Inspection on 28/07/06 for Brookfield

This inspection was carried out on 28th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Brookfield 15/03/06

Brookfield 07/11/05

Brookfield 27/02/05

Brookfield 16/09/04

Brookfield 29/03/04

Brookfield 01/10/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Brookfield 71 Crofts Bank Road Urmston Manchester M41 0UB Lead Inspector Elizabeth Holt Key Unannounced Inspection 28th July 2006 14:00 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.V297925.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 DS0000006700.V297925.R01.S.doc Version 5.2 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.V297925.R01.S.doc Version 5.2 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 March 2006 Date of last inspection Brief Description of the Service: Brookfield Nursing Home is registered to provide accommodation for up to twenty-one residents requiring nursing care. The responsible individual is Mrs M.J.Chell. The home is located in a residential area of Urmston and is within easy walking distance of local shops, market and public transport facilities. Brookfield is a large detached family home providing accommodation in eight double bedrooms and five single bedrooms. The lounge, dining room and bedrooms are furnished to create a comfortable homely environment. There is a well-maintained garden to the rear of the property. Ample parking facilities are provided at the front and rear of the building. The current scale of charges at Brookfield Nursing Home are £510 per week. There are currently no additional charges. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on the 28th July 2006. All the core National Minimum Standards (NMS) were reviewed during this inspection. Information was gathered as part of the inspection process, which included a questionnaire completed by the manager that gave information about the residents, the staff and the building. Information held by the Commission, for example notifications of significant incidents was also reviewed. Time was spent talking to the residents, visiting relatives, the homeowner and the staff team about day-to-day life in the home and to establish what the home was like for the residents living there. A partial tour of the premises was undertaken and examination of documents and care files for the individual residents. Three of the five-resident/relative questionnaires that were left to be forwarded to the Commission were returned. Comments from these have been included in this report. What the service does well: The relationships between the residents, relatives and the staff appeared to be friendly and relaxed. Staff were seen talking to residents and it appeared that the privacy and dignity of residents was protected. Relatives were spoken to during the inspection and it was clear the home had an open visiting policy. One relative said, “ The staff at Brookfield are well trained and I look upon them as my extended family. I visit the home every day.” The home ensures detailed assessments are carried out on prospective residents before admission to ensure they can meet all the needs of the resident. The residents spoken to were happy with the quality, choice and quantity of food provided. The home supports the care staff to undertake NVQ level 2 training. The home shows a commitment to all staff to undertake training. Accidents were appropriately recorded. The home maintained a good standard of cleanliness and the management of odour was good. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 6 The home looked after the personal monies of residents in line with the policy. The home supported the residents to pursue social and leisure activities both inside and outside the home. What has improved since the last inspection? 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.V297925.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 DS0000006700.V297925.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): 1, 3 and 6 Quality in this area outcome is good. This judgement has been made using evidence made available and following a visit to the home. Prospective residents had information made available to them and their individual needs assessed before an offer of a place is made to the home EVIDENCE: Wherever possible the home encouraged prospective residents and their families to visit the home and spend some time getting to know other residents. The home acknowledged this was not always possible. The home had a service user guide which informed prospective residents and their families about the home. Procedures are available to ensure that the needs of prospective residents are fully assessed before they are admitted to the home. The manager or the registered nurse in charge completed the assessment of needs for prospective residents. Examination of a sample of these assessments showed them to be detailed and informative about the individual resident. Residents who were admitted to the home by a social work referral had an assessment of need Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 9 completed by the social worker. Evidence of advice from other professionals was seen. The home does not provide intermediate care therefore this standard was not relevant. Brookfield DS0000006700.V297925.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 area outcome is good. This judgement has been made using available evidence including a visit to this service. Each resident had an individual plan of care, which detailed the resident’s health, personal and social care needs. Some aspects of the care of medication had the potential to put residents at risk. EVIDENCE: Three of the residents care plans were checked. Each care plan had a detailed assessment of need and gave staff guidance on how to meet the resident’s needs. Residents’ individual preferences were taken into account in the care planning process. There was evidence of resident/relative involvement with the care plans. Detailed moving and handling risk assessments, nutritional risk assessments and assessments for bed rails were available showing the needs and preferences of each individual. A discussion highlighted the need to include more detail in any identified personal risk assessments. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 11 Involvement of healthcare professionals such as GPs, chiropodist, tissue viability nurses was recorded on the residents’ individual file showing their involvement. At the time of the inspection there was only 3 residents with superficial wounds, the documentation was clearly recorded for these. The medication storage and recording was checked. The medication administration records (MAR) had some gaps in the recording of these and a requirement was made. A medication policy was in place. Residents and relatives spoken to say how kind, helpful and considerate the staff are. Staff was heard talking to the residents in a polite and respectful manner. One relative stated, “All the staff are very helpful, very kind and always there to get what you need.” Brookfield DS0000006700.V297925.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, 13, 14 and 15 Quality in this area outcome is good. This judgement has been made using available evidence and a visit to the service. Activities were provided and residents were able to maintain contact with family and friends. Residents could exercise choice over their lives and they received a balanced and nutritious diet. EVIDENCE: The home and relatives spoken to say they were always made welcome held an open visiting policy. One relative stated, “My wife is well fed and usually eats all before her. I join her for Sunday lunch every week, which is first class and is always a full roast dinner.” A range of activities was offered to residents each week, which included bingo, reminiscence, cards, exercise and music therapy. A day trip to Southport had recently been made and other visits included a trip to the Imperial War Museum and the Trafford Centre. From speaking to residents and staff it appeared that residents are able to exercise choice and control over their lives. Evidence was seen that residents are able to bring personal possessions into the home. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 13 The homeowner confirmed that ministers from the local churches did visit as requested. Meals are served from the dining room, which was pleasantly set out. Residents could eat in the lounge or their own bedroom if this was their preferred choice. The menu was seen and a balanced and nutritious diet was provided. Residents said the food was good and the cook arranged alternatives if a resident did not like the main meal of the day. Brookfield DS0000006700.V297925.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 area outcome is good. This judgement has been made using available evidence including a visit to the service. The home has the systems and procedures in place that allow people to express their complaints/concerns. All staff had received adult abuse awareness training to protect the residents. EVIDENCE: The complaints procedure was available and on display in the home. The home held a record of any complaints/concerns made which included three since the last inspection. These had been appropriately dealt with. Staff had attended training in the Protection of Vulnerable Adults. Staff spoken to were aware of the procedure to follow in the event of an allegation of abuse. It is recommended that staff sign to demonstrate they have read the local policy and procedure in the event of an allegation of abuse. Brookfield DS0000006700.V297925.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 area outcome is good. This judgement has been made using available evidence including a visit to this service. The premises were safe and well maintained. The home was clean, comfortable and homely. EVIDENCE: The home was comfortable and homely with the furniture and furnishings of a domestic nature where possible. All areas of the home were exceptionally clean. A number of bedrooms were viewed during the inspection and the bedrooms were personalised and homely. Since the last inspection four bedrooms had been redecorated, new furniture had been provided in one room and a number of new carpets and curtains had been provided. There were no offensive odours in any area of the home on the day of the visit. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 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 Quality in this area outcome is good. This judgement has been made using available evidence including a visit to this service. The number and deployment of staff available appeared sufficient to meet the residents’ assessed needs. The home could demonstrate that staff had completed the required training to meet the residents’ needs. Procedures for staff recruitment were robust. EVIDENCE: At the time of the inspection the home provided care and accommodation for 17 residents (plus 2 in hospital) receiving nursing care. On the day of the inspection the staffing numbers and skill mix appeared appropriate to meet the needs of the residents accommodated. The home employs 21 care assistants with 11 members of staff having successfully completed NVQ level 2. The home shows a commitment to training that allows them to do their work appropriately. Examples of recent study days included communicating with people with dementia, understanding dementia, feeding and swallowing and nutritional dysphagia, managing challenging behaviour, and report writing. The manager held a record of the types and dates of training the staff had undertaken. Staff spoken to were satisfied with the training they had done and had enjoyed recent training in Palliative Care. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 17 A sample of staff files were checked in relation to recruitment. The information required for the safe recruitment of staff was held on files. The recruitment policy and procedure was being followed. Evidence of POVA and CRB disclosure checks were available. There was a structured staff induction programme in place. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 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, 33, 35 and 38 Quality in this area outcome is good. This judgement has been made using available evidence and a visit to the service. The manager is fully able to discharge her duties. Some shortfalls identified in the fire officer’s inspection may put resident’s safety at risk. The home has systems in place to monitor the service based on people’s views. EVIDENCE: Residents and staff spoken to felt they could raise any concerns with the manager, homeowner or administrator. Maintaining open channels of communication and involving the staff in the home continued to be a priority for the home. Accident records were clearly recorded and audited on a three monthly basis. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 19 Following a fire inspection by Greater Manchester Fire in July 2006 the areas of non compliance were being addressed by the home. This included the following; updating and reviewing the Fire Risk Assessment, ensuring the means of escape are maintained to the required standard, ensuring fire doors have proper closure on their rebates and ensuring the basement laundry ceiling is reviewed. A requirement was made for these concerns to be addressed. Procedures were in place to safeguard the residents’ finances. Procedures are in place to find out from the people who use the service what they think of it. A recommendation was made that comment cards are sent to visiting professionals in order to obtain their opinion of the service being delivered. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 21 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 OP9 Regulation 13 Requirement The registered person must ensure that the medication administration records are appropriately completed. The registered person must supply the Commission for Social Care Inspection with a letter confirming how they intend to meet the requirements made during the inspection in July 2006 including timescales. Timescale for action 20/08/06 2. OP38 23 15/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations It is recommended that individual risk assessments are included in the care planning process. Brookfield DS0000006700.V297925.R01.S.doc Version 5.2 Page 22 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 © 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 DS0000006700.V297925.R01.S.doc Version 5.2 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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