Inspection on 16/05/05 for Brookfield

This inspection was carried out on 16th May 2005.

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

Brookfield 01/08/07

Brookfield 03/11/05

Brookfield 16/10/05

Brookfield 23/11/04

Brookfield 15/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brookfield 1 Clayhall Road Alverstoke Gosport, Hampshire PO12 2BY Lead Inspector Annie Billings Unannounced 16/05/05 11.00am 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 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 H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brookfield Address 1 CLayhall Road, Alverstoke, Gospport, Hampshire, PO12 2BY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 92581103 Mrs J A Filsell Mrs J A Filsell CRH 29 Category(ies) of DE(E), MD(E), OP registration, with number of places Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23/11/05 Brief Description of the Service: Brookfield is a twenty-nine bedded home, set in attractive grounds in a residential area with local amenities close by, with pleasant views of Stoke Lake. The home has been extended over the years to provide accommodation for twenty-nine older people, including those with dementia or mental health problem. Accommodation is arranged over three floors, with a passenger lift providing access between floors. Communal areas include a large comfortable lounge, pleasant dining room and two smaller conservatory lounges. Two communal assisted bathrooms are available, and many rooms benefit from an en-suite WC. The home is well screened from the road, and the grounds provide additional seating areas, including a sensory garden, recently developed. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first inspection of the year April 2005 to March 2006. No requirements were made as a result of the last inspection. The inspection took place over five hours. A tour of the premises was undertaken, lunch was observed, records were sampled and seven staff, eleven residents and two visiting relatives were spoken with, as well as the registered provider/ manager and deputy manager and training officer. What the service does well: What has improved since the last inspection? The home is currently trialling an occupational activities service, in addition to an Alzheimer’s Society activity organiser, to ensure that all residents, including those with dementia, are provided with stimulation and appropriate activities. An arts and crafts class was observed taking place in one conservatory. This was well attended, and completed work was seen displayed around the room. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 6 A foldaway hairdressing salon has been fitted in the lounge area, which was observed to be a popular addition. One resident said, “it’s a real treat”, and provides a sense of occasion. 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 H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 standard(s) 3, 6 The pre-admission and assessment process is comprehensive and detailed to ensure that all assessed needs of prospective service users can be met. The home does not offer an intermediate care service. EVIDENCE: A detailed and comprehensive assessment process had been undertaken for each of the three residents’ files sampled, including a pre-admission assessment. One residents’ file, admitted in February 2005, contained a preadmission assessment undertaken on the 29.1.05. This included an assessment of their environmental requirements, including special needs, to ensure that any requirements are put in place prior to admission. Families have been involved in the assessment process, by completion of a “Getting to know you” questionnaire. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 standard(s) 7, 8, 10, 11 Satisfactory systems are in place to ensure that residents’ health, social and care needs are well met. Residents’ rights to respect and privacy are upheld and are supported to spend their final days in the home with appropriate help from health professionals. EVIDENCE: Individual care plans sampled are detailed and provide staff with clear guidance on how to meet all residents’ assessed needs, while encouraging independence. One plan identified a need to cream pressure areas, but did not state which cream. The deputy manager agreed to address this, and to ensure that all plans are signed and dated. Daily care records are not made, although significant events are recorded, and communication systems in the home are good, with shift hand over meetings undertaken. Two care plans sampled detailed the need for plenty of fluids. Fluid intake is not recorded, and the deputy manager was advised to consult with the health care team, to determine if this is necessary. Where special needs have been identified, evidence was available to confirm that referral to the appropriate professionals is undertaken efficiently, and fact Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 10 sheets are made available to staff to ensure their greater understanding of the residents’ needs. The home has regular visits by domiciliary a chiropodist, dentist and optician. These visits are recorded and a separate record is made of any health professional visits. Involvement of community psychiatric nurses, speech and language therapists, continence advisors and falls co-ordinator was also noted, where appropriate. Staff and management were observed knocking on residents’ doors and requesting permission to enter. Staff interaction with residents was supportive and respectful. One resident is currently being supported to remain in the home with the support of Macmillan nurses and the district nurse who attends twice weekly. A specialist mattress has been supplied. A visiting relative commented: “They have gone out of their way to keep my relative here”, suggesting that “the home is the best around here”, and “they communicate very well with us”. Residents’ wishes in the event of death were seen recorded within files sampled. Staff spoken with confirmed they had received bereavement and palliative care training, and a notice displayed on the staff notice board offered the opportunity to attend a course on the funeral process. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 standard(s) 12, 13, 14, 15 Recreational activities, social contacts and meals are well managed, offering variety and choice for residents. EVIDENCE: A number of residents spoken with described a wide range of activities including ball games, reminiscence, skittles, sing-a-long, arts and crafts, music with movement, and manicures. Two residents said they could choose whether to join in or not. The Alzheimer’s Society currently organise activities within the home, with staff organising additional events and activities in the home. Photographs of recent events were displayed in the corridors, and evidence of a recent VE day celebration was still in place. An occupational activities service is currently being trialled to provide additional stimulation to residents. Volunteers are also utilised to provide further craft, reminiscence and reading sessions. During the summer months, the home hires a minibus, for trips to local places of interest, and invites relatives and friends to participate in home events such as a fete and barbecue. Local clergy visit the home monthly to meet the religious needs of residents. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 12 A foldaway hairdressing salon has been fitted in the lounge area, which was observed to be a popular addition. One resident said, “it’s a real treat”, and provides a sense of occasion. Three relatives spoken with advised they are welcomed into the home at any time. Privacy was seen to be upheld. Menus are displayed in the dining room, and a suggestion box has been supplied to ensure that preferences are catered for. Seasonal changes to the rotational menus are currently being planned. The meal served looked appetising and colourful and plenty of staff were on hand to provide support where necessary. Comments received by residents included: “lunch was very good” and “very nice”. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 13 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 standard(s) 16, 18 A satisfactory complaints procedure was available, which residents feel able to use. Staff have an excellent understanding of the reporting procedures to protect service users from abuse. EVIDENCE: The home has an up to date complaints procedure, which is on display in the entrance hall as well as in each service user’s care plan file. Several residents and two relatives were aware of whom to complain to. One resident commented: “I couldn’t wish to live anywhere better, they’re marvellous. I certainly have nothing to complain about”. Of seven staff spoken with, only one had not yet received training in the awareness of abuse, but all were aware of the reporting procedure. Financial records of three residents’ personal allowances were checked and balanced Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 14 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26 Residents live in homely, clean, pleasant comfortable surroundings with good facilities that meet their needs. Unrestricted access to the boiler areas did not ensure the residents’ continued safety. EVIDENCE: The home was decorated throughout in 2004, and has a continual programme of redecoration and refurbishment. although some areas were identified as needing attention. These included peeling wallpaper in one area of the lounge, and painting of two areas of ceiling following leaks have already been identified and a plan of action put in place. One area of carpeting on the third floor is frayed and loose. Another area has been taped and other corridor areas are showing signs of wear and tear, and will require replacement in the near future to prevent these areas becoming a hazard to residents. Communal areas include a large comfortable lounge, pleasant dining room and two conservatory lounges. Communal bathrooms and WC’s are sufficient to meet the needs of residents, and many bedrooms benefit from an en-suite WC. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 15 Uncovered hot water pipes were identified in two boiler areas, both open and accessible to residents. Following discussion, risk assessments were put in place during the day, and a requirement given that action must be taken to minimise any potential risk. The majority of rooms were seen, and confirmed that residents have the opportunity to personalise their rooms with their own possessions and furniture. Many rooms benefit from an en-suite WC, and several have direct access to the grounds and benefit from views over Stoke Lake. Every effort has been made to ensure that environmental aids are supplied where necessary, to encourage independence. Pressure mattresses, grab rails, hoist and in one room a winding window opener has been supplied. Further minor maintenance issues were identified that included several WC’s without lampshades, and one WC with no top to the cold-water tap. Agreement was given that these issues will be addressed. Tiles were missing in the shower room, although work was currently being undertaken in this area. A tube of Steradent was found in one vacant room, which was removed immediately by the manager. A sensory garden with additional seating has been established, with a further lawned area overlooking the Lake. The manager agreed to remove an old bed from this area. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 30 A well- trained and competent workforce are employed in sufficient numbers to meet all residents’ needs. EVIDENCE: Staffing levels are kept under constant review to meet the changing needs of residents, and are provided in such numbers to allow staff to spend quality time and support to residents on a one to one basis, even during busy times of the day, as observed. This is in addition to the manager and deputy manager who are supernumerary, and additional laundry, kitchen and domestic staff. The ratio of 80 of staff trained to a minimum of National Vocational Qualification II standard, demonstrates the managements’ clear commitment to training, which was also very much in evidence on the staff notice board. This was confirmed by six members of staff, who described the management as: “very supportive and giving training a high priority”. One staff member described a good team spirit, and said they all support each other. Teamwork was seen to be encouraged within the minutes of the last staff meeting on the 14th January. Discussion with a new member of staff confirmed they had undertaken a robust recruitment process, although records were not sampled. Currently undertaking induction training, they were shadowing two senior members of the staff team, and had been impressed by the managements’ commitment to training. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 17 Feedback from residents was all positive, describing them as “marvellous”, “very kind and caring” and “”I don’t know where they find them, they are lovely”. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 The home is well managed, with staff receiving clear guidance and direction to ensure that residents receive consistent quality care. EVIDENCE: The service is well managed by the provider / manager Mrs Filsell and a deputy manager who also acts as training manager. Both have obtained NVQ4 qualifications and the deputy is also trained as an NVQ assessor. Discussions with management clearly demonstrated the service is run very much for the benefit of residents. Comments received from residents and relatives suggest that nothing is too much trouble, and every effort is made to meet the changing needs of residents, and to improve the service. One staff member advised that management have “an open door policy, and they can talk to them about anything”. The deputy manager holds weekly Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 19 meetings with senior carers, and monthly meetings with night staff. Agenda items for the last staff meeting had been requested, to ensure staff involvement in the running of the service. Consultation had taken place recently regarding a change in uniform, and consideration had been given to staff comments. Residents are consulted on a regular basis, with evidence of regular residents’ meetings. Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 4 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x x x x Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 21 No 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 25 Regulation 13 [4] Requirement Action must be taken to minimise the potential risk to service users from uncovered and accessible hot water pipes within the boiler rooms. Timescale for action 30.9.05 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. Refer to Standard Good Practice Recommendations Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hampshire SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Brookfield H54 S11753 Brookfield V223645 160505.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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