Inspection on 20/12/05 for Brookfields

This inspection was carried out on 20th December 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookfields 07/03/07

Brookfields 13/07/05

Brookfields 22/03/05

Brookfields 19/10/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Brookfields 81 Dogkennel Lane Oldbury West Midlands B69 9LZ Lead Inspector Mr Patrick Wright Unannounced Inspection 20th December 2005 15:00 Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 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 Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 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 Adults 18-65. 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. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brookfields Address 81 Dogkennel Lane Oldbury West Midlands B69 9LZ 0121 544 6715 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) Milbury Care Services Limited Ruth Bailey Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 13/7/05 Brief Description of the Service: `Brookfields` is a converted and extended residential dwelling owned by Milbury Care Services. The property is two storey with residents accommodated on the ground floor only, the first floor is used for meetings and office space, and it also provides the laundry area and staff toilet. The home provides nursing care for up to 6 persons with a learning and physical disability. Aids and adaptations are provided which meet the assessed needs of the service users. The home is located in a quiet residential area of Oldbury, with local shops-amenities a short distance away. There is limited off road parking to the front of the house with a large spacious garden to the rear. Each of the rooms is single occupancy, and a communal lounge, dining kitchen and activity area are available. The home does not offer en-suite facilities. Overall the home is decorated and maintained to a high standard. Service users are enabled to participate in a wide range of `in -house` and community based social and recreational pursuits, plus a healthcare programme, which utilises various resources within the local area. The home has its own wheelchair-adapted vehicle. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was conducted as a statutory unannounced inspection. The purpose was to assess progress and compliance in meeting the National Minimum Standards and towards addressing issues identified as needing attention at previous inspection visits. A range of inspection methods was used to make judgements and obtain evidence, which included discussion with the Nurse In Charge, interaction with the service users and a number of records and documents were also examined. There are six service users currently living at Brookfields. The home is registered to provide nursing care for adults with learning and physical disabilities, and other complex needs. One of the service users spoke with the inspector and said how he was looking forward to enjoying Christmas at the home. Some of the service users were present during this visit, but formal interviews were not appropriate. Therefore the inspector relied upon body language, known responses and other observations of interaction between staff and the people who live at Brookfields. Service users who were observed/spoken with during the inspection appeared comfortable with their surroundings and the style of care being provided. Two service users were having a therapy session with aromatherapy oils and one service user had gone out with staff from home. The Management and staff team are always exploring ways of providing a needs led service and regularly evaluate the delivery of care. The staff maintain a sound professional knowledge of current good practice developments in the care of this client group. With the implementation of its Person Centred Planning approach, the home can provide additional evidence for the purpose of quality assurance and also enhance the quality of life for the service users. What the service does well: Brookfields nursing home utilises specialist/clinical services as required. The service recognises good practice and staff access the British Institute of Learning Disabilities, and others for guidance. At the time of this visit, the home was able to demonstrate it was meeting service users assessed needs. This was confirmed through discussion with the Nurse in Charge and staff, by observations made, and reviewing documentation. The service continues to present itself as a well organised and managed nursing home and provides tailored and individually dedicated care. Staff interact positively with service users. It is consistently evident at Brookfields, that the service users’ needs are being met in terms of personal/nursing care, healthcare, social inclusion and general lifestyle issues. Service users appeared content and well cared for. Staff demonstrated a calm and sensitive attitude in their interaction with occupants of the home. The relaxed approach Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 6 to daily routines was observed and service users are interacted with, and encouraged to contribute, regardless of ability. The service continues to offer a good standard of care. The home is awarded a score of 4:standard exceeded- (commendable) for the National Minimum standard relating to `Meeting Needs` of the service users. What has improved since the last inspection? What they could do better: With the exception of minor shortfalls the home is meeting the National Minimum Standards for Younger Adults. With this in mind, the management need to ensure that the current service is maintained and progresses with regard to further good practice initiatives. The laundry floor finishes must be impermeable and these and wall finishes need to be readily cleanable. The Registered Manager needs to ensure the organisation provides the mandatory and specialist training required by staff. It is recommended that the home is enabled to access and use e-mail and web site facilities. It is also recommended that copies of the service users medication prescriptions are held, as is current good practice. Please contact the provider for advice of actions taken in response to this Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): N/A EVIDENCE: No standards from this section were assessed at this inspection Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): N/A EVIDENCE: No standards from this section were assessed at this inspection. Requirements issued previously were reviewed. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, and 15 Service users are enabled to become part of the local community by using local facilities. The home provides access to a range of socially and age appropriate activities in accordance with the assessed needs and individuals plan of care. Staff support the service users to maintain links with family and friends and they are able to receive visitors in private. EVIDENCE: Service users are provided with a plan of activities combined with personal development opportunities. However, staff identify possible events/opportunities for further education, and evaluate the appropriateness and outcome for the group. Further education and employment skills are limited due to the service users profound disabilities. The home assists service users to take part in fulfilling activities and participate in shared events with the planning done at the home. This enables staff to adapt each planned activity on a needs led basis, dependent upon the feelings and preferences of the person at the time. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 12 Staff enable and regularly support service users to access the local community and provide a good level of social inclusion. Staff have been provided with information/training on service users rights of access to public facilities (under the Disability Discrimination Act 1995). Staff ensure that service users have access to and choose from an appropriate range of leisure activities and are supported to pursue interests/hobbies. Individual outings, and group trips are arranged and include day trips and holidays. The cost of service users holidays is met by the provider, through a budget for this purpose. Leisure activities also include trips to the cinema, swimming, sensory sessions, reflexology, aromatherapy, massage, art and crafts, spa baths, reading sessions and music/videos. Records and evaluations of these activities are maintained appropriately. In addition to daily records, staff maintain diaries for service users, giving details of lifestyle events/activities plus other essential information. Brookfields operates an open visiting policy, and welcomes relatives and friends of service users at any reasonable time. The Registered Manager and staff encourage service users to maintain links with family and friends. There are no restrictions on visiting times. Due to the level of social inclusion/activities the home offers, relatives/friends are generally requested to contact the home prior to calling to ensure the service user is available. Visitors are able to use the communal lounge, dining/activity area, the garden area, or service users bedrooms. The home continues to maintain a good relationship, with neighbours/the locality, and the property is in keeping with the local area. Brookfields has its own adapted transport. The vehicle can accommodate wheelchair users and ambulant passengers, plus the driver. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 The health care needs of service users are met due to good care planning, monitoring of conditions and evaluation. EVIDENCE: Brookfields has appropriate systems in place to promote the service users’ health care. Service Users health is regularly monitored and ongoing/potential problems dealt with through referral, and by accessing health care facilities in the area. There was ample evidence to suggest that service users healthcare needs were being met. Various healthcare services are utilised, for example, community nursing facilities and regular medication reviews with the individuals Consultant/General Practitioner are held. Staff are skilled in identifying any issues and immediately accessing appropriate support. Staff are noted to be sensitive and compassionate when recording/detailing services provided for service users differing lifestyles. It is recommended that as part of a Person Centred Planning approach and to acknowledge good practice as detailed in the Department of Health document `Valuing people` a healthcare action plan is produced with each service user. Requirements issued previously were also reviewed. It is recommended that copies of the service users medication prescriptions are held, as is current good practice. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 There is a clear complaints procedure for service users and relatives, thereby ensuring individuals views and concerns are listened to and acted upon. EVIDENCE: Brookfields operates Milbury Care Services complaints procedure and records will be kept of any complaint or issues raised. No formal complaints had been received since the last inspection. The complaint procedure contains details of the Commission for Social Care Inspection, and the procedure is available to service users and representatives, in appropriate formats. The company’s complaints procedure details how to make a complaint, to whom and the timescales involved. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Appropriate laundry equipment is provided and relevant Infection Control measures will be complete once the laundry room finishes, (floors and walls etc) are readily washable. EVIDENCE: Requirements issued previously were reviewed. Suitable laundry equipment (which includes a sluicing facility) has been installed in the existing laundry room. The equipment meets National Minimum Standards and professional guidance with regards to infection control. Given that the area is not to be relocated to the ground floor as proposed, it is required that the laundry floor finishes must be impermeable and these and wall finishes need to be readily cleanable. In addition, the location of the designated hand-washing sink in this area should be made clear, and it is recommended that a hand-washing poster is displayed with the laundry procedures. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 The number of NVQ level 2 trained staff is currently meeting the proposed target set by the Commission for Social Care Inspection and `Skills for Care`. The home has a stable and experienced staff team with sufficient numbers and skills to support the service users. There is a thorough recruitment procedure in place, which ensures the protection of service users. Staff will shortly require training updates/initial instruction, to ensure all of the staff team are appropriately trained and the service benefits from a planned development programme. EVIDENCE: Staff at Brookfields have the skills and experience necessary for the tasks they are expected to undertake. Six of the nine support workers have achieved an NVQ 2, with a further two carers currently undertaking an NVQ level 2/3 qualification. Seven members of staff have accessed Learning Disability Award Framework (LDAF) training. The staff duty rota was examined and showed that the home continues to meet its minimum staffing requirements. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 17 The home operates at staffing levels of one qualified nurse and three support workers during wakeful hours, and one qualified nurse and one support worker during the night time. These staffing levels are the minimum the home must operate at. The Registered Manager is advised of the need to monitor and adjust staffing levels, as needed, to ensure the needs of service users are being met and where necessary contact the appropriate health professional to conduct a reassessment. The home operates the organisations recruitment and selection procedure. A sample of staff files was viewed as part of this inspection. Information contained in staff files included application forms, (and statement of health/convictions) copies of two written references, job description and contract, and proof of I.D. Staff files seen indicated that a Criminal Records Bureau check had been secured. Staff files are well organised and presented. The management has worked well to secure this information and has made good progress. The organisations training plan has not progressed recently and shortfalls are imminent in the provision of staff training and development opportunities. For example, some staff are in need of training and direction in Basic Food Hygiene, Health and Safety and First Aid. Staff will shortly require training updates, or initial instruction, to ensure the staff team are appropriately trained and the service benefits from a planned development programme. The Registered Manager has reviewed the training needs of the staff team and produced an updated matrix, which forecasts the training to be provided through the company training schedule for the coming year. The induction system for new staff is provided through an in house system that is referenced to the `Skills for Care` induction standards. There is also evidence to suggest that staff have been enabled to access the Learning Disability Award Framework accredited training, (LDAF). Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The Registered Manager is competent and qualified to run the home and meet its stated aims and objectives. EVIDENCE: The Registered Manager has appropriate qualifications and experience for the post, and undertakes periodic training and development to maintain her knowledge and skills. She is a Registered Nurse (Learning Disability) and is currently working towards the NVQ level 4/Registered Managers Award qualification. It is recommended that the home is enabled to access and use e-mail and web site facilities to assist with communication and researching current good practice and guidance. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X 3 X X X X X X Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 20 No Are there any outstanding requirements from the last inspection? 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. 2. Standard YA6 YA30 Regulation 15 13,23 Requirement Timescale for action 30/06/06 3. YA35 18 The home should continue to implement a system of Person Centred Planning. The laundry room floor finishes 30/04/06 must be impermeable and these and wall finishes need to be readily cleanable. In addition, the location of the designated hand-washing sink in this area should be made clear. The Registered Manager must 30/04/06 submit an updated staff training and development programme, to the Commission for Social Care Inspection, for all mandatory and foundation training commensurate with staff duties. This must clearly identify programmed dates of training, for completion. Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA19 Good Practice Recommendations It is recommended that as part of a Person Centred Planning approach and to acknowledge good practice as detailed in the Department of Health document `Valuing people` a healthcare action plan is produced with each service user. It is also recommended that copies of the service users medication prescriptions are held, as is current good practice. It is recommended that a hand-washing poster is displayed with the laundry procedures. The home should continue to work toward meeting Sector Skills Workforce targets of 50 of care staff having achieved an NVQ level 2 or above. That the Registered Manager continues working towards the RMA/NVQ IV in Management (to be achieved by 30/9/07) It is recommended that the home is enabled to access and use e-mail and web site facilities to assist with communication and researching current good practice and guidance. 2 3 4 5 6 YA20 YA30 YA32 YA37 YA41YA3 Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Brookfields DS0000004823.V274848.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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