CARE HOME ADULTS 18-65
Brookdene House 1 Watling Street Radlett Herts WD7 7NG Lead Inspector
Mrs Sheila Knopp Unannounced Inspection 14th February 2006 14:10 Brookdene House DS0000057169.V282973.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.V282973.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.V282973.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 brookdene hse@hotmail.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.V282973.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. 10th January 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. Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second published report for the year April 2005 to March 2006. Three visits have taken place during the year to this newly registered service. As there were no residents at the time of the first visit an additional visit report was produced which is available from the Hertfordshire CSCI Area Office. This inspection was to follow up the requirements and recommendations made when the home was inspected on 10.1.06 when the majority of standards were inspected. No complaints have been received by the Commission about this service since registration. This was an unannounced inspection. The inspector had contact with the service user currently living at Brookdene House and registered manager and a support worker on duty at the time of the inspection. What the service does well: What has improved since the last inspection?
The hot water supply to the bath is now within health & safety limits to prevent accidental scalding and regular checks are being carried out to identify any adjustments needed. A second reference has been obtained for an employee where this had not been available. The manager needs to ensure that for new staff appointed two written references are obtained before they start work. Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 6 The manager has been in contact with the Environmental Health Department and obtained advice on the records to keep in relation to food safety following recent changes in the legislation covering this area. 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.V282973.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.V282973.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): Standard 2 was not inspected as assessed as being met when the home was inspected on 10.1.06 and there have been no further admissions. EVIDENCE: Brookdene House DS0000057169.V282973.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): Not inspected as standards 6, 7 & 9 were assessed as being met when the home was inspected on 10.1.06. EVIDENCE: Brookdene House DS0000057169.V282973.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): Not inspected as standards 12, 13, 15, 16 & 17 were assessed as being met when the home was inspected on 10.1.06. A recommendation to obtain further guidance on the food records to be kept has been obtained from the Environmental Health department. EVIDENCE: Brookdene House DS0000057169.V282973.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): Not inspected as standards 18, 19 & 20 were assessed as reflecting the needs of the service user when the home was inspected on 10.1.06 EVIDENCE: Brookdene House DS0000057169.V282973.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): Not inspected as standards 22 & 23 were assessed as being met when the home was inspected on 10.1.06. No complaints have been received by the Commission. EVIDENCE: Brookdene House DS0000057169.V282973.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): Not inspected as standards 24 & 30 were assessed as being met when the home was inspected on 10.1.06. EVIDENCE: Brookdene House DS0000057169.V282973.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): Standards 32, 33, 34, 35, & 36 were assessed on 10.1.06. Requirements made under standards 34 & 35 were followed up and had been met. The manager needs to ensure that staff working alone with residents have first aid training. EVIDENCE: A second reference for one of the support workers has now been obtained. The manager is aware that two written references are required before individuals start work and this needs to be followed up for future employees. Details of the dates specific areas of induction training were completed by another support worker have been recorded. The manager was advised to look at the new Skills for Care ‘Common Induction Standards for Social Care’ which are linked to NVQ core units and enable staff to build up their portfolio. The manager needs to ensure that there is a qualified first aider on duty at all times and where new staff are in charge this is supported by a risk assessment demonstrating their competency to deal with emergency situations. Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 15 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): 39 Action had been taken under standard 42 to reduce the temperature of the hot water supply to the bath to minimise the risk of accidental scalding. The manager needs to ensure that any staff left alone are capable of responding to emergency situations and have received first aid training. EVIDENCE: The manager has submitted her portfolio for assessment towards completion of the Registered Manager Award, which is the standard qualification to be achieved by new managers with 2 years of registration. As a new service the provider and manager need to move towards producing a report based on the outcomes of the quality monitoring systems in place, which involves feedback from service users, family, friends, advocates and other health & social care professionals. Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 16 The manager has advised that she is reviewing the homes policies and procedures, which were developed before registration. An external practitioner visits to monitor the service and act as a mentor for the manager. A report is made available to the registered owner and manager. The registered owner continues to send copies of his reports provided to the manager following visits to the home to monitor standards. The bath water temperature was tested and was found to be within the required range. The registered manager is also recording regular checks to identify adjustments that need to be made to maintain the safety of service users. A member of staff working on night duty has not had first aid training. This also relates to the recommendation that the manager reviews the induction process to ensure it has been fully completed before staff are left in charge. Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 17 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 x 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 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x x x 3 x x 2 x Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 18 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 YA42 Regulation 13(4) Requirement The registered manager must make arrangements to train staff in first aid before they are left in sole charge of service users. A qualified first aider should be available at all times (NMS42.2) Timescale for action 31/03/06 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 YA35 YA39 Good Practice Recommendations Review updated Skills for Care ‘Common Induction Standards and Guidance for managers’ against the induction programme in place. Identify a system for issuing an annual report, to service users, relatives, stakeholders and the Commission, on the outcome of the quality reviews and audits carried out. Brookdene House DS0000057169.V282973.R01.S.doc Version 5.1 Page 19 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
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