Inspection on 11/09/07 for Brookfield House Care Home

This inspection was carried out on 11th September 2007.

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 House Care Home 23/05/06

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 House Care Home Brookfield Park Shrewbridge Road Nantwich Cheshire CW5 7AD Lead Inspector Ms Julie Porter ` Unannounced Inspection 11 September 2007 07:00 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 House Care Home DS0000066254.V342312.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 House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookfield House Care Home Address Brookfield Park Shrewbridge Road Nantwich Cheshire CW5 7AD 01270 624951 01270 628643 brookfield_house@btconnect.com 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) Mr Jayantilal James Bhikhabhal Patel Mrs June Jones Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to people of either gender whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP The maximum number of people who can be accommodated is: 45 Date of last inspection 23 May 2006 Brief Description of the Service: Brookfield House provides care for forty-five older people. It is located in Brookfield Park about half a mile from Nantwich town centre, which has a range of shops, pubs and other amenities. It is within walking distance of the River Weaver and Nantwich Lake. The home is a two-storey building with a passenger lift providing access between the ground and the first floor. A variety of lifting aids, hoists and grab rails are provided for residents with mobility problems. All bedrooms are single rooms and contain hand-washing facilities; some of the bedrooms also have en-suite toilets. Staff are on duty twenty-four hours a day to provide care for residents. The home charges between £425 and £450 per week for residential care. This information was provided by the manager 11 September 2007. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 11 September 2007 and lasted 8.5 hours. The visit was carried out by one inspector. This visit was just one part of the inspection. Before the visit the home owner/manager was also asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were also made available for residents, families, and health and social care professionals to find out their views. Other information received by CSCI since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents and relatives were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? Activities on offer are planned in advance and information is available so that residents can decide whether to join in or not. Information about the home’s complaint procedure has been updated so that residents and relatives know who to contact if they need to complain about any aspect of the service. There is a continuing programme of maintenance and development for the home, which improves the facilities available to the residents. Changes have been made to the manager’s rota so that she can supervise and monitor all staff to make sure the aims of the home are met. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Brookfield House Care Home DS0000066254.V342312.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 House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available for prospective residents about the home and people’s needs are assessed before they move in so that they know that their needs can be met there. EVIDENCE: Since the last inspection a ten-bedroom extension has been built. Up to date information is available about the home and its services so that prospective residents are able to judge if the home meets their particular requirements. One care file for someone who had moved to the home in July was inspected. It showed that the person’s needs had been assessed and that the care manager for the home had met with her before she moved in. Care assessments had been signed by a relative of the person and included details of her personal care needs, information about her diet, and assessed risks relating to mobility. The care file also included a history of the person and Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 9 their likes and dislikes. Staff spoken with said that they found this useful so they could start conversations and talk about her past and her interests. The home does not provide intermediate care. Brookfield House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs and health care needs are continually monitored to ensure they receive the best possible care. EVIDENCE: Three care plans were inspected during the visit. All showed that the residents’ health was being closely monitored and that the care plan was being reviewed monthly. All the people who live at the home are registered with local doctors’ surgeries. Staff at the home maintain good links with community health services. A record is kept of visits to residents made by doctors, nurses and other health care professionals. The optician, dentist and chiropodist visit the home or residents can make their own arrangements. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 11 All visits by the district nurses on the day of the visit were done in private and the manager confirmed that the chiropodist now visits residents in their own rooms. All residents’ care plans checked during the visit showed that their weight is monitored and that risk assessments are done in respect of falls. One residents’ questionnaire returned stated that the home offers, “excellent care”. The home has a policy about administration of medicines. Residents are helped to look after their own medicines if a risk assessment shows it’s safe for them to do this. Senior staff are identified to administer medicines and training is available to ensure that it is done properly. The medicines records were checked at the visit and were being maintained appropriately. Medication storage was looked at and cupboards were clean, tidy and well organised. The store cupboard contained medication for two residents who had recently passed away and was waiting for collection by the pharmacy. Throughout the visit, staff were seen to knock on bedroom doors before going in and treating the residents with respect. One resident commented that “staff are very helpful and have a friendly attitude.” Brookfield House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged take part in the activities and to continue with activities and routines they had before moving to the home so that they maintain some control and their independence. EVIDENCE: A number of activities are arranged in the home and there is an activities coordinator there three times a week. Details of forthcoming activities are displayed in the entrance hall of the home and relatives are encouraged to join in. During better weather activities are arranged in the grounds of the home as well as trips to local pubs, garden centres or shopping. One resident is a keen gardener and has produced tomatoes and hanging baskets for the home. Records are kept so the manager can see how popular each activity has been. Routines in the home are flexible to suit the needs of the residents. A number of people were up at 7am at the start of the visit. Staff, residents and some families were spoken with indicated that these residents had chosen to get up early and have done so most of their lives. One relative spoken with said that her mother has always got up at 5am. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 13 Residents’ families were seen coming and going throughout inspection. The manager confirmed that visitors are always welcome in the home and one visitor spoken with said she was always made to feel welcome and offered a drink. Clergy from different denominations visit the home either to offer prayer as a group or in private as requested by individual residents. Meals and mealtimes are provided to suit the residents. The breakfast and lunch were observed during the visit; both were very social occasions. The new extension has given staff alternative access to the managers’ office and break out area so they do not have to use the dining room as a thoroughfare during meal times. One resident spoken with said that the meals were not always to her taste and sometimes vegetables were overcooked and others undercooked. All other comments received from residents were positive. Residents are encouraged to manage their own finances for as long as possible. When that is no longer possible family, friends or professional advisors take over. Small amounts of residents’ money can be kept by the home for safe keeping if necessary. Accurate records are kept of balances and money spent. Information was available in the home on advocacy services. A telephone is available for residents to use so they can make their calls in private. Brookfield House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an effective complaints procedure and staff have received training to ensure that residents are protected from harm. EVIDENCE: There is a complaints procedure for the home and details were seen in the entrance hall. A number of relatives were spoken with during the visit and all confirmed that they knew who to complain to should the need arise. One relative said that she had raised concerns regarding her mother’s care in the past and the matter had been dealt with promptly and efficiently. All the relatives and most of the residents knew the home manager by name and she was seen during the visit chatting and supporting residents with tasks. The complaints log was inspected and showed fourteen complaints since the last inspection. In each case the record showed the nature of the complaint, the investigation and the action taken to rectify the problem. Compliments and thank you cards were also seen about the home. At the last inspection in May 2006 all staff had completed training in relation to adult protection so this was not inspected again. At the time of this visit no referrals had been made under adult protection although by the time this report was drafted, one referral has been made. Brookfield House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a programme of maintenance and development for the home to make sure that residents live in safe, comfortable surroundings. EVIDENCE: The visit involved a tour of the building including all the communal areas and some residents’ bedrooms when invited. The empty new bedrooms of the new extension were seen. There is on-going maintenance and decoration in the main part of the home. The new extension has been completed to a high quality and offers more ground floor accommodation with en-suite toilets, two communal toilets and further bathing facilities. Some finishing is still needed and this was discussed with the manager. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 16 Housekeeping staff are employed at the home and on the day of the visit it was fresh and clean throughout. Brookfield House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff recruitment is satisfactory but staff records need to be maintained to include details of staff suitability to work so that residents continue to be supported by appropriate staff. EVIDENCE: The training plan for the home includes all mandatory training. Information provided on the day of the visit and following the visit identified that two care staff need to receive refresher training in fire safety. Seventeen care and auxicillary staff working in the home have achieved a National Vocational Qualification (NVQ) at level two or above and staff development plans identify staff needs in relation to future training. Four staff files were inspected. All contained completed application forms, references and evidence that Criminal Record Bureau checks had been obtained. The files also showed that staff did not start work in the home until POVA 1st information had been received to make sure they are suitable to work with the people who live in the home. A number of staff working in the home have come from overseas; although their application forms state that they have work permits records are not Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 18 maintained to substantiate this or identify when the work permit is due for renewal. Questionnaires and comments received by CSCI from residents and relatives were positive regarding the staff in the home. They said that staff are very caring, always available to listen and are there at all times when they are needed. Brookfield House Care Home DS0000066254.V342312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is aware of her responsibilities in respect the day-to-day running of the home to ensure the residents are well cared for. EVIDENCE: The manager has completed the Registered Managers Award NVQ level 4 and is a moving and handling trainer. Since the last inspection the manager has adjusted her working pattern and is therefore more able to monitor the performance of all the team in respect of their practise. Evidence was seen on the staffing rota of the hours she now works. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 20 Questionnaires returned to CSCI from staff state that they meet regularly with the manager to discuss their work. Staff spoken with on the day said that there is always someone in the home to discuss concerns with or ask for advice. The home holds small amounts of money for residents who are unable to do so for themselves, the records for these were satisfactory. A sample of safety certificates were inspected and in place for the following: • Fire equipment • Gas installation • Boiler • Electrical wiring • Passenger lift • Mobile hoist • Bath hoists The accident record was inspected and was being maintained appropriately. Brookfield House Care Home DS0000066254.V342312.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 3 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 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 22 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 OP30 Regulation 18(1) Timescale for action All staff must receive on-going 31/10/07 regular training in relation to moving and handling and fire safety so that the residents are not put at risk by out of date practice. Requirement 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 OP21 OP29 Good Practice Recommendations Soap and disposable towels should be provided in the toilets and bathroom in the new extension. So that residents, staff and visitors can wash their hands. Evidence should be available in the personnel files to confirm that all overseas staff have current work permits. Brookfield House Care Home DS0000066254.V342312.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 House Care Home DS0000066254.V342312.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!