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Inspection on 09/11/05 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 9th November 2005.

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

The service users spoken to were very complimentary about the staff. The comments made included `very good` and `absolutely marvellous`. Another said `The staff are lovely and I have no complaints`. Relatives generally felt that they can approach the manager to discuss their concerns and that she deals with them promptly. The lady who visits with her `Pat dog` said that she had visited for six years and has always been made welcome by the staff who are all very friendly. She said that staff would always listen to her when she went to them with problems on behalf of service users.

What has improved since the last inspection?

Terms and condition documentation has now been issued to all service users, however not all have been signed as yet. The assessment procedure has been reviewed and the one examined for the most recent admission to the home contained comprehensive information. Care planning within the home has improved in some of the units. This must be extended throughout the home. Medications are now being managed to an acceptable standard. Some of the staff have now received training in the policies and procedures to follow when dealing with abuse.

What the care home could do better:

All service users should sign the statement of terms and conditions document to confirm that it has been explained to them and that they understand the service that they are entitled to receive. Although it is acknowledged that there has been some improvement in the assessment and care planning documentation, further work is required throughout the home to demonstrate that service users have been consulted with regard to their care and to ensure that all of their needs are met. Not all staff have received training in abuse. This must be addressed. Additional NVQ (National Vocational Qualification) level 2 staff training must be provided. To ensure the safety of staff, laundry facilities should be reviewed.

CARE HOMES FOR OLDER PEOPLE Brockwell Court Care Home 9 Cobden Street Consett Durham DH8 6AH Lead Inspector Mrs Sue Lowther Unannounced Inspection 9th 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 Brockwell Court Care Home DS0000000703.V261121.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. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brockwell Court Care Home Address 9 Cobden Street Consett Durham DH8 6AH 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) 01207 501851 01207 501864 Alliance Care (Trendlewood) Limited (wholly owned subsidiary of Four Seasons) Care Home 75 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (59) of places Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Named Individuals 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. Two staff members must be nominated to be key workers and associate 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. 16th May 2005 2. Date of last inspection Brief Description of the Service: Brockwell Court Care Home is a purpose built home located in the centre of Consett. It is within easy reach of the shops, library and town centre amenities. The home provides care for older people offering 24hr general nursing care to those service users who require this level of care. The home also caters for those people who require residential care and there is a unit specifically for older persons with dementia. Accommodation is on two floors with a lift available for easy access to the second floor. All of the bedrooms are single and there are a range communal sitting and dining areas available. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. By law we have to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this obligation. The inspection took place over 7 hours, on the morning and afternoon of Wednesday 9th November 2005. 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 were assessed during the last inspection of the home. The inspector looked around the building and a number of records were examined. 12 service users, 6 visitors, the manager, 8 members of staff and one visitor from the ‘Pat Dog’ scheme were spoken to. What the service does well: What has improved since the last inspection? Terms and condition documentation has now been issued to all service users, however not all have been signed as yet. The assessment procedure has been reviewed and the one examined for the most recent admission to the home contained comprehensive information. Care planning within the home has improved in some of the units. This must be extended throughout the home. Medications are now being managed to an acceptable standard. Some of the staff have now received training in the policies and procedures to follow when dealing with abuse. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 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. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&4 Admissions to the home are well managed. Service users receive appropriate information about the home and their needs are assessed prior to admission. EVIDENCE: Service users have now been issued with terms and conditions documentation but not all have been signed to confirm that they understand the service that they are entitled to receive. All service users are assessed prior to coming into the home. In addition to care manager assessments the registered manager normally visits the service user in their current place of residence. She advised the inspector that she would sometimes take another person with her if she feels this is needed. If she is on holiday this would be done by one of the qualified nurse and care where appropriate. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Individual care plans are in place, but some require more comprehensive information to ensure that all care needs are appropriately met. EVIDENCE: 8 care plans were reviewed during the course of this inspection. Although it is acknowledged that progress has been made to update and regularly review care plans in some parts of the home, some still require further information. Evidence is required to confirm that service users and their relatives have been consulted and have agreed to their plan of care. The Registered Manager had a plan in place to address this and said that she would provide this to the inspector. The medication records were examined and were found to have improved. The home now has systems in place to ensure that audits are regularly made and appropriate action taken should an issue arise. Service users spoken to confirmed that their dignity is respected and that staff will knock before entering the room. The home has policies and procedures in place with regard to death and dying. No issues were raised with regard to this. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Meals are of a good standard and service users are offered a choice. EVIDENCE: Whilst standards 12 & 13 were not fully assessed 4 service users sitting together in the foyer were very excited to tell the inspector about the recent party they had to celebrate the 10th anniversary of the opening of the home. They had also enjoyed going out shopping the day before and one of them invited the inspector to see her clothes that she had purchased to wear on Christmas Day. Another service user had recently been on holiday with one of the carers and was also keen to talk about this. Service users’ nutritional needs are considered and recorded in care plans. The menus are rotated on a four weekly basis. They are devised by the company but can be adjusted to meet personal choice. The cook is provided with examples of alternatives she can use so as not to affect the nutritional content. Service users spoken to confirmed that there is a choice available. The meal at lunchtime was observed. It was noted that there was a relaxed atmosphere and that service users requiring help were given this in a discreet manner. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 11 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): 16 & 18 Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed on the home’s notice boards and in the home’s ‘Service Users Guide’. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents / Family meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. The home, through its parent company has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. A record is kept of all complaints made by service users or representatives or relatives of service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint. Company policy and procedure documents relating to adult protection provide information and guidance to staff. However, all staff require training in abuse and the procedures to follow. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the key standard areas were assessed during the course of this inspection. They were assessed at the last inspection. EVIDENCE: Although none of these standards were assessed during the course of this inspection, one service user wanted the inspector to see her room saying ‘Please look at my room it’s lovely’. The inspector this service users room was comfortable and contained many of her own possessions and met her needs. The location of the laundry has been reviewed but it has not been relocated as yet. It is kept locked and is therefore not a danger to service users. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the service users currently accommodated. EVIDENCE: From discussions with management and staff, and from an examination of duty rosters, sufficient staff are employed within the home. For staffing purposes, the home’s waking day runs from 8 am to 8 pm. On morning shifts, 1 qualified nurse and 10 care assistants are rostered throughout the home. Where service users’ needs increase, staffing levels are adjusted to provide an additional carer. On afternoon shifts, 1 qualified nurse and 9 care assistants are rostered throughout the home. After 8 pm, staffing levels are: 1 qualified nurse and 6 care assistants throughout the home. Although these staffing levels should be kept under review, they are considered adequate to be adequate to meet the needs of the people currently accommodated. Recruitment procedures within the home, and through the parent company are safe. Records confirm that CRB (Criminal Records Bureau) disclosure checks are carried out for all staff. Applicants for employment complete an application form and 2 references are obtained. A reference from the last employer is requested, plus another; any gaps in employment are explored at interview. Each member of staff receives a contract of employment and a job description. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 14 Although some difficulties have been experienced accessing training, staff training is being given a high priority. Core training such as in First Aid and Moving and Handling is arranged, along with other courses such as continence and catheter care. Nevertheless, excluding qualified nurses only 17 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. Although it is acknowledged that staff have recently started NVQ and others are to enroll, a minimum ratio of 50 of staff (excluding the registered manager and other qualified nurses) must be trained to NVQ Level 2 or equivalent by 2005. Brockwell Court Care Home DS0000000703.V261121.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, 33 & 38 Brockwell Court has appropriate quality assurance systems are in place to identify and rectify any concerns. EVIDENCE: The registered manager is a registered general nurse. She has previously managed another home with the same company and therefore is aware of the corporate policies and procedures. She advised the inspector that the management course she is currently undertaking is due to be completed shortly. Service users’ views are obtained through daily contact and an ‘open door policy’. Similarly, the views of family and significant others are also obtained. Staff meetings and residents meetings’ are held as additional forums to discuss any concerns or potential difficulties. Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 16 Quality assurance systems operating in the home ensure that the home runs smoothly. Routine audits, for example relating to health and safety are carried out and any issues raised are rectified. Records required by regulation to be kept within the home are to a good standard. Appropriate systems are in place to ensure service users’ health and safety is protected. For example, risk assessments relating to the use of bed rails in the home have been carried out and any safety measures required have been implemented. The manager advised the inspector that the company have reviewed the laundry facilities and have plans in place to relocate this. Brockwell Court Care Home DS0000000703.V261121.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 X 2 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 3 Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? YES 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 OP2 Regulation 5(1)(b) Requirement All service users or their representative must sign the statement of terms and conditions document to confirm that they understand the service that they are entitled to receive. Care plans formulated for all service users. These must be reviewed on a regular basis (at least monthly). (Previous requirement-timescale of 30/09/05 unmet. Excluding the Registered manager and Registered Nurses, a minimum ratio of 50 of care staff must be trained to NVQ Level 2 or equivalent by 2005. The registered manager must complete obtained an appropriate management qualification. Timescale for action 28/02/06 2 OP7OP8 14(1,b) 15(1&2) 17 Sch2 18 28/02/06 3 OP30 31/12/05 4 OP31 9 31/12/05 Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brockwell Court Care Home DS0000000703.V261121.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Darlington Area Office 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 DS0000000703.V261121.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!