CARE HOMES FOR OLDER PEOPLE
Brookfield 71 Crofts Bank Road Urmston Manchester M41 0UB Lead Inspector
Elizabeth Holt Unannounced Inspection 15th March 2006 10:00 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 Brookfield DS0000006700.V278271.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 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. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Brookfield Address 71 Crofts Bank Road Urmston Manchester M41 0UB 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) 0161 747 5365 0161 748 2626 Mrs M.J. Chell Mrs Catherine Ann Shea Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum number of service users shall be 21, all of whom require nursing care. Registration is subject to compliance with the minimum staffing levels indicated in the Notice served in accordance Section 25(3) of the Registered Homes Act 1984 on 20 October 1999. 15th November 2005 Date of last inspection Brief Description of the Service: Brookfield Nursing Home is registered to provide accommodation for up to 21 older people requiring nursing care. The responsible individual is Mrs M.J.Chell. The home is a large detached family home providing accommodation in eight double bedrooms and five single bedrooms. The lounge, dining rooms and bedrooms are furnished top create a comfortable homely environment. The home is located in a residential area of Urmston and within easy walking distance are local shops, restaurants, an outdoor market and public transport facilities. A well-maintained garden is available to the rear of the property. Ample parking facilities are provided at the front and rear of the building. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 4th March 2006. During the inspection time was spent talking to the registered manager, several of the residents, relatives and some staff members. In addition residents files, records and other relevant documentation were examined. Since the last inspection The Commission for Social Care Inspection has not received any complaints about the service. As this inspection only looked at a limited number of standards the report should be read together with the previous and any future reports to gain a full picture of how the home is meeting the needs of the people living there. What the service does well: What has improved since the last inspection?
Since the last inspection improvements in the care planning process had been made and some further improvements have been required. Improvements had been made in the recruitment process for new staff employed including Criminal Records Bureau disclosures for all staff employed. A programme of refurbishment and redecoration was in place. The home planned to purchase a new hoist in April 2006 to assist in the moving and handling of residents. Plans had been made to introduce a 12-week induction programme in line with Skills for Care since the last inspection.
Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 6 Staff are reading and signing to say they have read the policies and procedures of the home. 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. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 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 Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 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): These standards were not assessed on this inspection visit. EVIDENCE: The home does not provide Intermediate care. The other core standard was assessed at the previous inspection. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 9 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 and 9 Resident’s health, personal and some social care needs were set out in an individual plan of care. Addressing some minor shortfalls could improve these documents. Medication policies and procedures were in place to protect residents. EVIDENCE: A sample of care plans were examined. These were created from comprehensive pre-admission assessments. There was some evidence of residents/relatives involvement in their completion and reviews. Resident’s records contained evidence of involvement of other healthcare professionals. Risk assessments were linked to the plans of care. A discussion highlighted the need to weigh residents at the point of admission in order to establish a base line weight in line with the nutritional risk assessment and the residents general well being. Care plans could be expanded to include the resident’s recreational likes and dislikes and completed when they have participated in particular events/activities. Detailed wound care plans were available for the 5 residents who required these at the time of the inspection. These wounds were being appropriately
Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 10 managed however a discussion highlighted the need to grade the sores according to the good practice guidelines. Medication was appropriately administered and recorded on the medication administration record charts. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 11 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): 12,13, and 14 A range of social activities is provided by the home that matched the resident’s social, cultural, religious recreational interests and needs. Residents had assistance to exercise choice over their lives. EVIDENCE: Although there is no activities coordinator specifically employed one of the staff members took lead responsibility to organise and plan events. The homes objectives included a plan to improve the amount of entertainment provided for residents. Plans also included the setting up of a relatives/residents group where ideas could be exchanged. Outings included plans for a tea dance, music workshop and a shopping trip. Comments on thank you cards included; “we will always remember your kindness” and “not just performing a job but caring enough to make a difference”. One relative stated; “It’s my extended family, the staff are lovely”. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 12 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): These standards were not assessed on this inspection visit. EVIDENCE: These standards were assessed during the previous inspection. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 13 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): These standards were not assessed on this inspection visit. EVIDENCE: These key standards were assessed during the previous inspection. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 14 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 and 28 Systems are in place to protect the residents. EVIDENCE: At the time of the inspection the home provided nursing care for 19 residents. The numbers and skill mix of staff was adequate to meet the needs of the residents. One staff member was sitting in the lounge area enjoying a conversation with one of the residents. Residents and relatives spoken to said that staff at the home were kind and caring. One resident stated how the staff facilitated the resident’s daughter to assist in her care which they both enjoyed. Criminal Records Bureau checks had been requested for all staff employed. Staff training was being made a priority in the home. Staff spoken to stated they had regular opportunities for training on care related topics. A schedule of training was planned for 2006. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 15 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): 35 and 38 Practices in the home promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Systems are in place in the event to safeguard resident’s finances however the home does not manage the financial interests/personal allowances for residents. Inspection of fire records showed that fire instruction and fire drills had been carried out. Regular alarm checks, emergency lighting and extinguisher checks were carried out. Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 16 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 17 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 OP7 Regulation 15 Requirement Care plans must include the following: the resident’s weight on admission to the home, the recreational/social likes and dislikes of the individual and when they have participated in an activity. Wounds must be graded as part of the assessment process. Timescale for action 15/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brookfield DS0000006700.V278271.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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