Inspection on 06/06/06 for Brook Care Home

This inspection was carried out on 6th June 2006.

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

Brook Care Home 18/06/07

Brook Care Home 23/11/05

Brook Care Home 02/06/05

Brook Care Home 07/02/05

Brook Care Home 16/04/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Brook Care Home 17 Brook Close Rochford Essex SS4 1HN Lead Inspector Nicola Dowling Key Inspection 6th June 2006 10:00 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 Brook Care Home DS0000018074.V297996.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. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brook Care Home Address 17 Brook Close Rochford Essex SS4 1HN 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) 01702 549499 01702 549499 Mrs Vijay Luxmi Rattan Post vacant Care Home 20 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Mental disorder, excluding learning of places disability or dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20) Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Personal care to be provided to no more than 20 service users with a mental disorder, excluding learning disability, over the age of 55 years. Personal care to be provided to no more than 20 service users with a mental disorder, excluding learning disability, over the age of 65 years. Personal care to be provided to no more than 20 service users with dementia over the age of 65 years. Personal care to be provided to no more than 20 service users with dementia over the age of 55 years. Total number of service users accommodated not to exceed 20. (Total number 20). 23/11/05 Date of last inspection Brief Description of the Service: Charges at the home range from £319 to £625 per week. There are additional charges for hairdressing, chiropody, reflexology, personal transport and toiletries. The provider informed the Commission for Social Care Inspection about the charges on 31/05/06. Brook Care Home is registered to provide care and accommodation for up to twenty people over the age of 55 years who have dementia or a mental health disorder. The premises were purpose built and have been extended in recent years. Accommodation is provided on two floors and access is provided to all areas via stairs and passenger lift. There are ten single and two double rooms with en-suite facilities; there are an additional three double rooms without ensuite facilities. There are separate lounge and dining room. A new conservatory has been added on so that there is a separate visitors area. There is also a spacious conservatory, which is used by residents and staff who wish to smoke and there is a large garden. Brook Care Home is situated on a bus route near to the centre of Rochford and it is half a mile from the railway station. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, talking with staff and residents, observing the care given and reading of documents. Most of the residents were seen and four were spoken to. Information that was submitted to the Commission for Social Care Inspection before the home was inspected has also contributed to this report. Since the last inspection the home presents an improving picture. The inspector would like to thank the staff and residents for their help and hospitality throughout the day. What the service does well: What has improved since the last inspection? The acting manager has introduced new ways of recording health and care information in the home. Staff find it easy to fill in the daily notes and feel that it gives a better picture of the residents day. The staff are continuing to undertake a lot of training in various basic care topics for example, first aid, medication and fire awareness. For the year ahead the acting manager is planning more specialised training that is relevant to the residents needs. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 6 The home has employed a cook and a cleaner. Although some areas of the home were dusty most of the home was clean. The residents described the food as good. The cook speaks to each resident every day to find out what they want from the days menu. Then all food is cooked from fresh and no processed meals are used. Information about the home has been updated and this will benefit any new residents that are considering coming to the home. 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. Brook Care Home DS0000018074.V297996.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 Brook Care Home DS0000018074.V297996.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. There have been good improvements to make sure to home can meet the residents’ needs. However residents would like more information about the home before admission takes place. EVIDENCE: The home does not provide intermediate care therefore standard six was not inspected. There was evidence that the residents’ needs are assessed before they are admitted to the home. The new acting manager and deputy manager assess residents before they are admitted to the home. Also a new assessment form is now in operation for the home to use to establish the residents needs. From the resident’s survey forms that were sent back to the commission half of the residents would have liked more information about the home before they went there. The home have submitted an up to date statement of purpose and service user guide. Therefore new residents will have the benefit of this information. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 9 Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. Safe and adequate health care is provided by the home. EVIDENCE: There have been improvements regarding medication. Many staff members have had an update and undertaken a training course to test competencies on this area of care. The room that the medicines are stored in is secure and is now used as a treatment area for visiting professionals such as, community psychiatric nurses. The acting manager has obtained patient leaflets and is waiting on a new medicine trolley that can be fixed to the wall. The medication administration records (MAR) checked were correct and there is an audit trail of drugs disposed of by the home. Some residents’ files were checked and all had an up to date plan of care. Residents were unclear about the care plans but did confirm that they were consulted about their care and had a review with a professional person. However the acting manager confirmed that the written documentation from the annual review was not always received by the home making changes to the implementation of the care plan slow. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 11 Recording of health care visits in the residents’ files is clear. Residents inform staff of health care appointments so that they can be diarised. This in turn helps the home to book extra staff to escort residents to their appointments. The acting manager has, in agreement with residents changed to a new GP practice. This new practice is open seven days a week and also provides regular home visits. The home are in regular contact with CPN’s from the local mental health team and have established dental and chiropody services. Staff spoke respectfully to the residents at the home. A female member of staff always carries out personal care for females. The residents surveys indicated that staff generally listened to them and provided the care that they needed. Residents that were spoken to confirmed this. In the residents care files that were inspected some did and some did not have their last wishes completed. The acting manager was aware that this area of documentation and consultation had not yet been completed. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. Facilities for visitors have improved and there are adequate arrangements for residents to have control over their lives. Meals have improved, however stimulating activities in the home are limited. EVIDENCE: Social activities within the home are available in the morning. However on the afternoon of the inspection there was no stimulation for the residents and many were sitting watching TV and falling asleep. This gave an institutional picture. For those that are able they can go out, as there are no restrictions on any of the residents. Residents visit the local facilities such as the library or pub and will also go out to shopping areas. Staff will go out with residents if they need someone with them. Residents can maintain control of their personal finances if they choose to. For those residents that smoke they can either manage their own cigarettes or the staff will help the resident budget them. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 13 Families can visit the home when they please and some family members keep in regular contact with the home. A new conservatory has been added on to the back of the home to provide a separate visitors area that is private. Since the last inspection the home have employed a cook and all meals are now home made. The residents said that the meals were better. The cook speaks to everyone in the morning to establish what the resident wants from the menu for that day. Meals contain fresh ingredients and special diets are catered for. Currently there is no one in the home that requires any special cultural or religious diets. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. There is a clear complaints and protection of vulnerable adults procedure in place and staff have received training updates. EVIDENCE: The acting manager has introduced new complaint documentation and there was evidence that this had been used to record residents concerns. The complaints procedure is clear and easy to read. Since the last inspection there has been one adult protection issue. The new acting manager dealt with this issue immediately. Staff have received training in adult protection and have a better understanding of when incidents need to be reported. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. Lack of maintenance has resulted in old decor and worn furniture. However the home was fresh and clean. EVIDENCE: Most areas of the home require upgrading to make a comfortable environment for the residents to enjoy. Two bathing areas were not in use. This was the downstairs shower and an upstairs bathroom. Bathroom ceiling fans were clogged with dust and may be contributing to the peeling paintwork and tiles not sticking to the walls. This is as a result of moisture not able to escape. Some resident’s carpets had been replaced. Vanity basins were worn and showed bare wood. One resident did not have a bin in the ensuite toilet and Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 16 had left an incontinent pad on the floor. Some bed linen was worn and ripped and in need of replacement also one bathroom did not have any handwash. The acting manager is seeking to improve the environment and during the inspection made a ramp safe from a potential trip hazard. Outside of the home to the back of the property the guttering needed fixing and the patio is uneven. There is a large garden and at the bottom the laundry is hung out. The laundry facilities are good and residents commented that the home was always clean. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by staff that have good basic training. EVIDENCE: There is a regular staff team and residents knew most of the staff by their first names. Staff confirmed that they had supervision and had recently had an appraisal. Four staff have completed the National Vocation Qualification (NVQ) and three staff are undertaking this training. Currently most staff have completed an update of basic training. The acting manager intends to look at more specialised courses for staff in the year ahead. A new staff member is due to start at the home soon. The recruitment documents that were checked were sufficient for this staff member. An initial induction checklist and an induction programme was also prepared for them. Other existing staff had an up to date criminal records bureau check. There was discussion with the acting manager regarding the staffing levels in the afternoon. Currently there are five staff covering the afternoon shift. The manager would like to reduce the afternoon shift down to four and use the extra hours to facilitate extra residents’ activities. For example trips out. To support this idea it was suggested that the acting manager document the roles and activities that the staff undertake at the moment with the residents. Then Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 18 formulate an action plan as to how the change of staff time would benefit the residents. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. There is a competent acting manager that is making improvements to the home for the benefit of the residents. EVIDENCE: A new acting manager has been employed at the home since February 2006. The acting manager has over two years experience in management and has the National Vocation Qualification 4 Registered Managers Award. Also an application for registered manager has been submitted to the Commission for Social Care Inspection. The home have undertaken a quality assurance review. The results show that the residents would like some trips out and that generally residents are happy with the home. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 20 The records and system used for holding residents money was inspected. At random one resident’s money was checked. This was correct and there were receipts to confirm how the money was spent. Residents sign their books and staff witness the process. Information from the pre-inspection questionnaire confirmed that safety certificates were up to date. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 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 1 x 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 x 3 Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 22 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 OP11 Regulation 12(1) Requirement The Registered Person must consult with residents regarding their last wishes. Timescale of 13/01/06 not met The Registered Person must provide a plan detailing the maintenance and redecoration of the home. The Registered Person must ensure all areas of the home are clean and hygienic. This refers to: • Handwash in all bathrooms. • Cleaning of ceiling fans. (Previous time scale of 14.03.05 and 13/01/06 not met) Timescale for action 26/07/06 2. OP19 23(2) 26/07/06 3. OP26 16(2) 26/07/06 Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP3 OP7 OP12 Good Practice Recommendations The home should ensure that new and prospective residents have good information about the home before they are admitted. The home should ensure that resident’s review documentation is received by the home without delays. The home should ensure that stimulating activities are available throughout the day. Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Brook Care Home DS0000018074.V297996.R01.S.doc Version 5.2 Page 25 - 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. 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