Inspection on 20/10/05 for Brook Street (101)

This inspection was carried out on 20th October 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brook Street (101) 26/06/06

Brook Street (101) 05/05/05

Brook Street (101) 11/11/04

Brook Street (101) 08/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Brook Street (101) 101 Brook Street Northumberland Heath Erith Kent DA8 1JJ Lead Inspector Peter Daniel Unannounced Inspection 10:00 21 October 2005 st Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 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 Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 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 Adults 18-65. 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 Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brook Street (101) Address 101 Brook Street Northumberland Heath Erith Kent DA8 1JJ 01322 332840 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) brook@mcch.org.uk MCCH Society Limited Mr Kenneth Hazell Care Home 6 Category(ies) of Learning disability (6), Old age, not falling registration, with number within any other category (6), Physical disability of places (6), Sensory impairment (6) Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th May 2005 Brief Description of the Service: Brook Street is a purpose built detached two-storey property. It offers shortterm respite care to 6 adults with learning disabilities, referring to its service users as guests. It has six single bedrooms (four with en-suite facilities), four bathrooms and two WCs. Two of the bedrooms are on the ground floor. There is a lift between floors and hoists in the bathrooms. There are two lounges, a dining room, kitchen, utility room with laundry facilities and an office. There is a small area for off street parking at the front of the property, with an enclosed garden to the rear. Brook Street is owned by Bexley Council and operated by MCCH Society Ltd. The home is situated in a residential area and has ready access to public transport, shops, a park and other local amenities. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home is well run and is suitable to its statement of purpose. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Service users and their relatives have sufficient information before choosing to stay at the home. The home has a Statement of Purpose and Service User Guide, which is in the process of being updated. Prospective guests can visit the home for a ‘trial’. Service users are involved in the assessment process. MCCH do not yet issue proper contracts to its service users but this issue is under review and is now urgent. EVIDENCE: NMS 1 Following a previous recommendation, the registered manager agreed to produce an updated Statement of Purpose and Service User Guide in the form of a new brochure and DVD format. It was hoped to complete this by Summer 2005. Due to serious injury and resulting sick leave, the registered manager has not been able to complete this. This requirement has again been included as a requirement. See requirement 1. NMS 2 Service user’s needs are assessed. The inspector saw evidence of a service user’s care plan that included an assessment of need. The care plan included a full assessment of the service user’s needs. It included the service user’s capabilities and needs regarding washing/bathing, toileting, dressing, mobility, moving and handling, diet, eating and drinking, medication, communication, daytime activities, sleeping, behaviour and a risk assessment. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 8 NMS 5 The registered provider has still not supplied each service user with a written contract and statement of terms and conditions. The inspector was informed that this is still under review at Head Office. As Brook Street is a respite home the contract is likely to be a more generic than an individual contract. Once more, this has been set as a requirement. See requirement 2. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Each service user has a Care Plan that is drawn up between the home and the service user. The plan reflects the needs and goals of the individual and sets out the services to be provided in accordance with the service user’s assessed needs. EVIDENCE: NMS 6 Service users know their assessed needs and personal goals and this is reflected in their Care Plan. The inspector saw evidence on service user’s files of comprehensive care plans that addressed individual needs. Care plans were mostly up to date. NMS 7 and 8 Service users are helped to make decisions about their own lives and are consulted as appropriate. The service user is present at their review and is assisted by relatives. During the inspection, the inspector observed staff consulting with service users on every day issues. Members of staff also attend reviews convened by Day Care services. The home has introduced a consultation process for relatives. A first meeting was held in September and was reported to be successful Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 10 NMS 9 Some service users are sufficiently independent to be allowed to take risks. A risk assessment was seen included in a service user’s care plan. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Service users are encouraged to lead fulfilling lifestyles. The home provides opportunities for integration into community life and for maintaining links with family and friends, as appropriate. The home respects the rights of individuals and promotes their well-being and independence according to their individual needs. EVIDENCE: NMS 12 and 13 Service users take part in appropriate activities and take part in the community. A service user was interviewed. She informed the inspector that she frequently goes on outings –shopping to Bexleyheath, Bluewater, Woolwich, visit to restaurant and pubs. She had also been on a trip to the Bluebell railway. She expressed satisfaction that her recreational needs are being met. NMS 15 Service users have appropriate contact with their families who are free to visit or telephone. Brook Street is a respite care home and therefore the matter of contact is not such an issue. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 12 NMS 16 Service users rights are respected. The inspector observed staff communicating sensitively with service users to ascertain their wishes and feelings. This was done through signing or using pictures. One service user who has some communication skills told the inspector that if she didn’t like the food she would say so and would be offered an alternative. She said she felt listened to. The home plans to do some more work with the Speech Therapist in developing communication techniques. NMS 17 Service users are offered a healthy diet and enjoy their meals. The inspector saw the weekly menu in the kitchen and observed the contents in the fridge. There was evidence that service users are offered a balanced diet including fresh fruit and vegetables. A service user told the inspector that she enjoyed the food. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The staff at the home provide sensitive personal care including and promote the health needs of guests. EVIDENCE: NMS 18 and 19. The inspector observed service users receiving personal support. Staff were seen dealing and responding sensitively to service user’s individual needs. One of the service users who could express her views mentioned that she felt properly cared for at the home. As described above, service user’s have their needs assessed. NMS 20 The home has effective and secure procedures for administering medication. The majority of service users require medication to be administered on their behalf. Service users bring their medication to the home. Each service user has a medication sheet. Each time medication is administered, it is signed and dated by two staff. The staff member who administers the medication must be trained. The second signature is a witness. Evidence of signed medication sheets was seen. Medication is stored in a secure cabinet. Medication is checked out when the service user leaves. The manager also does ‘spot checks’ to ensure that medication has been given. A further check on the medication takes place at the handover meeting. The inspector saw this taking place. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 14 Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 There is a clear and effective complaints procedure and guests know how to complain. There is a policy to protect service users from abuse and the majority of staff have attended training in adult protection. EVIDENCE: NMS 22. The home has a Complaints Procedure and service users or carers know how to lodge a complaint. There have been no formal complaints since the last review. NMS 23. The home has an Adult Protection Procedure and this is included in the combined Statement of Purpose/User Guide. The majority of staff have already done the training in Adult Protection but two staff still have to do the training. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30 The home is suitable for meeting its stated purpose and needs of guests. It is comfortable and hygiene is given a high priority. EVIDENCE: NMS24 The home continues to offer suitable accommodation relevant to its stated purpose. The home was observed to be comfortable, homely and furnished to a very good material standard. The flooring in the dining room has recently been replaced following a requirement set at the previous inspection. The hallway is planned for re-decoration. NMS25 A suitable up/down bed has been installed in bedroom 6, once again this followed a requirement made at the last inspection. NMS 30. The inspector observed the home as exceptionally clean, hygienic and tidy. The manager reported that a recent visit by Environmental Health it was agreed that when the kitchen sink is replaced and a new seal put in, the home will be recommended for a Food Hygiene award. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 32, 33, 35,36 The home has a committed and experienced staff group. However, staff need to be trained in communication strategies and staff supervision should be offered at more regular intervals. EVIDENCE: NMS 31 There is clarity of staff roles and responsibilities. Copies of job descriptions were seen placed on staff files. NMS 32 and 35 The home employs competent, qualified and trained staff. There home has 9 staff including, the manager. The manager has an NVQ level 3 and level 4 qualification. The Senior Support Worker has just commenced NVQ level 3 training and will complete the training in 9 months time. Two support workers have obtained an NVQ level 2. One support worker has a Diploma in Social Work. Four support workers (including the two night staff) have signed up this month for NVQ level 2 training and should start before Xmas. Hopefully all the staff will have an NVQ qualification by the end of 2006. Almost 50 are now qualified. There was further evidence that in service training is offered by MCCH and staff are attending. One staff member’s file showed evidence that she had attended training in adult protection awareness, rectal preparation, epilepsy, Hep B and HIV, administering\medication, food hygiene and enteral feeding. The Speech Therapist working with the home has recommended that the home must develop a communication strategy to enhance its communication skills Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 18 with residents. It is understood that the home intends to achieve this. The inspector considers this must be given priority and has therefore set this as a requirement. See requirement 3 NMS 33 The home’s establishment is measured at 570 hours per week. There are vacancies for 10 hours per week for night staff and 24 hours for weekend work. The home uses bank and agency staff when there is a shortage. There is always a minimum of two staff on duty during the day but it all depends on individual service user needs. At night time there is always one support worker on duty. During the inspection, the inspector observed that there were 4 staff on duty. NMS 34 Service users are supported by the home’s recruitment practices. Staff records are kept centrally at MCCH head office in Maidstone but some copies of CRB records are now also being held at Brook Street. The manager has agreed to get copies of CRB checks for all staff files. The inspector noted a copy of a CRB check on the staff file that was inspected. NMS 36 The inspector spoke to staff who reported good morale and teamwork. Regular team meetings are held - the last one was held on the 22nd September 2005. The manager informed the inspector at present staff on average receive supervision every 12 weeks. The National Minimum Standard is that staff should receive supervision every 8 weeks. This has therefore been set as a requirement. See requirement 4. Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 The home is well managed. The health and safety of guests is promoted. The home has started to consult with relatives. EVIDENCE: NMS 37 The home is well run. The registered manager has completed NVQ level 4 and is an experienced manager. The inspector was satisfied that service user’s needs are being largely met and that there are good administrative systems in place. A requirement has been set to ensure that staff receive regular supervision – see standard NMS 36. NMS 39 Since the last inspection, the home has taken on board a requirement to consult service user’s through their relatives in the running of the home. The home has established a consultation meeting with relatives and separately a review working party that has invited two relatives as representatives. The inspector saw evidence of minutes of both meetings. Regulation 26 Reports are being completed on a monthly basis but copies are not always being sent to Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 20 the Commission for Social Care Inspection. This has been set as a requirement. See requirement 5 NMS 41 The inspector examined service user files and staff files. These were assessed to be in good order and kept in a secure and confidential place. NMS 42 The health, safety and welfare of service users is promoted by the home. The inspector saw evidence of the following safety checks within the home: weekly fire alarm test done 2/10/05; service of fire alarm 5/1/05; fire drill with day staff 6/7/05 and night staff 18/4/05; fire alarm inspection and servicing 29/4/05; fire extinguisher inspection 28/3/05; Fire risk assessment May 2005; emergency lighting test 25/4/05; electrical fuse boxes tested September 04; electrical inspection 26/10/04. Service to Malibu bath 4/8/05; gas safety check 9/5/05; check of lift 12/8/05; service of gas boiler 10/2/05; inspection of hoists 4/8/05 Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brook Street (101) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x 3 3 x DS0000038200.V260293.R01.S.doc Version 5.0 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 YA1 Regulation 4 Requirement The registered manager must update the Statement of Purpose and Service User Guide. This was a requirement from the last inspection and is again included as a requirement. The registered provider must supply each service user with a written contract/statement of terms and conditions between the home and the service user. The registered manager must ensure that staff are trained to have specialist skills in communication The registered manager must ensure that persons working in the home receive supervision at least six times a year. The registered manager must ensure that quality monitoring forms under Regulation 26 are sent to the CSCI on a monthly basis. Timescale for action 28/02/06 2. YA5 5 30/04/06 3. YA32 19.5(b) 30/04/06 4. YA36 18(2) 31/12/05 5. YA39 24 30/11/05 Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 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. Refer to Standard YA34 Good Practice Recommendations The manager should keep copies of CRB checks at the home and discuss this with MCCH Head Office Brook Street (101) DS0000038200.V260293.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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. 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