Inspection on 14/10/08 for Brockenhurst

This inspection was carried out on 14th October 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brockenhurst 03/06/06

Brockenhurst 07/12/05

Brockenhurst 20/07/05

Brockenhurst 17/01/05

Brockenhurst 23/09/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 13/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brockenhurst 46 Arundel Road Littlehampton West Sussex BN17 7DD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gary Bartlett     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Brockenhurst 46 Arundel Road Littlehampton West Sussex BN17 7DD 01903717984 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Norma Ann Matthews Type of registration: Number of places registered: Ms Norma Ann Matthews care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Brockenhurst is a care home providing personal care and accommodation for thirtyeight people over the age of sixty-five who have dementia. The home is situated close to the town centre of Littlehampton, a seaside resort in West Sussex, with a train station; shops and other amenities close by. Brockenhurst was established in 1974 and has been under the same ownership since that time. The three-storey building consists of two semi-detached properties, which have been linked to form one home. A later ground floor extension has been added and two garages converted to provide a large activities room. There are twenty-eight single and five double bedrooms arranged on all three floors. A passenger lift is also available. There are good size secure gardens to the rear of the property, which are accessible to residents. The home is owned by Mrs. 0 0 Over 65 38 38 Care Homes for Older People Page 4 of 26 Brief description of the care home Norma Matthews who is also the registered manager. Current fees range from £465 to £620 per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Brockenhurst from 9.30 a.m. until 4.30 pm. Judgements about quality of life and choices were taken from direct observation and by discussion with the residents, staff, a community nurse and visitors. Some records and parts of the building and grounds were inspected. The Manager had completed an Annual Quality Assurance Assessment, from which information was used to inform the inspection process. The Manager and staff gave their full assistance throughout the inspection. Care Homes for Older People Page 6 of 26 The Care Homes Regulations 2001 and the National Minimum Standards for Care Homes for Older People refer to people who use the service as service users. People living at Brockenhurst prefer to be referred to as residents. Accordingly this shall be done in the text of this report. The Inspector would like to thank everyone involved for their contribution to the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they are appropriately placed due to good preadmission assessments and benefit from being able to visit the home prior to admission. Evidence: The Manager described how a pre admission assessment is made of each prospective resident to ensure the home can meet his or her needs. If practical, a member of the senior team would visit the prospective resident in their home or hospital to ensure the necessary information was current and accurate. Records show that prospective residents, their families, advocates, and relevant health care professionals are involved in the assessment process. Specialist advice is sought from external sources where required. Residents said they or their families had been able to visit Brockenhurst before moving Care Homes for Older People Page 11 of 26 Evidence: in. A residents relative confirmed this and said staff are very helpful in assisting new residents to settle in. Brockenhurst does not provide intermediate care. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care and health needs are well met in a dignified and appropriate manner. An improvement to care plan records would better evidence how they are met. Evidence: The judgment for this outcome group has taken into account the quality of life for all the residents. The judgement also includes assessment of the level of knowledge and understanding displayed by staff when providing both personal and health care. Comments made by residents, their relatives, a visiting community nurse, observation during the day of the site visit and the previous inspection report, all indicate the standard of care provided is good. Residents say that staff are fully aware of their needs. Staff are aware of far more information than is recorded in care plans. A lot of information is shared verbally. The Manager described how she has been introducing a more detailed system of care planning. This needs to be done, as current care plans are just adequate. They contain some risk assessments and are accessible to staff. Some detail of individual needs is Care Homes for Older People Page 13 of 26 Evidence: given including personal preferences but they do not present a cohesive plan of care. The Manager is aware that some daily records are not detailed or specific and is addressing this by regularly monitoring them. She has also agreed to implement a system of keeping daily records that better maintains confidentiality. Residents consider their health needs are well met. References were made to a wide variety of healthcare professionals including local doctors, the community mental health team, chiropodists and hospital specialists. During the visit, a district nurse was present and was complimentary about both the care provided within the home and the commitment and skill of the staff team. The care plans contain some risk assessments. The Manager is aware they are limited in scope and content. Staff spoken with generally have a good understanding of getting a balance between perceived risks and promoting independence. There have been improvements to the risk assessments, but as with the care plans, further work is required for them to more fully encompass activities undertaken by residents. A senior carer has delegated responsibility for medication. The medicine storage area is well maintained and a system of monitoring the temperature is about to be implemented. There was some discussion about all hand written entries on the Medication Record Administration Record (MAR) sheets being double signed to help ensure accuracy. Staff receive medication training through a local college. The administration of medicines was not observed on this occasion. Residents feel that staff are kind and gentle, this was confirmed by observation and discussion with visitors. Staff are considerate of the age and dignity of residents and treat them with courtesy. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers activities and outings to provide interest and stimulation for the people who live there. Families and friends are made very welcome. Residents enjoy good quality meals. Evidence: The Manager takes pride in the way the home provides activities and stimulation for people. Activities undertaken are recorded and include art, manicures, organised games and music sessions. Outings are arranged in good weather using the local community transport and residents enjoy going to the beach or out for tea. Staff members also take people to the shops or out for a coffee. Some residents spoke of how they are looking forward to going to Glyndebourne for a performance of Carmen. Family and friends feel very welcome and know they can visit at any reasonable time. During the inspection a number of visitors were seen in the home and the visitors book records regular visits by families, friends and others. The design of the Brockenhurst Care Homes for Older People Page 15 of 26 Evidence: provides seating areas within the communal areas where residents can entertain their visitors, in addition to the privacy of their own room. Visitors say they are always greeted in a very friendly manner and offered a tray of hot drinks and cake. Residents are encouraged to personalise their rooms with their own possessions if they wish. Most residents have brought items of furniture and plenty of personal effects with them. As rooms are differently shaped and sized this leads to very individual environments. Some residents have strong spiritual beliefs and the home supports them in meeting these. There is assistance for those who wish to go to church and others may attend a service conducted by a visiting Minister. Residents said they like the food and think it is well cooked and well presented. There is a planned menu and an alternative is offered to the main course. Staff have a good knowledge of residents individual tastes and these are catered for. The meals are generous in portions and look appetising. Mealtimes are relaxed, staff are patient and helpful and allow residents the time they need to finish their meal comfortably. A few residents choose to eat in their rooms. On this occasion some hot deserts were taken to rooms at the same time as the main course. As a result, the desert would be cold by the time it was eaten. The Manager agreed to remind staff that hot deserts must be served only when the residents are ready for them. Hot and cold drinks are available through out the day. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives know their complaints are listened to and acted on. There are systems to protect residents from abuse. Evidence: The complaints procedure is readily available to residents and their relatives. They say they feel confident they are listened to and any necessary action is taken. The Home keeps a record is of all complaints received by them, the result of the investigation and how the complaint has been resolved. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The Manager and other staff spoken with have a sound understanding of adult protection procedures. The Manager stated any allegation of abuse would be referred to the concerned agencies without delay. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a homely, clean and comfortable environment in which to live. Evidence: The home offers a safe, homely and comfortable environment for the people who live there. There is adequate communal space, which is attractively decorated, small sitting areas are located throughout the house and there is an enclosed easily accessed garden. There are continual improvements being made. These include new dining room furniture, replacement carpeting, new floor covering in bedrooms, a new water boiler, thermostatic control valves on the baths, new assisted baths and bathroom equipment, and the refurbishment of the kitchen. To allow easier access, a first floor bathroom has been fitted with a sliding door. Residents can gain access to the upper floors by passenger lift. A staff call system is available with calls being answered promptly at the time of the inspection. Residents say the toilet facilities are adequate. There is a designated laundry that is suitably equipped with systems in place to reduce Care Homes for Older People Page 18 of 26 Evidence: the risks of cross infection. The sluicing facilities are also clean and well maintained. Alcohol gels have been fitted to various locations around the home to assist with infection control. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are in the care of people who are hardworking and enthusiastic. Evidence: Residents and their relatives speak very highly of the staff and of the care given. People applying to work at the home have to complete an application form, attend an interview, provide references and satisfactory POVA and CRB checks. The files of the most recently recruited staff show that appropriate checks are made prior to them commencing duties. The Manager was advised that the staff application form should be updated to comply with current employment legislation and facilitate the recording of a full employment history as required by Regulations. New staff are required to undertake an induction programme and there is ongoing training for all staff. The majority of staff have undertaken NVQ training. There was some discussion about the advantages of using a training matrix to give a management overview of courses attended and those booked. Staff feel there are enough staff on duty to meet the needs of residents. Although there are times when they are busy, they also have many opportunities to chat with residents and to offer one to one care and support. The home has a very stable staff Care Homes for Older People Page 20 of 26 Evidence: group and some staff have been working at Brockenhurst for a number of years. Residents like the staff and find them approachable, polite and kind. Throughout the site visit there was evidence of good relationships between staff and residents. Staff mentioned how much they liked working with the residents in the home and this was reflected in the way care and support was given. Staff obviously know the residents well and how best to put them at ease. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is committed to providing a good service and the home is well run in the best interests of residents. There is an open and friendly atmosphere. Evidence: Mrs Norma Mathews is the owner and registered Manager of Brockenhurst. She is committed to providing a high quality service tailored to the individual needs and preferences of the residents. In order to ensure that she is up to date with current legislation the manager regularly attends training courses. Most recently Mrs. Mathews has completed the NEBOSH Health and Safety course and is currently undertaking a course in continuing care. Residents, visitors and staff find the Manager approachable and supporting. A quality assurance process is in place, which elicits views from residents, their families and other professionals involved with the home and outcomes are collated and published. Care Homes for Older People Page 22 of 26 Evidence: Staff speak of ongoing supervision and appraisals. Residents manage their own financial affairs or have assistance from their family or representative. Payments made on behalf of residents are carefully recorded. The standard of cleanliness in the kitchen and surrounding area is good. There are records of fire systems checks and fire drills and training. Staff spoken with have a good understanding of emergency procedures. The Manager stated that records of maintenance and safety checks are in order. These were not inspected on this occasion. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is strongly recommended the Manager proceeds with the intended implementation of a revised care planning system. The system used should give clear evidence of: How care and support needs are to be provided. How they have been met. Give a true evaluation of activities of daily living including how these link to care plan issues. Responsive risk assessments that clearly state the manner in which the risk is to be reduced or removed. It is strongly recommended the staff application form is updated to comply with current employment legislation and facilitate the recording of a full employment history as required by Regulations. 2 29 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!