Inspection on 01/08/07 for Brookfield Nursing Home

This inspection was carried out on 1st August 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 Nursing Home 25/01/07

Brookfield Nursing Home 15/08/06

Brookfield Nursing Home 28/01/06

Brookfield Nursing Home 26/07/05

Brookfield Nursing Home 24/01/05

Brookfield Nursing Home 10/08/04

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 Nursing Home Grange Road West Kirby Wirral CH48 4EQ Lead Inspector Julie King Key Unannounced Inspection 1st August 2007 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 Nursing Home DS0000020903.V342698.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 Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookfield Nursing Home Address Grange Road West Kirby Wirral CH48 4EQ 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) 0151 625 5036 0151 625 2037 Brookfield Nursing Home (West Kirby) Limited Alison Bebu Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Twenty Four (24) Older Persons (aged over 65) and one (1) named male person (aged under 65 years) within a total of 25 25th January 2007 Date of last inspection Brief Description of the Service: Brookfield is a medium sized care home providing care for older people requiring nursing care. It is located in a quiet residential area of West Kirby on the Wirral. Local amenities such as shops, library, cafes, restaurants, churches and pubs can be found nearby. The care home is also situated near to the local beach and Dee estuary. Accommodation is provided over two floors with all rooms offering single occupancy. There is a small enclosed, private garden to the rear of the home and a car park to the front. Wheelchair access is provided to the home and a lift to the first floor. Fees at Brookfield range from £477 to £518 per week depending upon the service required Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of a key inspection, this site visit was conducted over one day; during which a full tour of the premises took place and staff and care records were examined. The Responsible Individual accompanied the inspector throughout this visit. Some staff on duty plus some residents were spoken to during this visit. Relatives were present during this site visit and questionnaires were given out by CSCI to obtain their views on the service. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 6 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 Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 7 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): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents assessed needs are being met, and the home is able to provide assurances to residents and their representatives that assessments will be a continuous process throughout the resident’s stay. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide, both of which are available for prospective and actual residents and their families to read at their leisure. Prior to admission to the home a full care needs assessment is undertaken by the manager or qualified nurse, who visit the prospective resident at their home or in hospital, to gather information regarding their nursing, care, social Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 8 and emotional needs. Information is gathered from the service user, their relatives and any other healthcare professional involved, to ensure that the home can meet their needs prior to the resident moving in. The care files of service users recently admitted to the home were inspected and all were found to contain informative, holistic assessments. Any specialist equipment necessary to meet the resident’s needs are identified to enable the home to provide these prior to the admission. Residents spoken to said that they “had met someone” from the home prior to admission, and that their “family was involved” during this process. Prospective resident’s are welcome to visit the home or stay overnight before moving in on a long-term basis to give them the opportunity to make an informed decision regarding their care provider. New residents are provided with a Statement of Terms and Conditions/Contract; this sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Standard 6 was not assessed as this home does not provide intermediate care. Brookfield Nursing Home DS0000020903.V342698.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place for all residents. This provides staff with most of the information they need to meet the resident’s needs. EVIDENCE: Following on from the pre-admission assessment, care plans are prepared for all residents, most of which are formulated on admission. These plans are reviewed and amended usually on a monthly basis, but some of the care plans evidenced the use of ‘Tippex’ correction fluid, and one of the care plans had not been fully developed until up to three weeks after one resident had been admitted. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 10 Information is recorded regarding the resident’s past life, their skills and hobbies and details of significant family and friends, and staff actively promote the resident’s right of access to the health services, both within the home and in the community. Regular appointments are seen as important and there are systems in place to make sure appointments are not missed. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. Staff keep a regular check on health aids, making sure they are working effectively and that each resident has the necessary aids to improve their quality of life. Records held in the home provide evidence of the input by other healthcare professionals and advice is sought from District Nurses and the Tissue Viability Specialist Nurse as necessary. Residents have choice over their personal care and are encouraged to be independent and responsible for their own personal hygiene where possible. Residents spoken to during the inspection were complimentary about the staff and the care afforded to them. They confirmed that their privacy and dignity were respected at all times. A key worker system allows staff to work on a one to one basis and contribute to the care plan for the individual. The home ensures that residents and their representatives are consulted on a regular basis to gather information about their satisfaction with the service provided. Residents said that they “could talk to the girls at any time”, and that “I am asked about what I want”. Medications are generally kept in accordance with current good practice, but a couple of the medication administration records evidenced the use of correction fluid, and some of the transcriptions were not double signed. Brookfield Nursing Home DS0000020903.V342698.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. 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. Links with the local community are good, and help enrich the resident’s lives. EVIDENCE: Residents in the home are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in. The residents informed the inspector that they enjoyed the variety of food in the home. Residents spoken with told us that they “loved the food”, and that there was “plenty to eat” whenever they wished, including if they are hungry at night. Visitors are welcome at any reasonable time of the day and service users may meet with their visitors in their own bedroom or in one of the communal areas. Ministers of Christian religions provide weekly services in the home and a list of ministers of other religions who can be contacted is held. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 12 Visitors are allowed in the home at any reasonable time for day, residents may entertain their visitors in the communal lounges or in their own bedroom. The gardens and large conservatory provide a pleasant setting for residents to sit with their relatives, especially in the warmer months. There are two activities co-ordinators at this home providing twenty hours per week organised indoor games and activities, and involve resident’s families as much as possible. The less able-bodied residents are also catered for and included with regular one-to-one sessions, such as hand massage, talking about past-times, reading newspapers together, etc. Residents spoken to told the inspector how pleased they were having this opportunity to enrich their lives. Brookfield Nursing Home DS0000020903.V342698.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaint and adult protection policy and procedure was in place that helps ensure the safety and welfare of residents. EVIDENCE: The home has an open culture that allows residents to express their views, and concerns in a safe and understanding environment. The service has a complaints procedure that is clearly written and easy to understand, is available on request to help anyone living at, or involved with, the service to complain or make suggestions for improvement. The complaints procedure is available to everyone living at the home and is displayed in a number of areas within the service. Residents, where able, and others involved with the home said that they “understand how to make a complaint”, and appeared clear about what will happen if a complaint is made. The manager keeps a record of complaints and this includes details of the investigation and any actions taken. Unless there are exceptional circumstances the service always responds within the agreed timescale. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 14 The policies and procedures for Wirral Safeguarding Adults are available and give clear specific guidance to those using them. The staff understand the procedures for Safeguarding Adults and will always attend meetings or provide information to external agencies when requested. There are a low number of referrals made as a result of lack of incidents, rather than a lack of understanding about when incidents should be reported. Training of staff in the area of protection is regularly arranged by the home. Other training around dealing with physical and verbal aggression is also made available to staff as needed. Appropriate checks, such as obtaining references, etc; are made on staff prior to them commencing work at the home to help ensure the protection of residents. Brookfield Nursing Home DS0000020903.V342698.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): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the resident’s rooms are personalized, providing an attractive and homely place to live. EVIDENCE: Most areas of the environment were inspected during this site visit, including some resident’s bedrooms. Screens are provided for privacy and the rooms reflect the chosen décor and personal belongings of both people. The residents are encouraged to personalise their bedrooms, and said they were “happy that I could bring some of my own things in”. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 16 The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers and of good quality. The Responsible Individual said that the ongoing improvement plan had identified one bathroom to be turned into an additional shower room, which would offer further choice for residents regarding bathing. Overall the home is well lit, clean and tidy and smells fresh. The management has a good infection control policy, and seek advice from external specialists, e.g. infection control, as needed; and encourage their own staff to work to the homes’ policy to reduce the risk of infection. Brookfield Nursing Home DS0000020903.V342698.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 good. This judgement has been made using available evidence including a visit to this service. There is a consistency of care within the home provided by permanent staff, which helps to offer safety and stability for the residents. EVIDENCE: People using services are generally satisfied that the care they receive to meet their needs, but there are times when they may need to wait a short time for staff support and attention. On the day of this site visit there were enough qualified, competent and experienced staff to meet the health and welfare of people using the service. Staffing rotas take into account the needs and routines of the people using the service. The home has a robust recruitment procedure and the staff files inspected provided evidence that all checks are made on staff prior to them commencing work at the home. Prospective staff are required to complete an application form prior to being called for interview. Two references are required and checks are made through the Criminal Records Bureau. Gaps in employment history are investigated and a record of the interview is held on the staff files. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 18 Staff records were found to be in order and the home has a full complement of staff. All new staff are required to follow a set induction training programme, evidence of which is held on the staff files. New staff shadow existing staff and are supernumerary until they are assessed as competent. The home is committed to ensuring that staff training continues. Records are held of all training undertaken by staff and a list of forthcoming training opportunities was displayed. Recent training by staff includes Fire Safety, Food Hygiene, First Aid, Manual Handling, Tissue Viability, Diabetes and Protection of Vulnerable Adults. All staff are required to complete an induction training programme prior to commencing work at the home on a permanent basis. Service specific inductions can help to ensure that the staff can meet the needs of the residents on a daily basis, and can improve standards of care. Brookfield Nursing Home DS0000020903.V342698.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): 31,32,33,34,35,36,37,38. Quality in this area is good. This judgement has been made using available evidence including a visit to this service. This home benefits from a long serving care staff team, thus helping to improve stability for the residents. EVIDENCE: The Manager and Responsible Individual have the required qualifications, experience and is competent to run the home. The manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities, and can evidence that she works to improve services and provide an increased quality of life for residents with a strong focus on equality and diversity issues. Brookfield Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 20 There is a strong ethos of being open and transparent in all areas of running of the home, and staff and residents spoken to confirmed that the home was run in an open, positive and transparent way and said that they felt comfortable in speaking with the manager at any time. Staff meeting are held, but on an irregular basis, and minutes of the meetings were available for inspection. All care staff are given supervision every few months to give them the opportunity to discuss issues relating to the home, and to identify with any training needs and opportunities. Residents or their representatives attend to service users financial matters and the home does not hold any bank accounts for individual service users. All safety checks had been made on the premises and equipment and the certification to provide evidence of these checks were seen to be well maintained and up to date. All health and safety issues were addressed with an excellent communication system in place to for staff to report any issues or repairs, which require to be dealt with. The home has a consistent record of meeting relevant health and safety requirements and legislation, and closely monitoring its own practice. Records are of a good standard and are routinely completed. Residents are aware of safety arrangements and have confidence in the safe working practices of staff. The Responsible Individual has the skills to provide a quality assurance and monitoring process to ensure efficient running of the home, which gives value for money and delivers effective outcomes for the people who use the service. Brookfield Nursing Home DS0000020903.V342698.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 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 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 3 3 3 3 3 3 3 Brookfield Nursing Home DS0000020903.V342698.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 OP7 Regulation 15 Requirement Care plans must not contain correction fluid or abbreviations, and should evidence direct resident involvement as far as possible. All medication records must comply with current good practice requirements and recommendations at all times. Timescale for action 31/08/07 2. OP9 13(2) 09/08/07 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 Nursing Home DS0000020903.V342698.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Nursing Home DS0000020903.V342698.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!