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Inspection on 20/10/05 for Brooklands Nursing and Residential Home

Also see our care home review for Brooklands Nursing and Residential Home for more information

This inspection was carried out on 20th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 home provides an extremely pleasant environment which is well maintained. Redecoration is on-going to ensure that the high standards provided are maintained at all times. A selection of different meals is offered at each mealtime and individual preferences are respected. The cook speaks with all new service users on their admission to ensure that special diets and individual preferences can be made available. The staff are well trained and fully aware of their role and responsibilities and were observed to be pleasant and polite to all service users and visitors to the home.

What has improved since the last inspection?

What the care home could do better:

Risk assessments in relation to the use of wheelchairs need to be put in place where they are currently missing. Specific mobility care plans may need to be put in place for some service users following risk assessments to ensure the protection of the service users.

CARE HOMES FOR OLDER PEOPLE Brooklands Nursing and Residential Home 44 Albany Road Old Swan Liverpool Merseyside L13 3BJ Lead Inspector Jeanette Fielding Unannounced Inspection 20th October 2005 10:30 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.V260811.R01.S.doc Version 5.0 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.V260811.R01.S.doc Version 5.0 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.V260811.R01.S.doc Version 5.0 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 4th January 2005 Brief Description of the Service: Brooklands care home is a large care providing both personal and nursing care to older people over the age of 65 years. It is located in the Old Swan district of Liverpool. Local amenities such as shops and churches can be found within a short walking distance of the care home. The care home is situated within several miles of Liverpool city centre and enjoys good transport links via bus to the centre. The care home has been purpose built for the provision of care. Accommodation is provided on two floors and a passenger lift provides full access to all areas of the home. There is wheelchair access to the care home and adequate parking at the front of the premises. There is a pleasant private garden to the rear of the building. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over a period of four and a half hours at a time when service users and their visitors could be spoken to and the main meal of the day observed. During this inspection, records relating to the identified needs of service users together with the records of the actual care given. All were found to be in order with the exception of risk assessments relating to the use of wheelchairs. Staff records were inspected to ensure that all staff were appropriately checked prior to them commencing work at the home and that relevant training had been given. The staff files were found to be clear and up to date and included all information necessary. The home is decorated and furnished to a high standard and provides a warm and pleasant environment. Service users and their visitors commented on the quality of the environment and the kindness of the staff. What the service does well: What has improved since the last inspection? What they could do better: Risk assessments in relation to the use of wheelchairs need to be put in place where they are currently missing. Specific mobility care plans may need to be put in place for some service users following risk assessments to ensure the protection of the service users. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 6 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 Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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.V260811.R01.S.doc Version 5.0 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, 3 Pre-admission assessments are undertaken on prospective service users by qualified nurses to ensure that the home can meet their individual needs and preferences and therefore provide the appropriate level of care. EVIDENCE: A comprehensive Statement of Purpose and Service User Guide have been prepared and are placed in each bedroom to give full information to both service users and their visitors. These documents are reviewed and updated as necessary. Copies are available from the home on request. Pre-admission assessments are undertaken on all prospective service users to ensure that the home can meet their individual needs and preferences. These assessments are undertaken by the manager or one of the qualified nurses. The information gathered enables the home to prepare a plan of care and to give the opportunity for any necessary equipment to be provided prior to admission. Information is gathered from the service user, their family and other healthcare professionals involved in their care. The assessment Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 9 information is held securely in the main office when the plan of care has been prepared as confidential information may be recorded on the form. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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 The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: Care plans are detailed and informative and provide full information for both qualified nurses and care staff to ensure that all needs are met. Some attention is required to the risk assessments that are prepared for some service users in relation to the use of wheelchairs. One service user was observed to be transported in a wheelchair without the foot rests being used. These should be used at all times unless an identified reason for not using them is risk assessed and appropriately recorded in the plan of care. Risk assessments are prepared for those service users who require bed rails to be fitted to beds and give details of the risk management strategy. The records also provide evidence that the care plans have been discussed with the service users or their relatives and that they are in agreement with them. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 11 All service users are registered with a doctor of their choosing. The records also provide evidence of visits to and by other healthcare professionals and give detailed information of changes to the service users care needs. The Tissue Viability Nurse is contacted for advice for any service user who has pressure sores as necessary. The home has a policy and a procedure to be followed for the administration of medications. Records relating to the administration of medications were found to be in order and completed as required. All medications are stored securely and the storage areas were clean and organised. Appropriate arrangements have been made for the disposal of unwanted medications and safety measures have been put in place. Personal care is given to service users in their bedroom or in bathrooms as necessary. The majority of service users are accommodated in single bedrooms and staff were seen to knock on doors prior to entering rooms. The home provides seven shared rooms, however, these are only used for shared occupancy at the specific request of service users. Service users may meet with their visitors in the privacy of their bedroom or in one of the communal areas as they wish. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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, 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: During the inspection, it was evident that service users could choose the time of rising or going to bed, where they took their meals and where they spent their time. A record of individual preferences is recorded in their plan of care. A comprehensive programme of activities has been prepared and this is displayed in the foyer of the home. Activities include both group events and one to one time with service users and records are held of the specific activities that each service user participates in. A high number of visitors were at the home at the time of the inspection and those spoken to said that they were completely happy with the care given to their relatives. Observation of the interaction between visitors and staff provided evidence that they were welcomed to the home and given information and updates on their relatives on a regular basis. Service users spoken to confirmed that they are offered choices on all aspects of daily living and that staff strive to meet their individual preferences and choices. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 13 The home follows a four weekly menu and a choice is available at all meals. The menus provide evidence that a wholesome and nutritious diet is served to service users and the meal being served on the day of the inspection appeared hot and appetising. Service users spoke highly of the meals served. Special diets can be provided on the advice of the dietician or on request. The cook speaks with all new admissions to the home to gather information regarding individual food preferences and to discuss the dietary options available. Service users are given the opportunity to choose the meal of their choice and a record is held of the meals taken by each service user. The two dining rooms are extremely bright and pleasant areas. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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, 18 Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a detailed policy and procedure to be followed in the event of a complaint and information on this, and how to make a complaint is detailed in the Service User Guide which is in each bedroom. This information is also displayed on the notice board in the hallway of the home. Service users spoken to said that they had never needed to make a complaint but would feel confident that any issues would be addressed. Training has been given to staff on the different types of abuse and of the action to be taken if it were suspected. The manager was able to demonstrate that she was aware of the policy, the procedure to be followed and the people to contact. Staff spoken to were also able to demonstrate that they were of the action to be taken. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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, 24, 26 Regular investment in the home continues to improve the appearance of this home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: The home is located in a predominantly residential area, close to shops and other amenities. The home is purpose built and provides 35 single bedrooms and 7 shared rooms. The shared rooms are used for single occupancy unless the service user requests to share. At the time of the inspection, all rooms were for single occupancy. A programme of redecoration and improvements continues to take place. Since the last inspection, several bedrooms have been redecorated and refurbished and are extremely bright and pleasant. New carpets have been fitted to the bedrooms following the redecoration. The programme of redecorating the corridors is now complete and all are bright and clean. The staff areas have been redecorated and refurbished. The home is bright throughout and all furnishings are good. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 16 The home is clean and hygienic throughout and there are no unpleasant odours. Bedrooms are tastefully decorated and furnished and service users are encouraged to personalise their rooms with pictures and items of memorabilia. All bedrooms inspected were found to be bright and are decorated and furnished to a high standard. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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, 30 The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their roles. EVIDENCE: The home employs and deploys staff in sufficient numbers to meet the needs of the service users. The home provides qualified nurses at all times who are supported by care staff. In addition to this, the home also employs ancillary staff to attend to domestic, laundry and maintenance duties. A domestic supervisor is responsible for overseeing all domestic tasks. The home now employs 42 of care staff who hold NVQ qualifications. Additional staff are currently working towards this. The records provide evidence that the home has a robust recruitment policy and procedure and that this is followed for all new staff. All prospective staff are required to complete an application form prior to interview. Two relevant references are taken together with Criminal Record Bureau and Protection of Vulnerable Adults registers. Copies of all necessary documentation, together with evidence of training qualifications are held in the staff files. All staff undertake a programme of induction training when they commence work at the home. On going training is undertaken by all staff and a programme of training was seen. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 18 Staff spoken to during the inspection confirmed that they continued to develop their knowledge and understanding through on-going training. Staff were knowledgeable about service users care needs and were observed to have a good rapport with both service users and their visitors. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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, 33, 35, 38 The clear and consistent management of the home protects the health, safety and welfare of service users. EVIDENCE: The manager is a qualified nurse with extensive experience in the care of elderly people. She is an experienced manager who has recently completed an NVQ 4 in management and is currently working towards a Degree in Health and Social Care Practice. Staff meetings are held on a regular basis and provide the opportunity for staff to exchange information and discuss any issue within a group environment. Staff spoken to confirmed that they felt comfortable speaking to the Responsible Individual and the Registered Manager on any issue in the knowledge that any issues raised would be given appropriate consideration. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 Page 20 A questionnaire has been sent to all service users and their families to audit the service offered by the home. The outcome has been evaluated and details are recorded in the Statement of Purpose. Service users family or advocates attend to service users personal finances. The home holds small amounts of money, up to a maximum of £10, on the request of families and detailed records are held of all purchases made by service users. Regular tests are made on fire detection equipment and records are held of these were seen to be in place and up to date as required. Tests are made on all equipment in the home including portable appliances, lift and hoists. Certificates of tests were found to be in place and up to date. Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 X 18 3 4 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 4 X 3 X 3 X X 3 Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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 7 Regulation 13(4)(c) Requirement The Registered Person must ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. This is with particular reference to the use of wheelchairs. Timescale for action 20/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brooklands Nursing and Residential Home DS0000025092.V260811.R01.S.doc Version 5.0 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.V260811.R01.S.doc Version 5.0 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. 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