Inspection on 04/08/05 for Brocklehurst Nursing Home

This inspection was carried out on 4th August 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brocklehurst Nursing Home 15/04/08

Brocklehurst Nursing Home 17/04/07

Brocklehurst Nursing Home 31/10/06

Brocklehurst Nursing Home 11/02/06

Brocklehurst Nursing Home 09/01/05

Brocklehurst Nursing Home 15/07/04

Brocklehurst Nursing Home 05/02/04

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

CARE HOMES FOR OLDER PEOPLE Brocklehurst Nursing Home 65 Cavendish Road Withington Manchester M20 1JG Lead Inspector Les Hardy Unannounced 4 August 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. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brocklehurst Nursing Home Address 65 Cavendish Road Withington Road Manchester M20 1JG 0161 448 1776 0161 448 1776 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) Anchor Trust Responsible Individual - Jane Rachel Ashcroft Cathryn Todd Care home with nursing (N) 40 Category(ies) of Old age, not falling within any other category registration, with number (OP) (40) of places Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 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. Date of last inspection 9 January 2005 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 F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was carried out on a Thursday, started at 7.15 pm and lasted for 7 hours. During the inspection, 16 residents, 2 visitors and 9 staff were spoken with whilst the inspector walked around the home. The improvement necessary from the the previous report had been actioned by the home and met. The 3 recommendations from the previous report have also been actioned. 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 the previous and any future reports. What the service does well: What has improved since the last inspection? Bedrooms are now fitted with locks for which residents can have a key, but which staff can override in an emergency. This means that residents can have privacy and extra security if they wish. The temperature of hot water at taps in the home is now maintained at a safe temperature and checked regularly. This will prevent residents being accidentally scalded. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 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 F55 F05 s21635 Brocklehurst V242864 D040805 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 Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 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) 3 By undertaking assessments prior to admission, the home ensured that they had the skills available to provide the care the residents required. EVIDENCE: Prior to admission residents were assessed both by the referrers and a Senior Nurse from the home. The full assessments obtained were used to write the care plan required by standard 7 (see next section). Residents admitted for care with nursing were also assessed for funded nursing care by NHS staff trained to do so. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 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 and 10 The home gave good individual care. Generally good care planning and medication management could be enhanced by attention to detail across the home. Good care is delivered to residents who are made to feel they are individuals. EVIDENCE: All residents had concise care plans that covered their assessed needs. Risk assessments were undertaken as appropriate and these were also used to contribute to the care plans. All assessments and records were kept in the resident’s room, the care plans and daily record being kept separately in three units, the care plans were kept with the other records on the fourth unit. It is recommended that the care plans be kept in the same location in all the units to avoid confusion and staff new to a unit not being able to locate plans. This will ensure that assessed care is given to residents uniformly across the home. Care records were still found to be left unattended in corridors. Ensuring this did not happen was a` requirement in the last report. This is reiterated and will ensure that records are not read by inappropriate or removed by unauthorised persons. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 10 Staff knew the needs of residents, how these needs could be met and possessed the skills to meet them. The home had links with specialist nurses, for areas such as continence and tissue viability, employed by the local NHS Primary Care Trust and the home used them to input to residents care as needed. The home ordered new prescriptions for residents, signed these as their agent and then sent them to the pharmacist for dispensing. When the medicines were received these were checked against a check sheet and if correct the receipt recorded on the Medicine Administration Record (MAR) Chart. Administration was recorded on the MAR. Gaps in the MAR where nurses recorded either the administration of a drug or a reason why it was omitted were evident on one unit. This put residents at risk of not receiving drugs or receiving drugs inappropriately. The Manager must ensure uniform good practice in recording administration across the home. Residents were treated as individuals by staff that knocked before entering rooms and carried out treatments behind closed doors. As residents said “They treat me as a person.” Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 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) EVIDENCE: None of these standards were assessed at this inspection Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 Regular discussion with residents and relatives normally prevented concerns being complaints. Staff awareness of adult abuse should prevent any incident that did occur being unreported. EVIDENCE: The home had a complaints procedure. All complaints were logged and investigated. There had been 1 complaint direct to the home this year and this had been dealt with appropriately. There had been no complaints direct to CSCI. Residents and relatives said that if they had concerns they would and had refer them to senior staff who “will deal with our concerns appropriately and resolve them”. The regular reviews held between the resident, their key worker, and involved relatives was seen as a good way of resolving problems. As one relative said, “the reviews are very good at ironing out concerns on either side.” The home had an adult abuse policy and staff were aware of what action they would take in the event of observing suspected abuse. The Anchor Organisation also has a confidential telephone hotline that can be used to report suspected abuse. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 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 standard(s) 19,24,25 and 26 The home is well maintained, clean and a safe environment offering a good standard of accommodation, which is fit for purpose. The provision of locks to bedroom doors means that residents can now choose the level of privacy they require. EVIDENCE: The home has its own handyman who maintained the building appropriately and dealt with minor matters when they were raised with him by staff or residents. Since the last inspection locks have been fitted to all bedroom doors which means that residents now have a choice over whether they lock there door or not if following assessment they are shown as capable of handling keys. This is of particular importance when residents bring in their own possessions into the home, which they are able to do. The accommodation is well furnished and the accommodation is suitable for the residents living there. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 14 The home is naturally well ventilated. The baths were found to be delivering hot water at a safe temperature; the handyman checks this regularly. As a final safety check a bath thermometer is used by staff to ensure that the temperature of the water is safe for the resident. The home was odour free and kept very clean. Staff were aware of infection control principals. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) EVIDENCE: None of these standards were assessed at this inspection. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 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 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) 33, and 35 The feeding back to residents of the main findings from the annual audit process helps them to hear how they think the home is doing and responding to their comments. The procedures for handling small amounts of money were satisfactory. EVIDENCE: The home undertakes an annual audit, using a corporate Anchor Homes tool, which because it is large, is undertaken over the course of a year. This tool includes taking views from residents and is feed back to them at the end of the year. The home did not look after the financial affairs of any resident, but kept small amounts of money if asked for everyday expenditure. These monies were found to reconcile with records kept. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 17 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x 3 x x 3 x 3 x x x Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 18 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 7,14 Regulation 17 Requirement The registered manager must ensure that all care records are kept securely. (Previous timescale of 01/04/05 not met). When medicines are given the Medicine Administration Record must be signed. If the medicine was omitted the record must show the reason why. Timescale for action 01/10/05 2. 9 13(2) 01/10/05 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 7 Good Practice Recommendations Care plans should be kept in the same location on each unit to avoid confusion. Brocklehurst Nursing Home F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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 F55 F05 s21635 Brocklehurst V242864 D040805 Stage 4.doc Version 1.40 Page 20 - 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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