Inspection on 10/01/06 for Brookdene House

This inspection was carried out on 10th January 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookdene House 10/07/07

Brookdene House 08/08/06

Brookdene House 14/02/06

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 Brookdene House 1 Watling Street Radlett Herts WD7 7NG Lead Inspector Mrs Sheila Knopp Unannounced Inspection 10th January 2006 2:00 Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 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 Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 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. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brookdene House Address 1 Watling Street Radlett Herts WD7 7NG 01923 857460 01923 839892 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) Mr Andrew Enstone Nicola Jane Jones Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate one named service user over the age of 65. The Registered Manager is required to notify the Commission when the place is no longer required. 21 September 2005 Date of last inspection Brief Description of the Service: Brookdene House is a modern 5 bedroom detached house which is registered to provide residential support to younger adults with mental health problems. There is a lounge / dining room, kitchen, utility area, toilet and office on the ground floor. The single bedrooms, bathroom and shower rooms are on the first and second floor. A garden room provides a further area for recreation and smoking. Parking is available at the front of the property. The home does not have a lift and is therefore not suitable for people with mobility problems. The house backs onto the railway embankment and is next to residential flats. Brookdene House is set back from the main road on the edge of Radlett. There is a bus stop outside the house. The main line station, shops and facilities in Radlett are within walking distance. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This service was registered for the first time in March 2005. An earlier inspection was carried out on 21.9.05. There were no residents living in the home at that time and details of the inspection were recorded in an additional visit report, which is available on request from the home or Hertfordshire Area CSCI Office. Details of the previous inspection have also been included in this report. This was an unannounced inspection. The inspector spoke with the manager and a support worker who were on duty and spent time with the service user currently living at Brookdene House. No complaints have been raised with the Commission about this service since it was registered. What the service does well: What has improved since the last inspection? The manager needs to continue to identify suitable training for staff as they take up their posts and develop the policies and procedures in line with the development of this new service. The previous inspection required a fire risk assessment to be completed and record of fire alarm tests to be maintained. This work had been carried out and the required information was available. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 6 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. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 7 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 Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 8 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): 2 Detailed pre-admission assessments involving the service user, manager and Community Mental Health Team had been carried out to confirm that the service provided at Brookdene House would meet their needs. EVIDENCE: Details of the Enhanced Care Programme Approach assessment and risk assessment for the current service user were seen and detailed in the care plan developed by the manager following admission. The manager has been working actively with the Community Mental Health support team and service users family over several months to gradually introduce the individual to their new environment. This included a period of day care. A new certificate was issued to enable the manager to admit a named service user over the age of 65 years but this has not been taken up at this time. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 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 & 9 The service user’s plan of care demonstrated that they were being actively involved in considering how their needs and aspirations were to be met. Areas of risk based on a multi-disciplinary assessment are identified and reflected in the encouragement given by staff to maintain independence. The involvement of service users in decisions about their lives and support from social workers or advocacy services is reflected in the approach of the manager, and information available to service users. EVIDENCE: The service user had written in their support plan and signed it. The daily progress notes were very detailed and gave a good picture of the individual concerned which would enable staff to pick up changes in their mental and physical well-being. The manager was able to demonstrate how the service user was being involved in making decisions about their life. Details of social worker contact and advocacy services were available. The plan of care detailed support to encourage an independent life style. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 10 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. The information provided to the Commission as part of the registration process demonstrated awareness of the needs of service users in relation to their leisure activities, community links, relationships and privacy. The responsibilities of service users living at Brookdene house are set out in the Service User Guide, which the manager confirmed had been available to the service user before coming to the home. EVIDENCE: The service user was able to talk about going to the local shops and their knowledge of the local area. They confirmed their visitors were able to have cups of tea. Staff confirmed the support they provided to visitors to Brookdene House. Details of involvement with the daily routines of living are recorded as part of the plan of care and staff gave examples of encouragement to promote independence in areas such as involvement with meal planning and preparation, shopping and personal laundry. Service users are able to have keys to their doors and have a lockable safe in their rooms for personal items. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 11 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 care record examined provided details of the guidance and support provided to enable the service user to meet their personal care needs. Local community health services are available to service users. There are systems in place to meet the medication standards required to support service users safely. EVIDENCE: The medication systems within the home were assessed as meeting the required standards when the home was registered. There is a system in place to encourage residents to manage their medication independently. Details of arrangements to provide support from local community health professionals were available. The medication currently being supplied is being overseen by the Community Mental Health Outreach team as part of their on-going involvement with the planned support of a service user. The team remove records at the end of the weekly cycle. The manager was advised to keep copies so a full record was retained in the home. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 12 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 Information about how to make complaints is available to service users. Service users are also able to make their views known through the placing authorities review process. The home have information available to enable them to work within the Hertfordshire multi-disciplinary procedure for the Protection of Vulnerable Adults. EVIDENCE: No complaints have been received by the Commission about this service since it was registered. Details of the complaint procedure and advocacy services are available to residents beside the hall telephone. This information is also in the Service User Guide given out prior to admission and retained by the service user. The manager has undertaken Protection of Vulnerable Adult training organised by Hertfordshire County Council and the multi-disciplinary procedure is available to staff. New staff will require training as they take up their posts. Staff have access to a Whistle Blowing procedure which provides details of independent agencies that can be contacted should the need arise. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 13 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 & 30 Brookdene House is a modern detached family style house providing well maintained accommodation in a style suitable for younger people. EVIDENCE: The accommodation at Brookdene House meets the National Minimum Standards for Adults. There is a fresh bright and airy atmosphere. The furnishings and flooring are in a modern style in keeping with the building. Service users have their own rooms and access to showers and a bath. There is a lawned garden and patio to the rear of the house, which backs on to the railway embankment. The windows in the house are double glazed and restricted. Low surface temperature radiators have been provided. A garden room, porta-cabin, which can be heated, provides an area for residents to spend time if they wish and can also be used as a smoking area. This area is fitted out with seating and has a music centre & pool table. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 14 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): 32, 33, 34, 35 & 36 The staff team is being recruited to respond to changes in occupancy levels as the service develops and are being supervised and trained by the manager. Currently 2 staff are on duty during the day with a sleep in member of staff at night for one resident. The manager needs to ensure that all the required information is available to demonstrate that staff have been recruited safely and are receiving the required training. EVIDENCE: The recruitment records for staff appointed by the manager were checked during the visit carried out on 21.9.05 confirming that the required checks are carried out on staff. However on this occasion it was identified there was only one reference on file for a member of staff known to the manager and no induction details for another member of staff who had just started. This means that standards 34 & 35 were not fully met on this occasion. Criminal record checks taken up for staff before they started work were seen. Since opening the manager has been organising training. One member of staff is due to start their NVQ 2 training following their induction. Staff with experience and qualifications in mental health work have been recruited. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 15 Formal systems have been set up for the manager to supervise staff on a regular basis and records to support this were available. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 16 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 & 42 The manager is experienced in supporting people with mental health problems and has a good working knowledge of services in the local area. Brookdene House met the required fire and health & safety standards on registration in March 2005. Standard 42 was not fully met on this occasion as the bathwater temperature was above health & safety standards and an immediate requirement was made to carry out a risk assessment and reduce the temperature to prevent accidental scalding. EVIDENCE: The manager is experienced in the care of service users with mental health problems and is knowledgeable about local services. She is well on her way to completing the NVQ 4 Registered Managers Award which is required to be completed for new managers within 2 years of registration and will ensure that standard 37 is fully met. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 17 Written reports by the provider fulfilling his obligations under Regulation 26 to report monthly on the conduct of the home have been sent to the Commission and are available in the home as required. To provide supervision and support to the Registered Manager and feedback to the Provider it was agreed during the registration process that an external consultant would be appointed to carry out a quality assurance role. This is proving to be a valuable resource to the manager and details of the visits and areas covered were made available. Both the Provider and Registered Manager have been very open in their approach to the Commission as they seek to develop this new service. The manager is reviewing the policies and procedures and it was suggested that staff sign to say they have read and understood them. A risk assessment under the Fire Precautions (Workplace) Regulations 1997 (as amended) is now in place and the manager intends to review it three monthly. The records seen indicate weekly fire alarm checks are being carried out and a contract is in place for servicing the fire safety equipment and systems. As a visit by the Environmental Health Department has not yet taken place since the home was registered the manager has been advised to obtain advice regarding recording the temperature of cooked food to ensure food hygiene standards are fully met. Two staff have completed their food hygiene training. The required service records were available on registration of the home. The hot water from the tap filling the bath was 48.5 degrees centigrade. The records did not indicate that risk assessed approach had been considered in relation to the water temperatures to maintain the independence of individual service users. An immediate requirement was made and the manager has since confirmed the action taken to ensure water is provided at a safe temperature. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 27 28 29 30 3 3 x 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000057169.V275148.R01.S.doc 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brookdene House Score 3 3 3 x 2 x x x x 2 x Version 5.1 Page 19 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. 2. 3. Standard YA34 YA35 YA42 Regulation 19(1)(b) 18(1)(c) 13(4)(c) Requirement Two written reference are required before a person can be employed. Keep a record of individual staff induction and training to meet Skills for Care standards. An immediate requirement was made to carry out a risk assessment and reduce the temperature of the hot water supply to the bath to minimise the risk of accidental scalding. The Commission received confirmation of the action taken on 13/01/06. Timescale for action 10/01/06 10/02/06 17/01/06 Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 20 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. 2. Refer to Standard YA42 YA42 Good Practice Recommendations Contact the EHO for advice on recording food temperatures. Maintain a regular check of hot water temperatures to test the functioning of the thermostatic mixing valves fitted to the bath taps. Brookdene House DS0000057169.V275148.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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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