Inspection on 17/05/06 for Brookfield Christian Care Home

This inspection was carried out on 17th May 2006.

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

The inspector 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 Christian Care Home 28/10/08

Brookfield Christian Care Home 29/11/07

Brookfield Christian Care Home 17/01/06

Brookfield Christian Care Home 19/07/05

Brookfield Christian Care Home 09/06/04

Brookfield Christian Care Home 29/04/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech 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 Christian Care Home Little Bury Oxford OX4 7UY Lead Inspector Philippa MacMahon Unannounced Inspection 17th May 2006 09:30 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 Christian Care Home DS0000027141.V295583.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 Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookfield Christian Care Home Address Little Bury Oxford OX4 7UY 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) 01865 779888 01865 779444 brookfield@trinitycare.co.uk Trinity Care (Brookfield) Ltd Mrs Susan Jane Chapman Care Home 66 Category(ies) of Dementia - over 65 years of age (33), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (33), Old age, not falling within any other category (33) Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission persons should be aged 60 years and over. The total number of persons that may be accommodated at any one time must not exceed 66, of which 33 may be in either the DE(E) or MD(E) category. 17th January 2006 Date of last inspection Brief Description of the Service: Brookfield Christian Care Home is a purpose built home situated on the outskirts of the Greater Leys area of Oxford, overlooking open countryside. The home is registered to provide care for up to 66 residents aged 60 and over. Accommodation is provided on two floors. There are spacious lounges and dining rooms on both floors and all bedrooms are single with en-suite facilities consisting of a washbasin and toilet. Spacious bathrooms with assisted baths are available. There is a small garden surrounded by fencing leading from one of the ground floor lounges. Ample parking is available at the front and side of the home. The range of fees for this home is £765 - £845. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 9.30am on the 17th and 25th May and was in the service for a total of 9½.hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The inspector was offered a warm welcome by the staff. On the first day the registered manager was not available but the operations manager was visiting the home at the time and was most helpful. The inspection included spending time observing the care being provided and talking to residents, relatives and staff. Records were examined and a tour of the premises was made. Care plans were examined and this was followed through by meeting with the individual resident to see if the care plan was meeting care needs. What the service does well: The home is able to meet the care needs of people with complex health care needs. The residents spoken to were well cared for and comfortable, although many were unable to express clear views about life in the home due to general frailty and some confusion. Those who were able to express a view commented that they were “well cared for and the staff are very nice and helpful”. Relatives spoken to say, “Staff are marvellous and always offer us a cup of tea, and will answer any questions we have”. Another relative made the comment, “It is marvellous how they cope here. My mother is very well cared for”. Meals and mealtimes are good. The quality of the food provided is of a high standard and the menus are thoughtfully and appropriately drawn up. There is very good communication between the staff, relatives and visitors. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 6 Overall the home offers a homely comfortable environment for the residents. 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 Christian Care Home DS0000027141.V295583.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 Christian Care Home DS0000027141.V295583.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, 6. The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Prospective residents have the information they require to make an informed decision about living at Brookfield. Every resident has an assessment of their care needs prior to admission. EVIDENCE: The service user guide is up to date and accessible in the entrance hall of the home. Pre-admission assessments were in place and appropriate to the residents’ needs. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 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, 8, 9, 10. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every resident has a care plan that gives a clear account of their care needs and how these will be met. The health needs of the residents are met and staff communicate appropriately with residents when carrying out care. EVIDENCE: A sample of care plans was examined and overall gave a clear picture of the person’s care needs. Risk assessments and reviews have been regularly monitored. One care plan for a person on respite care had a document for a short stay resident that had an assessment element, and basic interactions for immediate care needs. If the risk assessments show a high risk there is a direction in the documentation that an appropriate care plan must be written. The resident had three areas of care that required a care plan and these had not been put in place. The inspector spoke to the nurse in charge who agreed that this was an oversite and it would be corrected. It is a recommendation that the registered manager should discuss the use of the short stay document with all the registered nurses. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 10 Staff were observed to interact with residents at all times. There are regular visits by GPs, physiotherapist and community psychiatric nurses, and other specialist nurses are readily accessible when required. Relatives spoken to said that the care provision was excellent and that the staff were very good at communicating with them. The inspector spent some time observing the care provision and it was apparent that staff understand the issues of privacy and dignity. Residents were addressed by their first names and staff assured the inspector that the preferred form of address was obtained when residents were first admitted to the home. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 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, 14, 15. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given the opportunity for social and recreational activity and to exercise control over their personal choices. The food provision is of a very good standard. However, staff should be made aware of food handling guidelines and be attentive of residents who need assistance with eating. EVIDENCE: There were no activities happening at the time of the inspection. One resident said that the activities co-ordinator tries very hard to involve the residents in the activities but there were very few people who really were interested or wished to take part - She organises all sort of games, etc, but often there is just one resident who will join in. There was a service of Holy Communion taking place on the day of this inspection. Six relatives were spoken to and they all spoke highly of the care provided, and praised the staff for dealing with a very difficult client group to manage. One relative commented that the staff did not often engage in conversation with the residents, only to give direction. The food provided was of a high standard and there is always a choice of main course, one of which is always fish. The chef is very enthusiastic and Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 12 knowledgeable about special diets and catering for people with dementia. The inspector joined the residents for lunch and had a very tasty meal that was served by the care staff in one of the dining rooms. The tables were attractively laid with colourful tablecloths and napkins. There is a very attractive printed menu to go on the dining room tables, and cloth napkins have been purchased. The inspector observed that the residents who required assistance were left to their own devices and had inappropriate cutlery. The inspector also observed one member of the care staff not observing food handling guidelines of washing hands after clearing away the first course dishes and cutlery before serving the dessert. It is recommended that the manager reminds staff of the need to follow the food handling guidelines on all occasions, and to be attentive to the needs of those residents requiring assistance with eating. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 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 the following standard(s): 16, 18. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an accessible complaints system in place. Staff have a clear understanding about issues of adult protection. EVIDENCE: The complaints procedure is posted in the entrance hall and is in the service user guide. There have been two complaints since the last inspection and documentation and discussion with the manager showed that these have been dealt with appropriately. Staff files showed that training in the protection of vulnerable adults has taken place and was provided by an external trainer. Staff spoken to had a clear understanding of these issues, and the Oxfordshire Multi-Agency Adult Protection Team guidelines are readily available to staff. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 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 the following standard(s): 19, 26. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the environment offers a pleasant and comfortable home for the residents to live in. EVIDENCE: All areas were found to be clean. There was a malodour on the first floor next to the nurses’ station and the operations manager told the inspector that this is being addressed and advice is being sought from the community psychiatric nurse. Two of the communal lounges and the sun lounges have had ripped wallpaper for over two years that has not been addressed. The operations manager said that work is about to take place to rectifiy this. The residents’ individual rooms were in good decorative order and were most attractive with residents’ personal belongings in place. Hot water temperatures are being monitored on a regular basis. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 15 The laundry was found to be clean and orderly. However, there were three large skips of washing waiting to be dried and the laundry person had finished her shift. This was discussed with the registered manager who will look into the management of the laundry over each 24 hour period. The gardens are in need of some attention although the lawns had been recently cut. The home shares a gardener with other Southern Cross homes at the present time. Brookfield Christian Care Home DS0000027141.V295583.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, 30. The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is committed to ensuring that all her staff are competent to carry out their duties, and that every shift is staffed appropriately. EVIDENCE: Rosters showed adequate numbers and more than the establishment. The registered manager is looking at pressure points in the day to see if these can be eased by being creative with staff rosters. Staff files were examined and showed that appropriate recruitment procedures are in place. The percentage of care staff with a National Vocational Qualification is very small. This is being addressed by the company as they have a divisional trainer who has been helping the manager to develop a training matrix and arranging for training to take place. Two members of staff are now moving and handling trainers, and one is a first aid trainer. Training in dementia care has been arranged and is one that the Altzheimers Society has developed. All staff undergo induction training as soon as they commence duties. Trained nurses are able to attend training courses and seminars in order to maintain their registration with the Nursing and Midwifery Council. Staff spoken to said that they were given the opportunity for training and development. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 17 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, 38. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, with good support from the operations manager. EVIDENCE: The registered manager is an experienced registered nurse and has had some management experience prior to taking up the post at Brookfield. The registered manager told the inspector that she has not yet completed the National Vocational Qualification Managers’ Award due to the pressures of organisational change taking place within the company. Both residents and staff commented to the inspector that they did not see the manager very often, and one resident felt that she did not know her. It is recommended that the registered manager should make time in her busy schedule to get out of the office and meet with the residents and staff each working day. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 18 Southern Cross has a quality system in place and audits of various management systems take place on a regular basis. The operations manager visits the home and provides a written report, as required by regulation, on a monthly basis. It is some time since a residents’ questionnaire has been carried out and this is in the development plan. Regular relatives’ meetings take place and are well attended. The registered manager also has an open door policy so that relatives can speak to her at any time if they have any issues or concerns. The payment of fees is dealt with at head office, and those residents who wish to have cash for sundry items are able to keep them in the home’s safe. All receipts and transactions are documented. Staff supervision is not taking place at the present time. However, the manager is planning to implement this soon. The maintenance man discussed all the checks and balances that are in place to ensure residents’ safety, and records required by regulation were examined and found to be in good order. Southern Cross policies and procedures are in place. Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 2 X 2 X X X X 3 Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 20 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. 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. 1 2 Refer to Standard OP7 Good Practice Recommendations It is a recommendation that the registered manager should discuss the use of the short stay care documentation with all the registered nurses. It is a recommendation that the manager reminds staff of the need to follow the food handling guidelines on all occasions when serving meals, and to be attentive to the needs of those residents requiring assistance with eating. It is recommended that the registered manager should make time in her busy schedule to get out of the office and meet with the residents and staff each working day. OP15 3 OP31 Brookfield Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Christian Care Home DS0000027141.V295583.R01.S.doc Version 5.2 Page 22 - 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. 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