Inspection on 19/10/06 for Brooklands Nursing and Residential Home

This inspection was carried out on 19th October 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 Nursing and... 21/01/10

Brooklands Nursing and... 11/09/08

Brooklands Nursing and... 28/02/06

Brooklands Nursing and... 20/10/05

Brooklands Nursing and... 04/01/05

Brooklands Nursing and... 09/07/04

Brooklands Nursing and... 24/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Brooklands Nursing and Residential Home 44 Albany Road Old Swan Liverpool Merseyside L13 3BJ Lead Inspector Les Hill Unannounced Inspection 19th October 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 Brooklands Nursing and Residential Home DS0000025092.V305325.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. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooklands Nursing and Residential Home Address 44 Albany Road Old Swan Liverpool Merseyside L13 3BJ 0151 252 0080 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) Rosewood Care Services Limited Mrs Charlotte Sillitoe Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49) of places Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 49 Nursing and 11 Personal care in an overall total of 49 beds To accommodate one named person under 65 years old Date of last inspection 28th February 2006 Brief Description of the Service: Brooklands is a large home providing both personal and nursing care to older people over the age of 65 years and is located in the Old Swan district of Liverpool. Local amenities such as shops and churches can be found within a short walking distance and good transport links are available to local communities, nearby towns and Liverpool City centre. The home is purpose built with accommodation on two floors. A passenger lift provides full access to the upper floors of the home. There is wheelchair access and some parking at the front of the premises. A pleasant, private garden is located to the rear of the building. Fees for residential care are £391 .50 Fees for nursing care are as set by the Placing authority or PCT. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Brooklands Care Home was carried out on Thursday 19th October 2006 over a period of 2.5 hours. It involved the examination of some records, meeting with the manager, with nine residents, two visitors and a visiting social worker. The inspection was undertaken as part of the Commission’s responsibility to visit and report on all registered care homes. What the service does well: 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 Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. Brooklands Nursing and Residential Home DS0000025092.V305325.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 Brooklands Nursing and Residential Home DS0000025092.V305325.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made from available evidence and discussions with staff during a site visit to the home. Prospective residents can have the information they need to make an informed choice about where to live. EVIDENCE: The home has a statement of purpose that doubles as a service user guide. It is available in the entrance to the home and a copy is located in each resident’s bedroom. The document should include some further detail about staff numbers and qualifications, the fire procedures and a copy of the complaints procedure and it will then comply with Schedule 1 of the National Minimum Standards, Care Homes for Older People. Local authority or PCT contracts are in place for residents who are funded by those organisations. Brooklands has its own contract for residents who fund their own care and support. Pre-admission assessments are undertaken on prospective residents to ensure that the home is able to meet their needs. Prospective residents and their Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 9 families are involved in the process and are able to ask questions about the home’s ability to provide safe and supported care. The assessments are kept separately to the main working files but are used as a basis for developing plans of care and for identifying any specialist equipment needed. Prospective residents are invited to visit the home and to spend some time there before taking a decision to move in. The home is not contracted to provide intermediate care. Brooklands Nursing and Residential Home DS0000025092.V305325.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Individual care plans are in place, though they would benefit from regular oversight. The manager’s assertion that unused medicines will be managed according to RPS guidance means that whole process will be safe. EVIDENCE: Care plans were evidenced on the four residents files sampled during the inspection and additional risk assessments had been completed where appropriate. Guidance for staff, particularly around risk assessments, was in place. When a change in care plan is identified, staff record information about what has occurred and what actions should be followed. Where no changes are identified a date and signature is recorded with the phrase “continue with care plan”. The Commission advises care home managers to develop the practice of reviews so that any notes refer to the original plan of care and confirm that staff have given the identified need a thorough review. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 11 Previous CSCI inspections have confirmed the appropriateness of care plans. The manager was advised to regularly review the information kept in resident’s files to ensure that any new staff can gain a full picture of the individual resident and their needs. Care plans contain information about the health care needs of residents and how these should be supported. Residents can, wherever possible, retain the support of their own GP, or register with a local GP surgery. The manager reported that residents receive good support from GP’s in the area. Visits from the optician and dentist are arranged as appropriate and the home uses the services of the continence adviser and the tissue viability nurse. A private chiropody service is available for which there is a small charge. None of the current residents is able to manage their own medicines. Polices and procedures are in place for the management of medicines and a sample check of the records showed that they were being managed well. Arrangements for the disposal of medicines have been made through a contract with the pharmacist. Staff in the home were unaware that the same arrangements for storing and recording unused medicines are the same as those applied prior to the new arrangements being introduced. Therefore, unused medicines should be kept in a locked cupboard in the medical room until they can be collected and a record of all returned medicines must be kept for audit purposes. The Royal Pharmaceutical Society’s guidance for care homes on the management of medicines explains the process. Personal care is provided to residents in their own bedrooms or in bathrooms around the home. The majority of residents are accommodated in single rooms and staff were observed to knock on the door before entering their rooms. The home has seven double rooms but these are only used for married couples or for residents who choose to share. Residents can meet with visitors in their own rooms or in one of the lounge areas in the home. The inspector met three visitors to the home during the course of the inspection. A record is made on some files about the wishes of the resident and their family at the time of death. The manager told the inspector that she would develop this information to include as many residents as possible. Brooklands Nursing and Residential Home DS0000025092.V305325.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 at least once during a 12 month period. 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 and discussions with staff during a site visit to the home. Residents are helped to make choices about their lives and are provided with a varied and wholesome diet. EVIDENCE: Assessments identified the family structures and the previous lifestyles of residents together with things they liked to do. They also included food preferences and foods they disliked. The home is equipped with TV and radio and has a range of board games that residents can use. Staff also organise some activities including Bingo, dominoes, visiting entertainers, a mobile cinema and trips to local shops. Many residents have their own TV and choose to spend a good deal of time in their own rooms. Ministers of religion visit from time to time to attend to the spiritual needs of residents. Visitors are welcomed at any time and a policy and procedures are in place to encourage visits from family pets. However, owners are required to ensure the safety of all residents if one is brought into the home. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 13 Residents are encouraged to choose what times they get up and go to bed each day and the clothes that they wear. At the time of this inspection the home’s kitchens were clean and tidy. The cook meets with all new residents to discuss their likes and dislikes around food and whether they have any special dietary needs. A four-week menu is in place that has been put together using the expressed preferences of residents. A choice of foods is available at breakfast including the option for a full cooked meal. The main meal of the day is served at lunchtime and an alternative can be served to anyone who doesn’t wish to take the one on offer. A choice of foods is offered at teatime and again additional choices can be prepared. The home has a “Friday night Special” when curries and other savoury options are available. Food is carried to the first floor dining room via a “dumb waiter” system. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Residents are protected from abuse and procedures are in place to listen to their views. EVIDENCE: The home has a complaints system in place and information about making a complaint is kept in the entrance to the home. The home’s service user guide makes reference to the procedure but would benefit from an inclusion of the details. No complaints have been made directly to the home in the past twelve months. One anonymous complaint was made directly to CSCI and investigated. No action was taken against the home in response to the outcome of the investigation. All of the residents are listed on the Electoral Register and are eligible to vote in local and national elections. Policies and procedures are in place to protect residents from abuse and to encourage staff to raise any concerns. Training has been provided in recognising the different forms of abuse and the procedures to be followed if abuse is suspected. One adult protection matter was investigated that involved resident on resident concerns, and the home managed the outcomes. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 19, 20 21, 22, 23, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Some closer attention is required to ensure the physical environment is maintained to the same standards as those applied in the provision of personal care and support. EVIDENCE: Brooklands is located in the Old Swann area of Liverpool close to shops and transport routes across Merseyside. It is a purpose built home on two floors, that provide 35 single and 7 shared rooms, although most shared rooms are used for single occupancy. A programme of ongoing maintenance is in place and bedrooms are redecorated as they become vacant. The dining rooms have been decorated and furnished to a good standard. A communal lounge is located on each floor and both are well used by residents. A number of chairs in the lounges are worn and in need of replacement. Carpets laid to corridors have some heavy stains but the manager told the inspector they were due to be cleaned the next day. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 16 Bathrooms and WC’s are provided in sufficient numbers. Some assisted bathing equipment is provided. Residents bedrooms are decorated and furnished to a good standard and are personalised according to the wishes of residents and their families. The home is designed to meet the needs of disabled people and specialist equipment is provided when necessary. Risk assessments for the use of bedrails are in place. On the day of this inspection there were some unpleasant odours noted in the communal areas of the home. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. 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 and discussions with staff during a site visit to the home. Residents are supported by a staff team that is recruited and trained to support safe care practices in the home. EVIDENCE: Staff rotas confirm that qualified nurses and care assistants are employed in sufficient numbers to meet the needs of residents in the home. In addition, ancillary staff provide cooking cleaning and laundry support. The home employs a maintenance man and has a domestic supervisor to oversee all domestic tasks. Evidence to confirm that appropriate recruitment and selection procedures are in place was obtained from a sample of four staff files. Confirmation of CRB clearances was seen in all of them. All staff are expected to follow a programme of induction training and a record of the matters covered is kept on their file. Ongoing training is also provided in Palliative Care, oral health care, wound assessment, falls and risk assessment, care of the dying, fire safety, customer care, manual handling, adult protection, first aid and infection control. Nurses are supported to maintain their professional nurse status through appropriately funded training and some care staff have an award at NVQ level 2 in care. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 18 Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence and discussions with staff during a site visit to the home. Residents live in a home that is run and managed in their best interests and are protected by appropriate record keeping and health and safety controls. EVIDENCE: The Registered person (co-homeowner) for Brooklands spends a great deal of time in the home. The manager (co-owner of the home) is a qualified nurse with extensive experience in the care of older people. She has also completed an NVQ level 4 in management. The atmosphere in the home was calm and unhurried. Staff got on with their work without constant reference to the manager and appeared to understand exactly what is expected of them. There appeared to be a comfortable and supportive relationship between the manager and her staff that was also noted in her relationship with residents. During a tour of the building residents Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 20 appeared to be pleased to see the manager and she greeted them in a respectful manner. It was noted that all staff made the same respectful approaches. Residents and their visitors who spoke with the inspector were complimentary about the home and the care and support they receive. From discussions with the manager, from records maintained and from observations during the visit it could be evidenced that the needs of residents are given appropriate priority. The home’s business plans and audited financial reports were not seen during the inspection but the Commission is not aware of any matters that would affect the ongoing operation of the home. The home does not manage any money on behalf of residents except perhaps for very small amounts to cover the costs of hairdressing etc. The manager told the inspector that staff receive one-to-one supervision on a 3 –6 monthly basis. Standard 36 of the National Minimum Standards, Care Homes for Older people recommends that staff should receive formal supervision on six occasions each year. Regular tests are made on fire detection equipment and the fire alarm system is tested weekly. Information returned by the manager identifies that contracts are in place for the regular testing and maintenance of all essential equipment. The home is not connected to the mains gas supply. At the time of the inspection an electrical engineer was in the home and was preparing to carry out a full electric safety test, following which a safety certificate would be issued. The manager is aware of the requirement to maintain a safe working environment and ensures that all staff support safe practice in the home. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 2 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 4 3 3 3 3 2 3 3 Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP19 Regulation 23(2) Requirement The registered person must ensure that: 1. The cleanliness of carpets around the home is maintained. 2. Lounge chairs that are worn are replaced. The registered person must ensure that the home is free from any offensive odours. Timescale for action 30/11/06 2 OP26 16(2)(k) 30/11/06 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 OP36 Good Practice Recommendations The registered manager should ensure that staff receive one-to-one supervision on six occasions each year. Brooklands Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Nursing and Residential Home DS0000025092.V305325.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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