Inspection on 21/02/06 for Brooklyn

This inspection was carried out on 21st February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brooklyn 02/09/09

Brooklyn 16/10/07

Brooklyn 07/11/06

Brooklyn 13/06/05

Brooklyn 02/12/04

Brooklyn 20/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Brooklyn 22-24 Nelson Road Clacton on Sea Essex CO15 1LU Lead Inspector Sara Naylor-Wild Unannounced Inspection 21st February 2006 10:00 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 Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 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. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brooklyn Address 22-24 Nelson Road Clacton on Sea Essex CO15 1LU 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) 01255 430324 01255 688370 eileenmorley@btconnect.com Mrs Eileen Theresa Morley Mrs Eileen Theresa Morley Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 16 persons) The total number of service users accommodated in the home must not exceed 16 persons The registered person shall ensure that a continuing programme of development is provided for managers and staff in relation to dementia care and good practice equivalent to the recommendations of the Alzheimer’s Society The registered person shall keep under review the environmental provision to meet the assessed needs of service users with dementia in relation to good practice guidance 13th June 2005 5. Date of last inspection Brief Description of the Service: Brooklyn is a converted premises, which is in walking distance of Clacton seafront, and local amenities. Mrs Morley is the registered owner and manager of the home. The home provides accommodation for 16 service users on two levels. Communal space is made up of two lounges and a dining room. Twelve of the fourteen bedrooms are single and all but one room have en suite facilities. Service users have access to a passenger lift. The home is well maintained throughout and there is a small garden area to the back of the premises. Parking can be found to the front of the home. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in February 2006. The Manager/Proprietor Eileen Morley was present throughout the inspection visit. The previous visit to the home had considered the evidence for a large proportion of the National Minimum Standards considered key to the operation of a quality service delivery. This visit therefore concentrated on those standards not previously included. During the visit the inspector had opportunity to view service users’ records, staff records, staff training programmes, tour the premises and talk to service users and staff. What the service does well: What has improved since the last inspection? The manager continues to build on the staff’s understanding of person centred care and the importance of this in the delivery of the service. The décor and signage updates to the premises, proposed at previous visits, had commenced and thought had been given as to how service users’ orientation and movement could be supported in this initiative. The manager gave detail of the support provided to staff in relation to their understanding of good practice and the expectations of the National Minimum Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 6 Standards (NMS). This aims to assist staff to maintain a level of confidence in their daily processes that is not disturbed by the presence of an official such as the CSCI inspector. Previous visits have it is believed caused staff to act nervously and not necessarily present their normal behaviours and conduct. It is essential that staff understand the basis for the way in which the service provides care, and this in turn assists the inspector in gaining a greater insight into the service’s operations. 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. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 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 Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 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): These standards were not assessed. EVIDENCE: Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 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 the following standard(s): 9. The systems for medication management were not robustly adhered to. EVIDENCE: During the inspection the records relating to medication administration were sampled. Whilst the majority of records were appropriately completed there were unexplained gaps in the records. This did not provide a clear audit trail of accountability in the administration of medication or adhere to the home’s policy. These omissions were discussed with the manager and staff member responsible for medication on the shift and recommendations made in relation to quality monitoring of this task. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14. The service is committed to identifying opportunities for service users to exercise choice. EVIDENCE: The manager identified a number of areas where the service is seeking to support service users’ choices. These included the introduction of a finger buffet style supper that was moved to a later slot in the evening to encourage service users to stay up later and participate in a social event at the end of the day. This has been very successful and further initiatives were planned. Other areas included when they got up or went to bed, choice of meals and activities. The discussions with staff indicated that they understood the difficulty service users with dementia may have in expressing choice, and how their presentation may influence the opportunities. During the inspection, the observation of the midday mealtime identified that some service users experienced difficulties in eating the meal, but were not always provided with assistance. The manager stated that the aim of the service was to maintain individuals’ independence and that these service users had a better level of consumption if not assisted by staff. However the inspector observed that there was a tension between this and the upholding of service user’s dignity if food was allowed to drop on clothing, furnishing and Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 11 flooring. The manager was asked to review this process and ensure the outcomes were fully recorded in care plans. Other service users spoken with and observed were very positive about the home and spoke fondly of staff. There was a lively and humorous atmosphere throughout the whole visit, with service users joking with each other and staff. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 12 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. The complaints policy continues to meet the expectation of the NMS. Planned dementia care mapping will provide an insight into the levels of satisfaction that service users suffering from dementia are experiencing. The POVA policy is satisfactory, but is undermined by the omissions in the recruitment processes undertaken by the service. EVIDENCE: The existing complaints policy fulfils the requirement of the NMS in that it contains reference to the processes, timescales and the opportunity to alert the CSCI to concerns. The manager has attended a dementia care-mapping course, developed by the Bradford University. This tool aims to chart how service users with cognitive impairment respond to their interactions with staff. The manager plans to undertake mapping in the home to add to the staff’s understanding of service users’ satisfaction levels. The POVA policy and procedure is unchanged and meets the expectations of the NMS and the local guidance. Staff have received regularly updated POVA training as part of their annual training plan. The sample of staff files looked at during the course of the inspection indicated recruitment checks were not robustly followed prior to staff commencing employment. This is a significant shortfall in the protection process, as it included not obtaining CRB and POVA checks on newly recruited staff until after they were working in the home. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 13 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): These standards were not fully assessed, however progress in the plans to adapt the environment to support the needs of service users was acknowledged. EVIDENCE: Since the last inspection the communal areas have undergone a programme of redecoration. The plans have included consideration of how the design and décor of environments contribute to the well being of service users with dementia. Therefore the use of colour and signage has been addressed in this programme of works. At the time of the inspection this work was not yet complete, but good progress made. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 14 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): 28, 29 & 30. The staff are competent in their role. The staff training provided specialist insight into the support required by service users living at the home. The service does not adhere to the recruitment policy and there are not robust procedures followed when recruiting staff. EVIDENCE: Since the previous inspection the manager had invested a large amount of resources in raising the staff’s competencies in meeting the needs of service users with dementia. This had included each member of staff undertaking a Certificate in Dementia Care, as well as the NVQ level 2 qualifications. This is a significant commitment to the delivery of a specialist service, through a competent and skilled workforce. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 15 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): 33, 35 and 36. Overall the focus on service users is high. The home does not manage any finances on behalf of service users. Staff supervision is not always formally recorded. EVIDENCE: The attitude within the staff group supports the manager’s ethos of service user focused services. The service has developed its competencies over a period of two or three years to ensure that staff skills match the assessed needs of service users. There is a happy and friendly atmosphere in the home, which both service users and staff enjoy. The service already operates a quality assurance programme with staff and relatives involvement. The proposed dementia care mapping exercise detailed Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 16 in NMS 16, will provide added value to this process, through the insight given into service users’ assessment of wellbeing. The manager confirmed that the home does not manage any finances on behalf of service users. Records indicated that formal staff supervision is not consistent, and from discussion with the manager it was acknowledged that a small service and staff group where the manager works alongside staff often deal with these issues informally during the course of the working day. The manager was advised to consider how these discussions or observations of staff’s working standards could be included in the records of supervision. Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X N/A 2 X X Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 12,13 Requirement The registered person must ensure that all aspects of service users’ identified needs and aspirations are set out in an individual care plan. This is a repeat requirement. The registered person must ensure the medication administration adheres to the home’s policy and procedure. The registered person must ensure that staff recruitment policy and procedures are robust and that information required by Regulation 19, Schedule 2 is obtained prior to appointment. This is a repeat requirement The registered person must ensure that staff supervision is consistently provided. Timescale for action 30/06/06 2 OP9 13 30/04/06 3 OP18OP29 OP36 19, Schedule 2 30/06/06 4 OP36 18 (2) 30/06/06 Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 19 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 OP30 OP19 Good Practice Recommendations The registered person should ensure that training needs identified by staff through supervision processes are included in a training programme. The registered person should continue to give consideration to the layout, décor and signage of the home in accordance with established good practice guidance relating to dementia care. The registered person should ensure that there is a full assessment of service users’ needs in respect of meals and mealtimes, including specialist advice, provision of equipment and instructions to staff in care planning in relation to the support they should provide. 3 OP14OP10 Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Brooklyn DS0000017784.V284787.R01.S.doc Version 5.1 Page 21 - 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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