Inspection on 29/12/09 for Brockshill Woodlands

This inspection was carried out on 29th December 2009.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brockshill Woodlands 04/03/10

Brockshill Woodlands 01/03/10

Brockshill Woodlands 19/08/08

Brockshill Woodlands 22/11/07

Brockshill Woodlands 03/01/07

Brockshill Woodlands 23/11/05

Brockshill Woodlands 20/06/05

Brockshill Woodlands 26/11/04

Brockshill Woodlands 09/09/04

Brockshill Woodlands 25/03/04

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Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 28/03/2010.

Key inspection report Care homes for older people Name: Address: Brockshill Woodlands Briar Walk Oadby Leicestershire LE2 5UF     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Debbie Williams     Date: 2 9 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Brockshill Woodlands Briar Walk Oadby Leicestershire LE2 5UF 01162716014 01162716014 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Prime Life Ltd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Brockshill Woodlands care home is registered to provide personal care to male and female service users who fall within the following categories: Old age, not falling within any other category (OP) 30. No one falling within category MD(E) should be accommodated at Brockshill Woodlands when there are already five persons of the category MD(E) accommodated in the home. No one falling within the category of DE(E) should be accommodated in Brockshill Woodlands when there are already 27 persons accommodated under the category of DE(E). No persons should be accommodated in the double-bedded bungalow situated in the grounds of Brockshill Woodlands unless they are an established co-habiting couple, or have an established friendship/relationship, prior to being accommodated in the bungalow. Care Homes for Older People Page 4 of 28 Over 65 27 5 30 0 0 0 Only persons falling within the category OP should be accommodated in the two single bedroom bungalows situated in the grounds of Brockshill Woodlands. Persons should only be accommodated in the double-bedded bungalow situated in the grounds of Brockshill Woodlands under categories OP, and DE(E). A maximum of one person falling within the category DE(E) should be accommodated at any one time. The maximum number of persons to be accommodated at Brockshill Woodlands is 30. Date of last inspection Brief description of the care home Brockshill Woodlands is a care home providing personal care and accommodation for up to thirty older persons who may have additional needs, which may include Mental Disorder or Dementia. Accommodation comprises of the main care home and three self-contained bungalows; bedrooms are both single and shared. Parking for visitors can be found to the front of the home. Brockshill Woodlands is located in a residential area of Oadby. Communal areas consist of a dining room and three lounges, and are located on the ground floor, with access to the garden from the lounge to the rear of the home. Bedroom and bathing facilities are located on the ground and first floor. Information is located on site detailing the range of services offered, which includes the Statement of Purpose and Service User Guide. Copies of the Care Quality Commissions Inspections Inspection Reports are available by request at Brockshill Woodlands. The fees at Brockshill Woodlands range can also be obtained from the registered manager. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We visited the home on the 29th of December 2009. The main method of inspection used was case tracking which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. We also spoke with three other residents and two relatives. We checked all the standards which the Care Quality Commission have decided are key standards during this inspection. In some sections we have also checked additional standards, these will be detailed in the main report. Following our visit to the home, we received information which raised concerns about some care practices and some aspects of the management of Brockshill Woodlands. Care Homes for Older People Page 6 of 28 These concerns are being investigated by Leicestershire County Council, the Police and the Care Quality Commission, these investigations are not yet concluded. We are monitoring the actions of Prime Life Limited to address the concerns that have been raised with us. We will undertake a further key inspection of this service and issue an updated report within the next six months. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with the information they require to make an informed choice before moving in and have their needs assessed. Not all staff have received the training they require to meet peoples specialist needs. Evidence: A service users guide and brochure is provided to all prospective residents before they move in, this provides people with the information they require about facilities and services offered. We spoke with one person living at the home who told us they had visited the home before deciding to move in. Another person spoken with could not recall receiving this information, the manager said it had been supplied but ensured a further copy was provided. People have their needs assessed before moving in and this is to ensure the service Care Homes for Older People Page 10 of 28 Evidence: can meet their needs. The needs assessment is carried out by the registered manager. A trial period of four weeks is offered when people move in before they decide whether to move in permanently. We looked at assessment records of the people we case tracked. Assessments were detailed and included risk assessments. The service is registered to accommodate people requiring care due to old age, mental health needs and dementia. We looked at staff training records, not all staff had received training to care for people with mental health needs and dementia and some training had not been updated since 2008. We made a requirement about this. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Evidence gathered at this inspection suggested that the health and personal care needs of people living at Brockshill Woodlands are mostly met but that not all assessed needs were addressed within care plans or risk assessments reviewed. Evidence: We looked at care records for three people we case tracked. Care plans were comprehensive and addressed most assessed needs, some evidence was seen of people being involved in the care planning process where this was possible. Care plans included risk assessments such as risk of malnutrition and risk of developing pressure sores, however, risk assessments were not always reviewed and some risks identified had not been addressed by a care plan or by seeking appropriate advice. We saw evidence of people having access to health care services such as GPs and community nurses. People spoken with told us that staff would contact a GP as soon as they needed one. Following our inspection we received some information that alleged that there had been a delay in seeking medical attention for one person. This matter is being investigated. Care Homes for Older People Page 12 of 28 Evidence: We looked at medication administration records, practice and procedures. Records seen appeared accurate and up to date. Only three staff working at the home were responsible for managing peoples medication and they had received training for this. Five staff were in the process of completing medication training. An audit of medication procedures and administration is carried out by the registered manager twice a month, this ensures that medication policies and procedures are adhered to and that people are protected from harm. Interactions observed between staff and residents were positive, staff were friendly and helpful and residents appeared relaxed. Following our visit we received some information which alleged that some staff did not treat residents with respect and had been abusive to some residents, this matter is being investigated. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most people living at Brockshill Woodlands are given opportunities to participate in recreational and social activities that are meaningful to them. A wholesome and appealing diet is provided. Evidence: We spoke with four people living at the home who told us they could choose how to spend their day, what time to get up and go to bed or where in the home they wished to spend their time. People told us there were enough activities on offer to occupy them. Some residents were able to get involved in the day to day running of the home and helped out with domestic tasks such as setting tables or washing up in the kitchen. We observed some people moving freely around the communal areas of the home. Opportunities for participating in recreational and leisure activities were more limited for people who had more severe cognitive impairment. One person did not want their lunch on the day of this inspection, staff said they would offer them lunch later in the day. People told us they could have a snack or drink whenever they wanted one, one person was not sure if they could have a snack or drink during the night. Care records for one person stated that they went to bed before the night staff came on duty, the registered manager told us that routines of Care Homes for Older People Page 14 of 28 Evidence: daily living were flexible in order to meet peoples needs. We observed the lunch time meal during this inspection, the food served appeared appetizing and nutritious, people told us there was always a choice of meal. Food is cooked at a central kitchen away from the home and then re-heated by staff at the home. We looked at the kitchen and found this to be clean and well stocked with snack items such as bread, cheese, salad, fruit, cereal and tins of food. One person told us they did not like the food as the portions were too big. One person was observed struggling to see what was on their plate at lunchtime, a staff member came to their assistance when this was pointed out. We spoke with relatives who told us they were always made welcome at the home and usually offered a cup of tea. Following our visit to the home, we received information that alleges that people are not given a choice about when to go to bed at night or when to get up in the morning and that few opportunities were provided for people to participate in recreational activities. These matters are being investigated. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Since the last key inspection, the providers whistle blowing polices and safeguarding training have not been effective for some staff, therefore we cannot be confident that people living at Brockshill Woodlands are protected and neither can other agencies. Evidence: Following our visit to the home, we received some information that included allegations of physical and verbal abuse which are being investigated at the time of writing this report. Some staff have reported to social services and to the police their concerns about the care of people living at Brockshill Woodlands and the management of the service. People spoken with during this inspection told us they felt confident that they could approach the registered manager with any concerns and that she would take appropriate action. The providers have a complaints procedure which is given to people when they move into the home, this sets out the way the providers manage and investigate complaints. All staff receive training regarding complaints and safeguarding adults during their induction training and then go on to complete a distance learning course in safeguarding vulnerable people. The registered manager told us they intended to attend the local authorities safeguarding training and were waiting for a course to Care Homes for Older People Page 16 of 28 Evidence: become available. We have concerns about the effectiveness of the providers safeguarding training and whistle blowing policies. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comfortable and well maintained environment was provided which met the needs of people living at Brockshill woodlands. Evidence: The home is a converted older building with accommodation on two floors. There are two lounges and two dining areas. The entrance hall and lounges had recently been redecorated and refurbished. We looked at the private accommodation of people we case tracked. Private accommodation was personalized and contained the furniture and fittings required. One persons room was cold and the radiator was not working, the registered manager arranged for the company maintenance person to repair the radiator during this inspection. All areas of the home seen were clean and tidy. Staff had received training in fire safety and equipment such as fire alarms and fire fighting equipment were regularly checked and maintained in line with fire authority requirements. Ten of the fifteen care staff employed at the home had received training in infection Care Homes for Older People Page 18 of 28 Evidence: control. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all staff had received the training they required to meet the needs of people living at Brockshill Woodlands. People were protected by the providers recruitment policies and procedures. Evidence: We looked at staffing rosters and spoke with people about staffing numbers and staff training. People told us there were enough staff on duty and they did not have to wait for staff to attend to them. The registered manager told us that staffing levels at night had recently been increased from two to three staff. Following our visit to the home we received Information that alleges that staff were not provided with moving and handling training. This matter is being investigated. Staff training records were seen, not all staff had attended training in caring for people with dementia or mental health needs. Mandatory health and safety training had been provided but for some staff this had not been updated since 2008. Information sent to us in the providers annual quality assurance assessment stated that seven care staff had achieved a National Vocational Qualification in care. A staff training and development programme was ongoing. All staff were provided with induction training when they first commenced working at Care Homes for Older People Page 20 of 28 Evidence: the home. A personnel audit had recently been completed, this means that all staff files were checked to ensure they included all relevant checks and references. We looked at staff files and found them to include these checks, this ensures that people working at the home are suitable to do so. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Following our visit to the home and while the information we received is being investigated, it may be the case that the home has not been run in the best interests of people living there. Evidence: The manager is registered with the Care Quality Commission and has completed a National Vocational Qualification level 4 in care and is due to commence a Management and Leadership Award. People spoken with during this inspection told us they could approach the registered manager with any concerns and felt confident she would take appropriate action. However, information we received following this visit questions the conduct and ability of the registered manager, these matters are currently being investigated. A quality monitoring system was in place and this included seeking the views of people living at Brockshill Woodlands and their relatives. Audits were carried out on medication, staff recruitment procedures and risk assessment. A senior manager visits Care Homes for Older People Page 22 of 28 Evidence: the home on a monthly basis to carry out a quality assurance audit, records of these were seen. Small amounts of money can be kept securely for people living at Brockshill Woodlands. Records are kept of all transactions regarding peoples personal money and two signatures are obtained, this minimizes the risk of financial abuse. Health and safety training was provide to all staff members and this included training on safe moving and handling, fire safety, food hygiene, infection control and first aid. For some staff, health and safety training had not been updated since 2008, we made a requirement regarding this. Information sent to us in the providers Annual Quality Assurance Assessment confirmed that all routine maintenance and safety checks had been carried out, this minimizes risk for people living and working at Brockshill Woodlands. Records were seen of accidents and incidents that had occurred at the home, however, the information we received following this visit alleges that not all accidents or incidents had been recorded or responded to appropriately, this is being investigated. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 4 18 All care staff should receive 12/01/2009 training in caring for people with dementia and mental health needs. This is to ensure that all staff have the skills to meet the needs of people living in the home. (Original Time Scale 30/11/08) 2 8 13 People living at the home must have their risk of malnutrition assessed and their weight recorded and monitored. This is to ensure that people at risk of malnutrition are identified and referred to the appropriate healthcare professional to receive the appropriate treatment. 15/02/2009 Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 14 Care plans must be in place for all assessed needs. care plans and risk assessments must be updated on at least a monthly basis. This is to ensure that people have their needs met and are protected from harm. 12/02/2010 2 12 12 People living at Brockshill Woodlands must be given opportunities to participate in recreational and social activities that are meaningful to them. In particular, people with more advanced cognitive impairment must be given these opportunities. This is to ensure that people experience a fulfilled lifestyle that matches their expectations. 26/02/2010 3 15 12 Staff must ensure that appropriate assistance is given when required during 08/02/2010 Care Homes for Older People Page 25 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action mealtimes. advice should be sought from appropriate health care professionals such as dietitians or occupational therapists. This is to ensure that people receive a nutritional diet that meets their preferences and are assisted in an appropriate and sensitive manner. 4 18 13 People living at Brockshill 10/02/2010 Woodlands must be protected from abuse. Robust procedures for responding to suspicion or evidence of abuse or neglect must be in place and followed by all staff members. This is to protect people from harm. 5 30 18 All staff must receive the the 26/03/2010 training they require to meet the needs of people living at the home. This must include training for caring for people with dementia and mental health needs. All mandatory health and safety training must be updated on an annual basis. This is to ensure that people living at Brockshill Care Homes for Older People Page 26 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Woodlands have their needs met and are protected from harm. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 18 The registered manager and other senior staff should attend the local authorities safeguarding adults training. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. 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