CARE HOMES FOR OLDER PEOPLE
Bromfield House Residential Care Home Ltd 316 Minster Road Minster on Sea Sheerness Kent ME12 3NR Lead Inspector
Graham Cummings Unannounced 19/07/05 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. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Bromfield House Residential Care Home Ltd Address 316 Minster Road, Minster on Sea, Sheerness, Kent, ME12 3NR 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) 01795 873018 Mr Malcolm Paul Jackman Teresa Oakey Registered Care Home 10 Category(ies) of Care Home for Older People registration, with number of places Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 01/03/05 Brief Description of the Service: Bromfield House is a large detached property providing accommodation on two floors. The home is a registered residential service, providing care and support for up to 10 Adults over the age of 65, 7 rooms have en-suite facilities. The home is owned by Mr Paul Jackman and Mrs Teresa Oakey is the Registered Manager. The home employs a team of 11 care staff and 1 domestic worker. The home is located on the Isle of Sheppey, in the small town of Minster on Sea. It has local amenities close by. Bromfield House has comprehensive policies and procedures, and a transparent culture, which underpin the rights, fulfilment, dignity, privacy, independence and choice of the service users who live there. The home has a passenger lift to assist with any mobility difficulties of the Residents. The home has a gravelled parking area at the front of the house that can accommodate up to 10 cars. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Graham Cummings carried out the unannounced inspection on the 19th July 2005. The Inspector arrived at 09:25 and left at 13:45. The Inspection was carried out through discussion with the Manager Theresa Oakey, and owner Mr Paul Jackman, looking through 2 Resident files and 2 staff files, speaking to 2 Residents and a member of staff, viewing documentation and looking around the home. The initial feeling on entering the home was that it was caring, clean and homely. The Manager had a previous appointment that meant she was not available for the whole of the inspection but was available for the beginning and end of it. The Care plans and daily recordings were all found to be detailed and informative of how the Resident was feeling and what they had done during the morning or afternoon shift. The staff files were complete and contained all of the requirements set out in Schedule 2 of the Care Homes Regulations 2001. The Residents spoken to were positive about the care they received, one stated that ‘I’m very happy here’ and ‘I have everything I need’. The staff member said she was ‘very happy working at the home’ ‘the manager was approachable and listened to staff input on care issues’. The Inspector left the premises with no concerns for the care or safety of the Residents living at Bromfield House. What the service does well:
The home has a welcoming and friendly feel to it The homes care plans were detailed and would enable a new staff member to carry out the care of a Resident with minimal assistance. Throughout the inspection it was apparent that staff were aware of their duties and responsibilities and that morale was good. The Inspector noted that Residents rooms were spacious, well decorated and personalised. Staff training was discussed and the Inspector was given a copy of staff proposed and completed training, there are currently 5 staff completing their NVQ level 2 in Care, 2 already have NVQ2 and 1 staff has a City and Guilds qualification in care. The Manager has completed her NVQ4 and Registered Managers Award and is also got the NVQ Assessors qualification. The residents contact with family and friends was evidenced during the Inspection with one Resident going out with a family member for lunch and another resident had 3 or 4 visitors arrive to see them. A hairdresser also came to the home for the benefit of those wanting their hair done. The homes recruitment process was full and complete and individual staff supervision was being carried out. The menu book was seen and showed that Residents were given a healthy and nutritious diet, the inspector noted that entries were made for each individual resident and that individual likes and dislikes were catered for. The home provides good activities for the Residents including bringing in singers and groups for birthdays and celebrations.
Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 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. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 Prospective Residents have the information needed to make an informed choice about where to live. Residents pre placement assessments have been carried out. EVIDENCE: The homes Statement of Purpose and Service User Guide are up to date and contain the relevant information as laid out in Schedule 1 of the Care Homes Regulations 2001. The Inspector looked through 2 of the Residents files and found detailed pre placement assessments on file. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9, Residents health, personal and social care needs are met. Residents health care needs are met. No Resident self medicates. EVIDENCE: The Inspector looked at 2 of the Residents care plans. Each care plan set out their likes and dislikes, daily routine, medical and medication information and needs, personal care requirements, mobility and risk assessments. All of the Residents are registered with a local G.P. None of the Residents living at the home self medicate and none suffer from diabetes. The wording on one of the monitoring forms regarding a Residents behaviour needs to be more explicit in it’s description, the Manager said this would be changed within 24 hours, the form was understood by staff and management and was being used effectively. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15 Residents find the lifestyles experienced meets their need. Family and friends visit Residents. Residents are able to exercise choice and control over their lives and receive a wholesome and appealing diet. EVIDENCE: Residents wherever possible are encouraged to live their lives in the way they want, they make arrangements to see family, the layout of their rooms, the clothes they wear and the activities they attend. One of the Residents spoken to said that they ‘were very happy at the home’ and that they ‘had everything they needed’, another Resident said that the food was very good’. The Inspector whilst looking through the daily notes saw that on the previous day, Monday 18th July that a Resident had stated that they did not like Lamb steaks which was on the menu for lunch, when the Inspector looked at the menu book the entry had been altered to show that the Resident had been offered sausages instead. The Inspector also noted that the menu showed that when potatoes were on the menu each Resident had their choice of mashed, boiled or chipped. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 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 standard(s) 18 Residents are protected from abuse. EVIDENCE: The home has on display in several areas a whistle blowing and complaints policy that is accessible to staff, Residents and visitors. Out of the total staff group of 14 which includes the manager and provider 9 staff have attended an Adult protection training course within the last year, including the Domestic member of staff, 2 staff are due to attend a course in August 2005. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25,26 Residents live in a safe well maintained environment and have access to comfortable indoor and outdoor communal facilities. Residents have access to sufficient lavatories and washing facilities. Specialist equipment is available to maximise independence. Residents rooms are of a good size and comfortable surroundings with their own possessions around them. The home is clean, tidy and hygienic EVIDENCE: The home was clean and tidy throughout, the Residents rooms were of a good size and well decorated, one of the rooms has just been upgraded to have an en suite facility and where the sink had been removed from the bedroom it required some redecoration, furniture had been placed in front of it until the work is completed. Seven of the rooms now have en suite facilities and the home is looking at ways for the last 3 rooms to also have en suites. The bedrooms are on the ground and first floors and there are ample communal bathing and toilet facilities. Staff have their own toilet facilities. The Residents rooms viewed were all personalised and had good quality furniture. The home has a hoist and wheelchairs that assist the Residents with their mobility.
Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 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 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) 27,29,30 Residents needs are met by the number and mix of staff. The homes recruitment policy supports and protects Residents. Staff are trained to a competent level. EVIDENCE: The Inspector was given a training matrix of staff qualifications and booked training courses, this showed that the home places a high importance on giving staff the skills to provide a high standard of care. The matrix showed that since June 2004 two staff have completed their NVQ level 2 in care and five staff are presently completing the same training. One member of staff has a City and Guilds qualification in care. Nine staff have attended Adult Protection training and two further staff are booked in to attend in August 2005. Nine staff have attended Medication and Administration training and ten staff had completed the Moving and Handling course. Staff had also attended courses on Loss and Bereavement, Food Hygiene, Health and Safety, Dementia and Understanding Challenging Behaviour in the last year. The matrix shows that there is a need to carry out Fire prevention training in the near future. The Inspector looked at two staff files and found that these contained all of the requirements set out in Schedule 2 of The Care Homes Regulations 2001. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 14 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) 31,33,36,37,38 The Manager has a clear vision for the home, which she has effectively communicated to the Service Users, staff and stakeholders. The home is run in the best interests of the residents. Staff are appropriately supervised. Residents rights and interests are safeguarded by the record keeping and policies and procedures. The health, safety and welfare of Residents are promoted and protected. EVIDENCE: The Manager is supported well by the Provider in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The staff member spoken to told the inspector that ‘the Manager listens to staff input on care issues’ ‘the Manager is approachable and supportive’. It was clear to the Inspector on looking through the care plans, daily notes, speaking to Residents and staff and observation that the home was run in the best interests of the Residents. The Inspector had no concerns regarding the health, safety and welfare of the Residents.
Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 15 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x 3 x x 3 3 3 Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 16 No 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 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. Refer to Standard 24 30 Good Practice Recommendations The wall in the Residents bedroom where the sink had been removed and placed in an en-suite facility needs decorating. That staff should attend a Fire Safety training course in the near future. Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Bromfield House Residential Care Home Ltd H56-H05 S23922 Bromfield House V237123 190705 Stage 4.doc Version 1.40 Page 18 - 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!
