Inspection on 02/08/05 for Bromson Hill Nursing Home

This inspection was carried out on 2nd August 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

Bromson Hill Nursing Home 15/08/08

Bromson Hill Nursing Home 17/08/07

Bromson Hill Nursing Home 14/02/07

Bromson Hill Nursing Home 07/02/06

Bromson Hill Nursing Home 15/02/05

Similar services:

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 Bromson Hill Nursing Home Ashorne Warwick Warwickshire CV35 9AD Lead Inspector Paul Appleyard Unannounced 02 August 2005 09:30 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. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bromson Hill Nursing Home Address Ashorne Warwick Warwickshire CV35 9AD 01926 651166 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) Alpha Health Care Limited Mrs Judith Mary Corless Care Home 34 Category(ies) of OP Old Age - 65 Years and over (34) registration, with number of places Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 15 February 2005 Brief Description of the Service: Bromson Hill is a converted manor house, which has been extended to provide accommodation for 34 elderly service users who may require nursing care. The home is situated in the Warwickshire countryside close to Ashorne Village.The mainly single accommodation is provided on two floors with access via passenger lifts or stairs. The home’s décor and furnishings are to a high standard and are domestic and homely.The home has established and well maintained gardens, which are accessible to all residents including those who may require wheelchair access.Alpha Health Care Ltd is the current owner having acquired this home in November 2004. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and is the first of two inspections to be conducted this year. A tour of the premises was undertaken, looking at all communal areas, bedrooms and service areas, such as the kitchen, lounges, bathrooms and bedrooms. Six residents’ care plans were examined which gave an overview of the care prescribed and delivered, these records also contained information as to how any identified health care needs were being met. Records related to staff recruitment were examined along with records related to the upkeep and maintenance of the home. Medication administration and records related to this area were also seen. Six staff, 10 residents and one relative were spoken to. What the service does well: Residents spoken with said that they are well treated by the staff and that the staff are kind and treat them with respect. It was reported that the nurses are knowledgeable and provide a high level of nursing care. Residents said that relatives are made very welcome at home. The activities co-ordinator provides a wide variety of activities that the residents appear to very much enjoy. The layout allows care to be delivered in spacious surroundings with residents benefiting from country views and communal areas that are bright and airy. Meals are varied and home cooked, being nicely presented and offering choice and variety. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 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. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 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 Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 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) 3 The assessments completed by registered manager or her deputy at the home, prior to residents moving in, ensure that residents’ personal, health and social care needs can be met by the staff working at the home. EVIDENCE: The initial assessments of the last three residents to move into the home were reviewed. The layout allows all relevant information to be collected and thus enable the registered manager to make the decision if the residents’ needs can be met. Each resident’s care plan is written using the information from the initial assessment. Visits to the home often take place prior to admission. One resident was currently spending a month at the home with a view to a permanent move. Bromson Hill nursing home does not provide intermediate care but does on occasions provide short stay respite care. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 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, 9 and 10 Residents are treated with dignity and respect and although some individual care plans do not accurately reflect the resident’s current care and support needs these needs are generally being met. EVIDENCE: A number of care plans were inspected and found to contain information needed for staff to ensure care needs are met. Since the last inspection the manager has introduced clear risk assessments for nutrition, falls, care dependency and pressure area risk. It was noted in several of the care plans that reviews had not been undertaken sine June 2005. Many of the residents were spoken to by the inspector, both in groups and privately. All were happy with the care provided and stated they were well looked after. Comments such as “the care is smashing” and the “girls are delightful and helpful” were reported. Throughout the day it was observed that there is an extremely good rapport between staff and service users with general observation of care practice supporting service users’ views that staff treat them with respect and understanding. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 10 Staff knock on residents doors before entering and all personal and health care needs are met in the privacy of the residents room. Policies and procedures are in place for the safe handling and administration of medication with improvements in recording made since the last inspection. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 11 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 and 15 Meals provided are varied and offer a balanced diet for residents. Arrangements and management of mealtimes are well organised and present no obvious risks to the safety, well being and comfort of residents. The current arrangement for activities and entertainment provide adequate recreation or motivation for residents. EVIDENCE: Lunch was taken in the main dining room with the inspector sitting at a table with four residents. A choice of three courses was offered and over five deserts offered. The meal was of an extremely high standard and was nutritious and tasty. All residents spoke highly of the food and choices offered. During discussions with residents it was stated that on the whole activities were satisfactory but some residents would like to go out more often. The activities are displayed in the lounge area, on posters and in a monthly newsletter. Three residents stated that they particularly liked the indoor bowls and tennis. Other recent events included a trip to a local country park and a strawberry tea. A falconry display was held at the home recently with one relative writing to the manager stating “ a lovely treat for the residents and relatives. We are so appreciative of all the effort that goes into the activities programme, so a very big thank you”. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 12 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 Procedures are in place to ensure that complaints are handled in a structured manner within clear timescales and an objective response is made. EVIDENCE: The written complaints procedure is in the statement of purpose and service users guide. Residents spoken to knew who to speak to if they were unhappy or wanted to make a complaint. All of the relatives spoken to knew how to make a complaint. A number of minor concerns have been logged with evidence of swift resolution by the homes staff noted. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 13 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) 19,24 and 26 Residents are encouraged to bring in personal items for their rooms to make them feel more at home. All residents have access to all parts of the home and grounds including wheelchair users. The home is clean and hygienic in residents’ areas but potential risks to health were identified at the front of building EVIDENCE: The home is spacious with a number of sitting areas for residents including conservatories that face the homes court yard. Many of the bedrooms were visited during the inspection. It was noted that many of the service users have made their rooms very homely and taken the opportunity to personalise rooms with items from home or their family. Two resident reported that this made her feel more at home. Residents reported that the home is always very clean and tidy with no smells or “dirty, dusty areas”. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 14 The interior of the home is well maintained. It was noted that areas at the front of the home by the main front door are cordoned off due to failing masonry and the potential of further falls. This must be assessed with immediate effect and appropriate repair made. Access to the home is not compromised with a second entrance to the home used by all staff residents and visitors. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 15 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 and 29 Staffing levels were in sufficient numbers and skill mix, with indications that residents’ needs were being met appropriately. The procedures for the recruitment of staff are not robust. Appropriate pre employment checks are not being carried out or evidenced in the home thus potentially leaving residents at risk. EVIDENCE: The registered manager is presently recruiting staff with a good response. Staffs spoken to report they are happy to work at Bromson hill and many have worked at the home for several years. Service users spoken to said that the staff were usually available to meet their needs and also had plenty of time to talk with them although a couple felt that more staff could be employed. During the visit it was clear that all residents needs were being met promptly and appropriately. The staff file of most recently appointed member of staff was reviewed and indicated that not all necessary recruitment checks to ensure the protection of service users have been completed. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 16 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 and 36 Procedures are in place to manage residents’ monies and valuables so their interests are safeguarded. Most care staff receive support and guidance from the registered manager or trained nurses, this needs to be developed to include all staff and be structured around development and training needs, so safeguarding the health, safety and welfare of the service users. EVIDENCE: The policy of the care home is not to handle residents’ money or valuables with this being the responsibility of relatives, advocates or the resident. Systems are in place for providing support and supervision to care staff but currently this is not being provided on a regular basis. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 17 The registered manager does walk round the home everyday and speak to each service user and observe staff providing care. All care staff should be supervised at least six times a year. Residents spoken with reported that staff were very good at caring and knew what they were doing. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 2 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x 3 2 x x Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 19 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 36 Regulation 18 Requirement Timescale for action 30.11.05 2. 29 19 3. 7 15 4. 19 13 All care staff must receive regular supervision covering all aspects of practice, philosophy of care and career development needs. The Registered Manager must 30.9.05 ensure that all pre-employment checks are obtained prior to staff starting work. Residents care plans must be 30.9.05 reviewed on a regular basis and evidence of of any reviewed recorded by staff. The registered person must have 31.8.05 a survey of the building and roof area where masonry has been falling. This must be undertaken by a qualified person and findings actioned immediately. 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. Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 Page 20 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Bromson Hill Nursing Home E53 S62186 Bromson Hill Nursing Home V240880 020805 Stage 4.doc Version 1.40 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!