Inspection on 08/08/06 for Brookdene House

This inspection was carried out on 8th August 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brookdene House 10/07/07

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 8th August 2006 01:00 Brookdene House DS0000057169.V302731.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.V302731.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.V302731.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 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.V302731.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. 14th February 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 14.8.06). 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 Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on two visits, which took place on 8 & 14 August 2006. The first visit was unannounced. Information from discussion with 4 service users, 3 staff and the manager as well as a review of case records (3) and management records has been used to assess the service provided at Brookdene House. Information received about the home since the last inspection on 10 January 2006 has also been reviewed. No concerns have been raised with the Commission about this service between inspections. This is a relatively new service, which at the time of the previous inspection had only one resident. Therefore a track record of performance over time has not yet been established. Four out of the five service users have only recently come to stay at Brookdene House. Based on their short experience and the information available it was assessed that overall a good service was being provided. What the service does well: What has improved since the last inspection? Now that the home has achieved full occupancy the registered manager is increasing the staff team and reviewing the training programme to ensure it complies with standards for social care workers. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 6 She has identified resources to achieve this, which can be difficult for small independent providers. Staff have received first aid training in line with a previous requirement made. 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.V302731.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.V302731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. To ensure individuals can be supported at Brookdene House a full assessment of need involving the prospective service user, family members and key health & social care agencies is carried out. EVIDENCE: The manager carries out a pre-admission assessment by visiting perspective service users and attending review meetings with the other health & social care professionals involved in the discharge process. Copies of the Care Management assessments and risk assessments are obtained to ensure service users can be supported safely. The records seen confirm service users are involved in the admission process and are able to spend time at Brookdene House before making any decisions to stay. Following admission, service users are involved in developing their own preferred plan of care. Brookdene House DS0000057169.V302731.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Each service user is 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 assessment are in place to enable identified issues to be managed safely. EVIDENCE: A basic plan of care is put in place following admission and together with their key worker, service users are involved in developing this further to reflect their personal goals. The care plans include agreed risk assessments related to personal safety and treatment plans. Further Care Programme Approach (CPA) reviews involving service users are held following admission. The manager is aware of local advocacy services and has provided information to enable a service user to act independently and contact them directly. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 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 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Individual arrangements are being made with service users to support their interests while at home and in the wider community. Service users are encouraged to become involved in the day to day running of the house and are positive about the standard and variety of meals being served. EVIDENCE: Staff are supporting service users to be involved in the day-to-day running of the house and to use their time following hobbies and special interests. The manager agreed to keep a record of service user involvement with the running of the home and details of the decisions reached. As service users settle in, contact is being made with the local community and additional resources for day services are being identified. Staff identify what action is required to support the religious beliefs and cultural practices of service users. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 11 Contact with family members and friends is being supported and in some cases restarted. The rights of service users to privacy are respected in relation to where they spend their time and personal care arrangements. Service users have keys to their rooms and are able to use the facilities throughout the house. The service users spoke of the meals that they like and named particular staff as being excellent cooks. Homemade soup came in for a particular mention. A weekly menu is prepared in discussion with service users. Fresh fruit, snacks and a variety of drinks and cereals were available for service users to pick up. The main meal is in the evening. On the day of inspection service users had three different options cooked at lunchtime based on their preferences and dietary needs. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Staff have encouraged and assisted service users to maintain good standards of personal care and hygiene. The manager has demonstrated a commitment to ensuring that the physical health needs of service users are fully assessed following admission and that their mental health needs and any risk are clearly identified by the Community Psychiatric team so that on-going support can be provided. Medicines are given as prescribed and kept under review. There appear to be good links with local mental health teams and community psychiatric nurses. EVIDENCE: Staff have enabled service users to maintain their dignity and well being by encouraging them to maintain good standards of personal care, hairstyling and clothing. This has included visits to a hairdressers where this has not been achieved in previous settings. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 13 Service users are registered with a local doctor and access to other health and social care professionals is arranged to support individual needs. Arrangements were being made for a service user to see a dentist and optician. The manager has followed up health needs not identified by a previous health care provider. The storage systems and records for medicines meet the current guidelines. There is a step by step system in place to enable service users to manage their own medication if this is applicable. Staff have been vigilant in reporting the effects of medication changes. Records of staff training and competency assessments in relation to medication were seen. The manager was advised to check that the dispensing pharmacist is able to visit and provide advice to the home under arrangements with the primary care trust. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users feel their views are listened to and have access to a complaints procedure, which is also supported by contact with others who can act on their behalf. The manager and staff demonstrate an understanding of the systems and culture that needs to be in place to protect service users. EVIDENCE: The service users all appear to enjoy good relationships with the staff team. All interaction was relaxed and appropriate with staff taking time to listen, respond and reassure service users. It was the assessment of the inspector that staff, were working to promote the rights and interests of service users moving out into the community. When asked about staff one service user thoughtfully said ‘they are very good, they have empathy’. As the majority of the service have only been living in the home for a short period staff were actively involved in sorting out issues which had arisen as a result of long stays in hospital or other care settings to ensure for example that service users had someone independent to speak on their behalf and access to their finances. Service users have a copy of the complaints procedure and information is also displayed in the hallway. No complaints have been raised directly with the Commission between inspections. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 15 Service users have a safe in their room to store valuable items. Systems have been put in place to record and audit transactions where staff are involved in supporting service users with their finances. The manager agreed to set up a system for recording personal possessions, which may be deposited in the office safe from time to time. A list of items belonging to individual service users is kept. Staff have received training in protection of vulnerable adult issues and details of the Hertfordshire multi-agency policy were available. The new Mental Capacity Act, which comes into operation in April 2007 was discussed with the manager as this is an area, which needs to be developed through the home’s policies, procedures, training programme and records to ensure the rights of service users are protected under the new legislation. Details of a self-audit tool were provided. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users are living in a bright modern family house, which is well maintained and kept clean. EVIDENCE: Service users have keys to their own rooms. They are able to 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 for those wishing to smoke. This area has a music centre, small pool table, lounge chairs and heating. Garden furniture is available and one service user has been involved in looking after the planted pots of summer flowers. One resident felt that the noise from the railway line and main road could be intrusive particularly on hot sunny days with the windows and doors open. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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, 34, 35 & 36 Quality in this outcome area is assessed as good. This judgement has been made using available evidence including a visit to this service. Service users were positive about their relationships with staff. The staff interviewed all demonstrated a commitment to supporting people with mental health problems. Now that the home has achieved full occupancy steps are being taken to recruit a full staff team. The manager intends to involve service users in the selection process. The recruitment procedures in place protect service users by ensuring suitable people are employed. Staff receive regular supervision to ensure they receive support and understand their role. The training and development needs of staff are being reviewed to ensure staff receive on-going training and that 50 of staff with National Vocational Qualifications can be achieved in the future. Standard 32 will not be fully met until this is achieved. EVIDENCE: The manager reported that recruitment is in progress to increase the team of permanent staff. Where agency staff have been required a named individual has provided consistency on a full time basis and is known to the service users. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 18 Currently in addition to the manager two are provided during the day and there is a sleep-in member of staff at night. Additional staff have been provided to support service users in the community when required. The records of two staff employed since the last inspection were reviewed. These confirmed that criminal records checks are carried out and two references obtained before staff start work. In the case of an agency worker confirmation of the checks carried out by the agency and the individual’s qualifications and training details had been made available. Staff confirm that they feel well supported by the manager and that there are team meetings. Records of two monthly supervision sessions are maintained. These included formal supervision sessions for the agency works as a full member of the team. Staff training includes access to courses on mental health issues. Staff confirmed they felt competent and well supported in their jobs. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39 & 42 Quality in this outcome area is assessed as good. 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. An independent practitioner provides the registered provider with reports on the quality of the service at Brookdene House. An area for further development now that the home is established is the production of a quality assurance report for service users, the Commission and other interested parties. The manager is reviewing the staff training profiles and health & safety systems and records to ensure a safe environment is maintained for service users and staff. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has recently 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. Standard 37 will be fully met when this has been achieved. The manager continues to demonstrate an open and transparent approach to the running of the home and liases with relevant statutory agencies for advice and guidance. An external practitioner visits to monitor the service on behalf of the registered provider and act as a mentor for the manager. A report is made available to the registered owner and manager. The most recent report carried out in August indicates that this is a robust process, which identifies changes required to meet legislative requirements as the service develops. It keeps the registered provider and manager informed of their responsibilities under the Care Standards Act and other relevant legislation. The registered manager is in contact with a training company who assess the training requirements of staff against standards set for social care workers by Skills for Care. Following a requirement made after the last inspection staff have received first aid training. Details of the relevant staff training being provided are recorded. Following the recent quality audit the manager is reviewing the health & safety risk assessments and audits. Records of regular tests on fire safety equipment and hot water temperatures are being kept. No concerns were identified. The home met the requirements of the Hertfordshire Fire safety service on registration and has a sprinkler system installed. Any changes to systems within, such as the introduction of alarm activated door closures must be agreed in advance with the fire safety officer. Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 2 33 x 34 3 35 2 36 3 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 2 x 3 x x 3 x Brookdene House DS0000057169.V302731.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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.V302731.R01.S.doc Version 5.2 Page 23 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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