Inspection on 20/07/05 for Brockenhurst

This inspection was carried out on 20th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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 14/10/08

Brockenhurst 03/06/06

Brockenhurst 07/12/05

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brockenhurst 46 Arundel Road Littlehampton West Sussex BN17 7DD Lead Inspector Annie Taggart Unannounced Wednesday 20 July 2005. 9:30am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brockenhurst Address 46 Arunderl Road, Littlehampton, West Sussex, BN17 7DD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 717984 Ms Norma Ann Matthews Ms Norma Ann Matthews Care Home (CRH) 38 Category(ies) of Dementia - over 65 years of age (DE(E)) 38 registration, with number places of places Mental disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) 38 places Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2005 Brief Description of the Service: Brockenhurst is a care home providing personal care and accommodation for thirty-eight 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. Norma Matthews who is also the registered manager. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place at 9.30am and was carried out over a period of six hours covering both the early and late shifts. During the day the inspector spent time meeting all of the people who live in the home and held longer conversations with seven people. Six of the staff team were also spoken with, as were three visitors to the home. The inspector saw lunch, which is the main meal of the day, being prepared and served and observed staff interacting with the people who live in the home. A tour of all of the rooms in the building was also undertaken. Six care plans were read and six staff files were seen. Documents regarding the running of the home were also checked and these included staff training files, fire tests, health and safety checks and maintenance records. Prior to the inspection the inspector read the last two inspection reports along with any other documentation and correspondence regarding the service. The registered manager Mrs. Matthews was present for the early part of the inspection and Mrs. Robbins, the administrator at the home assisted for the rest of the day. What the service does well: The home provides a friendly and homely environment for the people who live there. Many of the staff team have worked at the home for a number of years and have built up good relationships with residents. Residents say they are well looked after and that staff are kind and caring. Visitors to the home said that the manager and staff team are approachable, friendly and well informed about the needs of the people they support. The staff team receive a comprehensive training programme including training specific to the needs of the people they support. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 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. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 8 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 standard(s) 1, 2, 3, 4, 5, 6 Prospective residents and their families receive sufficient information to allow them to make a choice about whether they would like to live in the home. EVIDENCE: The Statement of Purpose and Service User Guide have recently been reviewed and updated and contain all of the information required to inform prospective residents of the facilities available in the home. Each resident receives a contract setting out the terms and conditions of residency and the manager said these documents are also under review. The manager or head of care visit prospective residents in hospital or in their own homes where a pre-admission assessment is carried out to ensure the home can meet specific needs. A family member making a visit to the home confirmed that they were given comprehensive information and were able to make visits to the home prior to making a decision. Brockenhurst does not provide intermediate care. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8, 9, 10, 11 There is sufficient information available to inform staff of the health and social care needs of each resident. Medication is well managed and residents are treated with respect. EVIDENCE: Care plans contain comprehensive information regarding the health and social care needs of each resident. Plans are updated on a weekly basis with any relevant concerns about residents or changes in condition being addressed. There is evidence of input from a variety of healthcare professionals including local doctors, district nurses and psychiatrists. The manager said that the home receives an excellent service from the local district nurse team who provide specialist equipment, advice to staff and support to residents. The staff at the home carry out three handover periods a day where each resident’s condition and changing needs are discussed and fluid charts and specific care needs charts were in evidence for both day and night staff to complete. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 10 A family member visiting the home said that they came into the home at all varying times during the day and evening and always observed staff members being kind and respectful to the people living there. The home has policies and procedures in place regarding the care of people who are dying and some of the team have attended specific training. If possible people stay in the home until the end of their lives and during the visit the inspector saw staff members caring for, in a very sensitive manner a resident who was very ill. Staff members had also recently attended a resident’s funeral and letters of thanks were seen from families. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13, 14, 15 Social and religious preferences are recorded and there are activities available to stimulate and interest the people living in the home. Families and friends are made welcome and the food offered is of a good quality. EVIDENCE: Many of the people living in the home are frail and are difficult to engage in activities. However there is an activities room in the home with planned activities for each day recorded. The manager also occasionally hires a minibus to take groups of people on day outings. The manager or an ex member of staff who now acts as a volunteer also take people out in the car for shopping trips and to have coffee or lunch. One resident who was setting the tables for lunch said that she enjoyed carrying out this task each day. Contact with family and friends is encouraged. Three visitors who were in the home said they were made welcome at any time and were always offered refreshments. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 12 One family member said that they were especially pleased with the fact that residents had an identified key worker who was always well informed about their family member’s condition. Some of the people living in the home are also supported by advocate services. The local vicar attends the home and communion is also made available for Catholic residents. Residents were seen to move freely about the home and sat with the staff members when they were having a coffee break. There was evidence of staff members giving residents choices and these choices being respected. There is a variety of freshly cooked food available and residents said they enjoyed the meals provided at the home. People said that they especially enjoy the cakes, which are freshly made daily. The preparation and serving of lunch was observed which was roast pork, three fresh vegetables and semolina pudding. All was freshly cooked and looked attractive. Some meals were pureed and where people needed support to eat, this was carried out in a sensitive manner. Meals were served wherever the resident wished and when one person changed their mind as the meals were being served their wish was respected and their alternative choice made for them. Drinks and snacks are available at any time and as the weather was very hot staff were encouraging people to take extra fluids. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 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 standard(s) 16, 18 Residents and their families can be confident that complaints will be recorded and investigated. Policies, procedures and staff training are in place in order to protect the people living in the home from abuse. EVIDENCE: There is a complaints procedure available a copy of which is included in the Statement of Purpose and Service user Guide. Visitors to the home said that they felt confident that any concerns they had would be listened to and dealt with in a sensitive manner by the manager. Residents said that if they were unhappy they would talk to the staff or Mrs. Matthews. Copies of the Whistle-Blowing and Abuse policies are posted in the staff areas of the home. Staff members attend adult protection training and all of those spoken to during the inspection displayed an awareness of the procedures to follow should they suspect an abuse had taken place. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26 The home offers a safe, comfortable and well-maintained environment for the people who live there. Specialist equipment is made available as needed and the home is clean and hygienic. EVIDENCE: There is sufficient shared space, with comfortable lounge and dining areas available. The garden of the home is pretty, well maintained and safe for the use of vulnerable people. New carpets have been fitted in the lounge and extension and the first floor area has been redecorated. Some bedrooms have been also been painted, with new curtains purchased. Fridges and freezers have also been replaced and the outside of the house painted. There is an ongoing programme of redecoration and refurbishment in the home and the manager said that those areas still in need of attention would soon be addressed. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 15 The water in some outlets was found to be of too high a temperature and a plumber was called to re-set the valves. Sufficient toilet and bathing facilities are available with assisted baths and suitable equipment in place. There are handrails, grab handles and raised toilet seats in place and district nurses provide specialist beds and seat cushions as required. Bedrooms have been personalised with furniture and belongings brought to the home by residents and people said that they were happy with their accommodation. All bedrooms have washable floor coverings. Bedroom doors are not fitted with locks and this is stated in the Statement of Purpose and communicated to prospective residents and their families. There is a programme in place to ensure that all radiators and hot pipes are covered. This plan is due to be completed in September 05. To ensure the safety of residents risk assessments are in place for the rooms still awaiting completion. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 Residents in the home are supported by a committed, caring and well- trained staff team. Recruitment procedures are robust with a good recording system in place. EVIDENCE: There were six care staff on duty, three people were also working in the kitchen and one cleaner and a laundry person were available. There was also a maintenance man and an electrician carrying out work within the home. The staff on duty matched the rota. The rota showed that three staff are available at night. The staff on duty demonstrated a good knowledge of the needs of the people they were supporting and were observed treating residents in a friendly and respectful manner. Many of the staff at the home have worked there for many years and said they were dedicated to providing a good life for the people they support. Three visitors to the home spoke very highly of the staff team and said that they were caring, friendly and well informed. The home carries out robust recruitment and selection procedures and since the last inspection the administrator at the home has worked hard to review and update staff files. Six staff files were seen and all records were in good order. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 17 There is a new induction training pack in use which meets currents requirements and new staff are also given a comprehensive in-house induction and introduction to the home. Staff files show that a wide variety of training is accessed by the staff team including, mandatory training, infection control, abuse and neglect, risk assessment, bereavement and loss and best practice in the care of older people. In order to improve work practices at the home, the manager, head of care and senior carer are to attend a year’s college course to complete the National Certificate of Environmental Health Studies. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36, 37, 38 The home is run by an experienced and capable manager who delegates specific responsibilities to the deputy manager, administrator and senior carer. The policies, procedures and record keeping in the home are robust and well maintained. EVIDENCE: Mrs. Matthews is a registered nurse, has completed the Registered Manager’s award and has over thirty years experience in the caring profession. Staff members say that the manager is approachable and very supportive and runs the home with the best interests of both residents and staff in mind. Weekly meetings are held where the needs each resident is discussed and larger monthly staff meetings are also held which also include staff and training issues. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 19 There is evidence in staff files of supervision sessions having been undertaken, this was confirmed by the staff on duty. The home does not hold monies in respect of residents, personal finances being managed by families or legal representatives. Any expenditure carried out by the home on behalf of residents is invoiced every three months to the relevant people with receipts attached. The manager, head of care and the administrator have worked very hard to review and update the policies, procedures and records in the home ensuring that robust and easily tracked systems are now in place. All staff members are given a folder containing a précis of important policies and procedures in order to inform them of required working practices. Recommendations arising from the recent fire and environmental health check have been completed and fire records, health and safety and maintenance records were seen including gas and electrical checks. All were in good order. A quality assurance system is in place, which consists of questionnaires being sent to families, friends and any other professionals involved with the home. Peer group evaluation has also been undertaken which included the manager from another home making an informal inspection of Brockenhurst. Records have been kept of the outcomes and Mrs. Matthews intends to collate and publish the responses. Health and safety notices are posted throughout the home to inform staff of safe working practices and staff members attend training in infection control. There is a designated laundry person who had worked at the home for many years. New laundry equipment has recently been purchased which meets the current standards for sluice facilities and infection control. Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 3 3 3 Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? No 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 Regulation Requirement Timescale for action 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. Refer to Standard Good Practice Recommendations Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Brockenhurst H60-H11 S14409 Brockenhust V237704 200705 Stage 4.doc Version 1.40 Page 23 - 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!