Inspection on 13/02/06 for Brook House

This inspection was carried out on 13th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 House 13/09/06

Brook House 29/09/05

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Brook House 15 Bell Lane Husbands Bosworth Leicestershire LE17 6LA Lead Inspector Mrs Sarah Smart Unannounced Inspection 13th February 2006 12:00 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 House DS0000064289.V276454.R01.S.doc Version 5.1 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 House DS0000064289.V276454.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brook House Address 15 Bell Lane Husbands Bosworth Leicestershire LE17 6LA 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) 01858 880247 01858 881473 None Pradeep Arvind Patel Care Home 28 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Old age, of places not falling within any other category (28) Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Brook House is a home for older people sited in the village of Husbands Bosworth, offering personal care for 28 older persons. Husbands Bosworth is sited between the market towns of Lutterworth and Market Harborough and has the benefit of the local bus service. The home is a converted house situated in the centre of the village, and has four shared bedrooms and twenty single bedrooms, a significant number of bedrooms have en-suite facilities, which consist of a toilet and wash hand basin. The home offers three lounges, two adjoining dining rooms. Bedrooms are found on the ground and first floor, which can be accessed, by stairs or a passenger lift. The home is situated close to local shops and green space. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of midday and 3.15pm. Preparation for the inspection included review of the previous inspection report, requirements and recommendations, and took approximately 1.5hours. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, sample of policy review, staff rota, quality assurance, accident records, fire records, tour of the premises, previous requirements made, and staff and service user interviews. Two service users were case tracked. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst eight service users were spoken to in detail. What the service does well: Service users needs were being met at the time of the inspection. Pen picture information of service users previous life gave valuable information. Service users stated that their privacy and dignity was respected, and gave very positive feedback to the inspector. They are happy with their rooms, and the food provided. The management of the kitchen area was satisfactory. The home was clean and tidy at the time of the inspection. Staffing levels were satisfactory. Staff spoken to demonstrated a good knowledge of the service users in their care, and knowledge of the complaints and Protection of Vulnerable Adults procedure. The manager has recently been registered by the Commission for Social Care Inspection. Quality monitoring is undertaken biannually, and the results are published. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 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 House DS0000064289.V276454.R01.S.doc Version 5.1 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): 4 Service users needs are met. EVIDENCE: Through case tracking (see summary), observation, and discussion with staff and service users during the inspection, the inspector was satisfied that service users needs were being met at the time of the inspection. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Service users health and personal care needs are partially met, additional assessment could be improved. Medication management is not satisfactory. EVIDENCE: A sample of care plans were viewed. One of the service users case tracked (see summary) was very independent, and his care plan contained sufficient detail. The second was for a more dependant service user. Some of these care plans should contain additional information in order that her needs are consistently met in line with her wishes and needs. One service user walks into the town alone. A risk assessment should be recorded in relation to this to ensure his safety. The care plans contained a useful pen picture of the service users life and experiences. The service users residing at the home do not have high levels of need, and currently, other than recording regular weights of service users their nutritional status and pressure sore risks are not assessed. The manager should consider introducing such assessments over the coming months. A sample of medication was viewed, along with the medication policy. The management of medication had clearly improved since the last inspection. A Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 10 further requirement has been made, as numerous service users rooms were found to have topical medications belonging to others in them, indicating that the medication is used communally. Some prescriptions contained variable doses, however there was no indication as to the amount actually given. Such records must be held. The medication policy lacked information, and must be updated accordingly. In particular it must cover ordering, storage, administration checks, that the Commission for Social Care Inspection must be advised of drug errors, and retaining medication of a deceased service user for 7 days. The manager explained that the home does not currently have any service user who wishes to self medicate, however if this was to be requested, a policy would be written. This policy should include a written risk assessment. The manager advised that all senior staff have recently undergone medication training. Service users spoken to by the inspector stated that their needs are met, and their privacy and dignity maintained. This was reinforced by observations during the inspection. The death policy did not differentiate the management differences between sudden and expected death. This should be updated. One of the two service users files contained a very good record of the service users wishes in the event of their death. The other service user had declined to give such information. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. EVIDENCE: These standards were not assessed during this inspection. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. EVIDENCE: These standards were not assessed during this inspection. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 The environment of the home must be maintained and improved. Provision of equipment must be reviewed. EVIDENCE: The home appeared generally maintained to acceptable standard, however some areas appeared a little tired, and in need of redecoration or refurbishment. Carpets in several areas require refitting, or replacing to ensure that they do not pose a tripping hazard to service users. A redecoration and refurbishment plan, including dates, must be submitted to the Commission for Social Care Inspection. The home has several communal areas, all of which are accessible to the service users. Two bathrooms were viewed during the inspection. One bathroom did not have a call bell which could be reached whilst sitting in the bath, or using the toilet. This should be extended to maintain service users safety. Staff stated that all of the equipment in the home was in working order, however the inspector observed a dangerous wheelchair in use, and asked the Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 14 manager that it be removed until repaired. The wheelchair had only one functioning brake, and did not have any footrests. The manager stated that this would not cause difficulties in the short term. The home do not have a hoist. Whilst the lack of a hoist must be taken into account when admitting new service users, consideration must be given to purchasing a hoist for use when a service user falls, or if a service users condition deteriorates. The inspector was advised that currently if a service user falls, staff lift them. This is not acceptable practice, as it places both service users and staff at risk of injury. Service users stated that they are happy with their rooms, and several were seen. These areas were personalised by the individuals own belongings. Several of the service users bedrooms have doors onto the gardens of the home. Locks on service users bedroom doors were noted to be of a type where a service user could potentially be locked inside. These locks must not be used, and the keys, hanging in the corridor must be removed. The manager stated that few service users currently wish to lock their rooms. Such locks must be replaced for type that can be unlocked at all times from the inside, without using a key. Several radiators throughout the home did not have low surface temperature covers in place. Risk assessments in relation to this must be carried out, and identified action, i.e. fitting of covers, must be carried out as part of the refurbishment plan. The kitchen and associated records were inspected. Management of this area was satisfactory, and service users gave positive feedback about the provision of food. All areas of the home were clean and tidy at the time of the inspection, with the exception of two bedrooms which had a slight odour of urine. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 Staffing levels were satisfactory. EVIDENCE: The staff rota was viewed. staffing levels appeared to vary from day to day, however the manager explained that this was due to two staff currently undergoing supernumerary induction. Service users spoken to stated that they feel that sufficient staff are on duty, and that their call bells are answered promptly. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,35,38 Management of the home was satisfactory with the exception of records relating to fire. EVIDENCE: The manager has recently gone through the fit person process, and has been registered by the Commission for Social Care Inspection. Quality monitoring is undertaken biannually, and records were viewed. The feedback from service users, relatives and visiting professionals was positive. The manager stated that the results are shared with staff and service users. The inspector was advised that the home do not hold any money for service users. Fire records were viewed. Records were held of fire drills, and staff fire training was arranged for later during the week of the inspection. The fire equipment check records demonstrated that checks were recorded very regularly until Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 17 early December 2005, but had not been recorded since. This must be addressed. Chemicals were found to be stored in an unlocked bathroom cupboard. These were removed to a safe store by the manager during the inspection, therefore a requirement has not been made. Accident records were viewed. These were recorded to an acceptable standard, however there was no evidence of recorded reviews. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 3 2 3 2 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? no 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 OP9 Regulation 13 Requirement The management of medication must be addressed in relation to: a) medication must not be used communally b) variable doses must be recorded c) the policy must be reviewed. Broken or unsafe equipment must not be used. Written management strategies must be put in place to follow should a service user fall whilst the home do not have a hoist, or, a hoist must be provided. Locks on service users doors must be unlockable from the inside without using a key. A redecoration and refurbishment plan, including dates which will be met, must be submitted to the Commission for Social Care Inspection. This must pay particular attention to the carpets, and low surface temperature radiator covers. A risk assessment must be carried out in relation to a service user who goes out alone. DS0000064289.V276454.R01.S.doc Timescale for action 15/03/06 2 3 OP22 OP22 23 23 10/03/06 15/03/06 4 5 OP24 OP19 12 23 15/03/06 20/03/06 6 OP7 12 15/03/06 Brook House Version 5.1 Page 20 7 OP38 23 Fire equipment checks must be recorded timely. 15/03/06 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 4 5 6 Refer to Standard OP7 OP7 OP8 OP11 OP21 OP38 Good Practice Recommendations Care plans should contain more detail to ensure that service users needs are met consistently. The summaries or carers report on service users should be completed at least daily. Healthcare assessments should be introduced. The death policy should differentiate between expected and sudden death. Call bells should extend to the location where service users are most likely to require them, i.e. into the bath, to the toilet. Accident reviews should be recorded 12 and 36 hours following an accident. Brook House DS0000064289.V276454.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 House DS0000064289.V276454.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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