Inspection on 13/12/06 for Brooklands 1

This inspection was carried out on 13th 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

Brooklands 1 04/01/06

Brooklands 1 16/08/05

Brooklands 1 22/09/04

Brooklands 1 06/05/04

Similar services:

Flint House

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

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

CARE HOMES FOR OLDER PEOPLE Brooklands 1 14 Dashwood Road Banbury Oxfordshire OX16 5HD Lead Inspector Kate Harrison Unannounced Inspection 13th December 2006 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 DS0000046595.V320651.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. DS0000046595.V320651.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooklands 1 Address 14 Dashwood Road Banbury Oxfordshire OX16 5HD 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) 01295 268522 mail@brooklandsnh.co.uk Brooklands 1 Limited Julie Richardson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places DS0000046595.V320651.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one named service user under the age of 65 years. Date of last inspection 4th January 2006 Brief Description of the Service: Brooklands 1 is a large privately owned town house within five minutes from Banbury town centre, providing 24 hour nursing care to residents. The home has good access to the main shopping area, churches, bus and rail stations, library, hospital and doctors surgeries. The accommodation is spread over three floors, served by a passenger lift. There is a wheelchair lift for ease of access from the rear of the building and car park. Accommodation is provided in 9 single rooms and 7 double rooms. There is a combined lounge/dining area on the ground floor. There are small garden areas at the front of the building and four small patio garden areas. The weekly fees at present range from £627 to £721. The care home is being extended by the acquisition of the property next door, and the intention is that the home will then admit individuals with dementia. The building work has meant the loss of use of some of the rooms, and some of the residents are being cared for in the proprietors’ other home, Brooklands 2, nearby. The work is expected to finish in late Spring 2007, and will provide more accommodation and improved communal space. DS0000046595.V320651.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.30 hours and was in the service for 5 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The registered manager and both the proprietors were available during the inspection visit. The inspector asked the views of the residents, relatives and health and social care professionals about the home through questionnaires (comment cards) that the Commission had sent out. 11 relatives and four health care professionals, including GPs, replied to the Commission’s comment cards and their views are reflected in this report. The inspector also had meaningful conversations with several residents on the day, as no comment cards were returned by residents. Only 16 residents were in the home on the day of the visit, mainly because of the reorganisation due to the building work. From the evidence seen, the inspector considers that this home would be able to provide a good service to meet the needs of people from different ethnic, cultural, social and religious backgrounds. This is due to care being planned on an individual basis and on the good example shown by the manager in devoting time and attention to individual needs. The home’s brochure also recognizes the needs of individuals. All the residents who spoke to the inspector praised the qualities of the staff, and feedback from the GPs was very positive. What the service does well: What has improved since the last inspection? DS0000046595.V320651.R01.S.doc Version 5.2 Page 6 Work on the improved building has started and is progressing well. New equipment has been purchased to help evacuate residents in the event of fire, and timed trials have been carried out to help staff members test the equipment and the fire safety procedures. One bathroom has been converted into a shower room and several bedrooms and the day room have been redecorated. Staff training has continued, especially in care of people with dementia, so that when the home is able to admit more people with dementia the staff members will be suitably trained to look after them. The key worker system is in place, and residents and relatives know the name of the main carer responsible for them. To help the residents with memory difficulty, everyday items from the past have been acquired and used in memory work. The documents about the home have been updated to let prospective residents know about the home’s development. 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. DS0000046595.V320651.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000046595.V320651.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide was available for residents at the home, and includes a statement on equal opportunities and a commitment to caring for the individual. A senior member of staff usually visits the prospective resident before admission. The inspector checked two residents’ files to assess the admission process. One resident had recently been admitted from hospital, and information from the care manager was available, including a care plan, and the discharge information from the hospital. Information was available also from the prospective resident’s family who came to visit on behalf of the prospective resident. The home’s pre-admission assessment form was completed, and at admission was used with the care manager’s care plan to meet the needs of the resident from the time of admission. The resident said DS0000046595.V320651.R01.S.doc Version 5.2 Page 9 that she was happy with the admission process, and was glad to be at the home rather than the hospital. All the necessary information was available regarding the pre-admission procedure for the second resident whose file was checked, and a care plan was in place. DS0000046595.V320651.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager uses a good system of care planning with plans based on the Activities of Daily Living model, and adds on individual plans as necessary. Risk assessments are carried out, including nutritional risk assessments, and information from the assessments is used to plan the care. The inspector recommends that the nutritional risk assessments should include the body mass index (BMI) score to clearly identify those at risk, and to avoid misunderstanding. The manager has good links with community health care professionals and is able to quickly organise visits from GPs and other services such as the dentist when necessary. Residents, with the help of family members, are encouraged to complete the ‘About Me’ information, and this personal information is used to understand the resident and plan care to suit the individual. Residents are able to contact family and friends easily. Several residents said that staff members treat them with respect, and the inspector noted this during the visit. DS0000046595.V320651.R01.S.doc Version 5.2 Page 11 Comment cards from relatives show that they are consulted about care if residents are not able to make decisions themselves. The home has policies on medication and these are readily available for staff members. Medication is ordered regularly from a local pharmacy, is recorded as received and is kept securely. Staff members should record when topical applications such as creams are administered and should record the reason why medication prescribed ‘as required’ is not sometimes given. The GPs who responded to the Commission’s comment cards were happy with the care provided, and one GP commented that the home provides ‘a very high standard of care’ that continues to improve. All the relatives who responded to the Commission’s comment cards said that they were happy with the overall care provided at the home. DS0000046595.V320651.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One carer has dedicated time, 20 hours a week, to provide activities for the residents and the care team provide activities on a daily basis. The manager has a strong interest in person centred therapeutic care and the staff team is beginning to use information from the residents’ life history to improve daily life for the residents. Residents are encouraged to keep control over their daily lives and individual preferences are recorded. The ‘Friends of Brooklands’ group raises funds to help provide outings and entertainers for residents, and a it is planned to have a full time activities organiser when the home is ready to accept an increased number of residents. Comment cards from relatives show that they are welcome at the home, and that communication with the staff and management is easy. The home’s chef has been in post for four years and knows all the residents food preferences as she sees them daily to discuss the menu. New residents’ preferences and dietary needs are recorded on admission. Most of the residents took lunch from trays in the lounge, and the new building will include dining areas. All the residents who spoke to the inspector said that the food was good. DS0000046595.V320651.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a policy and procedure for residents and relatives to make complaints. All complaints are recorded and the records show that the last complaint made to the home in November 2005 was responded to according to the procedure. Comment cards from relatives show that there are no concerns about making complaints to the home. All new staff receive information about safeguarding residents at induction and the manager is experienced at seeking advice about issues arising. Safeguarding information is also discussed with staff taking NVQ courses, and according to records, one of the nurses had update training this year. The registered manager should make sure that all care staff who have not had safeguarding training or recent update training attend training soon. DS0000046595.V320651.R01.S.doc Version 5.2 Page 14 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The renovating and refurbishing work is continuing, and risk assessments have been carried out to make sure that residents and staff are safe. The home shares the two maintenance personnel with the sister home nearby, and there is a system in place for staff to report maintenance issues for repair. Residents’ rooms are appropriately furnished but some issues in the communal areas needed attention. A landing windowpane was cracked and the soap holder was broken in a downstairs bathroom. These issues were attended to during the inspection. The home’s laundry is housed in cramped conditions and a new laundry room is planned for the improved home. Policies and procedures are in place to control the spread of infection. DS0000046595.V320651.R01.S.doc Version 5.2 Page 15 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’ staff rota shows that there are sufficient staff on duty to meet the needs of the residents during the day, with one extra carer on duty to help residents from 6.30pm. The proprietors carried out a risk assessment regarding the implications of having one carer on duty at night with the registered nurse for the 16 residents. Extra measures are in place to maintain the safety of residents and staff, such as improved fire safety equipment and an on-call facility. Of the ten carers, five have completed the NVQ Level 2 programme, so that the home meets the standard of having a minimum ratio of 50 trained carers. The staff induction programme is based on the Skills for Care standards, and new members of staff complete a workbook monitored by a senior carer or nurse. Staff members have attended dementia training, and other care courses to equip them with the necessary skills. Mandatory training related to health and safety is provided as necessary. Two staff files were seen to check the home’s recruitment procedures, and all the necessary information about new staff was available. Staff members who do not have English as their first language are expected to attend free English language classes, and attendance is monitored for those identified as in need of help with improving their English language skills. DS0000046595.V320651.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a registered mental nurse with an interest in the care of individuals with dementia, and has completed several courses on dementia and mentorship. The registered manager is responsible for the care in the home, and as both the proprietors have gained the NVQ Level 4 they have not put the registered manager forward to complete the course. Usually one or both of the proprietors are available, as they manage the home on a daily basis. Quality assurance is carried out on a variety of levels and includes internal audits and an annual questionnaire about the quality of the service to relatives. The feedback from the proprietors’ other home is also included in the survey results, and it is recommended that the proprietors should produce the annual DS0000046595.V320651.R01.S.doc Version 5.2 Page 17 quality survey results for Brooklands 1 and Brooklands 2 separately, so that it is clear how each home is performing. None of the residents can manage their own finances, and relatives or the care managers usually take control. No cash is kept on behalf of the residents, and invoices are raised for any additional services requested, such as newspapers or trips out. The home has a health and safety statement and provides training for staff on safety issues. The fire warden is responsible for the induction of new staff regarding the home’s fire procedures. One of the proprietors is the named person responsible for health and safety, and has attended health and safety training. DS0000046595.V320651.R01.S.doc Version 5.2 Page 18 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 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 2 X 3 X X X X 3 DS0000046595.V320651.R01.S.doc Version 5.2 Page 19 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. 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 2 3 4 5 Refer to Standard OP8 OP9 OP9 OP18 OP33 Good Practice Recommendations The nutritional risk assessments should include the body mass index score to clearly identify those at risk. Staff members should record when topical applications such as creams are administered. Staff members should record the reason why medication is not sometimes given. The registered manager should make sure that all care staff who have not had safeguarding training or recent update training attend training soon. The proprietors should produce the annual quality survey results for Brooklands 1 and Brooklands 2 separately, so that it is clear how each home is performing. DS0000046595.V320651.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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. 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