Inspection on 12/07/05 for Brompton House Nursing & Retirement Home

This inspection was carried out on 12th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brompton House Nursing &... 23/06/08

Brompton House Nursing &... 27/03/07

Brompton House Nursing &... 05/01/06

Brompton House Nursing &... 19/01/05

Brompton House Nursing &... 12/05/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE BROMPTON HOUSE Station Road Broadway Worcestershire WR13 7DE Lead Inspector Nick Richards Unannounced 12 July 2005 - 12:30 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. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brompton House Address Station Road Broadway Worcestershire WR13 7De 01386 853473 01386 853808 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) BUPA Care Homes Limited Miss Amanda Jane Francis CRH 45 Dementia - over 65 Old age Physical disability - over 65 43 45 45 Category(ies) of DE(E) registration, with number OP of places PD(E) BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19 January 2005 Brief Description of the Service: Brompton House is a care home providing accommodation, personal care and nursing care for up to 45 older people.The home is owned by BUPA Health Care, and the registered manager is Ms Amanda Francis. The home is located on the outskirts of the village of Broadway and within reasonable walking distance of the high street, which provides a range of shopping facilities.The home is a large converted house, and was first registered under the Registered Homes Act 1984. Accommodation for service users is provided on the ground and first floor, and all the bedrooms are single occupancy, with en-suite facilities. Access to the first floor is gained through either a staircase or through the use of a central passenger lift (for residents who are mobility impaired). There is parking at the front of the house, a courtyard garden to which a number of ground floor rooms have access and a good-sized garden at the rear of the house. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours, and was carried out to assess how the home was addressing the requirements from the previous inspection, to establish how effective care was during the afternoon period and to find out what residents thought about the service being provided by the home. A tour of the premises took place and staff and care records were inspected. Five staff on duty and six residents were spoken to. What the service does well: What has improved since the last inspection? What they could do better: Further attention could be provided to the management of medication (insulin and controlled drugs), and care plans could be further developed. By further developing recording, residents welfare and protection can be further enhanced. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 6 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. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.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 BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.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) 1,2, 3, 4 and 5 Good progress had been made to improve the admission procedure to ensure that there is a proper assessment prior to people moving into the home. This helps to ensure that care needs can be met. EVIDENCE: The admission procedure was satisfactory to guide staff on the actions to be taken to ensure that new residents’ needs are properly assessed and planned for. Individual records are kept for each of the residents, and inspection of the records for three residents had full assessment information recorded. Staff members on duty were spoken to, and knew about the care needs of the three residents. Residents and one visiting relative who were interviewed all said that they felt that the home was effectively meeting care needs. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 9 The homes Statement of Purpose and Service User Guide are satisfactory – providing residents and prospective residents with details of the services the home provides, enabling an informed decision about admission to be made. The home does not contract to provide intermediate care, therefore Standard 6 is not applicable to the home. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 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 and 10. Significant progress has been made on improving arrangements to ensure that the health care needs of residents are identified and met. These improvements help to safeguard the health care needs of residents. EVIDENCE: Individual plans of care are available, and progress has been made to ensure that all aspects of health, personal and social care needs are identified and planned for. Most plans were detailed, up to date and had been regularly reviewed. However, some plans required further development to make sure that care needs were met correctly. Significant events in the home had been recorded, daily entries into case records had been made and entries available gave an indication of the actual care given. Residents spoken to were happy to confirm that their care needs were being met by staff within the home in a dignified and respectful way. Staff were seen providing care sensitively and discretely to residents, and discussions with staff confirmed that they were aware of residents’ care needs, and how the care was to be provided. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 11 The homes medication records were examined, and were being managed well. The registered manager was ensuring that medication records were being audited regularly to make sure they were being completed correctly. The homes prescription and controlled drugs were examined. These were, generally, being managed effectively, but greater care was needed on the stock control of insulin (which was in abundance) and with the recording into the home of controlled drugs. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 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 and 15. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. Social, recreational and leisure activities are being developed to enhance residents’ quality of life, and residents are able to maintain contact with family and friends. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it was and that they welcomed the daily choices offered. Menus were inspected and found to be balanced and interesting and meal time arrangements are also flexible enough to accommodate individual preferences. Catering staff have a detailed knowledge and understanding of individual residents’ dietary preferences and requirements. During the inspection, some relatives were seen visiting people, and staff greeted visitors politely. Residents spoken to said that they could receive visitors at any time of the day, thereby maintaining links with family members. Residents confirmed that there were “no restrictions” on visiting. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 13 An Activities Organiser is employed within the home, and activities are specific to the likes, dislikes, tastes and preferences of residents. On the day of inspection a group of residents were on a day trip to Weston-Super-Mare. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 14 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) 16 and 18. Complaints are handled objectively and residents are confident that their concerns will be listened to, taken seriously and acted upon. A vulnerable adults procedure is available to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a simple and clear complaints procedure, and the complaint records indicated that this is followed. A copy of the complaints procedure had been given to all residents, and was available to visitors and relatives. Residents spoken to were confident that concerns could be raised with the home. A procedure for responding to allegations of abuse is available. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 15 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 and 26. Investment within the home continues to ensure that a high environmental standard is maintained, creating a comfortable and safe environment for those living there and visiting. EVIDENCE: BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 16 The bedrooms are all single occupancy with en-suite facilities. Communal toilets and bathrooms are available throughout the home. Separate lounge and dining room facilities are provided within the home. Systems were in place for the management of infection control, and the home was clean, tidy and free from offensive odours. Some corridor carpets were marked due to extensive use, but the registered manager said that the carpets were to be replaced soon. Each bedroom seen had been furnished with residents’ personal possessions, thereby generating ownership and a sense of autonomy for individuals. The standard of the environment within the home is good, providing residents with an attractive and homely place to live. Residents confirmed that they appreciated the physical environment. Hot water temperatures have been risk assessed and had been regulated to prevent people being accidentally scalded when they have a bath, and radiators had been guarded and restricted to prevent people being accidentally burnt through intentional or unintentional contact All the windows located above first floor level had been restricted to prevent people from being injured through falling out of the windows (accidentally or deliberately). The home employs a “handyman” who undertakes maintenance and decorative work to a very high standard. Since the time of the previous inspection, the central garden area has been successfully landscaped and an activities area has been created within the main lounge. Residents and their next-of-kin were observed enjoying the garden area at the time of inspection. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 17 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, 28, 29 and 30. Staffing levels and competencies are suitable to ensure that residents’ needs are identified and effectively met. EVIDENCE: There were suitable nursing and care staff on duty to provide care and support for the people who were resident in the home at the time of inspection. In addition to nursing and care staff, there were also ancillary staff on duty to support service provision. During the visit, call bells were activated, and staff responded speedily to them. The duty rotas confirmed that the staffing levels were stable, with little evidence of staff being absent through short-term sickness. Training has been provided to staff, and includes infection control, first aid and moving and handling. Training was identified as a result of the needs of residents, to ensure that care delivered was appropriate to and in response to the needs of residents. Many staff had undertaken and completed National Vocational Qualification Level 2. Residents said that “staff are splendid”, were “very nice” and “care is good”. One resident said “(They’re) absolutely excellent, can’t praise them enough”. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 18 BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 19 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, 32, 33 and 38. There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The registered manager is competent and appropriately qualified and experienced to manage the service. Staff and residents spoke very highly of her, and significant diligence and action has been undertaken to maintain and further improve the quality of the service provided by the home since the time of the previous inspection. Residents clearly expressed their opinion that the home was being run in their best interests. Staff were being supervised in a positive manner. The home is undertaking regular quality assurance exercises on various aspects of the homes functioning to ensure that (a) quality is maintained and BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 20 (b) to improve standards whenever possible – thereby enhancing residents’ quality of life and well-being. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 21 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 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 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x 3 BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 22 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 7 Regulation 15 Requirement All care plans must effectively and clearly provide instruction and guidance to care staff in a manner that is easily understandable. Replace all fatigued corridor carpets. Timescale for action Immediate and ongoing 31/12/05 2. 26 16 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 9 9 Good Practice Recommendations Greater attention should be paid to the amounts of insulin retained within the home. When controlled drugs are received within the home, nursing staff should physically count and record the quantities received within the controlled drug register. BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 23 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Droitwich Road Worcester WR3 7NW 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 BROMPTON HOUSE E52 S4099 Brompton House V239123 120705.doc Version 1.40 Page 24 - 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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