Inspection on 16/08/07 for Brook House

This inspection was carried out on 16th August 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 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 10/05/06

Brook House 01/12/05

Brook House 03/06/05

Brook House 09/12/04

Brook House 05/05/04

Brook House 28/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Brook House 213 Barrack Road Christchurch Dorset BH23 2AX Lead Inspector Debra Jones Key Unannounced Inspection 16th August 2007 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 House DS0000026771.V348906.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 House DS0000026771.V348906.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brook House Address 213 Barrack Road Christchurch Dorset BH23 2AX 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) 01202 483960 NO FAX mchaumoo1@aol.com Mr Mahomed Rechad Chaumoo Mrs Ludivina Thelma Chaumoo Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2006 Brief Description of the Service: Brook House is registered to provide personal care and accommodation for up to eleven people in the category of frailty of old age. The home is an older style property situated on one of the main roads into Christchurch town centre. The home has seven single rooms and two shared rooms. Three of the single rooms are located on the ground floor, together with the communal areas of a lounge and dining room. There is no passenger or stair lift to the first floor. Car parking is available to the side of the home and residents have access to a small garden area at the back of the home. The home is a family run business with the staffing being provided by family members. Mr & Mrs Chaumoo live on the premises. Brook House DS0000026771.V348906.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 on 16 August 2007. Debra Jones was the inspector who carried out the visit. Mr Chaumoo one of the owner / managers at the home helped the inspector in her work. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for and to review progress in meeting requirements and recommendations made as a result of previous inspections. Most made at the last key inspection in May 2006 had been addressed by the time of the ‘random’ inspection at the home in February 2007. The inspector was made to feel welcome in the home throughout this visit. A tour of the premises took place and a variety of records and related documentation was examined, including care records. At the time of inspection there were nine residents accommodated, eight men and one woman. Time was spent talking with residents in the communal areas. Staffing at the home is provided by members of the Chaumoo family. One requirement and three recommendations were made as a result of this visit. Some good practice suggestions were discussed at the inspection and these are referred to in the report and the summary, intended to encourage improvement. The management of the home have demonstrated through their success in complying with previous requirements that there is capacity for the service to further improve. Prior to the inspection the home submitted to the Commission their annual quality assurance assessment (AQAA). This gave information about the service and it’s performance. This document was also helpful in the planning of this visit. The home also sent out comment cards on behalf of the Commission. Nine were returned by residents, 6 by relatives, 2 by health professionals, 1 by a care manager and 2 by GPs, Comments were as follows:‘Very good.’ (a resident) ‘I’m happy here.’ (another resident) ‘I am happy and like living here.’ (another resident) ‘I am generally very happy.’ (another resident) ‘I am happy and content.’ (another resident) ‘First class service and caring people.’ (a relative) ‘Excellent at meeting diverse needs of more challenging individuals. Allow people to follow chosen routine whilst ensuring care needs met.’ (a care manager) ‘Good patient care. high cleanliness. Caring. Well looked after.’ (a health professional) ‘staff very caring – organised.’ (a GP) Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 6 When asked what does the service do well? The following comments were made:‘Well fed. Regular baths and general cleanliness.’ (a relative) ‘I am pleased with all aspects of care my mother receives. She can be very difficult at times but they understand how to help her. She eats well, they always welcome me and involve me in decisions about her care.’ (another relative) ‘They provide the care my uncle needs. He is always clean and his meals are adequate and he feels safe in this environment.’ (another relative) ‘Prepared to take more challenging individuals with diverse needs and are able to accommodate them within the home. Good at ensuring health care needs are addressed – good liaison with local GP surgery.’ (a care manager) ‘Home always clean and tidy. Patient care excellent.’ (a health professional. What the service does well: Brook House provides a homely, relaxed and comfortable environment with a welcoming and friendly atmosphere. A good admissions procedure is in place that ensures that only people whose needs can be met are offered places at the home. Prospective residents and their representatives have the opportunity to visit the home to see if they like it before they move in. A range of community health professionals support the care staff in looking after residents. Residents were seen to be treated with respect and kindness. People living at Brook House are encouraged to exercise choice in their daily lives. Some activities are on offer at the home that residents can join in with if they choose to. Visitors are always welcome at the home and residents are encouraged to maintain and develop relationships with other people in the home, their families and friends. Meals are varied and the dining room is pleasant and comfortable. The complaints and adult protection procedures reassure residents, and their representatives, that the well-being and comfort of residents is important to the home and that any concerns raised will be properly investigated and resolved. The home is kept clean and smells pleasant. Sufficient numbers of people are on duty throughout the day and night to be able to meet the needs of the residents. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 7 The home is well managed and organised with the care and contentment of residents being central to the way the home is run. What has improved since the last inspection? What they could do better: It would be good if the home were to introduce a system to evidence that care plans are reviewed monthly. The home needs to monitor the temperature of the general fridge where some medicines are kept in order to ensure that it does not get too hot or too cold, a maximum minimum thermometer could be obtained to assist with this. Staff have access to a range of training that equips them to do their jobs well, however the home is not meeting the Department of Health target of 50 of care staff having an NVQ at level 2 in care. The fire safety of the home must not be compromised and doors should not be wedged doors. Also products hazardous to health e.g. cleaning products must be locked away when not in use. In addition to the requirement and recommendations made in this report the following good practice suggestions are made that the home is urged to adopt and act upon. The home is encouraged to • Date information relating to residents as to when it is received at the home. • Demonstrate in all cases that residents / representatives have been involved with care planning. • Obtain the clinical triggers available on the CSCI website in respect of continence, dementia, falls and nutrition. • Ensure that all staff have had adult protection training. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 8 • • • • Add to their policies how staff in the home are to keep commodes and bottles clean. Ensure that all creams in use at the home are clearly labelled with the name of the person who is to use them. Keep an overview of training so that it can be seen at a glance what training all staff in the home have had and when refreshers are due. Have a written annual development / improvement plan for the home for the next 12 months as part of their quality assurance system. 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. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 9 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 DS0000026771.V348906.R01.S.doc Version 5.2 Page 10 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 thorough pre admission procedure is in place and assessments are routinely undertaken to ensure that only residents whose needs can be met by the home are offered places there. EVIDENCE: Recently compiled pre admission assessments were seen. Prior to anyone moving to the home their needs are fully assessed by one of the registered people. The records indicated that the needs and circumstances of the person had been properly assessed. Information was also obtained from the placing authorities, although it was not dated as to when the home received it. The local authority assessments seen included information about the residents’ social history and daily activity preferences. Prospective residents are given the opportunity to visit the home as are their representatives. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 11 The home is very clear about their limits and what level of need they can meet e.g. given the limitations of the building, and only offer places to people who fall into that category. Copies of letters were on file that had been sent to prospective residents informing them that their needs could be met at the home. When asked ‘do the care service’s assessment arrangements ensure that accurate information is gathered and that the right service is planned and given to individuals?’ A care manager replied ‘they always assess service users in person prior to admission and discuss needs in detail. Ongoing process of assessment on admission to ensure appropriate service given to individuals.’ Prior to the visit the home sent comment cards out on behalf of the Commission to find out what people thought about the service. Two residents wrote about their experiences of first coming to the home. ‘They came to see me in hospital before I came here. My daughter visited the home personally.’ ‘Discussed with family, very happy with the way it was done.’ All nine residents who returned comment cards to the Commission said that they had had enough information about the home to make their decision to move there and had received a contract. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 12 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: All residents have a care plan appropriate to their level of dependency based on a series of relevant assessments carried out on arrival e.g. risk and manual handling assessments. A couple were reviewed. Files were well laid out. Plans were easy to read; informative about the needs of the resident and of how the home was to meet these needs. A particularly good example of a diabetic care plan was seen. All residents are currently funded at least in part by local authorities and so are subject to ongoing reviews of their care. It was clear that reviews were being undertaken and plans updated with changes, although there was not the evidence that reviews were being done monthly. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 13 One care plan had been signed by a resident / relative to show that they had been involved in it’s development and agreed with what the home was going to help them with and how, but the other had not, Plans were being kept securely in a lockable filing cabinet, as required at the main inspection visit last year. Daily notes support and evidence the delivery of care to residents. These notes give a good picture of the daily lives of residents and the care that is delivered to them by staff in the home. Information from these notes feeds into the care plan reviews. When asked ‘do you get the care and support you need?’ Eight of the 9 residents who returned comment cards prior to the visit replied ‘always’ and 1 ‘usually.’ Five of the six relatives who responded by comment card said that they were ‘always’ informed of important matters in respect of their relative and consulted about their care where appropriate and that the home gave the support or care to their relative that they’d expected or agreed. ‘Any medical conditions are notified to me when I visit.’ ‘I am very pleased with the care.’ ‘Always kept informed about matters concerning my uncle.’ There was evidence within the daily recording, and specific individual professional visit log, that the health needs of residents are addressed with residents accessing GPs and District Nurses. It was also found that other health needs in respect of eye care, dentistry, diabetes and chiropody are met. Residents access hospital clinic appointments through their GPs where needed. All 9 residents who returned comment cards to the Commission said that they always got the medical support they needed. The 2 GP surgeries that returned feedback to the Commission prior to the inspection visit were positive about the home and the care delivered there. Both health professionals commented that the home ‘always’ sought advice and acted upon it to manage, improve and meet individuals’ health care needs. A care manager said ‘GP and District nursing services are involved to enable health needs to be met e.g. care of diabetic patient. Dental and optical appointments are made. Health care needs are thoroughly addressed during monitoring / review of residents.’ GPs expressed confidence in the way that the home handled the medication of residents. Each resident is assessed when they move into the home as to whether they can safely manage their medication. At the time of inspection all of the residents were having their medication administered by the staff. The home uses a unit dosage system. A local pharmacist delivers medicines to the home and provides computer generated Medication Administration Records (MARs) Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 14 sheets. Not all tablets are delivered in the dosage system, some are in boxes and bottles. Once such set of tablets was checked and the number of tablets on the premises accorded with the records and how many there should have been on the premises, given the date of the visit and the date the medicines were delivered to the home. Where there is a variable dose of medication e.g. where it is prescribed that the resident should take 1 or 2, the amount given was noted. Medicines were generally appropriately stored with the exception of some medicines in the fridge, which were in an open drawer rather than in a locked plastic box. The home is checking the temperature of the fridge routinely but not with a thermometer that can confirm that the medicines are not getting too cold or too warm over the course of the day. The medication administration records for all of the residents were seen and found to meet good standards with no gaps within the records. Sample signatures were recorded at the back of the records. A file is kept of patient information leaflets in respect of the medicines prescribed for residents in the home. The home maintains a returns book for unused medication that is returned to the pharmacist. Residents were seen to be treated with courtesy, patience, kindness and respect throughout the visit. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 15 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are arranged in the home that meet residents’ expectations and they are able to have visitors when they choose. Residents are able to exercise choice over their lives and are provided with a wholesome and varied diet. EVIDENCE: Brook House provides organised activities such as quizzes, bingo and games. A range of books and board games were available in the lounge. A music entertainer visits the home every 3 weeks. Mr Chaumoo said that they often take residents out on short trips for example to Mudeford Quay, Bournemouth and Boscombe piers. Mr Chaumoo and the residents in the lounge talked of the trip they were making the next day to see the Red Arrows. During the morning most residents were sitting in the lounge, watching TV, reading the papers and benefiting from each other’s company. One resident spoken to was in his room. He said that at times he liked to watch different programmes from the others. Another resident was sitting out in the garden reading and hoping for some sunshine before lunch. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 16 Information about activities is displayed on the notice board. A quiz was advertised for the afternoon. Of the 9 residents who returned comment cards 4 said that it was ‘always’ the case that there are activities arranged by the home that they can take part in and 5 said that this was true ‘usually,’ residents commented:‘There are activities but it is my wish not to take part.’ ‘By choice if I want to join.’ ‘Sometimes I decide not to join with some of the activities on offer.’ Mrs Chaumoo provides hairdressing for residents. Residents records and the visitors book demonstrate regular contact with family and friends. A visitor who returned a comment card said ‘I visit three times a week but am welcome any time.’ Residents are encouraged to pursue their own lifestyles within the home and make choices wherever possible. These include choosing when to get up and go to bed, what to wear, what to eat or drink and to generally do as they wish during the day. Some have brought their own possessions into the home and personalised their bedrooms. A relative commented ‘Mother is always given choice.’ Most residents go to the dining areas for meals but can have meals in their own rooms if they wish or need. The home uses a four weekly menu, which reflects a basic, wholesome and balanced diet. A record is maintained of the food provided to residents in sufficient detail to be able to tell what each individual has eaten. On the day of the visit lunch was beef burgers, vegetables and potatoes. Dessert was rice pudding and fruit. Supper was to be soup and sandwiches or cheese on toast. Where residents have special dietary requirements, such as diabetes, meals are adapted to suit their needs. The home had a food hygiene inspection in January 2007; the officer commented on the good standard of monitoring records. Eight of the 9 residents who returned comment cards said that they ‘always’ liked the meals at the home, with 1 saying that they liked them ‘usually.’ Comments included: ‘I eat better than I used to!’ Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 17 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 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a complaints procedure. Policies and staff training in abuse protect residents from harm. EVIDENCE: The home has a full complaints procedure that complies with the standards. No complaints have been received by the home or by the Commission for Social Care Inspection since the last inspection visit. The comment cards sent to residents asked the question ‘do you know who to speak to when you are not happy?’ Of the nine who replied 7 said that this was ‘always’ the case and the other 2 ‘usually.’ Eight people said that they would know how to make a complaint, with one person commenting ‘I get confused so would ask my daughter to complain if necessary but I am sure it would be rare.’ A relative said ‘I doubt very much if I would ever have to complain.’ The home has full adult protection procedures and copies of the Department of Health ‘No Secrets’ document. Since the last key inspection some staff have had training in this subject and more is planned. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 18 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Brook House provides a clean, comfortable and well-maintained homely environment for residents. EVIDENCE: The Chaumoo family own and run the home, with Mr & Mrs Chaumoo living on the premises. As part of the inspection the premises was toured and were found to be clean, smell pleasant and in reasonable decorative order throughout. The lounge and dining area are comfortably furnished, with new easy chairs and lap tables having recently been purchased. Residents have access to a small garden to the rear of the home. Mr Chaumoo talked of his intention to build a patio to the front of the home for residents to Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 19 enjoy. He also talked of how they had recently made improvements to the driveway, evening out the surface and improving access to the home. The home is registered for 11 people. The home is permitted to use 2 rooms as doubles. At the inspection 8 rooms were being used for single occupation. There are a number of communal bathing areas in the home. Some aids and adaptations are available e.g. raised toilet seats - and some residents with particular needs have their own personal equipment to assist with their independence e.g. zimmer frames, rollators, walking sticks. Residents are able to personalise their rooms with furniture and general belongings as they wish and in agreement with the home. There are emergency alarm bells throughout the home – in each bedroom and in communal areas. Mr Chaumoo said that all of the radiators that are in use in the home are now covered, thus eliminating the risk of burns. The home has policies and procedures for maintaining infection control standards. Staff are provided with gloves and protective clothing and there are alcohol gels provided around the home for use. The laundry area for the home is sited in a garage building just off the back entrance to the home. Soiled laundry can be taken to the laundry area without passing through food preparation areas. Residents have all their laundry done on the premises and the home has suitable machines to launder clothes and bedding at appropriate temperatures. Since the visit in May 2006 the laundry area has been upgraded with new worktops and hand washing facilities. Some of the residents at times use a commode. The home does not have a designated sluicing facility. At the visit in May 2006 it was agreed that Mr Chaumoo would liaise with the infection control nurses as to the best means to clean commodes in line with infection control measures. How staff are to carry out the cleaning of commodes or bottles at Brook House is not written down. Some barrier creams were found around the home, in residents’ bedrooms and in a staff area. They were not labelled as to their owners as they should be, again as an infection control measure. The home was clean and there were no unpleasant smells. Seven of the 9 residents that returned comment cards said that the home is ‘always’ fresh and clean, with the other 2 saying that this was the case ‘usually.’ One said about the home ‘always clean and very presentable.’ Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are deployed to meet the needs of residents. Residents would benefit from more staff having National Vocational Qualification at level 2 in care so that those caring for them have the up to date skills and knowledge to look after them well. EVIDENCE: Mr Chaumoo said that staffing is currently exclusively provided by family members. Staffing levels remain as at the time of the inspection of May 2006 with two members of staff on duty between 8am and 8pm. During the night time period there is one awake member of staff on duty and one on a sleep-in duty. A rota was seen to this effect. Mr and Mrs Chaumoo and their family carry out domestic and catering duties as well as caring for residents. Residents were asked are the staff available when you need them? Seven of the 9 who responded said ‘always’ with the other 2 saying ‘usually.’ Asked if staff listen and act on what you say all 9 said yes; commenting ‘Yes any problems are sorted out for me.’ No new staff have been employed at the home since the time of the last inspection so how the home has recruited staff could not be evidenced. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 21 Five care staff are employed at the home (in addition to Mr and Mrs Chaumoo the owners). One is doing a National Vocational Qualification at level 3 in care. The Department of Health target is for 50 of care staff to have this qualification. Mr Chaumoo produced certificates showing that staff had just had moving and handling training. He said that there were sufficient staff trained in first aid for there to be one member of staff on duty trained in this field and that all staff who cook for the residents had trained in Basic Food Hygiene. An overview of staff training, so that it can be seen at a glance what training all staff in the home have had and when refreshers are due, was not available. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 22 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 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed and run with the interests of residents in mind but is currently not entirely protecting residents in respect of their health, safety and welfare. EVIDENCE: Mr Chaumoo has now completed his Registered Managers Award. He said that he and his wife originally trained as nurses and their registration on the National Midwifery Council register remains ‘live.’ They have both run the home for a number of years. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 23 Prior to this inspection the home completed an annual quality assurance assessment (AQAA), which they submitted to the Commission for Social Care Inspection. This identifies how the home have taken into account the views of residents and their supporters in the running of the home although does not set out their plans for improvement over the next twelve months. The home sent out and made available comment cards for the Commission as requested before this visit. Comments came back from residents, relatives, a community mental health nurse and some GPs. They were all generally positive about home. In addition the home gave questionnaires to residents and relatives earlier in the year. Responses were positives and comments included ‘All ok.’ ‘Everything perfect.’ ‘Very satisfied.’ Mr Chaumoo said that it was now the case that the home did not hold any money for residents at the home. Where goods or services are purchased the home pays and then residents / representatives are billed. All records were available as requested at the inspection for example an up to date insurance certificate was on display along with the home’s registration certificate. There were photographs of residents as required by law on the medication file. Dorset Fire and Rescue visited the home in April 2007 and confirmed that they were satisfied with standard of fire safety. A fire risk assessment was carried out in respect of Brook House in 2006 and was reviewed in May 2007. During the course of the inspection it was noticed that a residents’ bedroom door was wedged open, thereby compromising the fire safety of the home. Mr Chaumoo undertook to remedy this and find an alternative solution for the resident who prefers their door to be open when they are in their room. Some cleaning products considered hazardous to health were seen. These were stored high up in a staff area on the ground floor. This area was not locked. Mr Chaumoo undertook to store these items more securely. Accident records were looked at. These are analysed monthly. Very few accidents are noted as having taken place. In addition equipment is regularly maintained. Information sent to the Commission prior to the inspection confirmed that the home is undertaking appropriate checks of equipment and facilities at appropriate intervals. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 24 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 25 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 OP38 Regulation 23 and 13 • Requirement The registered person must take adequate precautions against the risk of fire, including containing any fires by not wedging doors open. The registered person shall ensure that all parts of the home to which residents have access to are so far as reasonably practicable free from hazards to their safety including keeping hazardous substances locked away. Timescale for action 30/09/07 • 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 OP7 Good Practice Recommendations The care plan should be reviewed by care staff in the home at least once a month and evidence be available to DS0000026771.V348906.R01.S.doc Version 5.2 Page 26 Brook House show that this has been the case. 2. OP9 • • 3. OP28 The temperature of the fridge used to store medicines should be monitored daily using a maximum and minimum thermometer. Any medicines stored in the fridge should be in a locked box, preferably plastic. 50 of care staff should hold qualifications of NVQ 2 in care or above. Brook House DS0000026771.V348906.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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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