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Inspection on 16/05/05 for Brockwell Court Care Home

Also see our care home review for Brockwell Court Care Home for more information

This inspection was carried out on 16th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

What the care home does well

Some of the staff were described as being very friendly, thoughtful, caring and good at interacting with service users. Several service users commented that the new acting manager ensures their needs are attended to promptly.

What has improved since the last inspection?

The majority of the carpets, which were identified as problematic at the last inspection, have now been replaced.

What the care home could do better:

The home has not had a registered manager in place for some considerable time. The acting manager, who has only been in post for a few weeks, has made an application to be registered with the CSCI. The acting manager must ensure that the service users are issued with their terms and conditions of residency. Assessment and care planning was inconsistent. This must improve in some areas so that staff know what to do for each service user. Medication procedures must be reviewed to ensure that an accurate audit trail can be undertaken. Staff must be employed correctly so that people living in the home are protected. Staff training must be reviewed to ensure that all staff are competent and trained to do the job for which they are employed.

CARE HOMES FOR OLDER PEOPLE Brockwell Court Care Home Gladstone Street Consett County Durham DH8 6AQ Lead Inspector Susan Lowther Unannounced 16 May & 15 & 22nd July 2005 th th 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. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brockwell Court Address Gladstone Stret Consett County Durham DH8 6AQ 01207 501851 01207 501864 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) Alliance (Trendlewood) Limited (wholly owned subsidiary of Four Seasons) CRH 75 Category(ies) of OP (59) registration, with number DE(E) (16) of places Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate individuals as set out in a letter to the registered person dated 8 April 2003, which establishes the basis on which the individuals needs will be met by the home. Where necessary the homes Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else other than the named individuals who fall outside the registered categories. 2. Two staff members must be nominated to be key workers and associated key workers for those 3 named individuals in the category of LD(E). They must receive appropriate training specific to learning disabilities unless they have relevant experience and have previously received appropriate training. Date of last inspection 7th December 2004 Brief Description of the Service: Brockwell Court Care home is a purpose built home in the centre of Consett. It is within easy reach of the shops, library and town centre amenities. The home provides care for older persons offering 24 hr general nursing care to those service users who require this level of care, residential care and a unit specifically for older persons with dementia. The home offers single room accommodation with communal sitting/dining areas. There is a varied and active social and recreational programme available for those who wish to participate.\ Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. CSCI has a statutory duty to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this duty. The inspection took place on the 16th May 2005, between the hours of 9.30am and 4.30 pm, the 15th July 2005 between the hours of 1.30pm and 4.30pm, and the 22nd July 2005 between the hours of 2pm and 3pm. Records were examined and a tour of the building took place. Time was spent talking to service users, staff and relatives. The requirements in the previous inspection report of the home were the main focus of this inspection. The majority of these remain outstanding. However the acting manager, who had only been in post for a few weeks, was aware of these and had an action plan in place to address them. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. What the service does well: Some of the staff were described as being very friendly, thoughtful, caring and good at interacting with service users. Several service users commented that the new acting manager ensures their needs are attended to promptly. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 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 Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 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) 1-5 Information is given to prospective service users to help them make an informed decision about moving into Brockwell Court. However there is still no statement of terms and conditions available to service users. The company are aware that this issue has been outstanding for some considerable time. Appropriate assessment procedures are in place but these needs to include more information about peoples mental health, psychological and physical needs to ensure that the home can meet the needs of service users. EVIDENCE: Copies of the Statement of Purpose and Service User Guide were available in the reception area of Brockwell Court along with copies of the home’s most recent inspection reports. Discussion with the acting manager indicated that all service users will be assessed before admission, to ensure that Brockwell Court is able to meet their needs and that relatives and people who may wish to move into the home can visit prior to making that decision. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 9 Individual records are kept for each service user and those inspected contained care management assessment and an assessment carried out by the home. Brockwell Court does not provide intermediate care, therefore the assessment of Standard 6 is not necessary. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 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 standard(s) 7, 8 & 9 Individual care plans are in place, but little progress has been made since the last inspection about the requirement that these should be much more comprehensive to ensure that all care needs are appropriately met At the time of this inspection medication was not always being managed correctly, with some practices considered to be unsafe. EVIDENCE: Evaluation of care plans were inconsistent as to when this was undertaken and where this had been done the information was often very limited. The acting manager said that she was in the process of auditing all of the care plans. The plans contained written evidence of input from other professionals and each service user is registered with a local General Practitioner. During the inspection it became evident that the recording and administration of drugs was not always being managed correctly and was therefore a Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 11 potential risk to the health and wellbeing of service users. There were gaps in the medication recording sheet and the inspector was unable to establish whether these drugs had been given or not. On another sheet the reason a drug had not been given was because the home had run out of stock. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13&14 Service users are encouraged and assisted to make a choice about their care and how they wish to spend their day. EVIDENCE: Service users spoken to confirmed that their friends, family and representatives can visit at times that are convenient to them and are welcomed into the home by the staff. There is a weekly programme of activities and regular visits by external entertainers. Three resident’s confirmed that when they do not wish to participate in the organised group activity, staff will try to spend time with them on an individual basis Details of how to access advocy services were displayed in the foyer. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 The home has a procedure for the protection of vulnerable adults, however not all staff were aware of this. The home could therefore not ensure that the people living there are protected from abuse. EVIDENCE: Several staff spoken to had not attended training in the Protection of Vulnerable adults and were not aware of the procedure to follow. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 14 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) 19,20,22,23,25 &26 Brockwell Court was purpose built and therefore meets the needs of the people who live there. The home is safe and well maintained for service users. EVIDENCE: Brockwell Court was purpose built and meets the room sizes as stated in the National Minimum Standards. There are a number of spacious sitting and dining areas available throughout the home, with the upper level being reached by a passenger lift or stairs. The grounds are pleasant and suitable for wheelchairs. During the tour of the building and whilst talking to people in their bedrooms, the inspector saw that service users could bring in their own furniture and belongings should they wish to do so. There was a range of specialist equipment seen around the home and bathrooms were noted to be appropriately equipped. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 15 During the tour of the building, the inspector found the building to be clean, tidy and free from offensive odours. The laundry area continues to pose a risk to the staff that work in the home. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 16 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) 28,29 &30 The home has a recruitment procedure which had not always been followed and therefore do not offer protection to the people who live there. Staff training required updating in some areas. EVIDENCE: The staff files of three members of staff were viewed. One had no written references and another had been recruited without the appropriate CRB check. The acting manager who was new in post had identified this problem and brought this to the attention of the inspector. She confirmed that an action plan was in place to address this. As previously stated, some staff require training in the Protection of Vulnerable Adult Procedures. Training records were seen to confirm that NVQ training is ongoing. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 17 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) 35&38 The acting manager has a clear development plan and vision for the home, which she has effectively communicated to staff and service users. Robust procedures are in place for the safe keeping of service users money. EVIDENCE: The acting manager has previously managed another home in the area and has application to the CSCI to be the Registered Manager of Brockwell Court. This is currently being processed. Individual records examined for money held in the home on behalf of service users were up to date and accurate. Records were in general up to date with the exception of care plans. The acting manager was able to demonstrate that as far as is reasonably practical the health and safety of service users is maintained. However as previously stated the laundry area poses a potential risk to staff as it is down several stairs. Health and safety records inspected were current and up to date. Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x 3 3 x 3 3 STAFFING Standard No Score 27 x 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x 3 x x 2 Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 19 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 OP 2 Regulation 5(1)(b) Requirement The home must ensure that each service user is provided with a statement of terms and conditions (or a contract if purchasing their care privately) at the point of moving into the home. Previous requirement timescale of 31/03/05 unmet. Comprehensive assessments must be undertaken upon admission and be reviewed on a regular basis (at least monthly). Previous requirement-timescale of 31/03/05 unmet. Comprehensive service user plans of care must be drawn up with service user involvement. These must cover all areas outlined in the regulations. Wherever possible care plans should be agreed and signed by the service user and / or their representative. Prevous requirement-timescale of 31/03/05 unmet. An adequate supply of medications for all service users must be maintained at all times. A full and accurate record must be maintained of medication receipt, administration and Timescale for action 30/09/05 2. OP 4 14(1)(b), 15(1) & Schedule 2 15(1)&(2) 30/09/05 3. OP 7 & 8 30/09/05 4. OP 9 13 & 17 31/08/05 Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 20 disposal. 5. OP 18 12(1)&13( All staff training must receive b) training with regard to The Public Disclosure Act and Department of Health Guidance as contained within “No Secrets – Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse”. 18 & Excluding the Registered Schedule Manager and Registered Nurses, 2 a minimum ratio of 50 of staff should be trained to NVQ Level 2 or equivalent by 2005. 18,19 & Staff records must include all Schedule documentation outlined in this 4 regulation. 13 & 16 An urgent review of the laundry facilities must be undertaken. Previous requirement-timescale of 31/03/05 unmet. 31/10/05 6. OP 28 31/12/05 7. 8. OP 29 OP 38 31/07/05 30/12/05 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 Good Practice Recommendations Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Brockwell Court Care Home B54 S703 Brockwell Court V219849 160505 Stage 4.doc Version 1.30 Page 22 - 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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