Inspection on 24/05/05 for Brook House

This inspection was carried out on 24th May 2005.

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

Brook House 02/05/07

Brook House 16/05/06

Brook House 24/01/05

Brook House 14/09/04

Brook House 05/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Brook House Seymour Street Cambridge CB1 3DH Lead Inspector Matthew Bentley Unannounced 24 May 2005 @ 11:00 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 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Brook House Address Seymour Street, Cambridge, CB1 3DH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01223 247864 dianejay@excelcareholdings.com Excelcare Holdings plc Care Home 34 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (34) of places Brook House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14/09/04 Brief Description of the Service: Brook House provides care, support and accommodation for up to thirty four people, including up to eight who have a diagnosed dementia. The home is close to a popular shopping area of Cambridge. Accommodation is provided on two levels, the upper floor being accessed by stairs or a shaft lift. All rooms are for single occupancy and are arranged in flats, with each group of rooms having a dining area/sitting room and kitchenette. Some of the residents choose to use a day centre which operates within the home. Staff support is provided 24 hours a day and an on-call manager is always available. The home has 2 cats which provide interest and company for those who are fond of animals. Brook House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took 3.5 hours and took place on 24 May 2005 between 11.00 and 14.30. The inspection was carried out by one inspector who spoke to a number of service users and staff. The inspection also included reading documents, speaking to management, and a tour of the building. The home was without a registered manager at the time of inspection. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brook House Version 1.10 Page 6 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 Standards Statutory Requirements Identified During the Inspection Brook House Version 1.10 Page 7 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 standard(s) 1, 2, 3, 4, 5 The home takes suitable steps to ensure that potential service users’ needs are fully assessed prior to their moving into the home, and an appropriate length of time is offered as a trial period, so that all parties can be sure of the suitability of the home. Some of the documents relating to the home did not contain up to date information, which meant that potential service users may not have full and up to date information about the service as a whole. EVIDENCE: The home had a service user guide, which could be given to people who may be interested in moving in. The document needs to be updated to include the current details of the Commission; this is also true of the home’s contract. When a person is referred to the home, the manager visits them at their home or in hospital, and also asks for information from family members and professionals so that a full picture of the person’s needs can be built up. The home’s admission policy encourages people who are interested in the home (and their families if appropriate) to visit before making a decision about Brook House Version 1.10 Page 8 whether they think it may be suitable. New residents are given a three month trial period to see whether the home is meeting their needs and whether they want to stay permanently. The home does not provide intermediate care so standard 6 is not applicable. Brook House Version 1.10 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 standard(s) 7, 8, 9, 10 The newly introduced system of care planning should give a good description of what help each person’s needs and how that assistance should be given so that staff can be clear about what they need to do. Arrangements are in place to ensure each service user receives input from relevant professionals to ensure each person’s health needs are met. Personal care is given sensitively so that individuals’ dignity and privacy are maintained. Procedures for managing service users’ medication are satisfactory and were being properly followed, so that medication is safely administered. Service users wishes with regard to death and dying were properly recorded so that appropriate arrangements could be made. EVIDENCE: Care plans relating to 5 residents were seen, and showed the action required to meet their assessed health, personal, and social care needs including hobbies, interests, personal histories and likes and dislikes. Service users’ wishes around death and dying are included in the care plans. The home’s procedures indicate that the care plans should be reviewed every month to Brook House Version 1.10 Page 10 ensure that they show current and changing needs; whether this is happening will be looked at during future inspections. The manager said that working relationships with the GPs, District Nurses, and other people working in the health service professionals were good, and arrangements had been made for individuals to receive regular dental and eyesight checks. Private chiropody services are available to people who need them. Medication is given to residents by care staff after they have been given enough supervision and training. The staff member responsible for medication at the time of inspection said that she felt both competent, and adequately trained and supported to ensure that medication was dispensed safely, and care staff who had not been trained said that they would not be asked to assist with medication without proper training. Records relating to medication were seen and found to be in order, as were the storage arrangements. Maintaining service users’ privacy and dignity is included in staff meetings, induction and supervision. Residents spoken to said that they felt their privacy and dignity were respected and staff used the names that they preferred. Care staff were seen talking with service users whilst helping them walk from one place to another and at lunchtime; the way they spoke was respectful and polite. Brook House Version 1.10 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 standard(s) 12, 13, 14, 15 Staff provide appropriate support to facilitate contact with family and friends, though there is scope for increasing the range and frequency of organised activities. Dietary needs are well catered for, with a balanced and varied selection of food available to meet residents’ individual tastes and choices. Residents are encouraged to make choices about their lives and are encouraged to maintain their independence. EVIDENCE: Two people said that they felt there was not enough to do in the home and they would like more activities to be organised. The home encourages people to have visitors at reasonable times and residents confirmed that they were able to see their visitors in private if they chose. Residents spoken to said that they were able to choose what time they got up and went to bed, and how they spent their days, and all those who voiced and opinion commented how good the food was. Brook House Version 1.10 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 standard(s) 16, 18 The home’s systems for dealing with complaints are generally satisfactory though some amendments were needed on the written procedures to ensure anyone wishing to make a complaint could be given accurate information about who to contact. The arrangements for ensuring the protection of service users from neglect or harm are satisfactory, so that service users are protected from abuse or mistreatment. EVIDENCE: The home had a complaints procedure to tell people how to make a complaint about the service; the procedures were generally satisfactory, but the version in the service user guide and other documents had contact details for the Commission which were out of date. A requirement has been made about this. Residents said that they would feel able to tell staff or the manager if they had a complaint or suggestion, and any complaints that had been made had been dealt with properly. The home had an adult protection policy to guide staff in dealing with allegations of abuse or mistreatment, and a whistle blowing policy aimed at encouraging staff to voice any concerns they may have, was also in place. Staff spoken to were clear about the need to make sure residents were protected from mistreatment and said that they would feel able to talk to the manager if they had any concerns. Brook House Version 1.10 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 standard(s) 19, 20, 22, 23, 24, 26 The home is suitable for the needs of those living there, and sufficient equipment is provided so that service users’ independence is maximised. Though it is well decorated and generally clean, a smell in one service user’s bedroom let down the home’s hygiene standards. A requirement has been made about this. EVIDENCE: The home is close to a popular shopping area of Cambridge. Accommodation is on two floors; access to the upper floor is gained using a shaft lift, and the building is fitted with aids and adaptations to meet the needs of older people. Whilst the building would not meet some of the new standards relating to, for instance, en suite facilities, the home appeared well maintained and had a homely, calm, and pleasant atmosphere. Residents have access to a range of communal space and when asked, all said they were happy with these areas. Discussions with staff indicated the there Brook House Version 1.10 Page 14 was sufficient equipment and adaptations for staff to adequately, and safely, meet the needs of the current service users. Bedrooms were well maintained, tidy and (with the exception of one referred to below) clean. Furniture appeared to be comfortable and appropriate to the needs of individuals, and there is evidence that service users are able to bring with them personal items and items of furniture provided they meet safety standards. The home had laundry facilities which were sited so that soiled linen and other items did not need to be carried through areas where food was prepared, stored, cooked or eaten. The home was generally clean and free from unpleasant smells though one room had a noticeable smell of urine; the manager reported that this was due to particular issues with one service user which she was trying to resolve. Brook House Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 Sufficient staff were on duty to ensure that service users’ needs were properly met. Staff were clear about their roles and were competent and properly trained and experienced, so that they could meet residents’ needs. The home’s recruitment procedures meant that appropriate checks were made on potential staff to ensure that unsuitable people were not employed. EVIDENCE: Five care staff were on duty, along with the manager, deputy manager, and kitchen and cleaning staff. Staff were well presented and were courteous, welcoming and helpful. The manager said that the target of 50 of staff having NVQ level 2 had already been achieved and more staff were going to be starting the award in the future. All new members of staff receive induction training, which is supervised by the manager. The home has a training programme, which included statutory training needed to ensure everyone’s safety, such as moving and handling, fire safety and first aid. Other training included dementia, continence, and avoiding pressure sores. Staff spoken to said that they had been given enough training to allow them to carry our their duties effectively and safely. Staff files were inspected and contained the information required to meet the relevant standard, including references, proof of identity and Criminal Records Bureau (CRB) checks. Brook House Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 38 The home is being managed properly and there is leadership, guidance, and direction for staff to ensure residents receive consistent quality care. However, the manager is not registered with the Commission. The home has quality assurance systems to ensure that service users’ views on the service are obtained and acted upon. A satisfactory system of induction and supervision of staff was in place to ensure that care provided was of a high standard, and staff were clear about their roles and responsibilities. Measures were generally in place to ensure that the health, safety and welfare of the people using the service were being protected, however, a number of items of electrical equipment had not been tested for safety; a requirement has been made about this. Brook House Version 1.10 Page 17 EVIDENCE: The manager of the home was properly experienced and was running the home competently. The home is without a registered manager and an application to register a manager has not been received by the Commission. An application should be submitted for consideration. Questionnaires have been developed to provide the opportunity for residents and relatives to give feedback about the services offered, and the manager said that further surveys were going to be made later in the year. Residents are expected to look after their own money or if they are unable, relatives or other representatives will be asked to help them. The manager said that she was setting up systems to ensure that staff received formal supervision every 2 months or thereabouts; the effectiveness of this will be evaluated during future inspections. Health and safety training is included in the induction of new staff and training is provided to update staff as necessary. A number of items of electrical equipment bought in by service users had not been tested for safety. Brook House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 x 3 3 3 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 Standard No 16 17 18 Score 2 x 3 2 x 3 x 3 x x 2 Brook House Version 1.10 Page 19 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 1&2 Regulation 5 Requirement The service user guide and contract must be amended to ensure that all of the information provided is accurate and up to date The programme of activities in relation to recreation, fitness, and training must be developed and expanded The complaints procedures must be updated to show the up to date contact details for the Commission All areas of the home must be kept free from unpleasant odours Timescale for action By 15 July 2005 2. 12 16(2)(n) By 15 July 2005 By 15 July 2005 From the date of this inspection (i.e. 24 may 2005) and ongoing By 15 July 2005 3. 16 22 4. 26 16(2)(k) 5. 38 13(4)(c) Electrical safety testing must be carried out on all portable appliances in the home RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Brook House Version 1.10 Page 20 No. 1. Refer to Standard Good Practice Recommendations Brook House Version 1.10 Page 21 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Version 1.10 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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