Inspection on 11/12/06 for Brookland House

This inspection was carried out on 11th December 2006.

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

Brookland House 09/12/08

Brookland House 17/07/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Brookland House 2 Watson Place St Judes Plymouth Devon PL4 9QN Lead Inspector Tina Maddison Unannounced Inspection 11th December 2006 10:00 Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 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 Brookland House DS0000065169.V324670.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 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. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookland House Address 2 Watson Place St Judes Plymouth Devon PL4 9QN 01752 690684 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 Nigel Bruce Troke Mr Nicholas Simon Troke Miss Vicky Anne Parker Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th July 2006 Brief Description of the Service: Brookland House is a end of terraced property conveniently positioned in a residential area in the centre of Plymouth. There is easy access to a bus route and all local shopping and social facilities. The home is registered for three adults who have a learning disability and who may have behaviour that will challenge the service. Brookland House is owned by Westlake Care who have another home in Cornwall. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over one day on the 11th December 2006. The Registered Manager was not available on this day, and the senior member of staff assisted the Inspector during the inspection. Three members of staff were spoken with. The two service users are not able to verbalise any opinions, but appeared happy and relaxed throughout the inspection. This is the first inspection of Brookland House since the first service user was admitted in August 2006. What the service does well: Brookland House provides a specialised environment for service users who have a severe learning disability and behaviour that may challenge the service. The house is homely and well decorated, having been recently fully refurbished. Staff are well trained and skilled in meeting the care needs of the service users living at the home. Comments were available from the relatives of one of the service users who were very pleased with the care their relative was receiving at the home, and how well they had settled in, in a short space of time. The service users benefit from clear policies and procedures regarding health and safety topics, and the Manager and staff are to be commended in their production of detailed, comprehensive and well written service user care plans and risk assessments. Service users benefit from a range of activities offered inside and outside of the home, and it was observed during the inspection that service users are encouraged to be as independent as possible with positive and enabling encouraging from the staff. There is a non physical intervention policy at the home, and staff were observed throughout the inspection using distraction techniques and appropriate humour to defuse any potential behaviour from the service users that may have challenged the service. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 6 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. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 7 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 Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good because service users or their representatives have the information they need to ensure that Brookland House will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Brookland House has a statement of purpose and service users guide that it offers to prospective service users. Work is being undertaken to produce this in a format that is accessible to the service users at the home. Following the previous inspection the statement of purpose has been amended by the manager to state that the home admits service users who have behaviour that may challenge the service. The home has a pre admission assessment document. Since the previous inspection in July 2006, two service users have been admitted to the home, and records evidenced that pre admission assessments on their required care needs were undertaken to ensure that their needs could be met at the home. Service users records also evidenced that service users were able to visit the home prior to admission, and were introduced to staff who undertook visits to the individual service users prior to admission to familiarise themselves with Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 9 the service users care needs, and to ensure the service users were able to trust and were familiar with them. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good because service users living at this home can be assured that their care needs will be documented on an individual care plan and they will be supported to safely take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recently appointed Registered Manager and the staff have worked hard to produce high quality care plans for each of the service users, that detail their care needs, and how these will be met. Both of the service users have complex care needs and limited verbal communication, so the staff are aware of the importance of the detailed care plans. Both the care plans had been recently reviewed. They also contained a communication guide for the service users that staff said was very helpful to Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 11 ensure that staff communicated to the service users in the most helpful and consistent manner. Whilst limitations and restrictions on freedom are detailed in the care plan, these have not been documented as having been agreed by the service users representatives in a multi disciplinary forum. The staff stated that the service users are encouraged to be as independent as possible, even though this is difficult due to the service users complex needs and at times the 2:1 staffing ratio that one of the service users has. Both service users had a daily planner that showed the daily routine of the house and any activities planned for the day. This was produced in a symbol format to ensure that the service users had understanding of this. Both service users had detailed risk assessments for activities both inside and outside of the home, and how these activities would be safely managed by staff. Service users records are stored safely in a locked cabinet in a lockable office. Staff were aware of the need for confidentiality with regard to information belonging to the service users. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. Quality in this outcome area is good because service users have varied opportunities for personal development and are assisted by staff to be as independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff stated that they followed the individual care plans to ensure that the service users are able to be as independent as possible, and are encouraged to do as much as possible for themselves. One service user has a talent for music, and staff encourage this by the provision of a piano for them to play and opportunities to listen to music whenever possible. Due to the service users complex needs it is not possible for either of them to undertake training or educational opportunities. However, staff at the home provide interesting stimulating daily activities inside and outside of the home. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 13 Families are welcome to visit the home and staff assist the service users to maintain contact with their families by writing cards and letters, and providing transport for family visits. Menus and meals taken that were recorded, evidenced a good variety of nutritious and wholesome meals are available, and the service users individual likes and dislikes are noted by staff. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good because service users complex health and personal care needs are met in a positive and successful manner by the staff at Brookland House. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was observed during the inspection that staff provided sensitive and flexible personal support to the service users. Staff observed the privacy of service users and interacted with them in a positive and enabling manner. Service users healthcare needs were recorded as part of their care plans. Staff were clear about when to obtain outside specialist healthcare advice. Details of healthcare needs and how these will be met were detailed in individual care plans. Detailed plans of how any behaviour that challenges the service would be managed by staff were recorded, along with strategies for managing the behaviours. It was evident that although the two service users had only been at the home for a few months that staff were successfully and positively managing any behaviour that could be challenging for the service. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 15 There is a medication policy and procedure in operation at the home, and staff spoken with were clear about this. Medication was found to be appropriately stored and records were found to be accurate. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good because service users will be protected by the homes adult protection policies and procedures, and service users and their representatives can be confident that the staff understand and are able to manage any physical and verbal aggression from the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear complaints procedure in operation at Brookland House. To date there had been no complaint made to the Commission for Social Care Inspection and there were no concerns or complaints recorded at the home. Service users would not be able to articulate a complaint or concern, but staff liaise closely with their families, and said that if they were concerned then they would be able to communicate their concern to the Manager who would resolve this. The home has an adult protection procedure that staff said that they were aware of and felt able to use. Staff also confirmed that they felt able to understand physical and verbal aggression from the service users and felt confident that they were able to deal with this appropriately. There is a non physical intervention policy at the home, and staff use redirection and distraction techniques to manage any physical aggression Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 17 toward them from the service users. Staff have undertaken breakaway training. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Quality in this outcome area is good, because Brookland House offers a homely, comfortable and safe environment for the service users living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Brookland House is a terraced older house situated in the centre of Plymouth in a residential area. The house was totally refurbished last year to a high standard, and has a homely and comfortable appearance. A tour of the whole house was undertaken during the inspection. Service users bedrooms were found to be individually decorated and furnished, and reflected their personality and tastes. Due to the steep stairs this service would not be suitable for a service user who had mobility difficulties. There are three bedrooms, and all have their own bathroom and toilet. The house has a good size lounge, kitchen and dining room and kitchen. The house is large enough so that the two service users are able to be separate if they wish to be so. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 19 A requirement of the last inspection was that the head of the stairs be made safe. This has now been achieved by robustly boxing in the head of the stairs so that service users are not able to fall. There is a small courtyard to the rear of the house that service users are able to access. On the day of the inspection the home was found to be very clean and hygienic and free from offensive odours. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. Quality in this outcome area is good because service users are supported by skilled, competent and well trained staff, who themselves are appropriately supported by the Manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels for the current service users are high, with both service user having 1:1 staffing for 12 hours of the day, and one service user having an additional member of staff for part of the day. It was not possible at this inspection for the Inspector to scrutinise staff records as the Manager was not available and the records were locked away. However, staff confirmed that they had undertaken a CRB check prior to appointment, and two written references were obtained. They also confirmed that they had undertaken an induction period at the commencement of their employment. They were clear about their roles and responsibilities and confirmed that they had received training in a variety of subjects including manual handling, first aid, fire safety and food hygiene. Also breakaway training was undertaken and most are qualified to NVQ2 level in care. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 21 It was observed throughout the inspection that staff interacted in a positive and enabling manner, and the Inspector was impressed with the manner in which staff managed potentially difficult situations with the use of distraction techniques and appropriate use of humour. Staff confirmed that they received regular formal supervision from the Manager, and said that she was always available for informal supervision if required. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good because Brookland House is managed by a skilled and competent Manager who is supported by a committed staff team. Appropriate regard for health and safety policies and procedures mean that the health, safety and welfare of service users is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager, Miss Vicky Parker, successfully undertook the registration process in October 2006. Although she was not available on the day of the inspection, it was evident that she has successfully organised the home on a day to day basis, and has the confidence and trust of the staff team. Staff confirmed that she has an open door policy and have benefited from her extensive knowledge base regarding the care of the service users. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 23 Health and safety records, including the accident book, fire safety records, and maintenance records of the gas and electrical systems were examined and evidence that health and safety at the home is taken seriously, and all records and checks were found to be up to date. The Providers make monthly monitoring visits to the home. There is a quality assurance process, although due to the recent admission of the first service users to live at the home this has not been full completed as yet. Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 3 x Brookland House DS0000065169.V324670.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The medication records of the individual service users should contain a documented consent to medication that is signed by the service user or their representative. Any restriction of a service users choices or freedom should be documented as having been agreed by a multi disciplinary team and the service user or their representative. 2. 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