Inspection on 22/06/05 for Brooklands Nursing & Residential Home

This inspection was carried out on 22nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 & Residential... 25/07/07

Brooklands Nursing & Residential... 24/05/06

Brooklands Nursing & Residential... 26/10/05

Brooklands Nursing & Residential... 25/02/05

Brooklands Nursing & Residential... 15/06/04

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Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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 Costessey Lane Drayton Norwich NR8 6HB Lead Inspector Marilyn Fellingham Unannounced 22 June 2005 11.45 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 Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brooklands Nursing & Residential Home Address Costessey Lane Drayton Norwich NR8 6HB 01603 262666 01603 261155 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) London & West Investments Limited Jennifer Carol Sharp Care Home 54 Category(ies) of Old age (54) registration, with number Physical disability (2) of places Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The two Physical Disability (PD) service users must be over the age of 50 years. Date of last inspection 25 February 2005 Brief Description of the Service: Brooklands is situated in Drayton on the outskirts of Norwich and consists of a detached property built on three floors. A bus service is available to the village but does not run past the Home, the nearest train station is Norwich. There is a lawned area and a patio for Service Users use; this is accessible to wheelchair users. The Home is registered, as a Care Home with Nursing, which also accommodates Service Users without any nursing needs. There are a variety of activities in and outside the Home and an activity co-ordinator facilitates these and is employed to work every weekday afternoon. There is a hairdressing facility for all Service Users. The Home is suitably adapted to provide accommodation for people with handicaps and a range of appropriate equipment is available to meet the needs of the Service Users. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over five and three quarter hours. The deputy manager was in charge of the home and ably assisted in the inspection process. Throughout the inspection the members of staff were courteous and helpful. The Inspector was able to speak with seven relatives, six service users, seven members of staff and two domestics; a great deal of time was spent with the relatives. The Inspector did not look at all the standards during this inspection and those not assessed will be inspected on future inspections. The Inspector gained the impression after her discussions with various relatives, visitors and staff, that some minor areas of care need to be addressed. A tour of the home took place and staff and care records were inspected. The Inspector was concerned that there are a large number of accidents recorded particularly for the month of May. What the service does well: The home has a good team of care staff that have worked at the home for a number of years, likewise the domestic staff also. These staff members work very well as a team and there is an open happy atmosphere. The management of the home is very good at responding to all requirements and recommendations made by the Commission especially in relation to safety aspects of the environment. The home has a good record for training and ensures that the staff attend many courses related to the care of the service users. The home keeps good records that are always available for the inspection process. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 6 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 contacting your local CSCI office. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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 Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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) 2,3, 5 The admission procedure is good and prospective residents are well assessed using a format that can then be used to plan care. EVIDENCE: Assessment documentation, for newly admitted residents, was seen by the inspector, this indicated a thorough admission process with all areas of need being assessed. The deputy manager confirmed that no one is admitted if it were thought that their needs could not be met. Relatives and one newly admitted person stated that they had been given enough information to enable them to make a decision about the home and whether the home could meet their needs. Documentation was examined that set out very clearly the services that were offered by the home. A statement of terms and conditions given to the newly admitted residents was in place and seen by the Inspector. These contained all the relevant information needed by the resident on the point of entry to the home. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 9 Prospective residents and relatives are given the opportunity to visit the home on a trial basis before they make a definite decision about admission. This was confirmed in discussion with relatives and residents. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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 standard(s) ,7,8,10,11 In many cases the health care needs of the residents are not identified or evaluated. These shortfalls have a potential to place residents at risk. Residents are treated with respect and dignity, but on occasions their specific requests are not adhered too. Care of the dying is handled well and with sensitivity and dignity. EVIDENCE: Examination of the care plans revealed that not all needs, as assessed, were being identified on care plans. Where specific needs had been identified these had not been evaluated and where they had been there was an enormous amount of confusion on the written plan of what constituted a need and where the review was itemised on the plan of care. This could ultimately lead to confusion and have the potential to place residents at risk. In some cases where a resident had been assessed at being at risk of falls and indeed records indicated this, this risk had not been identified on a plan of care to instruct carers what preventative action to take to prevent the risk of falling. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 11 It was also noted by the Inspector that there were two records of falls in a daily report that had not been recorded. It was also noted by the inspector that most of the recorded accidents happened in resident’s rooms. After discussion with relatives the Inspector formed the impression that on some occasions, resident’s requests to go to the lavatory are not conceded to; when a request is made there appears to be a reluctance to do so and remarks are made such as “do you really need to go” and “is it wind”. It was also evident after examination of the records for meeting hygiene needs that they are not fully met in many cases; mostly residents only get one bath a week, this was confirmed by looking at records for bathing and after discussion with residents and relatives. Skin integrity assessments are carried out and these were recorded in the plans of care, these were good records that also indicated continual monitoring of weight. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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 standard(s) assessed no standards EVIDENCE: Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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) 16,18 No complaints have been received by the CSCI since the last inspection, however some relatives and residents feel that their observations about care are not always listened to. Procedures are in place to monitor and handle instances of abuse, staff are made aware of all issues related to adult abuse, however more training needs to take place. EVIDENCE: The home has a detailed complaints procedure that was examined by the Inspector, it was most comprehensive and clear to understand. The residents and relatives spoken with understood this procedure and stated that they would feel quite comfortable in raising issues with the staff. It was evident after discussion with staff that they were conversant with the procedure for Whistle Blowing and those spoken to said they would not hesitate to report any incidents of abuse. Examination of training records revealed the need for yet more training to take place in relation to abuse to ensure all members of staff are familiar with the subject. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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) no standards assessed EVIDENCE: Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 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) 27,28,30 The deployment of staff is not adequate to meet the needs of the residents. Staff have the skills and are competent to do their jobs. EVIDENCE: Those residents and relatives spoken with expressed their concern about staffing levels and the time it took for call bells to be answered. Residents stated that the staff were very kind and caring but sometimes took a long time to get to them; two visitors to the home also voiced the same concerns. During the visit the Inspector noted the time it took for the call bells to be responded to and in some cases was three to four minutes. On investigation this appeared to be due to a number of reasons; the deployment of staff was not sufficient to meet the assessed needs of the residents. These assessed needs had been identified as part of the care planning process. It is a large home that has three floor levels to cover and on the day of inspection there were only six carers on duty with two qualified nurses; in the Inspector’s opinion this was not adequate to safely implement the home’s statement of purpose. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 16 Examination of the training records revealed that the staff were given adequate training in all areas related to caring for the residents that are in the home. This was confirmed by the carers who were seen by the Inspector, some of them said that they were always being opportunities to go on courses to extend their knowledge and expertise in care. One carer stated “we are always doing courses”. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 17 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) 31,32,37,38 At times there is inefficient leadership within the home to allow the residents to receive consistent quality of care, this would appear to result in some practices that do not promote the health and safety and welfare of the residents. EVIDENCE: Past duty rosters indicate that on many shifts there are not adequate numbers of staff on duty and quite often only one registered nurse on duty in the afternoons and evenings. These numbers do not reflect the amount of care that is required in relation to the assessed needs of the residents and could in part be the reasons for the delay in answering the call bells. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 18 The management of the PCT clients needs to be addressed and managed in a more productive way to ensure that these six residents are also receiving the appropriate care as set out in their care plans. The Inspector gained the impression that there was a lack of communication with all agencies and the care home staff as to who is responsible for what care. Some of the relatives of these six residents were also confused as to who to approach in relation to asking questions. The inspector also gained the impression having spoken with relatives that there were some areas of care that needed to be improved and that communication could also be improved. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 19 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 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 2 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 2 x x x x 3 2 Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 20 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 27 Regulation 18 Requirement Timescale for action Immediate and on going 2. 7 15 The registered person shall having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that at all times suitably qualified and experienced persons are working at the care home in such numbers as are appropriate for health and welfare of the service users. The registered person shall Immediate prepare a written plan (service and on users plan) as to how the service going users needs in respect of his health and welfare are to be met and keep the plan under review. 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 38 16 Good Practice Recommendations It is recommended that auditing of falls in residents rooms takes place to ensure that the incidence of falls might be decreased and preventative measures taken. It is recommended that relatives observations about care. I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 21 Brooklands Nursing and Residential Home 3. 32 are listened to and that they feel that their observations are listened to. It is recommended that communication is improved in relation to all agencies concerned with the six PCT service users so that all persons working in the home are aware of their responsibilities. Brooklands Nursing and Residential Home I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 I55 S15620 Brooklands V234111 220605 Stage 4.doc Version 1.30 Page 23 - 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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