Inspection on 16/10/05 for Brookfield

This inspection was carried out on 16th October 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 16/05/05

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 Peter J McNeillie Unannounced Inspection 16th October 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 DS0000011753.V315489.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 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 DS0000011753.V315489.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookfield Address 1 Clayhall Road Alverstoke Gosport Hampshire PO12 2BY 023 9258 1103 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) j.a.filsall@tinyworld.co.uk Mrs J A Filsell Mrs J A Filsell Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (29), Old age, not falling within any other category (29) Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 03/11/05 Brief Description of the Service: Brookfield is a twenty-nine bedded home, set in attractive grounds in a residential area of Alverstoke with local amenities close by. 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. At the time of the inspection charges were from £380 -£415 per week. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced inspection, which took place between 9:15am and 2:15pm, the inspector who was assisted by the owner/registered manager spoke with a number of resident’s (Both individually and in groups), the dayto-day manager and staff on duty. Evidence was also gathered from a tour of the building, reading residents assessments/care plans, staff recruitment/ training records and equipment servicing records comments by management/staff, observations and a pre inspection questionnaire provided by the homes Registered manager. What the service does well: What has improved since the last inspection? What they could do better: Written confirmation that residents were involved in the production of their care plan should be available in the records. No requirements or recommendations have been made Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 6 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 DS0000011753.V315489.R01.S.doc Version 5.2 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 DS0000011753.V315489.R01.S.doc Version 5.2 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): 3 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home has a well-developed system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. EVIDENCE: A sample of four residents records were viewed. These confirmed the manager or another member of the senior staff who visits the potential resident in their own home or in hospital only admitted persons on a planned basis following a pre admission assessment of need and risk. A detailed and comprehensive assessment process had been undertaken for each of the four residents files viewed including information on potential residents environmental requirements, including special needs, to ensure that any requirements are put in place prior to admission. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 9 Comments and signatures by residents confirmed they or their representatives were consulted during the assessment process. Dates on the assessment records confirmed assessments of need and risk for all residents are reviewed on a regular basis. Respite care is not available in the home. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 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): 7,8,9 and 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The arrangements for planning care are clear ensuring that the health, personal care and medication needs of residents are met and their privacy and rights respected. EVIDENCE: A sample of four residents care plans were viewed and a number of residents spoken to individually or in groups. All of the residents spoken to praise the quality of the care they received and confirmed all care was given with dignity in private and all staff treated them with respect. Staff and management were observed knocking on residents’ doors and requesting permission to enter. Comments from residents included, ”Better than a hotel, staff are so kind.” The inspector also overheard a conversation between residents where one person stated” I Have never been so well looked after and had so much done for me”. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 11 Individual care plans sampled are detailed and provide staff with clear guidance on how to meet all residents’ assessed needs, while encouraging independence. Residents confirmed they were aware of the care plans, which had been discussed with then, but no written confirmation to this effect was included in the file. A verbal undertaking was given by the manager that files will be updated to reflect this omission as soon as possible. This matter will be reviewed at a future visit to the home. All residents are able to choose there own G.P at the time of the inspection 16 doctors from 7 local practices were visiting the home. Any restrictions on choice are outside the control of the home. 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. All resident’s drugs and medicines which are securely stored are administered in accordance with the homes medication policy and procedure by trained staff and procedure including recording the administration and disposal of unwanted drugs records of which were viewed. Currently two residents are responsible for their own medication (following a risk assessment), others spoken to confirm they were happy for the home to administer their medication but were aware they could administer their own drugs if they wished. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 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 and 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected service users interests and choices. EVIDENCE: Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 13 Residents confirmed they were very happy and contented about living in the home, comments such as “The best” ”lovely here” “hotel service” also stated they would recommend the home to anyone if asked. All were very complimentary about the homes staff and management. Residents confirmed they were able to exercise choice in respect of all aspects of their day-to-day lives bedtime’s mealtimes, visiting or receiving relatives/friends including attending in house activities. An activities organiser is employed to organise activities for residents on a daily basis which included, craft, music and movement, keep fit, reminiscence, skittles, sing-a-long, arts and crafts, music with movement, and visiting external entertainers. Additional support for activities is also provided by the Alzheimer’s Society who are able to assist staff in ensuring activities are suitable and stimulating for persons with dementia. Residents said they could choose whether or not to join in. or not. During the visit a large enthusiastic group was seen enjoying them selves. A small in house shop selling sweets, toiletries and other day-to-day requirements at cost was also available. 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. Residents praised the quality, quantity, choice and presentation of food, which is provided. The inspector witnessed the preparation of the midday meal and would confirm the excellent manner in which the food was presented and the skill and care taken by staff in assisting those persons who needed assistance in feeding. A menu based on resident’s likes and dislikes and nutritional needs that are determined during the original assessment was available as were choices to the main dish. Although there are set mealtimes residents confirmed these were flexible and they were allowed to take meals in their own rooms. Tea and coffee was available at all times. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home has clear policies and procedures in place which ensures residents are protected from abuse. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon. EVIDENCE: The home has an up to date complaints procedure, which is on display in the entrance hall as well as in a welcome book and each service user’s care plan file contains information on how to contact The Commission for Social Care Inspection (C.S.C.I), as was record of complaints Residents spoken to stated they felt comfortable in discussing any concerns they had with the homes management and confident any matters raised would be addressed. An in house policy/procedure that operates in tandem with the policy and procedure produced by Hampshire County Council designed to protect vulnerable residents from abuse was available as were records to confirmed all staff had received training. Staff spoken with confirmed they had received training in recognising abuse and demonstrated they knew what to do should they witness or suspect the abuse of any resident. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for service users which meets their needs. EVIDENCE: Brookfield is situated in a residential area of Alverstoke, with several areas of the home enjoying views across Stokes Bay. A tour of the building indicated that it was safe, well-maintained and meeting resident’s individual and collective needs and free from adverse odours. Residents spoken with confirmed their satisfaction with their rooms, saying, “I am very comfortable and have everything I need”, and another described the home as “very friendly and comfortable”. Furniture in the lounge, dining room and two conservatory lounges, was comfortable and homely and in keeping with the decor. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 16 All areas of the home were accessible to residents including the well-tended garden which included sensory garden with additional seating raised flower beds and water a feature. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all service users. EVIDENCE: All residents spoken to were full of praise for their carers and spoke of them in positive and affectionate terms such as Staff are so good, friendly and helpful” and “They’re excellent, couldn’t do better”. Don’t know what I would do without them”. Staff confirmed that the rota, deployment, management support and the staffing numbers on each shift at the time allowed them in a calm unhurried manner to spend time with residents in a one to one situation to and chat, read or write letters etc. This ability was commented on by residents who felt that this flexibility allowed staff to treat them as an individual and “Make me feel special. Records seen indicated all staff are recruited and selected in accordance with a procedure designed to protect residents which included which the completion of an application form, an interview the signing of a rehabilitation of offenders declaration and satisfactory Criminal Bureau Records (C.R.B.), Protection of Vulnerable Adults (P.O.V.A), medical and reference checks. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 18 On commencement of employment all staff are subject to an in house induction course followed by Skills for care formal induction programme records of which were seen. Following induction and a probationary period all staff are expected to participate in National Vocational Qualification (N.V.Q.) training programme. Currently of a care staff group of 24, 87 have either completed or about to complete N.V.Q. level 2 many at level 3 and 2 at level 4In addition to the above training records seen further regular training and updates in first aid, fire, moving and handling, prevention of abuse, food hygiene, health and safety, safe handling of medication, infection control and dementia. Other training would be arranged as required following a resident’s assessment. Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 19 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): 31,33,and 35 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. EVIDENCE: The service is well managed by the provider / registered manager Mrs Filsell and her day-to-day manager who also acts as training manager. Both have obtained NVQ4 qualifications and the deputy is also trained as an NVQ assessor Comments received from residents and suggest that nothing is too much trouble, and every effort is made to meet the changing needs of residents, and Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 20 to improve the service. This view that was also echoed by the staff that confirmed management have an open door policy, and encourage us to share any concerns or ideas we have. There are clear lines of accountability within the home all staff were fully aware of there responsibilities. The day to day holds weekly meetings with senior carers, and monthly meetings with night staff. Staff and management confirmed staff meetings and one to one personal supervision takes place on a regular basis (records seen). Residents are consulted with evidence of regular residents’ meetings and the completion of a form at least annually (usually at a review) when there views about living in the home are formally sought. The home’s manager confirmed money was being held for some residents. The inspector examined all of the records, which reconciled with monies held securely for safekeeping. The inspector observed no immediate obvious hazards to health and safety during the inspection. Cleaning materials and chemicals were securely stored and staff had access to information requiring to be held under COSHH regulations. Protective clothing and gloves were available to staff for use when necessary. The home has a health and safety policy, a copy of which is given to new staff. Staff spoken with showed an awareness of the need to attend to health and safety matters or to report these to the manager for action. The home has a laundry procedure and the industrial washing machine is capable of disinfecting soiled items. A sample of records relating to the servicing of equipment used within the home were viewed, all agreed with the information provided by the manager in the pre inspection report, this included the home’s fire and accident books and record of staff fire training. There were no records of a confidential nature on display in any of the public areas of the home. Brookfield DS0000011753.V315489.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 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Brookfield DS0000011753.V315489.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 Brookfield DS0000011753.V315489.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton 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 DS0000011753.V315489.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!