Inspection on 10/01/06 for Britannia Care Home

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Britannia Care Home 03/07/08

Britannia Care Home 30/08/07

Britannia Care Home 23/01/07

Britannia Care Home 16/05/06

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

CARE HOMES FOR OLDER PEOPLE Britannia Care Home 4 Thorn Street Girlington Road Bradford BD8 9NU Lead Inspector Michael Smithson Unannounced Inspection 10th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Britannia Care Home DS0000061941.V271727.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Britannia Care Home Address 4 Thorn Street Girlington Road Bradford BD8 9NU 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) 01274 770405 Girlington Nursing Home Ltd Ms Shaheen Kauser Care Home 25 Category(ies) of Dementia - over 65 years of age (25) registration, with number of places Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/08/2005 Brief Description of the Service: Britannia Care Home is situated in the Girlington area of Bradford, which is approximately 1 mile from the city centre. The home is located in a multicultural area and the home provides a service for a wide range of multicultural service users including Older People and Younger Adults. There is a very good range of facilities located close to the home including shops, public houses, churches and mosques. The home is well served by public transport. The premises are purpose built with accommodation provided on 3 floors. There are both single and double bedrooms available with a shaft lift linking all floors. There is a ramp to the front of the building which provides good disabled access Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and was the second inspection for this year. The first inspection took place in August and was announced. Copies of inspection reports for this and previous inspections are available on the CSCI website. This inspection focused on the requirements and recommendations made at the last inspection What the service does well: What has improved since the last inspection? There was no evidence of any improvements being made since the last inspection. A significant number of requirements and recommendations were made at the last inspection. These appear not to have been addressed. However due to the lack of access to certain information the inspector was not able to see staff recruitment, staff training information and complaints records. No progress was noted regarding the information held in the care plans and the health care monitoring. The periodic up dates of the care plans had not been completed for approximately 6 months. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 6 What they could do better: The home had been left without adequate cover by either the registered provider or the registered manager. The emergency cover provided by a member of staff currently on maternity leave was unacceptable. None of the qualified staff were employed at the home on a fulltime basis. All had other paid work usually with the local NHS. A small number of none Asian staff were having to work excessive hours to cover the leave requirements of the staff wishing to have time off to celebrate Eid. The member of staff in charge during the inspection had worked the previous night duty and the early shift. A senior care staff was undertaking the food shopping. However it was unclear as to the extent of the budget provided and what additional resources were available for any emergency expenditure. The service provided for the younger adults living at the home was inadequate. The care records were not kept up to date and they contained very little information regarding future planning and service users wishes for the future. Many of the younger service users did not view the home as a long term placement. However no evidence could be found of any future planning by the home or the allocated social workers. Many of the service users spoken to wish to move to more independent living. No preparation was being made to achieve these goals. At the last inspection it was noted there was a lack of planned activities for both the older people and the younger adults this has not been addressed. Plans were being made for the home to celebrate the festival of Eid, however they tended to focus more on the needs of the staff team rather than the needs of the service users. The records kept of the drugs administered were not fully recorded. There were gaps noted in the signatures of the drugs administered, which made it difficult to complete an accurate stock check. The drug administration records for 1 month were missing making it impossible to stock check a PRN medication. Please contact the provider for advice of actions taken in response to this Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Service users are not provided with adequate information to enable them to make an informed choice about the home. EVIDENCE: A final version of the statement of purpose and service user guide is still outstanding. This issue is outstanding from previous inspections. There have been no new permanent admissions since the last inspection. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. The care records do not provide up to date information regarding the needs of service users. The medication administration records are not fully recorded. EVIDENCE: The care records for 3 service users were checked during the inspection. The standard of recording was very poor. All the 3 records included a care plan, however they were not kept up to date. Some of the records had not been up dated for 6 months. The health care assessments were not included for some of the service users and those, which were available, were not up to date. The home accommodates a number of service users who are younger adults. The care plans do not reflect the needs of younger adults. While speaking to a number of younger service users it was clear they did not view the placement as a long term move. The care plans do not include information regarding the social, employment and educational needs of service users and what Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 11 preparations were being made to prepare them for a move to more independent living. A spot check of the medications was undertaken. A monitored dosage system is in place. The records contained a number of gaps where no staff initials were recorded. It proved difficult to carry out an accurate stock check. The nurse in charge thought the staff had either forgotten to sign the sheets or the medication had been refused. The PRN medications were checked for one service user. The records did not correspond with numbers of tablets checked. The records of administration for one month could not be located. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12. An appropriate range of activities are not provided. EVIDENCE: There was no evidence of any activities taking place at the home. The home caters for service users with very different care needs. An activity programme must be produced to meet the needs of all service users. This issue is outstanding from the last inspection. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17. Access to adult protection and complaints information was not available at this inspection. EVIDENCE: The person in charge at the inspection was not aware of any complaints currently under investigation. She did not have access to the complaints records. The staff training records were not available on the day of the inspection. There was no information available to confirm whether any of the staff had completed adult protection training. It was a requirement at the last inspection that the staff are provided with the training. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: A building inspection was not undertaken during this visit. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. The staffing numbers were adequate, however the staff rotas were disorganised. The staff recruitment records were not available during the inspection. There were issues outstanding from the last inspection, which could not be checked. EVIDENCE: The staffing appeared adequate for the numbers of service users living at the home. The staff team has remained stable. At the time of the inspection the rotas were being organised to cover Eid. A large number of the staff team celebrate Eid and had requested time off. This had meant that a small number of staff had to work extra hours and long shifts. A number of the staff work at the home on a part time basis while working for the NHS. The person in charge at the time of the inspection did not have access to the staff recruitment files. They were not seen during the inspection. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31. The management of the home was not adequate. The home is not run in the best interests of the service users. EVIDENCE: The management of the home was not adequate. The provider was absent from the home for approximately 6 weeks. The CSCI had not been informed of his absence. The registered manager had been away from the home for 3 weeks. A member of staff who is currently on maternity leave from the home was providing emergency cover. The inspector was informed that the manager was due to return to the home later in the week, however this was not reflected in the staff rota. The arrangements made for food shopping was unclear. A member of the senior care staff was undertaking the responsibility for food ordering. However Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 17 it was unclear as to the level of the budget provided. It was noted that there was sufficient food provided at the time of the inspection. It was also unclear what arrangements were in place to cover any emergencies, which require finances. Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 1 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X X X X X X Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation Reg 4(1) Requirement A copy of the final version of the statement of purpose and service user guide must be sent to the commission. Timescale for action 28/02/06 2. OP7 Reg 15 Outstanding from last inspection. The care plans must include more information where service 28/02/06 users have been identified with special needs. Outstanding from last inspection. Health care information must be produced following an 28/02/06 assessment process. Particular attention must be paid to recording weight. Assessments must also include, manual handling, nutrition, pressure care and prevention of falls. Outstanding from last inspection The drug administration records must be improved An activities programme tailored to the individual needs of the service users must be put in place 28/02/06 28/02/06 3. OP8 Reg 12(1) 4. 5. OP9 OP12 Reg 13(2) Reg 16(2) Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 20 6. OP18 Reg 13 Outstanding from last inspection Adult protection training must be provided for all staff. The senior staff must be prioritised. Outstanding from last inspection CRB checks must be completed for all staff. 50 of the staff must achieve NVQ level 2 before the end of 2005. Outstanding from last inspection The CSCI must be informed in writing of any absence from the home over 28 days. The management cover at the home must be improved and maintained. The manager must achieve NVQ level 4 before the end of 2005. Outstanding from last inspection A staff supervision programme must be introduced. Outstanding from last inspection 28/02/06 7. 8. OP29 OP30 Reg 19 Reg 18 28/02/06 28/02/06 9. 10. 11. OP31 OP31 OP31 Reg 38 Reg 10 Reg 9(i) 28/02/06 28/02/06 28/02/06 12. OP36 Reg 18(2) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Britannia Care Home DS0000061941.V271727.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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