Inspection on 01/11/05 for Brookfield House Nursing Home

This inspection was carried out on 1st November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brookfield House Nursing Home 09/05/07

Brookfield House Nursing Home 03/10/06

Brookfield House Nursing Home 26/05/06

Brookfield House Nursing Home 20/12/04

Brookfield House Nursing Home 12/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Brookfield House Nursing Home Forton Road Newport Shropshire TF10 7JL Lead Inspector Keith Salmon Announced Inspection 1st November 2005 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 House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 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 Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brookfield House Nursing Home Address Forton Road Newport Shropshire TF10 7JL 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) 01952 810288 01952 810029 Mrs Margaret Jones Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home must comply with the Staffing Notice issued by the Shropshire Area Health Authority dated 25 June 2001. The home may accommodate a maximum of 18 Elderly persons of whom 5 may be suffering with dementia. 23rd June 2005 Date of last inspection Brief Description of the Service: Brookfield House is a Nursing Home situated in the market town of Newport, Shropshire. Being close to the Town Centre the Home benefits from a good range of shops and other facilities, and can be easily accessed from neighbouring towns and villages via public or private transport. The original Victorian building has been extended to provide additional ground floor accommodation, offering both single and double accommodation. The Home is owned, and managed, by Mrs Margaret Jones, who is supported by a team of qualified nurses, care staff, ancillary staff, a handyman, and a gardener. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection commenced at 09.30, lasted 5.5 hours, and was undertaken by one Inspector. This Report is a product of observations made during a tour of the Home, through discussions with the Proprietor/Registered Manager, Staff, Residents (5), Relatives/Visitors (3), together with a review of care related documentation. These included a range of documents/records reflecting the general operation of the Home, and Staff recruitment/deployment/training records. The Inspector recognises the number of Residents/Visitors spoken with is a relatively small sample, but this was determined by the nature of the client group. Previous good standards of overall management and direct care provision have been maintained, and implemented in an environment, which clearly is very friendly and open. Written and verbal comments made by Residents or Relatives included: “…I am very happy with the care my Mother receives at Brookfield. All the staff, without exception, are warm, welcoming, and attentive to Mum’s needs,” …“Very good care”, …“Food is very good and the cook gives us just what we like,”… “Our mother has been here for sometime now and right from the day of her admission we felt it was a very good home for her. Time has shown this to be true.” What the service does well: What has improved since the last inspection? A number of issues leading to ‘Requirements’ being made at the previous Inspection have been resolved. These include; the need to up-date the Home’s ‘Service User Guide’, improving levels of laundry staff input, obtaining appropriate documentation relating to the appointment of ‘Bank Staff’, and more thorough record keeping of formal staff ‘supervision’. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 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. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 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 Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 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): 1,3,4 & 5. Prior to taking up residency prospective Service Users are enabled to reach an informed choice, and to fully understand the service they may expect to receive. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are diligently and effectively applied. Staff are enabled to provide the type, and quality, of care required by Residents. Where possible, prospective Residents have opportunities to ‘sample’ services offered by the Home prior to admission. EVIDENCE: The Home has a Statement of Purpose and User Guide, both of which are concise, easy to read and their content meets the requirements of the Standard. Information obtained from Care Plans, and discussions with Residents and their Relatives, clearly demonstrate the Registered Manager, or Deputy Manager, assess all prospective Residents/Service Users, prior to admission and, where possible, prospective Residents have the opportunity to visit the Home, or enter the Home on a trial basis, prior to admission. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 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 Home utilises a model of Care Plan which is effectual in it’s design, and diligently applied to ensure Residents’ assessed care needs are identified and effectively met. The storage, administration, and disposal of medicines are generally in accordance with accepted good practice. Staff relate to Residents in a friendly and respectful manner. EVIDENCE: A review of Care Planning documentation, relating to five Residents, showed them to be well organised, current, clearly written and to comprehensively encompass the range of ‘care areas’ appropriate to meet the needs of each Resident. All accidents/incidents, however minor, are recorded in the Accident Book, showing action and outcome, and none proved of particular concern to the Inspector. Inspection of the medicine storage provision, and medicine administration records, demonstrated the Home’s practices meet the guidelines of the Royal Pharmaceutical Society. Relationships between Residents and Staff were observed to be strikingly friendly and respectful. Residents and Visitors confirmed this impression by being very complimentary about the quality of care provided, and the general warmth and friendliness of the Staff. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 10 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): 12,14 & 15. A range of leisure opportunities, consistent with Residents’ capabilities, is provided, and the Home facilitates achievement of desired lifestyle, through Residents conducting the pattern of their day as they wish. The Home provides a daily choice of attractive and nutritious meals for which Catering Staff are to be commended. EVIDENCE: Notices advertising leisure events and activities were evident around the Home, and showed availability of a variety of suitable options. Care plans and discussions with Residents, and Visitors, confirmed the Home works hard to provide opportunities which enable Residents to conduct their preferred ‘day-to day’ living, continuation of religious practices, and leisure activities consistent with individual capabilities. Discussion with Residents reflected their appreciation of the quality, quantity and choice of food provided through a four-week cycle menu. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 11 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 interests of Residents are protected through ready access to the Home’s Complaints Procedure and information relating to advocacy services. Staff are aware of their role in protecting Residents from abuse. EVIDENCE: A clear and concise Complaints Procedure is displayed, which includes reference to the Commission for Social Care Inspection as the regulatory body, together with contact details. Residents and Relatives and made aware of the availability of advocacy services, with information relating to their use and prominently displayed. Policies relating to the protection of Residents from abuse were observed to be in place and readily accessible, these included:‘Whistle Blowing’, ‘Abuse Awareness’ and ‘Adult Protection’. Staff training files indicated that Staff had received training in respect of these Policies. The Home maintains a system for recording complaints, though none has been received since the previous Inspection. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 12 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): 19,20,22,23,24,25 & 26. The Home is decorated to a good standard, with furnishings and fittings which create a comfortable and ‘homely’ atmosphere. The bedrooms appear to meet the requirements of Residents with the exception of the shared room into which the lift door opens. The Home has well tended gardens, which are accessible, and appropriate in design to the needs of virtually all Residents. Well maintained specialist equipment is available to facilitate provision of care consistent with the needs of the Residents, and the demands of tasks carried out by Care Staff. Residents are encouraged to bring their own possessions into the Home. Whilst the environment is generally safe, the lack of a sluice with disinfecting cycle presents an infection control risk. EVIDENCE: During the tour of the Home furniture in lounge and dining areas was observed to be of good order, presenting a ‘domestic’ ambience, and with evidence of an on-going refurbishment/redecoration programme. Also bedrooms showed evidence of many persona possessions. There are a full range of maintenance Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 13 contracts in place covering specialist equipment, including hoists and wheelchairs. Since the previous Inspection the Home has established, and recruited to, a dedicated post, to cover responsibility for the laundry – thus releasing carers from direct involvement in this task. However, the Home’s sluices are of an older and unsatisfactory design, in that they do not have the required disinfecting cycle, and will require replacement to meet this Standard. The Inspector was informed that the representative, of a company which installs ‘sluicing disinfectors’, is to visit the Home in the days following this Inspection, with installation expected by the end of January 2006. One of the Home’s double occupancy bedrooms receives direct traffic from the lift and is currently occupied by a long-term Resident. The Resident’s Relatives informed the Inspector that both their Relative and themselves were quite happy with the current arrangement. However, it is accepted by the Owner that this situation is not entirely satisfactory, and it is proposed the lift will be replaced at a future date, with the opening being repositioned to enable construction of a ‘bypass’ corridor. In the meantime, it is to be retained as ‘single occupancy’. Should a ‘new’ occupant be proposed this will be subject to appropriate ‘risk assessment’ and direct agreement with CSCI. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 14 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. Staff numbers, and skill-mix, on duty were consistent with that shown on the rota, and were sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The commitment of the Home to providing training for Care Staff is exemplary. EVIDENCE: The current staffing rota, and those from the immediately preceding weeks, were examined. Staffing numbers and skill-mix enable a service provision, which meets the care needs of Service Users. In addition, ‘bank’ staff are utilised to increase staffing levels, when judged necessary by the Proprietor/Registered Manager, e.g. periods of peak activity and/or increased dependency. Staff Personnel Files demonstrated evidence of full compliance with the Standard and Schedule 2 of the Regulations. A written training programme showed all new Staff undertake a thorough, and relevant, orientation/induction programme, which is followed by comprehensive ‘foundation’ training, e.g. manual handling and lifting, fire safety, simple infection control. Staff training records also evidenced on-going ‘update’ training. A high proportion of Staff have attained an NVQ Level 2 or Level 3 Qualification. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 15 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): 31,32,33,36,37 & 38. Operationally, the Home is very well organised, with the central purpose being ‘the best interests of Residents’. Staff are subject to effective support with regular ‘supervision, and appeared involved and happy in their work. EVIDENCE: It is the intention of the Registered Manager/Owner to hand over more of the day-to-day, and strategic, management of the Home to her Deputy (Irene Palmer) who, having recently completed NVQ Level 4 (Management), has commenced formal application to become the Registered Manager. The benefits of sharing management tasks in this way, is seen through the introduction of new management of systems and policies, and revised systems for staff ‘supervision’ and training. COSHH requirements were satisfactory, with maintenance and servicing regularly undertaken, and appropriately documented. Recording of accidents/incidents is satisfactory, and a ‘first-aider’ is always available. Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 16 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 3 3 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 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x 3 2 3 3 2 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 3 3 x x 3 3 3 Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? YES 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 OP23 Regulation 12(4)(a) Requirement The ‘double occupancy’ room, containing the shaft lift door, is to be retained as ‘single occupancy,’ should residency change and is subject to direct agreement with CSCI and following appropriate ‘risk assessment’. This arrangement is to remain in place subject to/and pending the lift replacement. To provide a sluicing disinfector. Timescale for action 31/03/06 2. OP26 23(2)(k) 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brookfield House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 House Nursing Home DS0000022238.V261943.R01.S.doc Version 5.0 Page 19 - 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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