Inspection on 28/04/09 for Bronswick House

This inspection was carried out on 28th April 2009.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 15 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bronswick House 04/08/09

Bronswick House 08/04/08

Bronswick House 11/10/07

Bronswick House 22/08/06

Bronswick House 27/09/05

Bronswick House 28/06/05

Bronswick House 19/10/04

Bronswick House 11/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bronswick House 16/18 Chesterfield Road Blackpool Lancashire FY1 2PP     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jacqueline Riley     Date: 2 8 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Bronswick House 16/18 Chesterfield Road Blackpool Lancashire FY1 2PP 01253295669 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Savitree Seedheeyan Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 14 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Additional conditions: 2 12 The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 14 Date of last inspection Brief description of the care home Bronswick House is registered to provide residential care for fourteen residents with a Mental health illness. The home is set on two floors with three residents rooms on the ground floor and ten on the first floor. There is one double room situated on the ground floor. There are no en-suite facilities. Care Homes for Older People Page 4 of 33 Brief description of the care home The first floor is accessed by three sets of stairs. There is assisted access to the first floor of the home, however most residents living on the first floor have good mobility. The home is situated in a residential area, and is close to the public transport network. There is a good transport network into town, and also local shops. A Statement of Purpose and Service User Guide is available providing information about the home. The information can be used by relatives/representatives to help them make an informed choice whether to move into the home. At the time of the site visit the range of weekly fees were £280 - £369. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A key inspection of the home was undertaken which included an unannounced visit to the service over a five hour period on 28th April 2009.. The registered manager post is currently vacant. We spoke to the registered owner acting manager, three staff members, and five people living at the home. There were no surveys received by us before the inspection telling us about the service, however comments we received from people during the inspection will be included in this report. We talked to people using the service, and asked about those peoples needs. We also looked at care plans, records, and daily notes for three people, this is called case tracking. As well as looking at records we looked around the home and talked to some Care Homes for Older People Page 6 of 33 people in their own rooms as well as communal lounges. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. This document is called Annual Quality Assessment (AQAA). We use this information, in part to focus on inspection activity. What the care home does well: What has improved since the last inspection? What they could do better: We found the lack of suitable pre admission information has resulted in staff having difficulties in meetings a persons needs. Information about a persons needs at the point of admission should clearly provide staff with what the presenting needs are and how they can be met. We found there have been no reviews of peoples needs taking place for a twelve month period thereby having the potential to have a negative outcome for the people living at the home. By not making records of incidents occurring, which may affect the health and welfare of people living at the home has the potential to put people at risk. For a two day period we found there had been no records made of what had occurred at the home affecting people who lived there. Risk assessments had not been reviewed or amended following two incidents which affected the well being of people who live at the home, having the potential to put them at risk. Whilst the medicines trolley has been put in place it should be securely bolted to the Care Homes for Older People Page 8 of 33 wall for security. We found there is a lack of co ordinated activities available to people living at the home which would provide a variety of activities to met the needs of people living at the home. Staff should be provided with more information and training to support the policies and procedures recently introduced for safeguarding people. We looked at the homes environment and found it requires decoration throughout most of the home. Individual rooms lacked good decoration or suitable furniture which must be in place to provide an acceptable standard of comfort. Lack of suitable fire precautions and equipment has resulted in posing risk to people who live and work at the home. A recent legal notice from the fire brigade means the home must improve all aspects of fire safety in the home. Lack of maintenance records means the home cannot monitor and manage how the environment is maintained. By not having working equipment in the shower room people living at the home may be disadvantaged. Poor decoration and equipment in the main bathroom has a negative impact on people using the facility. We found in one instance references were not available in the recruitment file. This has the potential to out people at risk if suitable recruitment procedures are not evident. By not having a suitable induction training programme staff may not be equipped with the knowledge and skills to carry out their roles. There should be ongoing training programmes for staff so that they can develop their knowledge and skills in meeting the needs of people living at the home. In order to confirm what training individual members of staff have received, training certificates should be in place on all staff training records. We found there is a requirement for there to be a competent and suitably qualified manager registered with the Care Quality Commission in order to manage the home on a day to day basis. Lack of records management means that the needs of people living and working in the home have not been met. We found there is no evidence of quality monitoring taking place which has the potential to have a negative impact in the development of the service. By not having evidence of monthly reports for visits undertaken by the registered provider, means that the management of the home cannot be monitored and reviewed. Care Homes for Older People Page 9 of 33 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessment planning information is limited having the potential for the staff to incur difficulties when meeting the needs of people living in the home. Evidence: We found there has been one recent admission since the previous inspection. Limited assessment information had been provided to the home so that whilst the staff team were endeavoring to meet the need of the person, they had limitations due to lack of information. We spoke to the acting manager about this and were told the social worker had been requested to visit to provide the necessary information to the home so a more specific care planning record could be put together. We looked at other files which had in place assessment information from social workers and Community Psychiatric nurses as well as hospital discharge forms providing information to the home in order to meet the individual needs of people who Care Homes for Older People Page 12 of 33 Evidence: live there. However many of the assessments had been made over a period of a number of years and more up to date information is necessary for any future placements so the home has a full assessment format to produce a comprehensive care planning record form. Comments included, the social worker brought me here to look round and so I knew what to expect, Ive been here a long time but my social worker stills comes to see me. It is really difficult sometimes when we dont get all the information we need, and people are sometimes harder to manage than we were told. We saw the home has recently revised and introduced a Statement of Purpose and Service User Guide which provides up to date information about the home and what services it is going to provide. As this has only recently been introduced the information could not be verified, but people told us they had been made aware of it. Care Homes for Older People Page 13 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. By not recording the needs and incidents affecting people living at the home have the potential to pose risk. Evidence: We looked at the records of three people living at the care home. In all instances prior to March 2009 the information was limited by way of not having a care planning programme which showed what the needs of people are and how those needs are going to met. In two of the three records there was limited information about risk and reviews. Since March 2009 we found all care plans have been reviewed and a more comprehensive programme has been implanted for all residents living in the home, however we could not measure the effectiveness of these plans as they had only recently been introduced. Comments included, I think it will be better now we have a better care planning record to use. In two instances we found there were limited records relating to serious incidents occurring, and affecting both residents. In both instances the information and records were limited or did not exist .This meant that no information was available to show how these incidents had been managed. This has Care Homes for Older People Page 14 of 33 Evidence: the potential to put people at further risk and is poor practice. Risk assessments have been put in place based upon the most recent assessments of people living in the home. We found in two instances where incidents had occurred there has been no review of the risk assessment planning thereby having the potential of putting these people at further risk due to it not being managed effectively. We spoke to staff , received surveys and talked to people using the service. We found people are now becoming involved in the care planning process by way of talking to staff about their needs and how they may be met. We looked at how the home manages medication practices. We found there is now a designated metal medication trolley which is locked and kept in the dining room. There is a need to ensure this trolley is bolted and fixed to the wall for safety purposes. The acting manager has recently carried out a review of medication practices at the home and is currently introducing revised policies and procedures for the staff to follow so that administration of medication and storage is safe. The home is currently working with the pharmacy to introduce a more effective medication dispensing system. The staff on duty told us they had received training in medication administration and management however there were no certificates to confirm this. Care Homes for Older People Page 15 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a lack of provision of social activities that means people do not have the opportunities to participate in stimulating and meaningful activities. Evidence: People living at the home make their own decisions about how they choose to live their lives or take part in any activities which may be in place for them. We talked to a number of people living at the home and found they tend to make their own choices as to what they do in their lives. Some of the people told us they like to make their own meals and go out when they choose to. In all instances this is now being recorded on the risk assessment planning records, however prior to the records being implemented in March 2009 there was no evidence this was being managed or recorded in full. Comments included, I like to make my own meals, we saw the people carrying out these tasks were capable of doing it. I like to do my own thing, if I want to lay on my bed I can do if I want to go out I do. There were no people using the communal areas during the inspection of the home. Those we spoke to said they like to use their own rooms. We did not find there was any structured approach to planning activities either Care Homes for Older People Page 16 of 33 Evidence: individually or as a group. This has the potential to have a detrimental affect on people living there as they are not provided with activities or stimulation which may benefit them. There should be a range of activities available to people so that they can make their own decisions and for these decisions to be recorded, so that this information can be used as part of the care planning review processes. Meals and mealtimes were seen to be flexible. Three people came to the dining area during the morning period for breakfast and this was not seen to be a problem to staff who provided them with a breakfast of their choice. They told us people have their own routines and come to the dining room at various times. A set meal is made for the lunchtime period, however again some people choose to eat at times of their choice. People using the service said they liked the meals very much and liked the way they can have what they choose. Comments included, they give us what we asked for really and they know what I like and dont like. Three of the people living in the home make their own meals in general although they do choose to have some of the main meals when they want to. Care Homes for Older People Page 17 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and are confident their concerns will be listened to. More safeguarding training for staff will help protect people. Evidence: We saw the home has now introduced a revised complaints procedure which is included in the Statement of Purpose and Service User Guide made available to people living in the home. Comments included, I have been given a new list of things about the home, we have been told about the booklet, I will get time to read it. There have been no complaints recorded since the previous inspection and no complaints have been received by the Care Quality Commission. People we spoke to said is they are not happy with something they tell the staff and it usually gets sorted out. Revised procedures and policies for safeguarding people have recently been put in place. We spoke to some staff members who said they are aware of the new policies being put in place but have yet to receive more advice and training as to how they will be implemented into the day to day running of the home. Staff also told us they have received safeguarding training although there were no certificates available to confirm this. We spoke to an acting manager who told us training in safeguarding has recently been arranged for all staff and would be implemented in the coming months so that Care Homes for Older People Page 18 of 33 Evidence: staff are equipped with the knowledge and skills to respond to safeguarding issues. Care Homes for Older People Page 19 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes environment has not been maintained to ensure the comfort and needs of people who live there are met. Lack of fire safety and maintenance has posed serious risk to people living at the home. Evidence: We looked around the home and found carpets have been replaced in the entrance hall, dining room and front lounge as well as the rear connecting conservatory area. In addition the dining room has also been decorated, which people spoken to said they liked. In other areas of the home we found some peoples rooms were sparsely furnished and lacked little personalisation. in one instance a wardrobe door was missing, in another furniture was chipped and in a poor condition. The front lounge had a range of seating which is worn and requires replacing, as well as this the item of furniture was chipped and in a poor condition.We spoke to two residents in their rooms and found these rooms were personalised and had items in them of their choice including individual items of furniture, electrical items and in one instance a fridge and tea making facilities. The first floor smoking room has moved to the front of the home. All furniture other than garden seating were in there and an air purifier was in place to control the air pollution. This room remains in a position which is close to other residents rooms and Care Homes for Older People Page 20 of 33 Evidence: consideration must be given to its position and the effect on those around it. We spoke to the acting manager who said people are being encouraged to smoke outside the rear of the home to counteract the pollution and to follow current government advice relating to care homes. Following a recent fire incident, not associated with smoking, it was confirmed by the fire brigade the home does not meet current fire safety regulations. This has resulted in enforcement action by the fire brigade and the home is currently implementing environmental fire safety requirements including fitting new fire doors and fire door encasements, and a new hard wire alarm system. We found there are no current maintenance records available, which would identify where the home requires essential maintenance and decoration so people who live there do so in an environment which is comfortable and safe. Bathing facilities in the home are situated on the rear ground floor and a bathroom on the first floor. We looked at both facilities and found the wall fitting for the ground floor shower was broken therefore people would have to hand hold the shower to use it. The first floor bathroom has a bath in place which is old and stained. Decoration in this room is poor and requires decoration to make it a suitable facility. The ground floor front room was seen to require necessary work to the floor joists which were resulting in a sloping effect in the window area. We were told this work is to be carried out in the immediate future and the home has agreed to provide the Care Quality Commission with an action plan in respect of maintenance work to be carried out in the home to improve it. Care Homes for Older People Page 21 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home receive care and support from a committed staff team. Procedures for recruitment and induction need to be more thorough, so people needs are met and they are safe from possible harm or poor practice. Evidence: We looked at two staff files as part of the inspection process. There has been one member of staff employed at the home since the previous inspection and we looked at the recruitment information. We found all areas of recruitment had taken place using a new and revised format recently introduced to the home. However we did not see any references on the record. We spoke to the acting manager and member of staff who told us they were with the member of staff. All recruitment records must include two verified references to confirm the employee is suitable to carry out work with vulnerable people. We looked at what induction records were available and none were. We spoke to the acting manager about this and were told a revised induction record is to be introduced and will provide evidence of an employees competence in their role. We spoke to the acting manager about training. We saw there has been a training needs analysis carried out to identify individual members of staff training needs. It showed specific areas of training including mandatory updates for moving and handling, first aid, managing challenging behavior and metal capacity act training. A Care Homes for Older People Page 22 of 33 Evidence: training programme is being put together for staff. There were no certificates for any training which had previously taken place. We spoke to staff about this and they said they have the certificates at home. They were asked by the acting manager to provide copies for them to be placed on their individual files so that they provide evidence of the range of their qualifications relating to their individual roles and responsibilities. All staff told us they have achieved a recognised national care qualification. We saw there is a staffing rota Which shows who is on duty at any one time. The ratio of staff is measured by the level of need of the people who live there. People who live there told us they like the staff and get on with them very well. Comments included, Ive been here a long time and so have some of the staff who are always helpful,If you needs them they are always there. Care Homes for Older People Page 23 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of management systems do not ensure the efficient and safe running of the home which means the best interests of the people living there are not being taken into account and met. Evidence: We looked at how the home is run for the benefit of people who live there. We found the manager post is vacant. There is no current management responsibility in the home for maintain records and systems which has the potential to pose risk to people who live there. There has been only limited recording of events in the home since the previous inspection resulting in little evidence of how systems have been managed on a day to day basis. Information the manager provided us with in the Annual Quality Assessment document (AQAA), told us the safety of the residents is monitored, however this could not be confirmed when an inspection of the home took place. We found evidence of peoples care not being monitored and incidents not being managed in their best interests. Care Homes for Older People Page 24 of 33 Evidence: Records for the maintenance of equipment in the home has recently been revised and current certificates for essential servicing were seen to be in place. A previous requirement was for improvements to be made in fire safety records, drills and staff training in fire safety. None of this requirement had been addressed. The recent fire incident highlighted the need for this to be carried out with immediate effect and is currently being carried out by the acting manager. We spoke to the registered owner about suitable management provision at the home and were told the acting manager is providing daily oversight with senior care staff in day to day control. An action plan is to be provided to the Commission to inform us of a timescale to introduce a member of staff with the relevant qualifications currently working in another home within the group of homes the provider owns. We looked at how the quality of the service is audited and found there are no current systems in place for this to occur, which impedes the development of the service and has the potential to have a negative outcome for people who live there. We found that following incidents which affected people living in the home it did not inform the Commission of them. This is a requirement and must be carried out following any incident which affects indiciduals living or working there. We looked at how the provider monitors the home and found that whilst there are regular visits to the home there are no reports being made as to how the home is being run. This is a requirement within the Care Homes Regulations and must take place to make sure there is monitoring of how the home is being run for the benefit of people who live there. Care Homes for Older People Page 25 of 33 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 13(4)(b)(c) Whilst risk assessments have 31/05/2008 been improved they must show how an identified risk is going to be managed so that people are protected. All residents must have in place a service user plan, which clearly identified their individual needs and how they are going to be met, and to review that service user plan on a regular basis so that changes can be identified. The home must make sure they provide choice in activities suitable to meet the needs of residents living at the home, so that they have a varied choice. There must be a system of review for the service in order to improve areas identified as necessary for the benefit of all stakeholders. 31/05/2008 2 7 15(1)(b) 3 12 16(2)(m) 31/05/2008 4 33 24 31/05/2008 5 38 17(2)(3) All records maintained by the 31/05/2008 home and referred to in Schedule 4 of the Care Home Regulations 2001 must be Page 26 of 33 Care Homes for Older People kept up to date so that they can be easily accessed. Care Homes for Older People Page 27 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 There must be evidence of a 30/06/2009 full assessment being undertaken prior to a person going to live at Bronswick House. This will ensure peoples needs have been identified and a decision to be made to see if the admission is appropriate. 2 7 13 Risk assessments must be put in place and monitored on a regular basis. This will reflect the needs of the people living at the home so that they are protected by systems the home has in place. 29/05/2009 3 7 17 Records relating to the welfare of people living in the home must be maintained on a daily basis so that any changes can be identified and action taken. 29/05/2009 Care Homes for Older People Page 28 of 33 This will ensure the needs of people are being recorded. 4 7 17 Care planning records must be in place and meet all the requirements in Schedule 3. This will ensure staff are equipped with the knowledge of individual needs and how to meet those needs. 5 7 15 All care plans must be reviewed on a regular basis so that the changing needs of people living at the home can be monitored and met. This will ensure the needs of people living at the home are being monitored. 6 12 12 The home must shows more evidence it consults with people living at the home about the range of activities it can provide and how it proposes to manage this. This will ensure people living at the home have a range of activities to choose from. 7 19 23 Both bathrooms must have in place equipment which is in working order and equipment must be of a suitable condition for use. This will ensure people living there have access to suitable bathing facilities. 8 19 23 The home must ensure furniture,fittings and decoration is kept in good 31/07/2009 30/06/2009 31/07/2009 30/06/2009 30/06/2009 Care Homes for Older People Page 29 of 33 order. so that it is a comfortable environment in which to live. This will ensure that it is a comfortable environment in which to live. 9 19 23 The home must have in 31/05/2009 place adequate precautions against fire including fire detection systems, fire fighting equipment, adequate escape routes, fire risk assessment, adequate fire safety maintenance, fire training for staff and recording of fire drills. This will ensure people are protected and safe in the environment. 10 19 23 People living at the home must have an environment which is well maintained for their comfort and which complies with local fire service requirements. This will ensure people live in a comfortable and well maintained environment which is safe. 11 31 37 The home must inform the Commission of any incident which affects the health and well being of a person living or working in the home. This will ensure the Commission is aware of any incidents and how the home is managing them. 31/05/2009 30/06/2009 Care Homes for Older People Page 30 of 33 12 31 26 The home must provide 30/06/2009 evidence that a monthly visit and report is undertaken by the registered provider to show how the home is being managed and the systems in place are effective to meet the needs of people living and working at the home. This would show the home is being monitored and the systems overseen by the registered provider. 13 31 37 The care home must inform 31/05/2009 the Care Quality Commission of any death, illness or other events which may affect the health and well being of people living or working in the home. This will ensure the needs of people living there are being met and incidents recorded and acted upon. 14 31 8 There must be a competent 01/06/2009 manager, registered with the Care Quality Commission who will effectively manage the home on a day to day basis. This will ensure the home is run on a day to day basis by a person who has the appropriate skills, experience and qualifications. 15 33 24 There must be evidence of a 30/06/2009 system in place which reviews the quality of care and takes into account the Care Homes for Older People Page 31 of 33 views of all stakeholders of the service so that measures can be taken to make improvements for the benefit of people who live and work there. This would ensure the views of people living there would be taken into account. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 9 9 The medication trolley should be securely bolted to the wall to ensure the safe storage of medication. The home should continue to work with the pharmacist so that improvements can be made in the management of medication. Staff training in safeguarding people should be focused upon and staff should be informed of the homes revised policies and procedures in protecting people so that they are suitably protected. There was no evidence of a maintenance record which should show what areas of the home need improvement and this record should be audited to manage the environment. The siting of the first floor smoke room should be reviewed to take into account the negative affect it has on other people living at the home and to reflect current government guidance on smoking in the environment. There should be evidence the home is carrying out quality assurance checks to make sure it is taking into account the views of all stakeholders of the service. 3 18 4 19 5 19 6 33 Care Homes for Older People Page 32 of 33 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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