Inspection on 07/06/05 for Brookdale Nursing Home

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brookdale Nursing Home 14/11/06

Brookdale Nursing Home 06/10/05

Brookdale Nursing Home 14/03/05

Brookdale Nursing Home 01/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Brookdale Nursing Home 16 Blakebrook Blakebrook, Kidderminster Worcestershire DY11 6AP Lead Inspector Chrissy Presley Unnannounced 7 June 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. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brookdale Nursing Home Address 16 Blakebrook Blakebrook Kidderminster Worcestershire DY11 6AP 01562 823063 01562 823150 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) Alder Meadows Limited Mrs Christine Wallbridge Care Home with Nursing 40 Category(ies) of DE(E) Dementia (over 65) - 3 registration, with number OP Old Age - 40 of places PD Physical Disability (55 years and over) - 1 PD(E) Physical Disability (over 65) - 40 TI Terminally Ill - 3 Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may also accommodate one person with a physical disability aged 55 years to 64 years on admission. Date of last inspection 14 March 2005 Brief Description of the Service: Brookdale is a care home for older people, providing nursing and personal care. The home is a traditional Georgian listed property which has been converted to provide nursing care for 40 older residents. Brookdale is situated in a pleasant residential area of Kidderminster, close to local amenities. The home provides accomodation on the ground and first floor, consisting of single and double bedrooms, lounges and dining areas. A lift is provided to assist residents to access all areas of the home. The home has a pleasant and well maintained garden which residents can access when weather permits. The home does not currently have a registered manager; the acting manager is Mrs Jane Hackney. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Tuesday morning and commenced at 11am the inspectors left the home at 2pm. The inspectors interviewed staff and residents. The inspection focused on care records, complaints and protection, the environment and health and safety issues. What the service does well: What has improved since the last inspection? What they could do better: There are major shortfalls regarding core training for staff and training specific to the needs of the residents. Health and safety issues, which had been discussed in previous inspections, had not been addressed. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 6 The environment in the home needed updating and upgrading, staff felt this was a priority. 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. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Despite residents being assessed prior to admission to the home, the information contained in the document was not sufficient to allow a care plan to be developed. This can potentially place residents at risk. EVIDENCE: The care plan of the most recent resident admitted to the home was inspected. There was information in the document as to why the resident had not visited the home prior to admission and who had visited on her behalf this was commendable. The initial assessment did not contain enough prescriptive information with regards to the required care needs to ensure a care plan could be formulated and the home could meet the needs of the resident to be admitted. The document was not signed or date. Oral care needs stated ‘needs to be cleaned’ the inspector was unsure if the resident had dentures or their own teeth. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 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 & 10 Care plans did not record individual needs and appropriate information for staff to ensure specific care needs could be met. Personal support was offered by a committed team of care staff that respected the dignity and privacy of residents and promoted independence where possible. EVIDENCE: The care records of four residents were inspected the following information was missing;• A photograph of the resident was not available in one care plan • Care plans did not contain specific information for staff to deliver care safely • The care records of one resident who was now nursed in bed did not reflect her altered circumstances • Monthly reviews did not reflect events of the past month • Risk assessments for falls not signed or dated • Specific risks had not been identified in the care plans such as wandering at night • Relevant aids and equipment to assist residents was not documented • There was no evidence of resident involvement in care plans Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 10 • There were no risk assessments for bed rails that were specific there were bedrail consent forms signed in care plans Residents spoken to during the inspection appeared happy with their care. Those residents who were unable to voice their views appeared well cared for and were treated with respect by staff that were seen interacting with them in a friendly manner. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 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 & 15 Resident’s needs were well catered for with a balanced and varied selection of fresh food. This does not reflect the time between meals. EVIDENCE: Residents spoken to were complimentary about the food on offer one resident said it could be a little more varied. There were no complete records of food given to residents. Specialised diets were catered for and liquefied meals were presented in a manner, which appeared appetising. The inspector was concerned that lunch was at 12.30pm, tea was at 3pm and supper was at 5pm, there appeared to be a gap of over 14 hours before breakfast the following morning; staff told the inspector residents were offered sandwiches and toast before going to bed concerns were around those residents who went to bed early and those residents who were unable to request food. A knife and fork was given to residents who were mentally frail 45 minutes before their meal this was discussed with the staff members who understood reasons why this was not appropriate. The dishwasher has been out of working order for over two years and had been noted at other inspections; staff are hand-washing crockery. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 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 complaints policy and procedure in the home was not good. The policy and procedure for the protection of the vulnerable adult did not meet the required standard and reflect the Worcestershire Vulnerable Adult policy and procedure. EVIDENCE: The complaints procedure in the home had reference to the old Commission and stated ‘If the proprietor is unable to satisfy the complainant within 7 working days then the complainant may refer to the Commission for Social Care Inspection’, this is not the case as anyone can refer a complaint to the Commission without notifying the home. The Protection of Vulnerable Adults polices and procedures were not robust enough and did not contain telephone numbers of the Worcestershire Vulnerable Adult Protection contact. Staff had received limited training in this field. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 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) 19,20,21,22,23,24,25,& 26 The standard of the environment was poor and a number of health and safety issues were noted. EVIDENCE: The home was clean and warm on the day of inspection. The following was noted when the inspector walked round the premises;• An oxygen extinguisher was blocking a fire exit • Some rooms did not have a bedroom lock and there was no evidence in all care plans as to reasons why • Not all bedrooms had a lockable piece of furniture • It was noted tiles were broken and there was no plug in one sink • Bed linen looked fatigued • Creams not belonging to the resident in that bedroom were noted • A lock was broken on a toilet door • The child gate used on one bedroom door had not been risk assessed • Fire doors were noted to be wedged open the most serious of these was from the kitchen to the downstairs sitting/dining room Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 14 • • • • • • • • • • • • A portable heater was noted not to be secure and had no guard fitted Communal combs appeared to be being used The bathroom doors which were on sliders did not close fully and did not therefore ensure resident’s had privacy during bathing The doorway carpet between the upstairs sitting room and dining room needed re-fitting and presented a trip hazard to staff and residents Water temperatures when residents were bathed were not consistent and accurate A lamp shade was missing in the lounge A room audit with minimum furnishing was not seen in all care plans Glass needed repairing in a bedroom window There was no ongoing plan to fit thermostatic control valves to wash hand basins, water temperatures charts showed that hot water was delivered in excess of 43 degrees on numerous occasions An adequate legionella risk assessment was not available for inspection The nursing station was not locked. Medication consisting of an inhaler was left unsecured in a bedroom Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 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& 30 Residents in the home had complex needs and staffing levels did not reflect the input required to look after residents in a safe environment. Staff lacked training in all aspects of care and health and safety. EVIDENCE: Staff felt there was not enough time to spend with residents particularly those who were mentally frail. There were enough ancillary staff, it was noted that a member of staff who was working in the laundry was under 18 years of age her working practices had not been risk assessed. Not all staff had received core training this included; • Fire training • Moving and handling • First aid • Infection control • Health and safety the inspectors were unsure if the home had a first aider on duty at all times. Staff said they felt their training had lapsed and there was no evidence that staff had received training specific to the needs of residents such as dementia training. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 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) 38 The acting manager does not ensure the health and safety of staff and residents through policies and procedures and safe working practices. EVIDENCE: The acting manager is a registered nurse who is new to the post of managing a care home, this was reflected in the inspection process when a number of immediate requirements, were left with the home about the environment, staff training and health and safety issues. Staff felt the home was friendly and residents said they were well looked after by a committed team of care staff who had worked in the home for a number of years. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 1 1 1 1 1 1 1 1 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x 2 x x x 2 Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 18 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 OP3 Regulation 14 Requirement A written assessment must be completed before the admission of any new resident and in accordance with the requirements of Regulation 14 and Standard 3 A care plan must be drawn up with each resident in accordance with the requirements of Regulation 15 and Standard 7 The care plan identified during the inspection must be re-written to reflect current care needs Monthly reviews must reflect what has happened in the current month Unless it is impracticable residents or their representatives must be involved in drawing up their individual plans Risk assessments must be carried out on all aspects of care needs Moving and handling risk assessments must be updated at least monthly and specific equipment needed for moving and handling residents must be noted Moving and handling equipment must be reviewed and replaced E52 S4100 Brookdale Nursing Home V226551 070605.doc Timescale for action Immediate and ongoing 2. OP7 15 Immediate 3. 4. 5. OP7 OP7 OP7 15 15 15 immediate immediate 31/07/05 6. 7. OP7 OP7 13 13 30/06/05 30/06/05 8. OP7 13 31/07/05 Page 19 Brookdale Nursing Home Version 1.30 as necessary. 9. 10. 11. 12. 13. OP15 OP15 OP15 OP15 OP15 23 23 16 16 13 &18 The dishwasher must be repaired and in working order The fire door leading from the kitchen to the dining room must not be wedged Records of food given to residents must be kept There must be evidence that residents are offered food in the evening More attention must be paid to ensuring the residents who are most mentally frail have their needs met during mealtimes Staff must have training in the protection of the vulnerable adult The complaints procedure must be amended to include information about the stages and the timescales for an investigation The complaints procedure must provide written information to all residents for referring a complaint to the CSCI at any stage should the complainant wish to do so Procedures for responding to suspicion or evidence of abuse must be drawn up Fire exits must not be blocked Residents must be provided with keys to their bedroom doors unless a risk assessment suggests otherwise Residents must be provided with lockable storage space for medication, money and valuables and a key which she or he can retain unless the reason for not doing so is explained in the care plan All of the items of furniture specified in Standard 24.2 must be provided in rooms occupied by residents. If the provision of 31/07/05 immediate immediate immediate immediate 14. 15. OP18 OP16 18 22 31/08/05 31/07/05 16. OP16 22 31/07/05 17. 18. 19. OP18 OP19 OP24 12,13 23 12,13 31/07/05 immediate 31/07/05 20. OP24 12,13 31/07/05 21. OP24 16 31/07/05 Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 20 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. OP24 OP9 OP19 OP19 OP19 OP19 OP19 OP19 OP19 OP19 OP19 OP26 OP19 OP26 16 13 16 13 & 16 13 12 & 13 13 & 16 13 13 16 16 13 17 13 any item poses an unacceptable risk to the resident or they decline the provison details of the discussions and decison about this should be recorded in the assessment of the residents needs Fatigued bed linen must be replaced Creams must be used for the named resident only Locks must be repaired The child gate used in one bedroom door must be risk assessed The portable heater must be risk assessed Communal combs must not be used The bathroom where there are sliding doors must be repaired so it closes fully The carpet identified as a trip hazard must be repaired Bath temperatures must be accurately recorded The missing lamp shade in the lounge must be replaced The broken window pane of glass must be replaced There must be a legionella risk assessment open to inspection The nursing station must be locked when not in use There must be an on-going programme of thermostatic valves being fitted to wash hand basins Staff must receive training that is specific to the resident group staff must receive fire training at least every 3 months Staff must receive core training E52 S4100 Brookdale Nursing Home V226551 070605.doc 31/08/05 Immediate 30/06/05 immediate immediate immediate immediate immediate immediate immediate immediate 30/06/05 immediate immediate and ongoing Action plan to the CSCI within 7 days Action plan to the CSCI within 7 days Action plan Page 21 36. OP27 18 37. OP27 18 38. OP27 18 Brookdale Nursing Home Version 1.30 39. 40. OP34 OP38 25 13 41. OP38 13 The policy and procedure regarding residents monies must reflect current practice There must be at least one member of staff on duty at all times day and night who is trained in first aid to at least the level of an Appointed Person to the CSCI within 7 days 30/06/05 31/07/05 31/07/05 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 OP34 Good Practice Recommendations A business and financial plan for the establishment should be drawn up, made open to inspection and reviewed annually. Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 22 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Droitwich Road Worcester WR3 7NW 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 Brookdale Nursing Home E52 S4100 Brookdale Nursing Home V226551 070605.doc Version 1.30 Page 23 - 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. 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