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Inspection on 06/04/05 for Brockfield House Nursing Home

Also see our care home review for Brockfield House Nursing Home for more information

This inspection was carried out on 6th April 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service is always co-operative with the inspection process and responds to requirements with the development of action plans.

What has improved since the last inspection?

There has been some improvement in the presentation of the premises. The dining room has been redecorated, the curtains cleaned and re-hung and a doorway has been made between the reception area and the dining room. New door locks have been fitted on the bathrooms and toilets to help prevent accidents happening. Staff have been given training in the correct methods of helping residents to move around the home and the safe use of moving belts, wheelchairs and hoists.

What the care home could do better:

They need to get better at supervising staff and making sure that residents are given all the care that nursing staff have identified that they need. The nursingstaff need to make sure that the medication is given to residents as the Doctors prescribe it and that stocks do not run out. The delivery of care to residents could be better. The plans detailing the care that should be given lack detail. The care is not always carried out and in some cases the resident does not receive the care that they need. The home needs to get better at preventing residents from getting pressure sores by providing equipment to help prevent these. We have made requirements about this but they have not been met so we have issued an enforcement notice about this. They need to be better at making sure that the food and drink residents` need is given to them and that any loss in weight is referred to the Doctor or dietician so that any supplements can be prescribed. When this is done they need to make sure that it is given. We have made requirements about this but they have not been met so we have issued an enforcement notice about this. The medication system is poorly managed with residents not always being given the medication that the doctor has prescribed for them. We made an immediate requirement about this. They need to get better at demonstrating that they involve relatives and where possible residents in deciding how care is given. They need to improve in the way that residents are occupied during the day rather than being satisfied that they occupy themselves, either by wandering around, sleeping or shouting out. To do this they will need better training for staff in recognising when people with dementia are distressed. They need to improve the way that they deal with people who make complaints about the service to restore confidence in this process. They need to consider how they will manage making changes at the home as it is now to comply with the standards and put things right before they focus on the changes to the premises and increasing the occupancy of the home. So that changes can be made they need to give the manager more time to manage the home and oversee the staff rather than expecting her to cover the nursing shifts.

CARE HOMES FOR OLDER PEOPLE Brockfield House Nursing Home Villa Lane Stanwick Wellingborough NN9 6QQ Lead Inspector Lynda Higgins Unannounced 6th April 2005 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. Brockfield House Nursing Home Version 1.10 Page 3 SERVICE INFORMATION Name of service Brockfield House Nursing Home Address Villa Lane Stanwick Wellingborough NN9 6QQ 01933 625555 01933 461191 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) A.G.E Nursing Homes Ltd Mrs Lesley Denise Turner Care Home with Nursing 40 Category(ies) of DE(E) Dementia - Over 65 (40) registration, with number MD(E) Mental Disorder - Over 65 (40) of places Brockfield House Nursing Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The age range of the service users is 50 and over. Date of last inspection 14th February 2005 Brief Description of the Service: Brockfield Nursing Home is located in the small village of Stanwick, close to the larger Towns of Rushden and Wellingborough. The home offers care for up to 40 people who have dementia or a mental illness over the age of 50 years old. The home provides Nursing care and has a registered nurse on duty 24 hours a day. At the front of the home there is a car parking area with gardens to the rear. The main access is via a steep flight of steps however level access is provided via a side door. The home has communal space in lounges and a large dining room. There are bedrooms over two floors of the home Brockfield House Nursing Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over the morning and early afternoon, a four-hour period. A selection of residents files were examined, staff were spoken with, as were residents. Some previous requirements were reviewed and 2 complaints were looked at. Time was spent observing practices and meeting with the manager to provide feedback. We have visited on a number of occasions since the last inspection in December 2004. This is because of the number of concerns that have been raised during inspection and complaint investigations to monitor the homes actions. The police, coroner’s office, social services, health and safety executive and the commission undertook a protection of vulnerable adults investigation into the death of a resident in December 2004. There were no suspicious circumstances but a number of care and safety issues were identified for the home to address. The management has undertaken some steps to rectify issues identified in this investigation and action plans have been submitted but we are concerned that the necessary steps are not being taken to sustain these changes. We have continued to identify areas of failing that are symptomatic of poor management and poor staff supervision. The number of permanent nursing and care staff is low and recruitment has not been successful. The management need to consider if the home can continue to offer a placement to so many dependent residents. What the service does well: What has improved since the last inspection? What they could do better: They need to get better at supervising staff and making sure that residents are given all the care that nursing staff have identified that they need. The nursing Brockfield House Nursing Home Version 1.10 Page 6 staff need to make sure that the medication is given to residents as the Doctors prescribe it and that stocks do not run out. The delivery of care to residents could be better. The plans detailing the care that should be given lack detail. The care is not always carried out and in some cases the resident does not receive the care that they need. The home needs to get better at preventing residents from getting pressure sores by providing equipment to help prevent these. We have made requirements about this but they have not been met so we have issued an enforcement notice about this. They need to be better at making sure that the food and drink residents’ need is given to them and that any loss in weight is referred to the Doctor or dietician so that any supplements can be prescribed. When this is done they need to make sure that it is given. We have made requirements about this but they have not been met so we have issued an enforcement notice about this. The medication system is poorly managed with residents not always being given the medication that the doctor has prescribed for them. We made an immediate requirement about this. They need to get better at demonstrating that they involve relatives and where possible residents in deciding how care is given. They need to improve in the way that residents are occupied during the day rather than being satisfied that they occupy themselves, either by wandering around, sleeping or shouting out. To do this they will need better training for staff in recognising when people with dementia are distressed. They need to improve the way that they deal with people who make complaints about the service to restore confidence in this process. They need to consider how they will manage making changes at the home as it is now to comply with the standards and put things right before they focus on the changes to the premises and increasing the occupancy of the home. So that changes can be made they need to give the manager more time to manage the home and oversee the staff rather than expecting her to cover the nursing shifts. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brockfield House Nursing Home Version 1.10 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 Brockfield House Nursing Home Version 1.10 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) No standards were assessed in this section EVIDENCE: Brockfield House Nursing Home Version 1.10 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 and 9 There is a care plan system but it is not followed by staff leading to the residents’ care being of poor quality and lacking in timely referral to healthcare professionals. The system of administration of medication is chaotic, lacks accountability and does not meet the standards required by the National Minimum Standards, the Nursing and Midwifery Council’s Code of practice and the guidance issued by the British Pharmaceutical Society. These poor practices place residents at risk. EVIDENCE: We have made requirements about the care and supervision of residents following previous inspections. One resident had been assessed as being at risk of tissue breakdown on the 15th March 2005. There was no pressure-relieving mattress on the resident’s bed and none available in the home. A pressure cushion was in use in the resident’s chair. On the 6th April 2005 the staff had identified that the resident had developed two grade 2 pressure ulcers. Action had been taken to order a mattress. The previous requirement has not been met. Brockfield House Nursing Home Version 1.10 Page 10 Weight loss is recorded and actions to be taken by staff are identified in the review of the care plan. There was little evidence to support that these actions were being carried out. On the medication records a resident had been prescribed nutritional supplements but these were only recorded as being given for 4 days. In the case of one resident where weight loss was recorded no further weight had been recorded in the timescale specified and any referral to the GP was not evidenced. There was no record of intake. The previous requirement has not been met. The records along with feedback from relatives identifies that there is a lack of involvement of residents or relatives in the development of care plans. Medication administration was not recorded properly with signatures being made for tablets that remained in the monitored dose packets. In other instances tablets not in the packets were not accounted for. The amounts administered in the record did not tally with the number of tablets dispensed by the pharmacist and then signed for a given. Antibiotics were given erratically. One resident was recorded as having been given a liquid medication for the month of March, up to and including the morning of the inspection. There was no evidence of the medication in the home for this resident. The manager said that they were probably using another resident’s supply. An immediate requirement was made. Brockfield House Nursing Home Version 1.10 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 and 14 The meeting of residents’ social and emotional needs is poor, these are not underpinned by the care planning process and information regarding life histories to identify meaningful activities is lacking. Therefore care is dictated by routines, is not individualised or aimed at enabling residents to retain skills or control over their lives. EVIDENCE: We observed that the main activity for residents was sitting in chairs, sitting sleeping or on occasions calling out to others. Some walked around the dining room aimlessly. There was a television on but no one was watching it. We spoke with some residents who were keen to converse. Residents presented as clean but some had only one slipper on and staff took no action to rectify this situation. There was limited conversation between staff and residents with the bulk of the interaction with staff mainly related to carrying out tasks. These interactions were carried out with a good level of caring discussion but in one instance a resident was observed being stood from a chair without any explanation to the resident about the interaction and the staff were unclear why they were standing her. Brockfield House Nursing Home Version 1.10 Page 12 A number of residents remained in their rooms but the reasons for this were not evidenced in the care plans as either a choice or due to management/behavioural reasons. Doors restricted the progress of residents who walked around with access being via the use of swipe cards. This prevents both residents’ and visitors from exiting areas of the home without a staff member activating the door. This presents issues of choice and restriction of liberty particularly as residents are not subject to any mental health detention orders. Individual risk assessments were not evident. Previous requirements have been made and are restated. Brockfield House Nursing Home Version 1.10 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, 17 and 18 The attitude to complaint resolution means that residents, relatives and healthcare professionals are not confident that their concerns are listened to or acted upon by the staff. There are restrictive practices regarding the residents legal rights with them being detained in the home without any evidence as to the reasons why these rights are curtailed. EVIDENCE: There has been a significant rise in the number of complaints made about the home in the last 6 months. Since December 2004 there have been 4 complaints made to us about the standards of care at the home and the abilities of staff. The complaints regarded poor care practices particularly in relation to nutritional care, pressure area care and Health and Safety. Relatives and healthcare professionals have made complaints and following investigation these have been upheld. Two complaints were made at the time of the inspection, one in relation to the care of a resident, the other regarding staffing levels of the previous weekend and a plague of flies at the home. When discussed with the manager it was evident that she was aware of both matters and felt that the concerns had been resolved. It was evident from the attitude of the manager in relation to one of the complaints that she gave little credibility to the concerns of the complainant and was dismissive of the matters raised. Brockfield House Nursing Home Version 1.10 Page 14 The complaints policy on display is no longer current and is in need of updating with the correct regulator details. It is not in a readily accessible position or in a print best suited to residents needs. Swipe cards remain in use on doorways in the home that restricts liberty for both residents and visitors. There is no evidence in their plan as to why their liberty is restricted. Previous requirements have been restated. In December 2004 a multi-agency Protection of Vulnerable Adults investigation was carried out following a serious accident, this involved the Social Care Commission, Police, Health and Safety Executive and the Coroner. A large number of requirements regarding the safety of residents were made. We have visited the home to interview staff and to monitor the process of compliance. The home was fully co-operative with this investigation and has taken steps to rectify the shortfalls identified however some issues remain of concern and further requirements have been made. Brockfield House Nursing Home Version 1.10 Page 15 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 and 26 Some progress is being made in improving the standards of the premises however the removal of food debris in the dining room needs further attention to improve the standards of cleanliness. EVIDENCE: The company have submitted plans to make extensive changes to the premises to improve them and better met the standards. Following the making of previous requirements regarding the premises an action plan detailing timescales for the introduction of changes has been submitted to us. This will be monitored during the inspection process. A new doorway has been made between the entrance hall and the dining room and decoration has taken place in both areas. The curtains have been removed and dry cleaned in the dining room and were waiting for re-hanging. The main areas of the home were viewed and seen to be clean with the exception of the dining area. Remnants of foodstuffs were seen on the floor in Brockfield House Nursing Home Version 1.10 Page 16 the dining room that attracted flies. A number of flies were evident in the communal areas including the office. The manager was aware of the concerns at the weekend raised by agency staff which resulted in the emergency service being called to the home. The manager said that flies are plaguing the home at present with this was a problem in the whole area. There was no evidence provided that identified any action being taken to address this issue. Brockfield House Nursing Home Version 1.10 Page 17 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 and 30 The home has made little progress in the recruitment of staff and continues to lack sufficient permanent care and nursing staff. Therefore by necessity there is an over reliance on agency staff. As highlighted elsewhere in this report this deficiency impacts on the delivery of quality care to residents. EVIDENCE: Also see evidence under standards 7 – 11, 12- 15, 16 – 18 and 31 - 38 The level of staffing meets the staffing level set by the regulation authority for nursing care that is a minimum of 1 staff member to 6 residents during the day and 1 staff member to 10 residents at night. Domestic and kitchen staff are employed. The premises are large and residents are located in several places in the home and many are highly dependent on staff for supervision and care therefore the minimum staffing levels need to be kept under review to ensure that residents needs can be met. The recent recruitment drive has not increased the level of permanent staff. A further process is planned. The number of qualified staff remains unchanged which has resulted in the manager providing the nursing cover on a regular basis. There is a shortage of qualified nursing staff therefore agency nurses are used to cover some nursing shifts. The registered persons need to consider the dependency and admission of residents where staffing levels have a large reliance on agency staffing. On the morning of the inspection 3 out of the 5 care staff on duty were agency staff. However the home does try to maintain a consistency of staffing by Brockfield House Nursing Home Version 1.10 Page 18 retaining the same agencies and the same staff in order to promote knowledge of the residents needs. A training plan has been developed to include the training of staff in first aid. Staff have received training in the safe practices of moving and handling residents and the use of equipment such as hoists. Brockfield House Nursing Home Version 1.10 Page 19 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 and 38, The lack of supernumerary time available to the registered manager has resulted in the home lacking leadership and oversight with a decline in the quality of care delivered. EVIDENCE: All see evidence under other standards. The registered manager is a registered nurse and has the experience necessary to manage the home. The lack of permanent nursing staff has resulted in the manager working more nursing shifts. The impact has been that managerial oversight has declined. Some examples of this are: 1. The limited development of care plans. 2. The lack of monitoring of the care delivery as identified by the care planning process. Brockfield House Nursing Home Version 1.10 Page 20 3. The chaotic medication system with poor recording of the administration of medication. 4. The failure to return the pre-inspection questionnaire by the due date of 31 March 2005 5. The developments made regarding previous requirements have not been sustained and this has resulted in further requirements being made. The registered persons have submitted action plans to address areas covered by previous requirements therefore some requirements will be reviewed at future inspections. There has been progress in developing the premises with the introduction of new door locks and some redecoration. Moving and handling practices have been observed and brought to the attention of the manager on previous inspections, consequently further equipment has been purchased and training provided to staff. A complaint made at the time of this inspection has reported that equipment is not used when inspectors are not present. Managerial oversight will be needed to ensure that staff continue to carry out moving and handling manoeuvres as per the homes policy. Brockfield House Nursing Home Version 1.10 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 1 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 1 2 2 2 x x x x x 2 Brockfield House Nursing Home Version 1.10 Page 22 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 7and 8 Regulation 12 (1)(a) and (b) Requirement You are required to ensure that all service users have been risk assessed in relation to pressure area needs and the necessary preventative aids are supplied and in use. (Detailed in the enforcement notice issued 19 April 2005.) You are required to ensure that any service user identified at nutritional risk is referred to the appropriate professional for advice and, where necessary, treatment and that instruction provided to staff regarding the management of that risk is evidence and carried out. (Detailed in the enforcement notice issued 19 April 2005.) Care plans and risk assessments must reflect the assessed and current needs of the service user and detail the actions required of staff. (Timescale had not elapsed at the time of inspection.) Care plans and risk assessments must be used as a working tool to guide the provision of care. (Timescale had not elapsed at the time of inspection.) A notification of the receipt of a Version 1.10 Timescale for action 28 April 2005 2. 7 and 8 12 (1)(a) and (b) 28 April 2005 3. 7 12(1)(a) and (b) 13(4)(c) and 17(3)(a) 12(1)(a) and (b) 13(4)(c) 37 15 April 2005 4. 7 15 April 2005 5. 7 17.00 Page 23 Brockfield House Nursing Home 6. 7 12(1)(a) and (b) and 13(4)(c) 13(2) 7. 9 8. 12 and 17 12(1) 9. 12 and 17 12(1) 10. 26 23 11. 12. 26 27 23 18(1)(a), 12(1)(a) and (b) and 13 (4)(c) 12(1)(a) and (b) 13. 30 pressure mattress and its use for the named service user must be made to the Commission detailing the date of use and the type of mattress in use. (This was an immediate requirement) Service users must have a risk assessment detailing the level of supervision and monitoring they required throughout the 24-hour period. (Previous timescale 14 March 2005 not met) All medication must be administered as prescribed by the service users GP with any reasons for omission being recorded on the MAR sheet or the service user plan. (This was an immediate requirement) The internal security arrangements must be reviewed to ensure that both the health and safety and human rights of service users are protected. (Previous timescale of 01 February 2005 not met.) Any resrictions placed on the human rights of service users must be accompanied by individual risk assessment. (Previous timescale of 01 January 2005 not met.) Consultation with environmental health department must be undertaken to put strategies in place to remove the plague of flies. The food debris in the dining room must be cleared after each meal Staffing levels and deployment must be based on the requirements of the service user risk assessment. (Previous timescale 14 March 2005 not met) The staff must be aware of who the designated First Aider is on Version 1.10 hours on 06 April 2005. 30 May 2005 18.00 hours on the 06 April 2005. 30 May 2005 30 May 2005 30 May 2005 30 May 2005 30 may 2005 04 March 2005 Page 24 Brockfield House Nursing Home 14. 30 18 15. 30 18 16. 30 18 17. 37 and 38 12(1)(a) and (b), 13(4)(c), 17(2) schedule 4(16) 12(1)(a) and (b) 18. 37 and 38 19. 16, 33 22 each shift and their role in an emergency. (This requirement was covered by an action plan and was not reviewed.) Staff left in charge of the home must be competent in dealing with an emergency. (This requirement was covered by an action plan and was not reviewed.) Staff left in charge of the home must be able to communicate clearly with the emergency services. (This requirement was covered by an action plan and was not reviewed.) A plan of staff training must be submitted to the Commission that covers the person centred approach to dementia care and the provision of activities that are meaningful for people with dementia. There must be clear procedures in place for the management of a medical emergency, which are understood by staff. (This requirement is covered by an action plan and was not reviewed.) Systems must be in place to ensure that staff understand the homes policies and procedures. (Timescale had not elapsed at the time of inspection.) The complaint procedure must be updated with the details of the correct Commission and be in a format easily accessible to the service users 04 March 2005 04 March 2005 30 May 2005 07 March 2005 15 April 2005 30 May 2005 Brockfield House Nursing Home Version 1.10 Page 25 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 Brockfield House Nursing Home Version 1.10 Page 26 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB 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. 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