Inspection on 24/01/07 for Bronte Park

This inspection was carried out on 24th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bronte Park 23/10/09

Bronte Park 12/06/09

Bronte Park 18/06/08

Bronte Park 07/11/07

Bronte Park 13/06/06

Bronte Park 05/10/05

Bronte Park 23/06/05

Bronte Park 14/02/05

Bronte Park 07/10/04

Bronte Park 29/04/04

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

CARE HOMES FOR OLDER PEOPLE Bronte Park Bridgehouse Lane Haworth Keighley West Yorkshire BD22 8QE Lead Inspector Liz Cuddington Key Unannounced Inspection 24th January 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bronte Park Address Bridgehouse Lane Haworth Keighley West Yorkshire BD22 8QE 01535 643268 01535 647468 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Bronte Regency Healthcare Ltd John Calver Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28) of places Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2006 Brief Description of the Service: Bronte Park is a detached, converted property situated in the village of Haworth and is registered to provide nursing care for older people with dementia. The home is close to local amenities and public transport routes, although there is a long driveway leading up to the home. There is parking to the front of the property. The rear gardens are accessible to the residents and steps have been taken to make this a secure area. A side entrance provides disabled access into the property. The main house is a listed building with an extension to the rear of the property. The accommodation is on two floors, with access between floors via a stair lift. There are twenty-one bedrooms; fourteen are single rooms and seven are twin rooms. None of the bedrooms have en suite facilities. There is a lounge and separate dining room on the ground floor. There are three bathrooms, one shower room and seven toilets in the home. The weekly fees are between £427 and £461. There are additional charges for personal items such as hairdressing and chiropody. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group, for example ‘Choice of Home’, and ‘Health and Personal Care’. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers these outcomes to the people who use the service. The judgement categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded in the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk I visited this home unannounced and spent 7.5 hours in the home. The purpose of the inspection was to make sure that the residents’ needs are being met and to check on progress in meeting the requirements made at the last inspection. The methods I used to gather information included conversations with residents and staff, case tracking, examining records and touring the home. Although there are still areas for improvement the home has made significant progress since the last inspection. I would like to thank the ladies and gentlemen who live at Bronte Park, and all the staff, for their welcome and hospitality during the inspection. What the service does well: The home’s pre-admission assessments are thorough and enable the home to decide whether or not they can meet the individual’s needs. Each resident’s care plan contains clear and detailed information to guide staff in how the person prefers their care and support to be provided. The staff regularly review the plans. I saw staff treating residents with respect and consideration and the residents I spoke with said that the staff are kind and caring. Residents’ wishes and preferences are respected. The home has a suitable complaints procedure in place. Staff receive training in all areas of adult protection. The recruitment procedures are robust and make sure that all the staff employed at Bronte Park are suitable to work in a care home. There are Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 6 opportunities for staff to attend training courses to update their knowledge and skills. There is a detailed induction programme in place for all new staff. 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. The summary of this inspection report can be made available in other formats on request. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive pre-admission assessment is carried out before someone is offered a place at the home. EVIDENCE: Thorough pre-admission assessments are completed for every prospective resident of Bronte Park. The manager prefers the person to visit and perhaps stay for a meal, to allow him or her to gain a proper feel for the home before making a decision. If this is not possible then the manager will visit the person in his or her own home, or in hospital. A comprehensive range of information is gathered to enable the manager to decide whether or not the home can meet the individual’s needs. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans show how each resident’s needs are to be met and plans are reviewed monthly. There was no evidence that the resident or their relatives were consulted about the original plan, or any changes. Medications are stored, administered and disposed of safely and accurately. Staff treat residents with respect at all times. EVIDENCE: I looked at a number of residents’ care plans. The plans contained sufficient detail to guide staff on the way the resident prefers to receive each aspect of their care and support. The plans also include a personal profile of the individual, records of GP visits, nutritional screening and risk assessments. The different parts of the plans are reviewed every month. There are some parts of the plans which may benefit from being reviewed, to decide if they are really useful. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 10 When a care plan is drawn up, and when any significant changes are made, the resident or their representative, usually their next of kin, must be involved wherever possible and sign the plan to show they have agreed to it. This is not happening at present. If it is not possible to gain agreement then the efforts made and the outcome should be noted in the plan. I looked at the medication administration systems in place. The Medication Administration Record (MAR) charts are being signed accurately when each dose of medicine is offered. Since the last inspection a contract with a clinical waste disposal company has been arranged. Unused medicines are now being disposed of safely and records of these are kept. Throughout my visit to the home I saw staff treat residents with respect and consideration. Their manner is quiet and gentle and the residents who commented said that the staff are kind and caring. Residents’ dignity is respected and personal care is carried out in private. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to choose how they spend their time. Some activities are available. Support for people to manage their finances, and information about advocacy services is available. The residents enjoy their meals, and mealtimes are relaxed. EVIDENCE: The people who live at Bronte Park are able to choose how and where they spend their time. Some residents prefer to spend time in their rooms, while others like more company. While I was there it was clear that each person’s wishes are respected. The home has not yet appointed an activities co-ordinator. It seems that at present activities are arranged on an informal basis. I was told that some people like to go into Keighley and a member of staff will go with them. Other activities include singing, bingo, occasional visiting entertainers and ‘one to one’ activities such as nail care. Someone from a local church comes in every Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 12 two weeks to conduct a service and give communion. The manager plans to arrange outings during the summer. Visitors are welcomed to the home. Everyone who commented said they enjoy their meals and look forward to them. Staff quietly assist residents at mealtimes, if they need help. Residents are supported to manage their own finances for as long as they are able and wish to do so. Information about advocacy services is available for residents and relatives. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are made aware of how to make a complaint. The home has suitable adult protection policies and procedures and staff are receiving adult protection training. EVIDENCE: The home’s complaints procedure was available to view in the entrance hall. The home has adult protection and ‘whistle-blowing’ policies and procedures in place that cover the way any concerns or allegations of abuse or poor practice would be handled. All the staff are currently taking Protection of Vulnerable Adults training. The manager is arranging to undertake training to enable him to deliver adult protection training to the staff. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The programme of refurbishment is underway. When they are implemented the improvements planned for the home will make the environment much more attractive and comfortable for the residents. Some of the linen needs to be replaced. EVIDENCE: The home’s planned programme of refurbishment is underway. Some of the bedrooms have been re-decorated. I was told that some new armchairs have recently been purchased. A new carpet for the entrance and lounge has been ordered. The garden has been made more secure, with just one more piece of work to be done to complete the improvements. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 15 Parts of the home still have scuffed and damaged paintwork. Some of the bedding needs to be replaced and the tablecloths I saw being used in the dining room were so badly laundered that they were not fit for their purpose. I was told that household linen is being replaced. The home’s management are considering creating another smaller lounge to connect with the present lounge, although no formal proposals have been made. There are plans to add en suite facilities to those bedrooms where there is sufficient adjoining space that can be used. Although there was an odour on entering the home I was assured this will be eliminated once the old carpet has been replaced. The home is clean and hygienically maintained. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff recruitment procedures are robust and thorough. There is a range of relevant staff training available. More than 50 of the care assistants are suitably qualified. EVIDENCE: Staff are employed in sufficient numbers to meet the needs of the residents. I looked at a sample of staff files. They all included completed application forms and two written references. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks had been obtained. After their basic induction training all care and nursing staff complete a ‘Skills for Care’ training course. I saw evidence in the files that the staff are attending training courses relevant to their work. Five of the eleven care staff are qualified nurses from abroad. They are working as care assistants until they have completed further training to enable them to be registered as nurses in the UK. One of the other care assistants has a level 2 National Vocational Qualification (NVQ) in care. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there are still improvements to be made the management of the home is effective and positive changes have already been made to improve the quality of the service for the residents. EVIDENCE: The home has a registered manager who is a qualified nurse and is suitably experienced to manage the home effectively. Staff confirmed my view that the manager and owners are continuing to make changes and improvements at Bronte Park, which will benefit the residents. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 18 The manager has made proper arrangements with a bank for depositing and withdrawing money belonging to residents who have no family to assist them. The manager outlined the quality assurance systems that are in place to gain the views of the people most closely involved in the home and to make improvements. The work to implement the Schedule 1 recommendations in the most recent Fire Safety Officer’s report is almost completed. Work has started on the Schedule 2 recommendations. I saw up to date test certificates, including those for the gas appliances and fire alarms. Some of the bedroom doors have self-closures fitted, connected to the fire alarm system, which allows them to be safely left open if the resident wishes. Other doors were being propped open with chairs, which will prevent them closing in the event of a fire. One resident’s wheelchair was very dirty and the lap belt on one of the bath seats had not been cleaned after use. All the wheelchairs and other equipment should be maintained in a clean and hygienic condition. Most confidential records are being stored securely but some records were left unsecured. I was told that the home’s policies and procedures are currently being reviewed to make sure they are up to date. Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X X X X 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 3 X 3 X 3 X 2 2 Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 20 YES 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 OP19 Regulation 23 Requirement The registered person must complete the maintenance works identified in the report. (Previous timescales of 30/11/05, 30/06/06 and 31/08/06 not fully met). The registered person must provide proposals for alternative communal space for residents and separate facilities for staff. (Previous timescales of 31/12/05, 30/06/06 and 31/08/06 not met). The resident or their representative’s agreement to the care plan must be obtained where possible. All confidential records must be securely stored at all times, in accordance with the Data Protection Act 1998. Doors must not be propped open in such a way that they will not close in the event of a fire. Timescale for action 31/03/07 2. OP20 23 31/03/07 3. OP7 15(2)(c) 31/03/07 4. OP37 17(1)(b) 28/02/07 5. OP38 23(4) 28/02/07 Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 21 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. Refer to Standard OP11 Good Practice Recommendations The registered person should discuss and record with residents and/or their representative their preferences and wishes regarding death and dying. The home should develop a policy for staff in dealing with dying and death Not assessed at this inspection. The registered person should recruit an Activities Organiser to the staff team, to develop the activity provision within the home and link the residents to the community. The registered person should produce a user-friendly guide or flow chart with contact details of relevant agencies, mapping what staff need to do if abuse is suspected. Not assessed at this inspection. Wheelchairs and other equipment used by residents should be regularly cleaned. The home’s policies and procedures need to be updated to reflect the needs of the current service. 2. OP12 3. OP18 4. 5. OP38 OP38 Bronte Park DS0000050797.V324585.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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