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Inspection on 28/07/05 for Brooklands Care Home

Also see our care home review for Brooklands Care Home for more information

This inspection was carried out on 28th July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service assesses service users needs before they move into the home and produces a good plan of care. It usually meets individual and collective needs well, and though this was found to be poor for one respite service user recently, the standards of care provision have been raised again. The service involves relatives and friends in the care of service users and encourages them to take part in community activities. The general environment is well maintained and good practices are followed which promote health and safety of service users and staff.

What has improved since the last inspection?

Staff communication, report writing and following plans of care have improved since the last inspection and as a result of a complaint in June 2005. Some of the home has been re-decorated. Adherence to recruitment and selection procedures has improved.

What the care home could do better:

Service users views are that more male carers could be employed to assist with personal care of male service users, and that a service userrepresentatives committee could be set up to speak to service users and pass on ideas to the Manager and staff. The Inspectors views are that service users could be better informed about the complaint procedure, that new service users could be informed in writing whether or not their assessed needs can be met, and that more tasks should be delegated to care staff in respect of recording and reporting.

CARE HOMES FOR OLDER PEOPLE Brooklands Care Home Springfield Road Grimsby North East Lincs DN33 3LE Lead Inspector Janet Lamb Unannounced 28 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 Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brooklands Care Home Address Springfield Road Grimsby North East Lincs DN33 3LE 01472 753108 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) Highfield Home Properties Ltd Mrs Dorothy Marfleet Care Home 63 Category(ies) of DE(E) (24) OP (31) PD (10) registration, with number of places Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Brooklands is a purpose built care home in a residential area of Grimsby, providing nursing to a maximum of 63 service users. The home has two floors and rooms are all single. There are satisfactory communal facilities, a rear garden area and a passenger lift. Local facilities are within walking distance and the centre of Grimsby is only a bus ride away. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over nine and one quarter hours and was one of the two inspections the home is required to have in each year. The Inspector looked around the house and talked to residents, the Manager, staff and visitors. Some of the records were inspected. Of the fifty-three residents living in the home five were interviewed and another five were briefly spoken to. There were ten care staff, one nurse, one administrator, one cook and two kitchen assistants, three cleaners, one laundry worker and one handyman working in the home. Three senior care staff and one carer were interviewed. The Inspector observed interaction between residents and staff, and between residents. What the service does well: What has improved since the last inspection? What they could do better: Service users views are that more male carers could be employed to assist with personal care of male service users, and that a service user Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 6 representatives committee could be set up to speak to service users and pass on ideas to the Manager and staff. The Inspectors views are that service users could be better informed about the complaint procedure, that new service users could be informed in writing whether or not their assessed needs can be met, and that more tasks should be delegated to care staff in respect of recording and reporting. 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 Care Home J54 Brooklands S2776 V229614 UI 28.7.05 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 Care Home J54 Brooklands S2776 V229614 UI 28.7.05 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 only. The Manager does a good job of ensuring service users’ needs are assessed before they move into the home. EVIDENCE: Service users are fully assessed by their placing local authorities and then by the Manager of the home before admission. Senior staff, usually the trained nurse on duty, admitting a new service user will complete reception details and then observation of the service user takes place over a period of time to determine current needs. Community care assessment documents and community care, care plans are held on file. The home does not put in writing to new service users that it can or cannot meet their needs once the assessment has been completed. Service users spoken to related the processes of assessment and remembered visits from the Manager and documents being completed. Staff spoken to do not usually complete assessments. This is the Manager and trained nurses role. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 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) 7, 8, 9 and 10. The Manager and staff do a good job of recording service users’ needs, of meeting them on a daily basis, of upholding privacy and showing respect, and of protecting those service users who wish to self-medicate. This performance was poor in June 2005, when investigation of a complaint revealed a service user’s needs were not met. EVIDENCE: Service users needs are set out in a detailed plan of care covering all of the assessed areas listed in standard 3.3, and meeting the requirements of standard 17. Service users sign their plans of care on admission and after reviews. Health care needs are met daily by providing assistance with personal care, emotional support and by encouraging a healthy lifestyle in terms of food and fluid intake and exercise, where possible. Visits to hospital and health care professionals are arranged and supported by staff where necessary. Documents; diary notes, plans of care, risk assessments and charts etc., record all of this. Service users spoken to felt their privacy is fully respected, staff provide care discreetly, and one in particular explained about the support he was getting for Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 10 handling his own medication. Policies, procedures and guidelines are in place to cover privacy and self-medication, amongst others. The complaint in June 2005 was partly substantiated and records and reports show one service user receiving respite care did not have his needs met, which could have had serious consequences for his health. Training issues in respect of communication, record keeping and following care plans, for staff have been addressed since then, and now the home is operating to a better standard. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Generally the staff do a good job of satisfying service users’ social, recreational and personal expectations, with one or two exceptions. The Manager and staff do a good job of encouraging visitors to the home, supporting service users to maintain contact with the local community and helping them to exercise control over their lives. The home provides good choice of a wholesome, balanced diet. EVIDENCE: Service users spoken to had different views about their experiences in the home matching their expectations and preferences. Some service users have had very drastic changes in lifestyle on entering the home and mostly due to the situations they found themselves to be in as a result of accident or illness. Service users were very honest in giving their views about routines, choices and flexibility. They said living at Brooklands required “give and take,” an ability to make adjustments, and working in partnership with the staff to achieve results. One service user wanted this report to mention one staff member who has been especially supportive to him. He said “all the staff are good, but ? has been a real rock and deserves special praise.” Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 12 Service users and staff spoke positively about receiving visitors, who are made welcome and given refreshments if required. The home was observed to be very busy with visitors, health professionals and maintenance staff. Comments about making choices, exercising self-determination and about food provision were mostly positive. One service user thought the food could be better but others were satisfied with it. The dining rooms are pleasant and meals are a social event. Two visiting relatives spoken to praised the service of care, but one did uphold a service user’s view that general preference in the home is for male carers to assist male service users with personal care. Conversation also revealed the GP call out service in the area is very poor after surgery hours and at the weekends. Staff try to avoid calling GPs at these times and service users feel frustrated by this. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The Manager and staff do a fairly good job of listening to service users’ and their relatives’ complaints and acting on them. They do a good job of protecting service users from abuse. EVIDENCE: Not all service users spoken to were aware of the complaint procedure, but everyone did feel confident they could speak to a staff member, the administrator or the Manager. Records of complaints and their outcomes are held in the office and in service user’s files. There are policies, procedures and guidelines for protecting service users’ from abuse, including whistle blowing, most staff have completed training on adult abuse, and there are opportunities to make representations through visiting health professionals, relatives and friends. Advocacy services are limited in the area. Service users said they were not aware of any inappropriate behaviour or practices amongst the staff team. One service user recalled quarrelling with staff in the early days of his stay, but feels time, ‘honest speaking’ and the good friendship of another service user has resolved the problems, and now everyone at Brooklands is his new family. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The Manager and staff do a good job of maintaining a safe, clean, comfortable and hygienic environment. EVIDENCE: A tour of the building and observation of the way in which equipment is used revealed the home to be clean, comfortable, safe and well maintained. Documents are kept for all maintenance checks on such as fire safety systems, gas and electrical installations, lifting equipment, etc. Staff practices follow set policies, procedures and guidelines, and include the use of personal protective equipment, as well as general safety equipment. Service users expressed satisfaction with the cleanliness of the home. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 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 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) 27, 29 and 30. There is a good mix of staff, which could be better if more males were employed. There is a good level of training and there is good protection for service users through the recruitment process. EVIDENCE: Staff employed in the home cover a mix of ages and include both genders, though service users felt more males should be employed as carers. The staff have a range of experience working in care, and have had opportunities at this and other homes to do training relevant tot heir roles and responsibilities. There is a trained nurse on each shift throughout the 24 hour period, plus the Manager working 9am to 5pm who is also a trained RGN. Recruitment policies and procedures are followed and all staff now have Criminal Records Bureau clearance. Staff files hold the relevant documents required in schedules 3 and 4, but where passport or picture driving licences and birth certificates are not held by staff or are lost, the home should try to obtain further documentary proof of identity through such as national insurance numbers and by requesting staff obtain a replacement birth certificate. Staff undertake induction and foundation training, mandatory training with Southern Cross and enrol for NVQ. There are currently 22 of care staff with level two or above. Few staff actually produce records of the care they give, this is mainly the responsibility of trained staff, but could be delegated to carers. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 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 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) 38 only. The Manager and staff do a good job of promoting the health, safety and welfare of service users and staff. EVIDENCE: Staff receive training in fire safety, lifting and handling, first aid, food handling, and infection control, to name a few. Practices in the home follow policies, procedures and guidelines on handling dangerous substances, maintenance of gas and electrical equipment and systems, and security of the home. There is a health and safety policy statement, risk assessment documents for the building and practices, and records of accidents, injuries, illness and communicable diseases. The relevant health and safety legislation is complied with and the home reports situations to the appropriate bodies concerned. Records of all health, safety and welfare issues are maintained. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 17 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 18 Yes 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 OP7 Regulation 14 Requirement The Registered Provider must ensure that all care plans have been reviewed and audited to ensure continuity. The Registered Priovider must ensure that all specialist equipment used by service users is recorded in the care plans and is maintained. Timescale for action Was 30/08/05. Now 31/12/05. Was 30/07/05. Now 31/12/05. 2. OP24 16 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. Refer to Standard OP28 OP31 Good Practice Recommendations The Registered Provider should ensure 50 of care staff achieve NVQ level 2 by the end of 2005. The Registered Manager should achieve NVQ level 4 Registered Managers Award by the end of 2005. Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit 3, Hesslewood Country Office Park Ferriby Road Hessle East Yorkshire HU13 0QF 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 Brooklands Care Home J54 Brooklands S2776 V229614 UI 28.7.05 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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