved since the last inspection? A manager has been appointed and registered. The service users have been supported in settling at the home and establishing their own daily activities in and out of the home. The majority of the previous requirements and recommendations have been actioned. The lounge and dining furniture are being replaced. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 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 DS0000059942.V264551.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Suitable information was available for service users and their representatives to make an informed choice about the service and the care provided. An appropriate assessment and transition process takes place for a prospective service user. The service agreement had been developed. EVIDENCE: There was suitable information about the home for prospective service users and their representatives. The statement of purpose had been updated but could be further developed in line with Schedule 1 and to outline how the service provides for service users with additional disabilities/challenging behaviour. The service user guide was also in an alternative format for service users. There had been a new admission since the last inspection and a very detailed assessment had been provided by Social Services from the person’s day centre and social worker. The home did not appear to have recorded it’s own assessment which would be beneficial to ensure that the service can meet the individual’s needs and the person will be compatible with the other service users. Previously the inspector had been shown a detailed assessment document. However it was evident that there had been a suitable, planned and slow introductory period taking into consideration the service user and his family. The manager and staff had considered how his needs could be met at the home. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 9 The manager advised that the agreement had been updated in line with the standards and introduced to the service users. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The individual needs and choices of the service users were known and respected. The documentation needed improving to evidence this, to ensure that care and support was delivered in a consistent manner, changing needs were recognized and goals aimed at with service users. EVIDENCE: The sample service users’ files viewed did not include detailed plans for the individual, their needs and how these needs would be met. The staff were relying on the detailed assessments for information about an individual. This was disappointing and a detailed service user plan for each service user needs to be compiled, with the service user, based on the original assessment and covering standards 2.3,6-21. The plans must include details of how special needs and/or challenging behaviour will be met. Nevertheless it was apparent through discussions with the manager, staff and service users that their individual needs were known and being met. Logs were being kept for each service user regarding their daily activities, food and drink eaten, weighing and doctors’ appointments. These were reviewed on a monthly basis by staff. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 11 There were two risk assessment formats in place, which could be confusing. The risk assessments for individuals need to be reviewed and developed using an agreed format. For the newest service user risk assessments had not been compiled but copies of the day centre’s assessments were in the home as guidance for staff. Risk assessments should also be completed for the service users at night (see page 17). It was apparent that service users were able to make decisions about their own routines and involved in the running of the home. Residents meetings had been introduced and minuted. It was noted that two service users had gained in confidence and felt able to speak up. Also another service user was settling into the home and examples given of how some of his challenging behaviours were beginning to improve with reassurance and consistent responses from staff. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were assessed and met previously. At this visit it was apparent through discussion and observation, that the service users continue to have opportunities to participate in a variety of activities in and out of the home, personal development is supported and service users maintain contact with their families. The deputy takes the lead on ensuring that the service users have a varied and nutritious diet, which is recorded. Service users can request or help themselves to drinks and snacks at any time. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The personal and healthcare needs of the service users continued to be met. A suitable medication system was established. EVIDENCE: Standards 18 & 19 were assessed and met previously. At this visit it was apparent through discussion and observation, that the service users continue to be offered appropriate support with their personal and health care needs. The service users were all well and professional help is sought at an early stage if a physical or emotional problem arises. The service user plans needed to detail the personal and health care (physical and emotional) needs of each person and how these are met (see page 11). The Worcester Health Action Plans would be beneficial and once implemented be a useful, clear method of recording each person’s health care. The manager agreed to follow this up. The medication system was viewed and found to be well organized with suitable recording of medication kept in the home and administered to the service users. A controlled drug was also being suitably stored and recorded. It was pleasing to note that two of the service users were not on any medication and medication was not being used to assist with challenging behaviour. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 14 The company had recently introduced a more appropriate medicine policy and procedure, which will be viewed by the pharmacist inspector. Some of the staff had undertaken a medication course through Solihull College. It was recommended that written consent be obtained for staff to administer medication to individual service users. It was pleasing to hear that the staff had attended courses on the safe handling of medication and ‘death and dying’ during the last six months. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The service users were listened to and any concerns acted upon. There were systems in place to ensure the service users were being protected. EVIDENCE: The home had a suitable complaints procedure and it was evident that service users felt able to raise concerns with staff or the manager. Currently there had been some concerns raised by service users about compatibility in the group. These issues had been followed up and recorded by the manager. Company procedures were in the home relating to protecting vulnerable adults. The manager was arranging further training for herself and the staff regarding protecting vulnerable adults. Individual procedures need to be in place for any service user who displays challenging behaviour as already commented upon on page 11. Service users were encouraged to manage their own monies, with support. Records were kept when the manager and staff were involved in handling monies on behalf of a service user. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home was well maintained and comfortable for the service users. EVIDENCE: These standards were fully assessed at the last inspection. See the previous report for details of the accommodation. The requirements and recommendations had been implemented: There were now privacy locks with an override device on every bathroom, toilet and en suite door. The en suite windows had a suitable covering. The access to the laundry had been altered so that laundry was no longer carried through the kitchen. A new, larger television had been installed in the lounge. The requirement to install a call bell system was not considered necessary by the management. They considered that the majority of service users were capable of calling or coming out of their rooms to summon assistance. Also the home has a waking member of staff at night. One service user has a listening in monitor at night to alert staff if he is in distress. This had been agreed, and recorded, as necessary with the service user’s specialist doctor. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 17 On this occasion it was noted that: The home was warm, clean, safe and bright. A new DVD and video had been purchased with the television. A new dining room table and chairs arrived during the visit and were immediately set up by staff. The service users seemed pleased with the new furniture. New sofas were also being delivered. The previous recommendation and proposal of the garage being converted into a games room would be welcomed. The home now has full occupancy and with service users having differing interests and behaviours, a second communal room would be beneficial. Alternatively an all weather conservatory would give the service users further space. The home may benefit from having a computer for the use of the service users in the dining room, as previously. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 The service users were being supported by a staff team who were suitably recruited and had relevant experience, skills and training. EVIDENCE: The home had an established, small, staff group of experienced staff led by the new manager, who used to be the deputy. Four members of staff had left during the last six months and been replaced with two permanent carers and a relief carer. The rotas and visit indicated that there are three staff on duty when all the service users are at home during the day. At night there is a waking member of staff and a second person sleeping in. The staff continue to have long shifts and the manager agreed to monitor this, although staff were said to like the shift pattern. Also the rotas indicated that the manager and some staff were routinely covering additional shifts. The staff were clear about their roles and responsibilities. The manager advised that staff had been given the GSCC code of practice. The staff had undertaken training in safe working practices and caring for service users with learning disabilities. Staff were currently completing an infection control course. The manager is now an accredited trainer in managing challenging behaviour and has trained the staff. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 19 62 of the permanent staff have an NVQ in care; four have level 2 and one has level 3. Hence the home met the recommended level of 50 of staff having an NVQ by 31.12.05. It was pleasing to hear that these staff were progressing to the next NVQ level. New staff were awaiting the opportunity to undertake the LDAF induction programme and in the mean time were commencing the in-house induction package, having started work in October 2005. A sample of staff files were viewed and it was evident that a suitable recruitment process was adhered to. The manager advised that she was catching up with the regular staff supervision sessions and annual appraisals. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The home has an experienced, registered manager who is undertaking relevant management training. The company need to introduce a recognized quality assurance system. The home had suitable systems in place to ensure the service users’ health and safety were protected. Staff were familiar with safe working practices. A few aspects of health and safety needed developing. EVIDENCE: The new, registered manager has nineteen years experience of working with service users and children who have learning disabilities. She has commenced her registered manager training in November 2005 and is also updating some of her core training. She has recently been accredited as a trainer for managing challenging behaviour and physical intervention. She has worked at this home since it opened and is committed and enthusiastic about her new role. Her management style is open and relaxed encouraging both service users and staff to express their views. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 21 With regard quality assurance, the home does have processes in place to check health and safety aspects of the service. Also surveys have been completed with service users and sent out to the families. As yet these surveys have not been analysised. The manager advised that it was proposed that surveys were also sent out to Doctors and Social Services. The home did not have a recognized quality assurance system, annual development plan or annual audit of the service. The company had reviewed the policies and procedures in the last month. The manager had just received these documents, for her consideration and circulation to the staff. A sample were glanced at and appeared to be more appropriate for a home caring for younger adults with learning disabilities. CSCI had not been receiving the monthly reports of the area manager’s visits to the home, as required. The manager confirmed that these visits had taken place and sent copies of the reports to the inspector following the inspection. The reporting format had changed since the one submitted for registration and was now a brief, mainly tick list. The company need to ensure that CSCI receive the reports on a monthly basis and the CSCI guidance on reporting has been sent to the company. The standard on safe working practices was fully assessed with the manager. It was apparent that there were good systems in place to ensure the health and safety of the service users and staff. The staff had completed training in most safe working practices. They were undertaking a distance-learning course in infection control, which should be completed in the new year. The manager was aware that more staff needed to undertake first aid training, preferably the four-day course. Also that the three new staff needed to complete training in safe working practices. A legionella risk assessment needed to be carried out. The fire risk assessment had been reviewed and developed since the last visit and following the manager and deputy attending ‘fire safety for managers’ course. The fire precaution records needed developing in line with the local fire authority’s guidance and sample recording formats have been sent to the manager. Staff had received training in fire awareness but not quarterly, as required. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 22 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 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brinton Care Home Score X 2 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 X DS0000059942.V264551.R01.S.doc Version 5.0 Page 23 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 YA6 Regulation 15,13 Requirement Service user plans must be compiled for each service user and cover all aspects as set out in Standards 2.3,6-21 and Schedule 3, in particular any special needs/challenging behaviour. All service user plans must be maintained and reviewed with the service users once every six months or when needs/goals change. A risk assessment format must be agreed and implemented for each service user to cover any identified risky situations. A quality assurance system must be introduced in accordance with the requirements of Regulation 24 and all of the aspects of Standard 39. There must be at least one member of staff on duty at all times, day and night, who is qualified in first aid. A legionella risk assessment must be carried out. The staff must receive training in fire awareness quarterly. The fire precautions must be DS0000059942.V264551.R01.S.doc Timescale for action 28/02/06 2 YA9 15,13 28/02/06 3 YA39 24 31/03/06 4 YA42 13,18 31/03/06 5 6 7 YA42 YA42 YA42 13 24,13,18 24,13, 28/02/06 31/01/06 31/01/06 Page 24 Brinton Care Home Version 5.0 checked and recorded at the intervals recommended by the fire authority. 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 Refer to Standard YA1 YA2 YA19 YA20 YA24 YA33 YA32 YA39 Good Practice Recommendations The statement of purpose should be developed. The home should record it’s own assessment for a prospective service user. Consideration should be given to the Worcestershire Health Action Plans being introduced for each service user. Written consent should be obtained from service users (and their representatives if necessary) for the administration of their medication. Consideration should be given to further development of the premises to include the provision of a games facility and an all weather conservatory. 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. Brinton Care Home DS0000059942.V264551.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Worcester Local Office 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 DS0000059942.V264551.R01.S.doc Version 5.0 Page 26 - 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. 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