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Inspection on 23/01/06 for Brookes House Care Centre

Also see our care home review for Brookes House Care Centre for more information

This inspection was carried out on 23rd 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All residents are assessed prior to admission to ensure that the care home is the right place for them. The home`s environment remains pleasant and homely and generally provides residents with a safe place in which to live.

What has improved since the last inspection?

The registered person has appointed a new acting manager. The acting manager has experience of working within a care home environment, both as a carer and within a management role. From discussions with the acting manager it is evident that she is committed to improving the homes current standing and to raise staff morale. Since the last inspection the acting manager has made some improvements to the homes recruitment processes and filing system. In addition the acting manager is trying to secure more training for staff and to ensure that previous gaps and shortfalls are addressed. Some improvement has been made to the home`s care planning processes etc.

What the care home could do better:

Additional work and improvement is still required in relation to improving the home`s care planning/risk assessments. All care staff within the home need to receive appropriate care planning and risk assessment training. The deployment of care staff within the home continues to need reviewing so as to meet the needs of residents. The registered provider needs to ensurethat there are sufficient numbers of staff on duty at all times and that the home`s lounge areas are adequately staffed so as to ensure resident`s health and well being. A programme of meaningful and stimulating activities must be provided to all residents residing at the care home. The registered provider must ensure that the number of hours provided by staff to enable residents to receive both `in house` and community-based activities are increased and ensure that clear records are maintained. This requirement has been highlighted many times and to date there has been no further progress by the registered provider to address this shortfall. It remains no longer acceptable to ignore this requirement. Interaction between care staff and residents must be improved upon and care staff must ensure that at all times residents are treated with respect and given choices wherever possible. It is unacceptable for all residents to be given gravy with their dinner and for them to receive a meal that is unappealing to look at and sloppily served. Before any care/interventions are provided by care staff to residents, staff must speak to residents and explain their actions. Continued efforts must be made to ensure that care staff receive a range of training which meets the needs of residents (both mandatory and specialist). Additionally continued improvement must be made in relation to ensuring that recruitment procedures are adopted in line with regulatory requirements.

CARE HOMES FOR OLDER PEOPLE Brookes House Care Centre 79-81 Western Road Brentwood Essex CM14 4ST Lead Inspector Michelle Love Unannounced Inspection 08:00 23 January 2006 rd X10015.doc Version 1.40 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 Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brookes House Care Centre Address 79-81 Western Road Brentwood Essex CM14 4ST 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) 01277 212709 01277 200706 Ashbourne (Eton) Limited Manager post vacant Care Home 70 Category(ies) of Old age, not falling within any other category registration, with number (70) of places Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Personal care to be provided to no more than 70 service users over 65 years of age. (Total number not to exceed seventy). Total number of service users for whom personal care is to be provided shall not exceed 70. 25th July 2005 Date of last inspection Brief Description of the Service: Brooks House Care Centre provides 24 hour accommodation and personal care for up to seventy older people. The home is not registered to care for people with dementia. It is a three storey building with residents accommodation on the first two floors and staff accommodation is provided on the top floor. It is situated a short distance from Brentwood Town Centre with its shopping areas and public transport. The home provides mostly single bedrooms, however there are some shared rooms as well. All bedrooms have en-suite facilities. There are lounges and dining rooms on both floors, which are accessible to residents by way of a passenger lift or ramp. A smoking room and hairdressing facility is available. Parking facilities are available at the front of the premises. There is a garden to the rear which has a small patio area that is accessible to residents. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by Michelle Love and Carolyn Delaney, inspectors, over a period of 15.5 hours. At this visit both inspectors met with the newly appointed acting manager and spoke to a number of senior/care staff. A tour of the premises was undertaken and a number of care records, staff files and other records as required under regulation were inspected. During the inspection a number of residents and relatives were spoken with as part of the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Additional work and improvement is still required in relation to improving the home’s care planning/risk assessments. All care staff within the home need to receive appropriate care planning and risk assessment training. The deployment of care staff within the home continues to need reviewing so as to meet the needs of residents. The registered provider needs to ensure Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 6 that there are sufficient numbers of staff on duty at all times and that the home’s lounge areas are adequately staffed so as to ensure resident’s health and well being. A programme of meaningful and stimulating activities must be provided to all residents residing at the care home. The registered provider must ensure that the number of hours provided by staff to enable residents to receive both `in house` and community-based activities are increased and ensure that clear records are maintained. This requirement has been highlighted many times and to date there has been no further progress by the registered provider to address this shortfall. It remains no longer acceptable to ignore this requirement. Interaction between care staff and residents must be improved upon and care staff must ensure that at all times residents are treated with respect and given choices wherever possible. It is unacceptable for all residents to be given gravy with their dinner and for them to receive a meal that is unappealing to look at and sloppily served. Before any care/interventions are provided by care staff to residents, staff must speak to residents and explain their actions. Continued efforts must be made to ensure that care staff receive a range of training which meets the needs of residents (both mandatory and specialist). Additionally continued improvement must be made in relation to ensuring that recruitment procedures are adopted in line with regulatory requirements. 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. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 Pre Admission Assessments are completed for prospective residents and wherever possible, residents and/or their representatives are encouraged to visit the home prior to admission so as to make an informed choice as to whether or not Brooks House Care Centre is a care home they wish to live in. The home’s Statement of Purpose is out of date and contains inaccurate information. EVIDENCE: The home’s Statement of Purpose needs to be reviewed as it is not up to date i.e. it details the previous responsible individual and registered manager and details that the care home is a 68 bedded residential home (4x double bedrooms and 64 single rooms). The latter is not accurate as there are 6x double bedrooms and 58 single rooms. The latest inspection report was not readily available and the acting manager had not seen a copy since their employment within Brooks House Care Centre. Pre Admission Assessments were devised for the newest residents, and included information from the resident’s placing authority where applicable. No Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 9 formal ‘dependency tool’ to determine whether or not the home was able to meet the residents needs had been completed. As part of good practice procedures assessments should be signed and dated by the person completing the document. In addition the acting manager/registered person should ensure that information from placing authorities/hospitals are clear and decipherable. Evidence was available to indicate that one prospective resident had visited the home prior to admission. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Improvements have been made to the home’s care planning processes since the appointment of a new acting manager. The systems for resident consultation remain relatively poor with little evidence to indicate that resident’s views are sought and acted upon. Medication records and administration procedures within the home remain appropriate and satisfactory. EVIDENCE: On inspection of five individual care plans, improvements were observed since the last inspection, whereby the majority of elements within the care plans had been completed. Some elements were seen to be more detailed than others i.e. one person’s care plan pertaining to recreation/social care did not include information relating to their personal preferences, hobbies and leisure interests. Risk assessments were not devised for all areas of assessed risk i.e. one care plan made reference to the resident refusing personal care, refusing their antidepressant medication and refusing meals on several occasions. No risk assessments had been devised detailing the identified risk to the resident, how the risk was to be managed by care staff and how to minimise risks for the future. Daily care records were written daily, however in most cases Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 11 additional information is required detailing care staff’s interventions. No formal assessments are completed relating to falls, nutrition, continence and pressure sores. Not all elements of individual’s care plans had been reviewed in line with National Minimum Standards recommendations. It was positive to note that at the time of the inspection, no residents had pressure sores. Healthcare records included information pertaining to healthcare professionals and services utilised i.e. District Nurse Services, Chiropody, GP, Dentist etc. Visits by professionals were recorded within residents `Multidisciplinary Contacts` and in most cases appeared to include treatment and outcomes. The acting manager advised inspectors that a new care planning format is to be introduced in the future. Senior care staff have, received training by Southern Cross Healthcare. It is envisaged that this training will be cascaded to all staff working within the home in the near future. Rapport and interaction between the majority of care staff and residents was observed to be very poor throughout the inspection. When care was provided to residents or residents were moved in their wheelchairs, care staff did not always speak to residents or inform them of their intentions/actions. Some care staff were observed to talk exclusively with one another and not talk to residents. This was very disappointing and has been highlighted at previous inspections to Brooks House Care Centre. Deployment of care staff during the inspection continues to need reviewing as lounge areas on occasions were left unattended and residents were left without support. The home’s medication storage systems, records and policies and procedures remain appropriate. Since the last inspection PRN (as and when required medication) protocols had been devised. Accident records for residents were well organised and the majority of records were satisfactory. The acting manager was advised that in some cases additional information is required detailing treatment and outcomes. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 Insufficient hours are provided to residents for meaningful activities and stimulation. A two weekly activity programme has been devised, however little evidence suggests that residents receive and participate within this activity programme. Little evidence indicates that residents are empowered to exercise choice. EVIDENCE: The home has 36 hours per week allocated so as to provide activities to all residents residing at Brooks House Care Centre. The hours are split by two activities co-ordinators (1x 24 and 1x 12). The number of hours provided by the registered provider for the number and needs of current residents remains insufficient and inadequate. The inspectors were advised that a two weekly plan of activities has been newly implemented and includes such activities as exercises, classic film afternoon, sing along, residents choice, craft afternoon and painting, bingo and indoor bowls. Limited evidence depicting activities for residents was recorded within those care plans/daily care records inspected. The registered provider must ensure that activities and meaningful stimulation are not only provided to those residents who are more independent. Activities must be provided to those residents with more complex needs. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 13 Residents were observed to have a choice of two main meals at lunchtime (shepherds pie and Cornish pasty). In addition alternatives to the menu were available for residents i.e. salad, jacket potatoes, sandwiches and omelettes. Observations during the lunchtime meal evidenced that condiments such as salt, pepper and sauces are not readily available for residents. Residents were not given the choice of whether to have gravy or not with their meal and care staff assumed this was wanted. Additionally no due care was given by some staff when serving the meal and on some plates this looked unappetising and sloppy. Residents were placed at the dining table for up to 25-30 minutes before lunch was served. During the lunchtime meal there was little verbal interaction between care staff and individual residents. The majority of comments by residents relating to food were positive. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a complaint and adult protection policy and procedure in place. Staff spoken to demonstrated knowledge and understanding of adult protection issues which protect residents from abuse. EVIDENCE: Since the last inspection the home has had two complaints. Records were available pertaining to both complaints, detailing the investigation undertaken by the home, actions taken and outcomes. At the time of the last inspection to the home, Social Services and the Commission were dealing with one protection of vulnerable adults issue relating to a resident being locked in their bedroom by night staff. Following the inspection, an investigation was undertaken by the Commission and a report complied. The Commissions findings were that the home’s investigation had been very poor and incomplete, the registered provider had failed to adopt proper protection of vulnerable adults procedures, some members of staff had received no protection of vulnerable adults/resident welfare training and issues relating to one resident had not been addressed sooner i.e. notification to the resident’s care management team sooner relating to their inappropriate behaviours. The registered provider was requested to provide a detailed action plan outlining how issues were to be addressed for the future and how systems would be put in place to ensure that nothing like this would happen again. Two members of staff spoken with demonstrated a good awareness and understanding of protection of vulnerable adults policies and procedures. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The standard of the environment remains good and provides residents with an attractive, homely and safe place in which to live. EVIDENCE: The home is well maintained and decorated for residents needs. All bedrooms remain personalised and individualised. Lighting within some residents bedrooms were seen to be very dim and additional lighting is required. Additionally some wardrobes were observed to require securing to the wall as they could present a health and safety risk to residents and staff. The sluice room door was unlocked despite a sign stating that this room must be locked at all times. At the time of the inspection one bathroom was out of order and had been so for the past two weeks. The inspectors were advised that another bathroom was available for residents use. The homes laundry was well organised and throughout the home there were no obvious odours. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The standard of vetting and recruitment practices has improved. Staffing levels within the home remain inadequate for the numbers and needs of residents. Staff training for staff has improved, however gaps still exist whereby staff require both mandatory and specialist training. EVIDENCE: As stated previously staffing hours allocated in relation to activities for residents, remains inadequate and poor and must be reviewed. Additionally on some days staffing levels fell below those agreed by the previous registration authority. Staff rosters showed that some members of staff continue to work long days/double shifts i.e. some members of staff worked in excess of 50 to 63 hours per week. The staff rosters also detail that there are no domestic staff available at the weekends. Recruitment practices within the home have improved but some gaps were still noted in relation to no staff photographs, no record of induction, no evidence of qualifications/training undertaken and references in some cases not from the employee’s last employer. The induction format continues to not cater for those newly appointed members of staff who have no previous experience in care work. A staffing matrix relating to training was handed to inspectors. This document indicated many gaps pertaining to refresher/updated mandatory training and specialist training courses. A list was also provided to inspectors identifying Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 17 training planned/booked in March 2006 for fire awareness, health and safety, basic food hygiene and dementia training. It is of concern that several members of staff are due to receive fire awareness, health and safety and basic food hygiene training all in the same day. Following receipt of the inspection report, information pertaining to the course content for the above training must be forwarded to the Commission. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 and 38 Management arrangements at the home have changed since the last inspection. Evidence indicates that there is ongoing staff supervision at the home. Resident’s health and safety are promoted and protected. EVIDENCE: Since the last inspection the home has appointed a new manager and she has been in post since October 2005. The new acting manager has come from another of the companies homes and has many years experience working with older people. It is envisaged that the acting manager will commence the Registered Managers Award shortly. A manager’s application to become formally registered with the Commission for Social Care Inspection has been forwarded to the acting manager and it is envisaged that this will be completed and returned in due course. It is evident that since the appointment of a new manager to Brooks House Care Centre she has made an impact and progress in trying to address previous identified shortfalls and raise staff morale. Staff Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 19 spoken with during the inspection stated that they felt things had improved since the new acting manager’s arrival, however they still remained unsettled as a result of recent changes i.e. new company takeover. Records indicated that staff supervision has been reintroduced and commenced since the acting managers arrival. During the inspection a number of records as required by regulation were inspected. Monthly checks are conducted by the homes maintenance person relating to the passenger lift, cold water and hot water checks, the home’s call alarm system, wheelchairs utilised by residents, window restrictors and emergency lighting and fire extinguishers. Since the last inspection there have been three fire drills conducted at the home. The acting manager was advised that information recorded should also include the names of all staff attending and the time of the drill. It was unclear as to whether or not night staff had participated in any fire drills. Other records inspected included the home’s gas safety/electrical installation certificate, passenger lift certificate, hoist and assisted baths certificate and the home’s employer’s liability certificate. All were seen to be satisfactory. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 X 3 Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 6(a) and (b) 18(1)(a) (c)(i) Requirement Ensure that the homes Statement of Purpose is kept under review and updated as necessary. All staff must undertake appropriate training to the work they perform and meet the specialist needs of residents. Previous timescale of 01.01.06 not met. Ensure that comprehensive and detailed care plans are devised for all residents. Previous timescale of 01.11.05 not met. Ensure that risks are identified and as far as possible eliminated. Previous timescale of 01.11.05 not met. Ensure that residents care plans are regularly kept under review. Ensure that staff maintain good relationships with residents. This refers specifically to a lack of verbal interaction between staff DS0000018120.V267968.R01.S.doc Timescale for action 01/05/06 2 OP4 01/08/06 3 OP7 15(1) 01/06/06 4 OP7 13(4) 01/05/06 5 6 OP7 OP10 15(2)(b) 12(5)(b) 01/04/06 01/04/06 Brookes House Care Centre Version 5.0 Page 22 7 OP12 16(2)(m) (n) and residents. Ensure that all residents receive an appropriate programme of activities. Previous timescale of 01.10.05 not met. Ensure that residents are consulted in relation to their personal choices, wishes and feelings. All staff within the home must receive training relating to dealing with residents inappropriate and aggressive behaviours. Previous timescale of 01.01.06 not met. Ensure that suitable lighting is available for all residents within the home/individual bedrooms. Ensure that all parts of the home are kept free from hazards to resident’s safety. This refers to the securing of residents wardrobes. Ensure that there are adequate numbers of staff on duty at all times. Previous timescale of 01.10.05 not met. Ensure that the numbers of hours provided for activities is reviewed and increased to meet resident’s needs. Ensure that robust recruitment procedures are adhered to in line with regulatory requirements. Previous timescale of 01.09.05 not met. Ensure that a quality assurance system is devised. Not inspected on this occasion. 01/05/06 8 OP15 12(3) 01/04/06 9 OP18 13(6) 01/07/06 10 11 OP19 OP19 23(2)(p) 13(4)(a) 14/04/06 14/04/06 12 OP27 18(1)(a) 14/04/06 13 OP27 18(1)(a) 01/05/06 14 OP29 17(2),19, Sch2&4 01/04/06 15 OP33 24 01/06/06 Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 23 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 3 4 5 Refer to Standard OP7 OP8 OP18 OP26 OP28 Good Practice Recommendations Residents daily care records should be detailed and include an account of the resident’s day, outcomes and staff interventions. Accident records should include details of staff interventions and outcomes. Ensure that whenever a protection of vulnerable adults issue is highlighted, all procedures are followed. Ensure that the sluice room is locked at all times when not in use. A minimum of 50 of care staff should be trained to NVQ Level 2. Brookes House Care Centre DS0000018120.V267968.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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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