CARE HOMES FOR OLDER PEOPLE
Brockshill Woodlands Briar Walk Oadby Leicestershire LE2 5UF Lead Inspector
Fiona Stephenson Unannounced Inspection 23rd November 2005 09:30 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 Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 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. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Brockshill Woodlands Address Briar Walk Oadby Leicestershire LE2 5UF 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) 0116 2716014 0116 2716014 Prime Life Ltd Mrs Sylvia May Wright Care Home 30 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (30) Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. No one falling within category MD(E) may be admitted into the home where there are 5 persons of category MD(E) already accommodated in the home. Only persons falling within category OP may be accommodated in the 2 single bedroom bungalows situated in the grounds of Brockshill Woodlands. Double Bedded Bungalow No persons to be admitted to the double bedded bungalow situated in the grounds of Brookshill Woodlands unless they are an established co-habiting couple, or have an established friendship/relationship, prior to being accommodated in the bungalow. Double Bedded Bungalow Persons in the double bedded bungalow situated in the grounds of Brockshill Woodland may only be admitted under categories OP, and DE(E). A maximum of 1 persons falling within the category DE(E) may be accommodated at any one time. 20th June 2005 4. Date of last inspection Brief Description of the Service: Brockshill Woodlands is a residential care complex for up to 30 older persons, some of whom have physical disabilities or mental health needs. The registration includes a large detached house and three self-contained bungalows. The house has communal areas on the ground floor, including two large lounges, a through lounge and a dining room. Bedrooms are on the ground and first floor. To the rear of the home is a secluded garden, which is wheelchair accessible. The bungalows are for older people who are semiindependent. The complex is situated near the centre of Oadby in Leicestershire. Off-road parking is available for visitors. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Wednesday 23rd November between 09:30am and 1:00pm. It was conducted by one inspector and was the second statutory inspection of the home this year. The inspector focused on the outcomes for residents living at the home, and to do this she case tracked the care of three residents living at Brockshill Woodlands. This means that their care records were checked, they were spoken with, and their relatives where possible, and staff supporting their care were also talked with. The inspector focused on the standards not checked during the previous inspection, although other standards were covered again during the course of this inspection. What the service does well: What has improved since the last inspection?
The hallway and through-lounge have been re-decorated to make the area lighter and brighter for residents who enjoy using the lounge. The dining room has also been re-decorated and this again provides a more pleasant atmosphere for residents when eating their meals.
Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 6 Staffing has been reviewed and care staff, now have more time to spend with residents supporting their care needs. The manager informs the inspector that new garden furniture will be available to residents in the spring, which will be more comfortable, thereby encouraging residents to use the garden. Staff are now encouraging residents to sign their care plans to acknowledge that they understand them and agree with them. Management have provided training in medication administration and have supervised all staff in this area to ensure that medication is administered and recorded appropriately. Management have ensured that the window restrictor on the first floor window that was not in operation at the last inspection, is now being used, and that the side gate to the garden is secure to ensure that residents are kept safe. What they could do better:
The recently delivered armchairs for the double bungalow could be changed for armchairs that are more likely to meet the needs of older people. The home could consider changing the bell at the front door to ensure that residents whose bedrooms are near to the door are not being annoyed by the tunes being played each time the door bell is rang. The company could consider revising the new Statement of Purpose by not using abbreviations, to ensure that potential residents are aware of what training such as NAPPI and COSHH means. The manager could consider whether it might be more effective to remove the carpet from the bedroom identified as having an unpleasant odour, to remove the odour from the room. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 7 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. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 8 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 Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 9 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): 1,2,4,5,6. Prospective residents have sufficient information to make an informed choice about where to live. EVIDENCE: The inspector checked the files of the residents who were case tracked for the inspection. Within the files there were contracts, and needs assessments and they all received a statement of purpose. Through discussion with the Manager, the inspector noted that good care is taken to ensure that the needs of the potential resident are clearly identified, to ensure that the home can meet their needs. The inspector spoke with one visitor to the home who was very involved in placing his relative in the home, and spoke highly of the process and the care she had subsequently received. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 10 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): 9,10,11. Resident’s health and social care needs are well supported by staff at the home. EVIDENCE: The manager informed the inspector that additional training had been provided to all staff to ensure that there was effective management of medication, and that staff were being supervised to ensure standards of administration remain high. Residents spoken with were very happy with staff and felt their dignity and privacy was well respected by them. Visitors also informed the inspector that they were very satisfied with what they saw on their visits, and felt that staff treated residents well. During the inspection the inspector observed residents privacy being supported. The manager also showed records to the inspector to demonstrate they had followed up the recommendation from the last inspection to ensure the wishes of residents in relation to death and dying were recorded where appropriate. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,15. Resident’s social, emotional and religious needs are well supported at Brockshill Woodlands. EVIDENCE: The inspector arrived at the end of breakfast time and was pleased to note that not all residents were dressed for breakfast. The residents themselves decide whether they want to be dressed when having breakfast or whether to stay in their nightwear. Visitors were made welcome during the inspection, and the inspector was also informed of the activities residents undertake outside of the home. For example one resident goes to her church regularly. The inspector spoke with one resident who likes to play cards with another, and who expressed a wish to play dominoes. The manager said she would get dominoes for her. There is also a programme of trips out from the home, and the manager has arranged for the residents to attend a school Christmas concert, to go to a local pantomime for Christmas, and has organised a residents Christmas party. Residents spoken with were satisfied with the food they received. The manager informed the inspector that they have changed the breakfast menu and teatime menu to make them more appetizing. The dining room has recently been re-decorated and is a much more pleasant environment for residents to eat in. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 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): 17 The legal rights of residents are protected. EVIDENCE: The inspector was informed that residents had the opportunity to vote either through postal voting or through attendance at the local voting station. She was also informed that representatives of two political parties visited the home to talk with residents. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 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): 19,20,23,24,25,26. Residents live in safe, comfortable surroundings. EVIDENCE: The inspector checked the communal living areas; the bedrooms of residents who were case tracked and also looked at other bedrooms when talking with residents, and found all areas of the home to be in a very clean and tidy condition. One bedroom, although clean and tidy, did have an unpleasant odour. The manager thought it was coming from the carpet, and said that the carpet is regularly cleaned however the smell is not eliminated from it. Residents have their own personal possessions around them in the bedrooms. New décor in the hallway, through lounge and dining room improved the home by making it lighter and brighter. The inspector visited one of the newly registered bungalows but was not satisfied with the two armchairs that had recently been delivered as they did not have head support and the design may make it difficult for residents to move from a sitting to a standing position. The manager had not been responsible for the furniture that had been delivered and had not seen it prior to the inspection.
Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 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): Not checked on this occasion. EVIDENCE: Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 15 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): 31,32,34,35. The manager has created an open and transparent approach that has vastly improved the quality of care provided to residents. EVIDENCE: The manager has a staff team that are working effectively to support her in her aims of delivering high quality care to residents living in the home. The manager has provided staff with good supervision, and training opportunities in all aspects of care at the home, but in particular training relating to Dementia care. She ensures that relatives are kept fully informed about the care residents receive. One relative spoken with at the inspection informed the inspector that ‘Sylvia keeps me fully informed about …’s condition’. The manager is also very responsive with health and social care professionals who work with residents living at the home. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 16 The Prime Life head office is responsible for issuing contracts, however copies are kept in the residents files. Small money transactions are also documented and the inspector noted records kept of these transactions. The company does not have power of attorney over any residents living at Brockshill Woodlands. Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 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 Standard No Score 16 X 17 3 18 X 3 3 X X 3 X 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 4 4 X 3 3 X X X Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 18 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. 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. 2. 3. Refer to Standard OP24 OP26 OP19 Good Practice Recommendations Ensure the armchairs provided to residents living in the bungalows are suitable to meet the needs of older people. Ensure the unpleasant odour from the resident’s bedroom identified during the inspection is eliminated. Consider ways in which the residents and staff at the home can be alerted to visitors at the door, which minimise distress or disturbance to those whose bedrooms are near the front door. Revise the Statement of Purpose by explaining the abbreviated information e.g. NAPPI, to enhance the reader’s understanding of the information. 4. OP1 Brockshill Woodlands DS0000001814.V257279.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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