CARE HOMES FOR OLDER PEOPLE
Brooklands 2 Nursing Home 11 Old Parr Road Banbury Oxon OX16 5HT Lead Inspector
Kate Harrison Unannounced 20 July 2005 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 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. Brooklands 2 Nursing Home Inspection report OP.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Brooklands 2 Nursing Home Address 11 Old Parr Road, Banbury, Oxon, OX16 5HT Telephone number Fax number Email 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 262083 01295 278404 mail@brooklandsnh.co.uk Brooklands 2 Limited - Mark & Madeline Taylor Mrs Doolyn Lacey Care Home with Nursing 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Brooklands 2 Nursing Home Inspection report OP.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Admittance of one under age service user Date of last inspection 17 March 2005 Brief Description of the Service: Brooklands 2 is a three storey late Victorian town house situated in a residential road within easy access of Banbury town centre. The accommodation is spread over three floors served by a passenger lift and comprising 17 single rooms and 6 double rooms. There is an assisted bathroom on each floor, and three lounge/dining rooms. There is a small enclosed garden and patio area at the rear of the building. Brooklands 2 Nursing Home Inspection report OP.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one morning. The inspector spent time with a number of residents to hear their views of the home, and discussed care issues with staff. The inspector met both the proprietors and the registered manager during the inspection, and discussed management issues, including the intention to improve and extend the home in the near future. What the service does well: What has improved since the last inspection? What they could do better:
The home should acquire the initial care needs assessments of prospective residents referred to them by Care Management, so that all information is available before admission. Brooklands 2 Nursing Home Inspection report OP.doc Version 1.40 Page 6 The information in the ‘About Me’ booklet needs to be better used to support the individual’s emotional needs, so that the individual’s interests and hobbies are reflected in the home’s activities programme. The complaints procedure needs to be amended and standardised in all the relevant documentation. Proof of identity for all staff members needs to be available in all staff files. 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. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Prospective residents’ needs are appropriately assessed by the home, but the additional information from any Care Management assessment needs to be available. EVIDENCE: The registered manager usually conducts the assessment of prospective residents after initial referral, but the home rarely receives a copy of any initial Care Management assessment carried out by the Social and Health Care team. The Care Management assessment is needed as evidence for the home of the original needs assessment, and a copy should be available. The inspector saw individual assessments and noted that care plans were developed from them. Several residents told the inspector that they felt that their needs were met by the home’s facilities and the qualities of the staff. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8 and 10. The physical health needs of residents are met, but emotional/psychological support should be improved. Residents are treated with respect. EVIDENCE: The inspector saw care plans detailing the needs of individual residents, and saw information confirming that appropriate referrals are made to other health care professionals when required. Psychological care plans, linked to the individual’s interests and hobbies need to be developed for all residents, so that staff can actively promote the psychological wellbeing of residents. Staff receive update training on health topics such as prevention of falls and continence issues, and residents have regular access to chiropody and to opticians. Residents said that they were treated with respect, and the home’s induction programme and monitoring systems includes topics on respecting the privacy and dignity of individuals. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14. Residents are encouraged to have control of their lives for as long as possible. Group activities are encouraged inside and outside the home, and visitors are welcome. EVIDENCE: Residents told the inspector that the routines of the home suited them. One said that she could have a cooked breakfast if she requested it, and another said that there were trips outside the home if he wanted to go. After admission residents and their relatives are invited to complete a document ‘About Me’, detailing the life story of the resident, with social interests included. An activities organiser is employed four days each week to encourage residents to take part in activities, and regular trips to places of interest are organised to include all residents, especially wheelchair users. There are no restrictions on visitors unless requested by a resident, and information about the home’s visiting arrangements is included in the Service User Guide. The home does not handle residents’ financial affairs and provides information on how to contact an advocate for residents who need someone to help act in their interest. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Complaints are well managed, but information about rights to refer a complaint to CSCI for residents, relatives and prospective residents is confusing. The home’s systems protect vulnerable adults. EVIDENCE: The home has a complaints policy and procedure, which must be amended to include the CSCI’s telephone number. A summary is included in the home’s Statement of Purpose and Service User Guide, but the summary in both documents does not match the policy. In the Statement of Purpose the summary states that complainants can refer the complaint to CSCI only after the proprietor is unable to resolve the issue, and in the Service User Guide conflicting information regarding the complainant’s right to refer to the CSCI is given. Residents said that they felt that staff listened to their concerns. The inspector saw the complaints record, and was satisfied that complaints are managed appropriately. The home has a policy and procedure on protecting vulnerable adults, including appropriate recruitment checks, and staff have had training on adult protection and work to the Oxfordshire Adult Protection Codes of Practice. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) X None of these standards were assessed at this inspection, and some or all will be assessed at the next inspection. EVIDENCE: Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30. The home has an appropriate induction and further training programme. The recruitment system needs some improvement. EVIDENCE: The home has a thorough recruitment procedure and sees the applicant’s proof of identity before applying for the Criminal Records Bureau disclosure, but the information was not available on the recruitment file seen by the inspector. All other necessary information was available on the files inspected, and the inspector requires that photocopies of proof of identity be available in the recruitment files. The home has a good induction and foundation programme and staff are encouraged to enrol on NVQ courses. Training on key aspects of care is provided for staff, and the inspector heard from staff members the details of recent training attended. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 Staff and residents benefit from the support offered through the good supervision systems in place. EVIDENCE: The inspector saw supervision records showing that supervision is well organised and is regularly offered to nurses and care staff. Staff told the inspector that they felt well supported. Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x x x x 3 x x Brooklands 2 Nursing Home H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 16 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. Standard 16 Regulation 22 Requirement The proprietors must amend the complaints procedure to include the CSCIs telephone number, must also amend the summaries of the procedure in the Statement of Purpose and Service User Guide, and must include a timescale of within 28 days to inform the complainant of any action that is to be taken. The proprietors must ensure that all the information about staff detailed in Schedule 2 of the Care Homes Regulations is available at the home. Timescale for action 31/08/05 2. 29 19 31/08/05 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.
Brooklands 2 Nursing Home Refer to Standard 3 8 Good Practice Recommendations The home should acquire Care Management assessments of prospective residents referred to them. Psychological care plans linked to the individual’s interests and hobbies need to be developed for all residents. None.
H57-H08 S46642 Brooklands 2 V233927 200705 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Burgner House, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Cowley, Oxford. OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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