Inspection on 09/06/06 for Brinton Care Home

This inspection was carried out on 9th June 2006.

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 9 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 02/12/05

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 9 &16 June & 6th July 2006 2.00 th th Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 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.V294494.R01.S.doc Version 5.1 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.V294494.R01.S.doc Version 5.1 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 Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person with an additional physical disability and one person with an additional mental disorder. 2nd December 2005 Date of last inspection Brief Description of the Service: Brinton Care Home is a detached, four bed roomed 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 responsible individual for Brinton Care Home. Mr Colin Farebrother, operations director and Mrs Maria Baughurst, operations manager visit the home on a regular basis. The registered manager has left. The weekly fee ranges from £1000-£1800 and there are some additional charges which are outlined in the home’s service user guide and contract. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. These visits were part of a key inspection. It was unannounced and took place over three days carried out by an inspector and a pharmacist inspector. The visits covered the daily and early evening routines. The twenty-one key national minimum standards (NMS) were assessed. The inspection also involved reading the pre inspection questionnaire, reports of the visits of the operations manager to the home and comment cards received. At the visit discussions took place with the manager, staff, service users and the operations director, who was visiting the home. Some of the service users showed the inspector their bedrooms and all the communal parts of the home were viewed. A sample of records, policies and procedures were viewed. The home has been open for two years and has full occupancy. Since the last inspection the registered manager has left and the deputy, Ms Hayley Martin has been appointed as manager. At the time of writing this report her application to register as manager has just been received. The inspector appreciated the co-operation and time of the service users, staff and manager. What the service does well: The service provides a permanent, safe and relaxed home for four service users who may have challenging behaviour or other special needs. The staff group is established and know the service users individual needs. Service users either voiced their opinions about how they liked living at the home or were observed as settled and contented. The service users go out daily. Each person is supported with their individual activities including visiting family and friends. Two of the service users relatives returned positive comment cards. Also a trainer spoke positively about the service and the commitment of the staff. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 6 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. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 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.V294494.R01.S.doc Version 5.1 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): 1,2,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information and arrangements are in place to introduce a service user to the home. EVIDENCE: The home has up to date information available about the service for service users, families and their representatives. The service user guide has been produced in two formats. Each service user also has an agreement. The provider relied upon the initial assessment being undertaken by the social worker or the placing authority. Copies of these assessments were available. The company has introduced an assessment form but this had not been used as there have been no new admissions this year. There was a suitable, planned and introductory period for each person, taking into consideration the service user and his family. The service ensures the transition goes smoothly and is currently providing ‘shared care’ with a family for a service user. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 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 the following standard(s): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users would benefit form the care planning and risk assessment processes being developed to reflect a person centred approach. Service users could be more involved in decision-making. EVIDENCE: The company has introduced a new care planning format recently and plans for each service user had been compiled by the manager. However these plans did not give an up to date, detailed picture of the individual, their identified needs, how these are met, their aspirations and goals. The plans were not user friendly and did not appear to have involved the service user, their family and relevant professionals. The provider should explore Valuing People, Person Centred Planning and consider implementing this model of care planning. As the service is small it would lend itself readily to this and the manager was arranging training in person centred planning. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 10 In contrast the manager and staff were able to give a clear account of each service user’s routine, needs and examples of goals achieved which was commendable. The plans did not reflect the good care and support that service users were receiving. During discussions other monitoring forms, monthly reviews or agreements were shown to the inspector and need to be included in the care plan, regardless of whether this latest information is typed up or not. Monthly reviews of the service user and monitoring charts were being completed but did not involve the care plan, the service user, their family and relevant professionals. A reviewing system, six monthly or when a service user’s needs change, did not appear to have been established. A risk assessment format had been introduced but all the risk assessments were similar and need to be individualized to reflect how the person is to be supported in a risky situation and/or cross-referenced with the care plan or behaviour management plan. Service users are allocated a key worker and co-worker and staff described a clear understanding of this role. The care plans and records about service users need to be signed and dated. Service users were observed making decisions about their daily routines, activities and meals. Two residents’ meetings had taken place this year and should be more frequent. The service knew of the local advocacy scheme and was encouraging a service user to re-new contact. Any limitations made in the best interests of a service user need to be clearly recorded in their service user plan including any restrictions as a result of a guardianship order. A notice on the kitchen door indicated that the kitchen was to be locked when not in use yet the door was observed open throughout the visits. The manager explained that the kitchen door used to be kept locked for safety reasons but this was no longer necessary so it was suggested that the notice be removed and these changes recorded in the service user’s plan. However the manager advised that the kitchen door was being locked at night, after supper about 10.30 pm and this seemed reasonable. Again this arrangement needed to be recorded in the service user’s plan. Night staff have a key to access the kitchen should a service user request a snack or drink during the night. Service users’ personal monies were being kept safely in the office and clear records available to indicate when staff had been involved with handling service users’ monies (see page 17 of this report). Consideration should be given to the service users retaining their own monies in a lockable place in their bedrooms, unless there are recorded reasons in the service user’s plan why this is not appropriate. The manager was not appointee for any of the Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 11 service users but was being asked by a social worker to act as appointee for a service user. This proposal should be reconsidered as the manager did not wish (for sound reasons) to take on this role and there were other options. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 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): 12,13,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Contact with family and friends are good and service users have the opportunity to go out on a daily basis. However the range of activities in and out of the home need to be developed according to each service user’s interests and personal aspirations and development. Service users are able to choose their meals but the service need to ensure that there is a varied, nutritional diet provided for the service users. EVIDENCE: It was evident through observation, discussion with service users, staff and the manager that the service users 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. Individual hobbies and further education are encouraged. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 13 The home has it’s own vehicles for outings, which are daily and staff assist with transporting service users to college, visits to families and friends. A brief record is kept of activities and outings that a service user has participated in each day. This needs to be developed to indicate the aim of the activity, if the service user enjoyed it and to consider new activities. A weekly planner for each service user would be beneficial. Other local facilities could also be considered. On both visits to the home the television in the communal room was on yet it did not appear that service users were watching the programmes. The home has a music centre, dvd player and some games, whilst service users have their own games or interests. The home does not have a computer for service users. Service users would benefit from a sensory room and games room, the latter that was agreed at registration but has not materialized. In the garden there was a seating area in a corner used by staff and service users for smoking but no other garden furniture or games, even though it was summer. A service user and a member of staff advised that there is a snooker table and swing ball but other games were broken. A member of staff and relative have commented that more activities should be available. Maintaining contact with family and friends is positively encouraged although not detailed in the service user plans. Annual holidays were being discussed and the manager was about to visit and assess a possible holiday location. Service users, who are assessed as able, have a bedroom door key. Two of the service users liked to keep their rooms locked which was respected. Service users open their own mail, and are given support to read the contents, if needed. The service users chose on a daily basis what they would like to eat and where they go for meals out. A two weekly sample menu was submitted but at the visit it was apparent that service users, with staff, chose their meals on a daily basis. A record of food provided for each service user was kept. A review of this arrangement needs to take place to ensure that the service users are having a varied, nutritional diet including fresh fruit and vegetables daily. Service users’ records of personal monies indicated that on occasions service users have paid, whilst out, for drinks, meals and snacks. The fee includes these items so service users should not paying when they are out (see page 17 of this report). Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 14 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service by a pharmacist inspector. The service users receive appropriate support with their person and health care needs. However this needs to be detailed in their care plans and specific assessments would be beneficial. The service has a comprehensive medicine policy that reflects good practice and staff can identify through records exactly what has been given to service users. This means that service users medicines are stored safely and that the majority of records show that the right medicine has been given to the right service user at the right time. EVIDENCE: At this visit it was apparent through reading the service user plans, discussion with the manager, key workers and observation that the service users continue to be offered appropriate support with their personal and health care needs. Professional help is sought at an early stage if a physical or emotional problem arises. This was evident at this visit and the manager was working closely with other professionals to support a service user through a difficult period. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 15 Agreements had been reached with the service user to ensure a consistent approach. Another service user’s behaviour had improved since admission, which was commendable to observe and hear about. Restrictions that were in place in the home were no longer necessary. Another service user was being supported discreetly with personal care and physical health care problems. The home has a key worker system and service users can choose who assists them on the shift. There is only one male worker for a group of four men and the manager is actively seeking to recruit other male staff. Routines were observed as flexible according to the preferences of the individual. Some of the service users would benefit from communication, nutritional, eating and drinking assessments, which had been discussed at a previous visit. The brochure includes details of TEACCH but there was no reference to this during the visit to the home. Also menus, fire notices and the complaints procedure should all be in pictorial format to assist some of the service users. Health care needs were included in the care plans and some references to supporting challenging behaviour but often not in detail to indicate the personal, behaviour and health care needs of the individual and how staff should support them with each need. The positive developments that were evident in discussions with the manager and staff were not always recorded. Service users were receiving routine check ups. Health action plans would be beneficial to service users, as previously recommended. The medicine policy was detailed and reflected how medicines were handled in the home. The receipt, administration and disposal of medicines were recorded. Senior care staff have completed training on medicine management. This means that service users are receiving their medicine from trained staff. It was pleasing to note that two of the service users were not on medication and that there was a system in place for the safekeeping and administration of medicines for the other two service users. All service users prescriptions must be seen by the home before being sent to the pharmacy in order to check the order and to sign the exemption declaration. The service users wishes regarding serious illness and death were not included in their service user plans and these need to be. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are listened to and there are procedures in place to protect them. However the complaints procedure needs to be updated and in suitable formats for the service users. Staff need to have training in protecting vulnerable adults. The arrangements for the service users’ monies need reviewing. EVIDENCE: The home has a complaints procedure displayed in the front hall. The manager had identified it needed to be updated and in different formats for the service users. The complaint logbook indicated that there had been one complaint, which had been appropriately dealt with by the manager. The company have introduced a complaint recording format, which will be preferable to the book to respect confidentiality. The manager was continuing to monitor the incompatibility, on occasions between the service users. Company procedures were in the home relating to protecting vulnerable adults. Training for the staff regarding protecting vulnerable adults was still awaited. Individual procedures need to be in the service user plans for any service user who displays challenging behaviour. One behaviour management plan was on file and other service users should have these plans to assist the staff in caring for individuals in a consistent manner. Service users were encouraged to manage their own monies, with support. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 17 However service users’ personal monies were kept in the office safe rather than with the service users. Clear records were being kept when staff were handling monies on behalf of service users. The records indicated that service users have purchase meals, drinks and snacks whilst out. Also a service user had purchased furniture for his bedroom. These items should be supplied by the service as the fee includes provision of these items (as well as day activities and an annual holiday), as stated in the agreement. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 18 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): 24,26,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users have good sized, en suite bedrooms, which they can personalize. The communal areas of the home need decorating and refurbishing and more communal space with facilities would be beneficial to the service users. The laundry facilities need improving. 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. The home has good access to local amenities by walking, bus and car. The home is clean and safe with a suitable ramped front entrance. The rear parking area needs to be a levelled so that the service users can easily access the vehicles. The ground floor of the home level for one service user with mobility problems. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 19 There is no lift to the first floor where three of the bedrooms are located. The four, single, en-suite bedrooms are suitably furnished and service users encouraged to personalize their rooms. There is one communal bathroom on the first floor and an en suite bathroom and toilet in the bedroom on the ground floor. The other three bedrooms have en suite toilets. There is a communal lounge/dining room and a small sitting area in the front hall. The proposals for the garage to be converted to a games room and an all weather conservatory to be built have not yet happened. The manager advised that the company are considering an extension to the home, which would include a conservatory. Additional communal space was agreed at the time of registration and now that the home has full occupancy should be a priority. The one communal room used by service users and staff is limiting and there needs to be a variety of facilities for the service users (see page 14 of this report). There is a small office for the manager and staff. There is nowhere suitable and private for meetings, which a doctor has highlighted. The communal areas of the home need decorating and the lounge refurbished. The manager advised that the company has identified this and work was to commence soon. The manager was also going to make the communal areas more homely. There is a separate laundry, in a shed in the garden. A new washing machine is about to be installed. The machine needs to have a sluice cycle and disposable bags need to be considered for the safe management of soiled laundry. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 20 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): 32,33,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by committed, caring staff. However the service needs a larger staff group to include a deputy and seniors, with two staff on the premises at night. There needs to be a training and development plan. EVIDENCE: The service has a small staff group of enthusiastic, committed staff who are often working excessive hours to cover for sickness and vacancies (including the manager). The service needs to have a larger staff group with additional senior staff who have experience and knowledge of caring for service users who have challenging behaviour and autism. It was of concern that the current number of staff could not long term cover all the shifts. Three staff were on duty during the days and evenings which was insufficient when service users were taken out. Two of the service users, individually, needed two staff with them when they are out (indicated in their care plans). Some service users may choose to stay in, so the house also has to be staffed. At night there is one waking member of staff whereas previously there had been two staff on at night, which was the agreement at the time of registration. Neither CSCI nor the placing authorities had been consulted about the reduction in night staff. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 21 As the service users are all male, the manager was seeking to employ staff of the same gender. There was currently one male member of staff and he did not work weekends. Staff have training opportunities and 45 have an NVQ in care. Staff are undertaking NVQ’s in care so it is anticipated that the service will soon meet the standard of a minimum of 50 of staff having an NVQ in care. The NVQ assessor was at the home at the time of the visit and commented positively on the commitment of the staff and their manner with service users. None of the staff have undertaken learning disability award framework (LDAF) training, which needs to be arranged. Staff need further training in communication, caring and supporting service users with challenging behaviour and autism. Some staff have undertaken training in safe working practices and the manager advised further training was proposed. The service should have a training and development programme based on the needs of the service users, and individual staff training and development assessments. The service had a suitable recruitment process and records indicated that the last two staff employed had been appropriately vetted. Interview notes should be kept. These two staff were completing an in-house induction programme with the manager. Supervision is established but not been taking place as frequently as recommended. This was partly due to the staff shortages and the home not having a deputy. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 22 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users are benefiting from having a new manager who ensures the health, safety and welfare of the service users and staff. A quality assurance programme must be introduced. EVIDENCE: The manager had been in post for two months, having previously been the deputy in the home. She has worked in care settings for 24 years and has considerable experience of working with service users who have learning disabilities. Her application to register as manager was received at the time of writing this report. It was apparent at the visit that the new manager has coped well with staff shortages and a service user unwell. She has regularly had to undertake care shifts yet found time to review many aspects of the service and introduce new service user plans. The manager needs identified management time within her contracted, working hours to run and develop the Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 23 service. Staff and service users found the manager approachable and supportive. The company have not yet implemented a quality assurance programme but were said to be working on this. The manager had sent out questionnaires and the responses had been returned to the company office. The results were not available or an annual development plan or audit. The operations manager visits the home on a regular basis and reports of these visits are now being received by CSCI. The standard of safe working practices was assessed and it was apparent that there were systems in place to ensure the health and safety of the service users and staff. Equipment, gas and electrical services were being checked regularly. Risk assessments for safe working practices and accident book were in place. Water temperatures were regularly being checked and records kept. When water temperatures fall above or below the recommended temperature, this needs to be addressed. The manager confirmed that a legionella assessment had been carried out. The recommendations from this assessment were being carried out or considered by the company. Some staff had received training in safe working practices and further courses were to be arranged. The majority of the staff had undertaken first aid training. The fire precautions were being regularly checked and a fire risk assessment was in place. Staff had received some fire awareness training in-house but not always quarterly, as required. The manager was reminded to notify CSCI of incidents involving service users as outlined in regulation 37. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 24 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 Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 2 X 2 X X 3 X Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 25 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 to cover all aspects as set out in Standards 2.3,6-21 and Schedule 3, in particular assessments for any special needs and challenging behaviour. All service user plans must be maintained and reviewed with the service users once every six months or when needs/goals change. Timescale of 28/02/06 partially met. Risk assessments must be individualized and indicate how the risky situations will be managed. Timescale of 28/02/06 partially met. The range of activities and facilities must be developed in consultation with the service users and their representatives. All service users prescriptions must be seen by the home before being sent to the pharmacy in order to check the order and to sign the exemption declaration. DS0000059942.V294494.R01.S.doc Timescale for action 30/09/06 2. YA9 15,13 30/09/06 3. YA12 16 30/09/06 4 YA20 13(2) 30/09/06 Brinton Care Home Version 5.1 Page 26 5. 6. YA30 YA33 13 13,18 7. YA35 13,18 8. YA39 24 9. YA42 24,13,18 Sluicing facilities must be provided. The company must employ sufficient, suitably qualified and experienced staff to meet the individual needs of service users including support workers, by day and night and seniors. The home must have a training and development plan based on the needs of the individual service users and the training and development assessments of the members of staff. A quality assurance system must be introduced in accordance with the requirements of Regulation 24 and all of the aspects of Standard 39. Timescale of 31/03/06 not met. The staff must receive training in fire awareness quarterly. Timescale of 31/01/06 partially met. 30/09/06 30/09/06 30/09/06 30/09/06 31/07/06 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. Refer to Standard YA7 YA7 YA7 YA7 YA17 YA19 YA21 Good Practice Recommendations Service users should be supported to manage their own monies. The manager should not act as appointee unless there is no one else to act on behalf of a service user. Consultation with service users should be developed and recorded. Any limitations made in the best interest of a service user should be recorded in the service user plan. The record of food provided should be reviewed to ensure that each service user has a varied and healthy diet. Consideration should be given to the Worcestershire Health Action Plans being introduced for each service user. The wishes of service users regarding serious illness and DS0000059942.V294494.R01.S.doc Version 5.1 Page 27 Brinton Care Home 8. YA23 9. 10. 11. 12. 13. 14. YA24 YA24 YA24 YA32 YA35 YA39 death should be included in the service user plan. The policy relating to service users’ monies should clearly detail the circumstances when service users purchase items such as food, drinks and furniture with their personal monies. Consideration should be given to further development of the premises to include the provision of a games facility and an all weather conservatory. The communal areas of the home should be redecorated, refurbished with sturdy furnishings and made homely. The parking area should be levelled. 50 of the staff should have an NVQ in care. New staff should undertake the induction training of LDAF The questionnaires should be collated and findings available to interested parties. Brinton Care Home DS0000059942.V294494.R01.S.doc Version 5.1 Page 28 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.V294494.R01.S.doc Version 5.1 Page 29 - 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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