Inspection on 22/05/07 for Brooklyn House Nursing Home

This inspection was carried out on 22nd May 2007.

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

Brooklyn House Nursing Home 25/04/06

Brooklyn House Nursing Home 26/10/05

Brooklyn House Nursing Home 16/11/04

Brooklyn House Nursing Home 08/06/04

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 House Nursing Home Queen`s Road Attleborough Norfolk NR17 2AE Lead Inspector Mrs Geraldine Allen Unannounced Inspection 22nd May 2007 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 Brooklyn House Nursing Home DS0000015621.V341523.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. Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooklyn House Nursing Home Address Queen`s Road Attleborough Norfolk NR17 2AE 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) 01953 455789 01953 455789 brooklyn@caringhomes.org. Brooklyn House Limited Mrs Bridget Sullivan Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2006 Brief Description of the Service: The home is purpose built, close to the centre of the town of Attleborough and is registered to provide nursing care, including long term and short term respite care, for up to 31 elderly people. There is parking on the adjacent supermarket car park. Accommodation is arranged over two floors, with communal areas predominantly on the ground floor. There is one first floor sitting area. A shaft passenger lift is provided. Information for service users outlines services available, such as hairdressing, chiropody, and activities organised during the week. The home’s current fee levels range from £475:00 to £575:00 per week based on needs and if en-suite facilities are available. Additional charges are set out clearly in the Service User Guide. Prospective residents and their representatives are advised of the fee rate prior to admission to the home both verbally and in writing. The fee rate is also stated within the resident’s contract. Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the day of 22nd May 2007. The manager, Mrs Sullivan, provided information about the day-to-day running of the home before the inspection took place. Four visitors and 9 people who use the service completed and returned questionnaires to the Commission. On the day of inspection, information was obtained from a variety of sources including looking at records, speaking with residents, visitors, staff and the manager, touring the building and observing practice. The last full inspection at this home took place over 2 days on 25th April & 3rd May 2006, when some areas of concern were noted. A follow up inspection took place on 21st September 2006, when significant improvement was seen. This improvement has continued and this inspection demonstrated the hard work that has taken place by Mrs Sullivan and all the staff at the home. As a consequence of their efforts, people who live at the home and visitors spoke positively about their experiences. Comments were especially warm about the caring and supportive attitude of staff. What the service does well: What has improved since the last inspection? The most significant improvements have been in the standard of recording done by staff. It is now possible to see clearly what specific care each person needs and how it should be given. Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 6 There is now discreet screening in place by the 2 communal toilets in the entrance hall. This helps to protect people’s privacy and dignity when using the facilities and receiving personal care. Good records are now in place that show how the social and emotional needs of people are met. Staff are working hard to develop a biography and life history for each person so that their preferred lifestyle and interests are properly understood. 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. The summary of this inspection report can be made available in other formats on request. Brooklyn House Nursing Home DS0000015621.V341523.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 Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive sufficient information to help them choose to live in a home they are confident will meet their needs. The home does not provide intermediate care. EVIDENCE: Mrs Sullivan said the current fee range was between £475:00 and £575:00 per week. Potential residents or their representatives were advised of the fee at the time of their initial enquiry and the fee payable was dependent on their assessed needs and the room available. Mrs Sullivan said that the amount payable was put in writing prior to admission to the home and a contract of residence was provided on admission to the home. Three resident files were looked at in detail. Each person had received a full assessment of their needs before they moved into the home. This helped to Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 9 identify specific issues and to ensure that staff at the home were aware of and could meet individual needs. Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive health and personal care based on their individual needs. Staff know and understand the principles of privacy, dignity and respect and for the most part put this into practice. EVIDENCE: Three resident’s care plans were looked at in detail. Each was clearly laid out and included the pre-admission assessment. This provided good information about the specific needs of the individual and helped staff to develop meaningful plans about how care was to be given. A further assessment was completed on the day of admission to ensure all information was up to date and correct. There was evidence that staff were putting together a biography and life history about each person. These provide staff with valuable information about the person and the things that are important to them. Risk assessments were also seen that were relevant to the individual. The risk assessments were reviewed & updated monthly. The specific care plans gave good information about the care needed and how it should be given and they Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 11 were reviewed and updated monthly. Daily records gave good information about daily events and the activity log showed all the social activity that takes place for each person. There was plenty of evidence to show that people using the service are able to access healthcare services as necessary. One resident said Mrs Sullivan was trying to get his access to physiotherapy sorted out for him. The nurse on duty said that she felt the GP, district nurses and tissue viability nurse offered good support to the home. .There was evidence on people’s files to show that staff seek advice from healthcare professionals appropriately. The storage, administration and recording of medicines were looked at and good practice was seen. Records were properly completed and legible. The medication trolley was kept locked when unattended. The treatment room was used to store the medication trolley and this room was locked when not in use. There was also good practice seen regarding the use of controlled drugs. For the most part, staff were seen knocking on resident’s doors, speaking politely and respectfully and engaging in appropriate interaction. However, 1 carer who was undergoing her induction training was seen to enter a toilet without knocking on the door, despite knowing a resident was using the facility. This was brought to Mrs Sullivan’s attention. Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to make choices about their lifestyle and are confident staff will respect these. EVIDENCE: People who live in the home and also visitors to the home were spoken to. One person said he had been very pleased with what the home had done to help him to celebrate his recent birthday. Another resident said he was very happy at the home and described the staff as wonderful. He said the food is good and there was plenty of it. The night staff make him sandwiches if he feels hungry during the night. His wife visits every day and is always made to feel welcome by the staff. Visitors said they were very happy with the staff at the home whom they described as “lovely”. They had been told they could visit at any time. They felt there were enough staff about to look after their mother. They also said they were pleased with their mother’s room, which they described as being always clean and tidy. Visitors also referred to a relatives meeting that had been held the previous week at which they had enjoyed cheese and wine. Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 13 Residents were seen engaged in various activity and occupation. The activity co-ordinator was seen taking a resident out in a wheelchair for a visit to the shops. She described some of the activities arranged at the home and also the opportunities to spend time in 1:1 activity. Most people said there were activities going on that they could join in with if they wished. Lunchtime was observed in the main dining room. One member of staff was sat at a dining table eating her sandwiches whilst the residents ate their lunch. This generated plenty of conversation between the staff and residents. All meals were served plated up and were attractively presented. Some residents were being discreetly prompted by staff to eat and staff sat beside residents to offer more assistance as necessary. People were heard being offered choices of food. Ill-matching dining tables and chairs spoilt the appearance of the dining room. Some of the over chair tables being used by people were in a very poor state of repair and some were unhygienic as the surfaces were badly split and broken. Catering staff have worked hard to satisfy the Environmental Health Officer following shortcomings identified at an earlier inspection carried out by Breckland Council. Mrs Sullivan provided evidence that staff have now achieved the “Good Food Hygiene Award” and this is commended. In addition, all catering staff are about to commence NVQ in catering. Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel they can express their concerns and know how to complain. People are protected from abuse by good practice and well-trained staff. EVIDENCE: The home’s complaint procedure was displayed in the home. People said they felt able to speak with Mrs Sullivan or another member of staff if they had any concerns, complaints or worries. One said that Mrs Sullivan will “always get things done”. Mrs Sullivan confirmed that no complaints had been received by the home since the last inspection. There was some discussion about concerns received by the Commission, for which Mrs Sullivan had fully co-operated and provided information. This matter had not been resolved by the time of the inspection. Staff spoken to confirmed they had received training about abuse awareness. They also knew about the home’s whistle blowing policy. The home follows good recruitment procedures that help protect people from abuse. Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is safe, accessible and well-maintained. However, some furnishings need to be replaced and storage facilities improved. EVIDENCE: A tour of the building was undertaken with Mrs Sullivan. All areas of the home were clean and tidy. There were no unpleasant odours detected. Those bedrooms seen were in a good state of decoration and some personalisation was seen. Corridors used by residents were unimpeded. However, there was generally a lack of storage space, with hoists and wheelchairs needing to be stored in a corridor close to the nurses’ room or in bathrooms when not in use. Illmatching dining chairs and tables spoilt the appearance of the dining room and Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 16 the over chair tables used by people needed to be replaced as the surfaces were badly cracked and split. A screen was in place in front of the toilets situated in the main entrance hall to preserve privacy and dignity. There was evidence that the building is well maintained and the maintenance book recorded all day-to-day repairs. People were in the garden, enjoying the sunshine on the day of inspection. This area is now fully accessible and attractive with flowerbeds and plenty of seating areas. Mrs Sullivan said that plans are in place to further develop this area. Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are trained, competent and employed in sufficient numbers to meet the needs of people living at the home. EVIDENCE: The staff rota for the week of inspection was provided. This showed that sufficient care staff were on duty to meets the needs of people using the service. In addition to nursing and care staff, there were also catering, housekeeping, administration and maintenance staff on duty in good numbers. Three staff files were looked at in detail. These showed that good recruitment procedures are followed. These included two written references and a Criminal Records Bureau check. This helps to ensure that people living at the home are protected. There were additional checks and references on files of staff who had been recruited from overseas. New staff receive induction training and records of this process were seen. There was a checklist to cover the initial induction and all issues were fully signed and dated. Staff training records were provided. These showed that staff are able to access training relevant to their role. All kitchen staff are due to commence NVQ2 in catering in September 2007. The housekeeper and 3 domestic staff are to commence NVQ in housekeeping in September 2007. Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 18 60 of care staff have completed NVQ 2 or 3. The training available is comprehensive Brooklyn House Nursing Home DS0000015621.V341523.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in an open way that promotes the rights of people who use the service. The manager is competent and well qualified. There is an effective quality assurance system in place. EVIDENCE: Mrs Sullivan is a well qualified and competent manager who instils confidence in people who use the service and also staff. The home has a quality assurance process in place. Mrs Sullivan said that stakeholder questionnaires had been sent out earlier in May and had started to be received back. The quality audit for 2006 was looked at. This had covered health & safety, kitchen hygiene and safety. The stakeholder survey for 2006 Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 20 was seen together with the feedback, summary and action plan. The resident meal survey was also seen together with its findings. The administrator deals with resident’s personal allowances. Good practice was seen and good records were kept. The amount held was checked randomly against records and was correct. There was evidence seen that staff receive regular supervision and annual appraisal. The supervision and appraisal matrix to May 2007 was provided and showed that supervision was taking place in accordance with good practice. Various health & safety records were seen. The fire log showed that the fire alarms are checked weekly and inspected by an outside contractor ¼rly. There was evidence that emergency lights, fire doors and fire fighting equipment are all checked and serviced regularly. The last staff training took place in November 2006 and there was evacuation training in January 2007. COSHH data sheets were seen and were appropriate to the chemicals used in the home. The storage of chemicals was looked at. All chemicals are kept in a locked cupboard and the quantities kept were not excessive. Premises and health & safety risk assessments were seen and in good order. The monthly accident logs for March & April were provided. These showed that good analysis takes place that identifies location, time and injury. Accident records were seen and were well completed and cross-referred to all relevant records. Brooklyn House Nursing Home DS0000015621.V341523.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 X 3 X 3 3 X 3 Brooklyn House Nursing Home DS0000015621.V341523.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. Standard Regulation Requirement Timescale for action 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 OP10 OP15 Good Practice Recommendations Staff need to make sure that they always knock on doors. This will help to ensure that the person using the service has their right to privacy and dignity protected. The over chair tables used by some people at mealtimes need to be replaced as the surfaces of some are badly split and broken. This will ensure that people can have their meals served on a hygienic table. Brooklyn House Nursing Home DS0000015621.V341523.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 House Nursing Home DS0000015621.V341523.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. 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