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Inspection on 11/02/06 for Brocklehurst Nursing Home

Also see our care home review for Brocklehurst Nursing Home for more information

This inspection was carried out on 11th February 2006.

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

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 home provides a safe caring environment for its residents. As one resident said, this is my home and the staff are my friends. Brocklehurst staff provide good nursing care to a very dependent group of residents in a well maintained and furnished, modern setting. Care needs are well assessed and planned and delivered by knowledgeable staff who treat as one resident said "us all as individuals." The home had good pro-active means of dealing with residents and relatives/visitors concerns including regular planned reviews, which visitors said were a good place to discuss any concerns. Residents and visitors spoke highly of Christmas and New Year at the home, which had left a lot of positive memories. Good recruitment and training procedures ensure that good care is given by staff.

What has improved since the last inspection?

Staff now ensure that throughout the home the giving of medication is recorded correctly and that all records are securely kept.

What the care home could do better:

Ensure that all units give the same attention to detail to ensure that tubs of prescribed medication and equipment are securely kept.

CARE HOMES FOR OLDER PEOPLE Brocklehurst Nursing Home 65 Cavendish Road Withington Manchester M20 1JG Lead Inspector Leslie Hardy Unannounced Inspection 11th February 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brocklehurst Nursing Home Address 65 Cavendish Road Withington Manchester M20 1JG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 448 1776 0161 448 1776 Anchor Trust Ms Cathryn Todd Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of patients for whom accommodation is provided at any one time shall not exceed 40 patients of either sex over pensionable age 4th August 2005 Date of last inspection Brief Description of the Service: Brocklehurst is a purpose built care home of 40 beds providing care with nursing for people over the age of 60 years. The home is on two floors with a passenger lift between the two floors. It is situated in West Didsbury on the site of the old Withington Hospital. The home is situated on a reasonably busy road used by local traffic. The centre of West Didsbury is about a quarter of a mile away. Main roads giving ready access to Manchester and the motorway network are close by. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was carried out on Saturday 11 February starting at 11am and lasted for 3.5 hours. During the inspection, 17 residents, 10 visitors and 10 staff were spoken with whilst the inspector walked around the home. This gave a clear picture of a well run home, which was well maintained and had a warm atmosphere. The improvement necessary from the previous report were found to have been actioned by the home. During this inspection only a selection of key National Minimum Standards were assessed. Therefore, to gain the full picture of how the home meets the needs of residents, this report should be read with any previous reports. What the service does well: What has improved since the last inspection? Staff now ensure that throughout the home the giving of medication is recorded correctly and that all records are securely kept. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 6 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. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were assessed at this visit. EVIDENCE: Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 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 the following standard(s): 7 and 9 Care plans are kept secure and in uniform formats. The generally good medication practices were slightly let down by a small attention to detail in one unit. EVIDENCE: The previous inspection found a good level of care planning across the home, apart from finding that care plans were not kept securely or in uniform formats which could lead to records being accessible to anyone people or being removed from the unit. At this inspection it was found that this had been resolved with care records being held securely and uniformly. At the last inspection though medications practices were generally safe and satisfactory, gaps in the record where medications should be signed for or a record made of why a drug was omitted, could have put residents at risk. There were no gaps found in the record at this inspection. A jar of prescribed cream along with some medication dispensing equipment was found on a shelf in a bathroom. All prescribed medication must be kept securely locked and equipment must not be freely available as both these practices could put residents at risk. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents have control over their day, with a good number of activities available during the week and also a good supply of wholesome well-cooked meals served in a relaxed setting. Residents were able to stamp their own personality on their room. EVIDENCE: Residents stated that they were able to determine what time they got up in the morning, when they went to bed and how and where they spend their day. There is a lounge on each of the four units and also a main lounge and dining room. The home had a good programme of activities available Monday to Friday ranging from craft, to talking about past times, to sing-a-longs. There were no formal activities arranged at weekends but staff were seen engaged in one to one activities with residents and a small group of residents went to a local pub with staff. Visitors were seen in the home throughout the inspection and confirmed that they were not only able to visit when they wished, they were also made to feel welcome and said that they held the staff in high regard. The well-decorated rooms contained many items of resident’s personal possessions ranging from lots of pictures and photographs to bigger items of Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 11 furniture including dressing tables and tables. One resident used the pictures on display to tell the inspector about his past life. Residents spoke highly of the food served at Brocklehurst, which they could have either in the main dining room, one of the small lounges or their bedroom. Lunch served during the inspection consisted of home made shepherds pie and vegetables, and a number of other choices were available and the home catered for special diets required for medical reasons. The cook knew each residents particular needs and was seen discussing requirements with residents. Care staff encouraged residents to eat if necessary giving discreet assistance if required. Meal times were seen to be an enjoyable social activity. Staff were also heard to be aware of the need to encourage good fluid intake by residents and drinks were not only freely available but were also encouraged. This inspection took place 7 weeks after Christmas but it commendable to note that a resident and a visitor both commented on how wonderful it had been and the huge effort that staff had made to make the time very special. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this visit. EVIDENCE: Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this visit. EVIDENCE: Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Appropriate numbers of well recruited and trained staff ensured good levels of care EVIDENCE: The home was found to be staffing at least to the minimum level required by the staffing notice currently in force and levels were very frequently above this. The home had appropriate numbers of registered nurses and tries to ensure that, as required by these standards, they have at least 50 of carers with NVQ level 2 in care. At this inspection they had 35 with level 2 as a number of carers with the qualification had moved on, mainly into nurse training. A number of carers are due to complete the course shortly, which will take the figure over 50 again. Having appropriately trained nurses and carers on duty should ensure that residents continue to receive a good level of care The home has a training programme that details when each member of staff is scheduled/required to undertake mandatory training including manual handling and fire training. Staff confirmed attending these types of training. The programme also shows other training scheduled and when supervision will be undertaken. All care staff receive individual supervision 4 times year with group supervision in-between. The induction and foundation programmes used in the home, which are programmes developed by Anchor, and are being redeveloped in the light of recent National Training Organisation changes. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 15 The homes recruitment procedures ensure that required checks are undertaken before new staff commenced. This should ensure that resident’s are safeguarded from unsuitable people being appointed. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The home is well run by an experienced, well-trained manager with good systems in place to ensure residents safety. EVIDENCE: The manager who had worked at the home for 15 years is a registered nurse. She has the Registered Managers Award and also a Masters Degree in gerontology. She had a clear view of the need to continually develop care services and was well thought of by residents, visitors and staff, who all felt that they could approach her with problems to which a solution she would endeavour to resolve. The home had appropriate service contracts in place for equipment and installations used in the home. Servicing was undertaken at required intervals to ensure that they were safe to use. The manager had recently undertaken a health and safety course to enable her to increase her awareness of health and Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 17 safety issues. The home has its own handyperson who deals with day-to-day maintenance and keeps the home in good order. Safe working practice procedures are in place so that staff have relevant information on how they should be working to maintain a safe environment. Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X X X X 3 Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 19 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 OP9 Regulation 13(2) Requirement Prescribed medications and equipment must be stored in an appropriate locked cupboard. Timescale for action 01/01/04 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Brocklehurst Nursing Home DS0000021635.V283657.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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