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

This inspection was carried out on 5th 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 Street (101) 26/06/06

Brook Street (101) 20/10/05

Brook Street (101) 11/11/04

Brook Street (101) 08/07/04

Similar services:

Ashlong House

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Edenvale

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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 Brook Street Northumberland Heather Erith Kent DA8 1JJ Lead Inspector Peter Daniel Unannounced 5 May 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brook Street Address 101 Brook Street, Northumberland Heath, Erith, Kent DA8 1JJ 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) 01322-332840 01322-332840 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 G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4/5/05 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 WC’s. 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 G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on the 6th May 2005. it involved meeting with staff, attending a staff meeting, meeting guests and inspecting files. 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 G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5 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: 1. Following a recommendation from the previous inspection it is acknowledged that the registered manager is producing an updated Statement of Purpose and Service User Guide that will be featured in a new brochure and DVD format. It is hoped to complete this by Summer 2005. See requirement 1. 2. The home has made improvements in assessing need and undertaking risk assessments. The inspector observed evidence on service user’s files of effective assessment of need that was demonstrated in the care plan. It covered a medical diagnosis, general health issues and medication, an assessment of moving and handling, toileting, dressing, mobility and diet. Care Plans were mostly up to date and had been completed by the key worker. 3. The home has a Service User Guide that was seen that gives a briefing of the services provided by the home. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 8 4. The home has a policy that allows prospective residents to ‘test drive’ the home. Guests are first invited to visit for tea and do an informal tour of the home. 5. Service user’s contracts are the responsibility of the head office at MCCH. A draft contract is under review. Once contracts have been completed a copy for each service user should be held at the home. This has been set as a requirement. See requirement 2. This is now urgent. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 standard(s) 6,7,9 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: 6. Service users know their assessed and changing needs. These are included in the service user’s Care Plan and are explained in more detail under standard 2. The service user is involved in contributing to the Care Plan. Also in attendance is the service user’s relative and key worker. The inspector saw evidence of this on the service user’s file. 7. Through attending their own review and with assistance from their relatives, service users are helped to make decisions about their lives. The inspector saw evidence of this on the service user’s file and observed staff consulting with service users on every day issues. 9.Some service users can be sufficiently independent to take risks. A risk indicator checklist was seen on a service user’s file. Another file showed that a resident had had a risk assessment about a feeding regime and tube care. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 10 Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 standard(s) 12,13,15,16,17 Service users are enabled to lead fulfilling lifestyles whilst staying at the home. The home provides opportunities for integration into community life and leisure and for maintaining links with family and friends, as appropriate. The home has effective house rules and daily routines and guests are looked after with respect to their dignity and consideration of their individual needs and choice. EVIDENCE: 12. Service users are able to take part in appropriate activities. The inspector perused the home’s activities folder that verified that the services users have been on days out to Woburn Abbey, Octupus Club, the cinema, bowling, boat trip, visit to hop farm , visit to the coast, visits to local pubs. During the inspection two service users were being taken out for a walk to the local park. Service users also attend church if they so wish. Staff discuss activities with relatives prior to undertaking longer trips. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18, 19,20 The staff provide sensitive and flexible personal support and promote the healthcare of service users. EVIDENCE: 18. Service users receive personal support through the key worker system but all staff are involved in each guest’s care. Scrutiny of care plans showed that personal support was being offered in terms of medication, health issues, washing and bathing, toileting, daytime activities, self help skills and communication. 19. This standard is addressed above under standard 18. To support the evidence, the inspector spoke to a guest who confirmed that when she c0mes to stay at the home, she is made to feel looked after by the staff. If guests are unwell the home has a link to Northumberland Health Centre where medical support is offered although guests may be referred to their own general practitioner. 20. The majority of guests require medication that is administered on their behalf. Guests usually bring medication with them. The home has a secure system. When a guest arrives, the home completes a new drug sheet. Evidence of completed and signed drug sheets was seen on file. Each time Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 13 medication is administered, it is signed and dated by two staff. The second signature is a witness. Medication is stored in a secure cabinet. Medication is checked out when the guest leaves. The inspector saw a medication risk assessment on a guest’s file. The manager told the inspector that the home does ‘spot checks’ to check that medication has been given. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 14 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 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 staff are undergoing training in adult protection. EVIDENCE: 22. The home has a complaints procedure and service users or carers know how to complain. There have been no complaints since the last review. 23. The home has an Adult Protection Procedure and this is included in the combined Statement of Purpose/User Guide. Some staff have had Adult Protection Training and further dates are planned in June 2005. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24, 30 The home is comfortable and clean and suitable for the needs of service users. EVIDENCE: 24. The home continues to be suitable for its stated purpose. The home was observed to be comfortable and homely and furnished to a good material standard. The hallway and living room are on a list to be re-decorated this year. The replacement of flooring in the dining room is still outstanding although it was included in this year’s budget. This has been set as a requirement. See requirement 6. 25. The inspector observed bedrooms that were suitable to the needs and lifestyle of occupants. Bedroom 6 is in need of an ‘up and down’ bed to aid staff with moving and handling and providing personal care to guests who have special mobility needs. This has been set as a requirement. See requirement 3. 26. The bedrooms have a single bed, bedside cabinet, wardrobe, chair and chest of drawers. Doors can be locked on the inside but can be overridden on the outside. Windows have restrictors. The rooms are bright, friendly and clean. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 16 27. Toilet and bathroom facilities offer sufficient personal privacy and have locks on the inside. Toilets and bathrooms were observed to be clean and hygienic. 29. A new up and down bath in the downstairs bathroom has been installed and this will help guests to maximise their independence. 30. The inspector observed the home as exceptionally clean, hygienic and tidy. All carpeting has recently been steam cleaned. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35,36 32 ,333, 34, The home has a committed, well-trained and experienced workforce. There is good morale amongst the staff group who are well supported by management. A requirement has been set to ensure that all staff receive regular supervision. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 18 EVIDENCE: 31. Copies of job descriptions along with staff profiles are now being held at the home. 32. The home has competent and qualified staff. There are 9 staff who are experienced and have the necessary skills for the task. The manager of the home has completed the NVQ level 4 qualification. The Senior Support Worker has started the NVQ level 3 qualification and will complete the training by October 2005. She has also completed a 12 week certificate in management. One RSW has a Dip SW qualification, one has an NVQ level 2 and one member started NVQ level 3 training in January 2005. Another will start in September 2005. A new support worker who has completed NVQ Level 2 will start at the end of May 2005. The home deploys a pool of bank and agency staff when necessary. 33. The inspector observed an effective staff team with sufficient numbers on duty - there were three staff on shift who were providing a ratio of one to one supervision and support. The staff appeared to be working as a unit. Records show a low turnover of staff. No staff had left since the last inspection. There was evidence that regular staff meetings are held between 4 –6 weeks. The inspector attended part of a staff meeting and saw evidence of effective team working and harmony amongst the staff. The minutes of the previous staff meeting were seen. 34. The home operates a thorough recruitment procedure. Although staff records are kept centrally at MCCH head office in Maidstone, copies of staff records are now also being held at Brook Street. All CRB checks are understood to be up to date but are still held at MCCH head office. It is recommended that copies of CRB checks should be kept at the home. See Recommendation 1 35. The level of training of staff is referred to under standard 32. In addition individual staff having undertaken other training as follows: fire warden training, client handling, health and safety, first aid, adult protection and epilepsy. 36. The inspector interviewed two staff and attended a staff team meeting. Overall staff are well supported and there is good morale and good communication between staff and management. One staff member reported that supervision is offered six weekly. Another said that supervision had been less frequent. A requirement has been set for the manager to ensure that all staff receive individual supervision at least six times a year. See requirement 4 Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The home has procedures in place suitable for the purpose and running of the home. The manager and his staff are competent to run the home. Overall the home is meeting its stated aims and purpose. The home needs to develop ways of listening to and consulting service users. EVIDENCE: 37. The home is well run. The registered manager has completed NVQ level 4 and is an experienced manager. 39. Service user’s views are not fully included in monitoring of the home. A requirement has been set for the home to pay more attention to consulting and listening to service user’s. See requirement 5. However, the home is planning to devise a questionnaire to obtain feedback. The home has a comments book for relatives to fill in and positive comments about the running of the home were seen as recorded. The inspector commends the home for the regular completion of regulation 26 reports. Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 20 40. The MCCH policies and procedures manual was seen. 41. The inspector examined service user files. These were seen to be in good order and kept in a secure and confidential place. 42. The inspector saw evidence of the following safety checks within the home: weekly fire alarm test done 25/4/05; service of fire alarm 5/1/05; fire drill with day staff 5/1/05 and night staff 18/4/05; emergency lighting test 25/4/05; electrical fuse boxes tested September 04; fire risk assessment 6/8/04; electrical inspection 26/10/04. 43. From speaking to staff the inspector was satisfied that there is clear accountable management of the service. The inspector also has spoken to the area manager who is responsible for the overall management and standards of the home. The inspector was impressed with the latter’s ‘hands on’ approach and awareness of the day to day issues of the home. 42 Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 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 3 3 1 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 3 3 x 3 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brook Street Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 3 3 3 3 G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 22 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 Regulation 4 Requirement The registered manager must update the Statement of Purpose and Service User Guide. Following a recommendation from the previous inspection it is acknowledged that the registered manager is in the process of doing this and hopes to complete this by the Spring of 2005. The two should be combined as one brochure. This is nevertheless again included as a recommendation. 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 bedroom 6 has a suitable up/down bed to meet the needs of service users with severe physical disability problems. The registered manager must ensure that persons working in the home are appropriately supervised. The registered manager must ensure that quality monitoring systems seeking the views of Timescale for action 31.8.05 2. 5 5 30.9.05 3. 25 23 (2) (n) 30.9.05 4. 36 18(2) 31.7.05 5. 39 24 30.9.05 Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 23 service users are in place. 6. 24 23(2)(b) The manager must replace the flooring in the dining room. 31.7.05 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 34 Good Practice Recommendations The manager should keep copies of CRB at the home and discuss this with MCCH Head Office Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Sidcup Area Office River House 1 Maidstone Road, Sidcup Kent 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. Extracts may not be used or reproduced without the express permission of CSCI Brook Street G51-G01 S38200 Brook Street V224745 05-05-05 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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