Inspection on 10/07/07 for Brookdene House

This inspection was carried out on 10th July 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookdene House 08/08/06

Brookdene House 14/02/06

Brookdene House 10/01/06

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 July 2007 12:00 Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 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.V343368.R01.S.doc Version 5.2 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.V343368.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookdene House Address 1 Watling Street Radlett Herts WD7 7NG 01923 857460 01923 839892 nicola.janejones@btinternet.com 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.V343368.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may admit 2 named service users over the age of 65 years. The registered manager is required to notify the Commission when the places for the named service users are no longer required. 8th August 2006 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. The current fees range from £630 - £928 per week based on an individual assessment of needs (correct as of 10.7.07). No additional charges are made. Information about the home is contained in the Service User Guide & Statement of Purpose, which are available on request from the manager together with a copy of the latest inspection report. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information in this report is based on an unannounced visit to the service where the inspector met with four people currently living at Brookdene House, two staff and the manager. The views of four service users, one relative and three health & social care workers who sent completed survey forms directly to the Commission have also been included. Information received by the Commission since the last inspection on 8/8/06 has also been reviewed. No concerns have been reported regarding the quality of service provided to the people who live at Brookdene House What the service does well: What has improved since the last inspection? The manager has established the rights of individuals to receive the money they are entitled to following discharge from acute or long stay care settings. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 6 The well being of individuals and their positive interaction with each other demonstrates the improvements they have made in their health and independence since coming to stay at Brookdene House. A stable and experienced staff team who are able to provide continuity and support has been established. The manager has identified a training organisation to provide resources and audit the needs of staff so they receive the training they require to develop their skills. Over 50 of the staff team have achieved qualifications at NVQ level 2, which is the standard set for individual care home staff teams to achieve. 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. The summary of this inspection report can be made available in other formats on request. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 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.V343368.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Before individuals make a decision to live at Brookdene House they are involved in an assessment process that includes the opportunity to visit and try out the service. EVIDENCE: No new people have come to stay at Brookdene House since the last inspection. The last inspection identified that the manager carries out a preadmission assessment by visiting each individual and attending review meetings with the other health & social care professionals involved in the discharge process. Copies of the care management and risk assessments are obtained to ensure service users can be supported safely. The information gathered at this inspection confirmed the needs of each individual are kept under review and responded to as needs change. Staff receive specific training to enable them to support people with mental health problems. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who live at Brookdene House are involved in developing a plan of care, which sets out how their needs and aspirations are to be met. This information is kept under review and risk assessments are in place to enable identified issues to be managed safely and promote independence. EVIDENCE: A health care worker said residents were ‘well supported and given independence’. A social worker said that ‘autonomy and self determination are always encouraged’ and ‘risk assessments and care plans are robust..’ A relative felt that strength of the service provided at Brookdene House was in ‘responding to individual needs’ and providing guidance and support in relation to life style choices in order to achieve positive outcomes. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 10 The four care plans reviewed demonstrated that staff responded to the changing needs and views of the individuals concerned. In some cases the person concerned had written their own support plan. People who need support making decisions about their life are put in touch with local advocacy services that have proved to be supportive in taking issues forward. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual arrangements are made with service users to support and develop their interests while at home and in the local community. Support is given to maintain and establish personal relationships and family links. Service users are encouraged to be involved in the day to day running of the house according to their wishes. Service users are involved in planning a varied menu, based on freshly cooked food, which they enjoy and takes account of individual dietary needs and preferences. EVIDENCE: Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 12 A social worker said that staff ‘actively respect service users privacy and dignity..’ They said their client was ‘always treated as an individual, and as such had access to “ordinary life principles”.’ Each service user has a key to their own room and the rights of individuals to come and go as they please are clearly understood by staff. There are rules on alcohol consumption and smoking, which are challenged at times by individuals. These issues are discussed with service users and their social workers in the context of maintaining the health & well being of the individuals concerned. There is a designated smoking room in the garden. From discussion with service users and staff there is clear evidence that people’s independence and increasing links with the local community are being promoted. One person who was not able to leave the house is now going out alone. Another person described watching football matches in the local pub and meeting people in a nearby café. Links with a local church have been established for another person. At a recent resident meeting the group discussed planning a holiday. People spoke about visits and links with family members. Arrangements are being made to extend people’s community contact further by arranging day services. One person is exploring voluntary work. Service users are involved in planning the menu, shopping and preparing meals, which are prepared from fresh ingredients. They said they enjoyed the meals and confirmed the staff were good cooks. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who live at Brookdene House receive the support they require to maintain their physical and psychological needs. There are safe systems in place to ensure individuals receive their prescribed medication and structured support is provided for those wishing to manage their own medicines. EVIDENCE: A health worker confirmed that the health needs of residents were always met. Another person said that staff asked for advice and acted upon it to improve the service users health care needs. There was evidence from this inspection that individuals are encouraged to visit local surgeries and take responsibility for attending regular check ups. The health needs of individuals are identified and there was clear evidence of the progress made by individuals following their admission from acute hospital units. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 14 Another health worker said that staff ‘ remain vigilant no “need” and “unmet” need. As such all issues are flagged up and addressed’. A social worker said that the ‘management of medication is taken very seriously’. The medication systems were reviewed and this demonstrated that they are well managed with regular reviews and checks. The competency of staff is assessed before they administer any medicines and training is provided. There are systems in place to enable residents to progress on to managing their own medication at varying levels if this is appropriate. A new storage system has recently been introduced to hold the monitored dose system cassettes. The manager confirmed she was in the process of identifying suitable fixings to secure it. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The views and concerns of the people who live at Brookdene House are listened to and acted upon. Staff protect individuals by ensuring their rights are promoted and upheld. EVIDENCE: A social worker said that ‘staff and management within Brookdene House have always taken service users comments, questions concerns or complaints seriously. They actively encourage honesty, disclosure and discussion.’ No complaints have been received by the Commission regarding the care and support of individuals living at Brookdene House. Concerns raised by individuals living at Brookdene House are dealt with in a positive and considerate manner. A house meeting is held and some individuals are involved in writing the minutes. Social workers and advocates support individuals. Service users have access to a telephone and help-line numbers. The manager has worked hard to ensure individuals receive the money they are entitled to following their admission. This was clearly a positive development for one person who is now able to buy things for themselves. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 16 Records of money or valuables held on behalf of service users are kept to ensure there is a clear record of transactions. Staff receive training in the principles and practice of safeguarding vulnerable adults. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are provided with fresh clean accommodation in a bright modern family style house close to the centre of Radlett with its amenities and transport links. EVIDENCE: Each person living at Brookdene House has their own bedroom, which they have their own key to. Lockable keypad safes are provided in each room for secure storage. Service users can add their own personal possessions to the furniture and fittings provided. All areas of the home were found to be fresh and clean. Service users are free to use the kitchen and utility area. As well as a large lounge dining room with patio doors on to the garden, there is a separate porta-cabin room in the garden that provides a designated room for those wishing to smoke. This area has a music centre, small pool table, lounge chairs Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 18 and heating. Garden furniture is available for sitting out. One individual said they had a BBQ at the weekend. The garden is well kept and flowering pots and tubs make an attractive display. Smoking is not allowed in individual rooms due to the fire safety arrangements in place that include a sprinkler system. None of the service users raised any concerns about the noise from the railway now that they have settled in. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 & 35 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. An experienced staff team that can provide service users with stability has now been established as this new service has developed. Employment and criminal record checks are carried out on staff before they start work to check that they are suitable to work with vulnerable people. Recording details of the management decisions taken as part of the recruitment process would further demonstration that all areas had been considered and equal opportunities policies were being followed. The training needs of staff are kept under review to ensure they have the required skills to support the people who live at Brookdene House. EVIDENCE: A social worker said that staff manage ‘difficult situations well, without constant contact with the care co-ordinator’. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 20 A health professional said they have found ‘all staff very helpful and caring towards residents’. Another person said that staff act as role models for new staff. A health professional said that they found the staff at Brookdene House to be ‘professional and competent’. A social worker commented that on a rare occasion their client had not been able to go out as staff were not available. The manager reported that where possible flexible arrangements are made and gave an example of arranging for a member of staff to support a family taking an individual to the theatre. The staff on duty felt they were able to provide an individual level of care that responded to the changing needs of the people who live at Brookdene House. The recruitment records of four staff employed since the last inspection were reviewed. This demonstrated that references and criminal records checks are obtained before people start work. Induction and supervision records confirm staff are well supported by the manager. To demonstrate all areas of the applicants work history and suitability to work with vulnerable people has been explored the manager should record how decisions have been reached as part of the process. For example the reason specific references have been taken up, requesting applicants complete a health declaration and the reasons for leaving previous care work. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42 - People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced in supporting people with mental health problems in the community and has a good working knowledge of local services. The quality monitoring systems continue to be developed to gain the views of people who use or have contact with the service. Following a planned audit by an external assessor the manager needs to identify a suitable format for providing people with feedback and information on future developments. Regular maintenance and monitoring systems supported by staff training are in place to protect the health & safety of the people who live at Brookdene house and the staff. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 22 EVIDENCE: The health & social care professionals who completed survey forms confirm that there is a positive management approach to meeting the needs of the people who live at Brookdene House. The manager has submitted her portfolio to be awarded the Registered Managers Award, which is the standard qualification to be achieved by care home managers The manager reported that a visit from an independent practitioner who provides professional has been arranged to review the quality of the service feedback from service users, relatives and other key people who were invited to give their views. The next step will be to provide feedback to service users and key people in a suitable format. The registered owner visits regularly to meet service users and provide a report to the manager as part of the quality monitoring processes. The records of safety checks on equipment and systems within the home were found to be up to date. The Hertfordshire Fire safety service carried out a routine planned fire safety inspection on 3.5.07, which did not require a follow up visit. Arrangements are made for staff to receive the statutory training they require to support safe working practices. Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 23 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 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 OP34 Regulation 19 Requirement Each employees personal file should include – • Written verification of the reasons of leaving previous similar employment. • A statement by the employee of mental and physical fitness. Safe & Sound – Checking the suitability of new care staff in regulated settings (CSCI Infocus issue 4 June 2006. Timescale for action 10/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Brookdene House DS0000057169.V343368.R01.S.doc Version 5.2 Page 26 - 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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