Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 25/04/06 for Brooklyn House Nursing Home

Also see our care home review for Brooklyn House Nursing Home for more information

This inspection was carried out on 25th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

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

Residents receive care and support from staff who are caring and committed to providing good standards of care. Staff are respectful of and to residents and strive to meet individual resident`s preferences and aspirations. The relationship between residents and staff was appropriate. Residents spoke favourably about the food they receive. Positive comments were made about the quality and quantity of food provided and residents stated they could make choices about what they eat and where they eat it. Staff receive training that is relevant to the work they do. Staff were knowledgeable about the needs of the residents, specific conditions and how they should be cared for to meet their specific needs.

What has improved since the last inspection?

There has been a significant improvement in the way care needs for residents are recorded although there is still more to be done. The home has reintroduced the named nurse and key worker system. Training is about to commence in order that staff understand their responsibilities and how they are met. The environment is continuing to improve, with an on-going redecoration and refurbishment programme. The gardens are to be refurbished on 16 May 2006. All heaters are now covered and difficulties with the laundry equipment resolved. Concerns were expressed at the last inspection because there was no registered manager in post. Mrs Sullivan has since been appointed as the home`s manager and is currently proceeding through the registration process.

What the care home could do better:

There are some issues around how residents access the communal toilets located in the entrance hall. Residents were seen queuing to use these facilities after lunch and the home needs to consider dignity and privacy issues as a result. There continue to be concerns that the staffing levels are not adequate to meet the needs of the residents at the home. The home needs to keep these matters under constant review in order that residents needs are met in a timely and appropriate way.

CARE HOMES FOR OLDER PEOPLE Brooklyn House Nursing Home Queen`s Road Attleborough Norfolk NR17 2AE Lead Inspector Mrs Geraldine Allen Unannounced Inspection 09:30 25th April 2006 & 3rd May 2006 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.V291965.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 House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 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 House Limited Mrs Elizabeth Carlton 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.V291965.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 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 £525:00 per week based on needs and if en-suite facilities are available. 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.V291965.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over a period of 11 hours on the 25 April and 3 May 2006. The first day of the inspection was unannounced and the second day took place by agreement with the manager, Mrs Sullivan, and the Regional Manager, Mrs Scott. During the inspection, 5 residents were spoken to in private and a further six were spoken to briefly in the communal areas of the home. Six members of staff were spoken to, in addition to Mrs Sullivan and Mrs Scott. The opportunity was taken to speak with visitors to the home where possible completed comment cards were received from 10 residents and a visiting GP. Mrs Sullivan completed and returned a pre-inspection questionnaire and various records were seen during the course of the inspection. An action plan was also received from the company on 1 March 2006. Overall, it was found that there has been some improvement in the recording of care needs and how they are delivered although it has been acknowledged that there is still significant work to do. There have also been improvements to the environment, with a continuing programme of redecoration and refurbishment in place. What the service does well: What has improved since the last inspection? There has been a significant improvement in the way care needs for residents are recorded although there is still more to be done. The home has reintroduced the named nurse and key worker system. Training is about to Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 6 commence in order that staff understand their responsibilities and how they are met. The environment is continuing to improve, with an on-going redecoration and refurbishment programme. The gardens are to be refurbished on 16 May 2006. All heaters are now covered and difficulties with the laundry equipment resolved. Concerns were expressed at the last inspection because there was no registered manager in post. Mrs Sullivan has since been appointed as the home’s manager and is currently proceeding through the registration process. 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 House Nursing Home DS0000015621.V291965.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 House Nursing Home DS0000015621.V291965.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): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home provides information to prospective residents and their representatives that allow them to make an informed decision to enter the home. Residents enter the home only after a pre-admission assessment has been completed. This home does not provide intermediate care. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been reviewed and updated by Mrs Sullivan. Copies of these documents were provided at the time of inspection. These are in accordance with National Minimum Standards and Care Homes Regulations. Care plans seen showed that a pre-admission assessment has taken place in each case. The views of health professionals were included within the Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 9 assessment to ensure the home was aware of all care needs and how they should be met. The assessments also considered any aids that may be needed. Mrs Sullivan confirmed that the home does not provide intermediate care. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 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 & 10 Quality in this outcome area is adequate in some circumstances and poor in others. This judgement has been made using available evidence including a visit to the home. The standard of care planning has improved although there is still much work to do before all care plan records are of an acceptable standard. The home ensures residents can access all health professionals as needed. Most practice ensures residents dignity and privacy is protected, however there are examples where this is not achieved and remedial action is required. EVIDENCE: Two care plans were looked at in detail and the care provided to the residents tracked to ensure it was appropriate to their needs. Discussion with the manager revealed that she had commenced a review of care planning and had developed an improvement strategy. This was in accordance with her stated “key areas” and the company action plan received on 1 March 2006. Staff were spoken to in private and comments from the GP were also considered. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 11 The work to improve care planning and recording of care provided is at an early stage and the care plans seen reflected this, with 1 spread across 2 folders whilst the other had been rationalised and was kept in 1 folder. All care plans had been stored within 1 folder by the second day of this inspection. Some of the issues raised at the last inspection were yet to be resolved and there was continued evidence that recording of important events was inconsistent. For example, there was an accident record for 1 resident dated 27 March 2006, however this was not recorded within the care plan or daily record. There have been improvements to the care plans and there was evidence of regular reviews taking place at least monthly and more frequently if necessary. However, no care plans were seen for either resident that considered their social, emotional or spiritual needs. Daily records were also task orientated and did not make reference to these issues. The new care plan formats are typed and therefore legible. Mrs Sullivan advised that the named nurse and key worker system had now been reintroduced to the home and as of 3 May 2006, residents had been allocated a key worker. Those residents asked were aware of the named nurse & key worker allocated to them. Mrs Sullivan described her strategy for training and supporting staff over the coming months to ensure that care plans are developed and recorded appropriately. It is acknowledged that there remains much to do before the care planning records provide an accurate reflection of all the care provided to residents. However, based upon evidence seen at this inspection, achievable goals have been set and progress will be assessed at future inspections. The care plans contained good information about healthcare needs and how they should be met. A comment card was received from the visiting GP, who stated “There has been less turnover of nursing staff, whom I very much enjoy working with and clinically trust”. Care plans also contained evidence of interventions by other health professionals such as the dietician and chiropodist. These visits were appropriately recorded. Staff felt they did not always have as much time as they would like to spend with residents. A significant number of residents require help with their mobility and also personal care. Staff were observed using the hoist to transfer a resident from a wheelchair to armchair in the lounge. This was done with as much discretion as the location allowed and efforts were made to preserve the residents dignity, with a blanket being placed across her legs. Residents spoke about having to wait for longer periods than they would like before staff were available to assist them to use the toilet. This was a problem they described as occurring especially after lunch. Observations made after residents had eaten their lunch revealed residents queuing to use the 2 assisted toilets adjacent to the lounge and in full view of the front door. Discussions with visiting relatives revealed that 1 visitor had become aware of resident’s agitation at having to wait to be taken to the toilet. Discussion with Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 12 Mrs Sullivan and Mrs Scott considered the possible reasons for residents needing to wait, including staffing levels and also the sufficiency of assisted facilities. Mrs Sullivan agreed to assess these concerns. It was also suggested that screening should be in place in order that residents’ privacy and dignity can be supported in this very open and visible area. Mrs Sullivan confirmed that an additional member of staff had been employed to work between 10:00 and 14:00 to provide assistance with eating and other personal care needs. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 13 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 Quality in this outcome area is good in some areas and adequate in others. This judgement has been made using available evidence including a visit to the home. Generally, residents feel they are able to enjoy a lifestyle that matches their preferences. Residents and visitors are welcomed at the home. Residents mainly felt that their choices were respected although referred to some limitations because of staff availability. Residents receive a well balanced diet that reflects their choices and preferences. EVIDENCE: Five residents were spoken to in private and 6 residents spoken to briefly in communal areas of the home. Evidence was also obtained form completed comment cards and through discussion with staff. Further evidence was obtained from the Pre-Inspection Questionnaire and the companies annual audit summary. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 14 Residents stated that they were happy at the home and generally felt well cared for. They felt they could make choices around their daily living but 1 resident spoke of getting up when staff call her rather than having a lie-in as she was aware how busy staff were in the mornings. Staff stated that they would respect the expressed wishes of a resident to stay in bed later in the morning. Residents were observed taking part in various activities during the course of this inspection. On 25 April 2006, there was a mobile clothes shop visiting the home and on 3 May 2006, the activities organiser spent 1:1 time with a resident who wished to play trivial pursuit in the morning and she arranged a prize bingo afternoon. The activities organiser has not long been in post and is currently involved in seeking the views of residents about what activities they would like to see in the home. The returned resident comment cards showed that only 20 felt there were activities at the home in which they could regularly take part; 50 felt this was the case part of the time. This is not in accordance with the findings of the home’s annual audit, however it is noted that the audit was taken when the previous activities organiser was in post and well established. The home has appointed activities organiser in accordance with the company action plan dated 1 March 2006. She is very enthusiastic and keen to understand the preferences of the residents so that she can provide meaningful activities for them individually as well as in a group activity. Visitors were seen during the course of this inspection and the opportunity to speak with them was taken where possible. The comments received generally suggested that improvements have been made to the care provided and also the environment. The visitors felt they were able to visit the home whenever they wished and were welcomed by staff. Residents stated that their visitors were always made welcome and offered refreshment on arrival. One visitor spoke about the good care received by her mother and how grateful she was for the care and kindness of staff. Residents spoke very enthusiastically about the food offered at the home. All stated that it was of a high quality and plentiful. References were made to the choices on offer and that they would always be offered something else if they did not like what was on the menu. The returned comment cards show that 70 of residents liked the meals offered, with 30 liking the meals “sometimes”. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has a complaints procedure in place that is well known to residents and their representatives. Staff are well trained in respect of adult abuse awareness and understand their responsibilities in this regard. EVIDENCE: The home has, in total, received 3 complaints in the last 12-months. Mrs Scott has investigated each of them. The process described complied with the home’s complaints procedure and was in line with good practice. Both Mrs Scott & Mrs Sullivan described a positive attitude towards complaints and expressions of concern and regarded them as an opportunity to review and revise practice as necessary. The Commission has received no complaints since the last inspection. All residents and visitors spoken to felt able to speak to Mrs Sullivan or one of the staff if they had any concerns. The returned comment cards also supported this In addition to Mrs Sullivan and Mrs Scott, 6 members of staff were spoken to during the course of this inspection. Staff from all disciplines in the home were seen and were able to describe their understanding of adult abuse awareness. Staff confirmed that they had recently received training and were able to demonstrate a good understanding of the issues and how to deal with them. It is particularly pleasing to note that housekeeping staff have been included in this important training. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 16 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, 23 & 26 Quality in this outcome area is mainly good but adequate in some respects. This judgement has been made using available evidence including a visit to the home. The home is well maintained, with an on-going redecoration and refurbishment programme in place. The external environment is due for refurbishment on 16 May 2006. Resident’s rooms are furnished and decorated as they wish, with good levels of personalisation seen. The home was clean, tidy and free of unpleasant odours. EVIDENCE: A tour of the premises was conducted with Mrs Sullivan. Issues raised at previous inspections regarding the exposed hot surfaces of heaters have now been met and Mrs Sullivan confirmed that all heaters are now covered. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 17 There was evidence of a continuing redecoration programme taking place. The entrance hall, both corridors and some bedrooms have now been completed. The main lounge and dining room have not been included in the current phase of redecoration as there are plans for a refurbishment of this whole area and the redecoration will be incorporated into this. The first floor sitting area has been well furnished to offer comfortable seating and dining facilities for residents who prefer not to use the main communal areas on the ground floor. Mrs Sullivan described work scheduled to take place in the garden on 16 May 2006. The garden project was awarded to the home through the Norfolk Voluntary Services scheme. The plans described should result in a very pleasing external environment for residents to enjoy and will include sensory planting. The home has experienced some continuing difficulties with the laundry equipment. However, these issues had been resolved by the time of inspection and all equipment was in good working order. The laundry room was seen and was kept clear and tidy. Mrs Sullivan confirmed that all hoists were now in working order and were on service contracts. Hoists were seen being used by staff on both floors. Sufficient slings have now been purchased to ensure individual resident’s needs are met. As each of the bedrooms is being redecorated, new furniture is being provided as required. All new bedside tables have lockable drawers to enable residents to store their belongings securely. It was agreed that the provision of lockable facilities should continue as the refurbishment takes place. However, Mrs Sullivan will ensure that all residents are offered lockable facilities and these will be provided immediately as requested. There are 2 assisted toilets situated in the entrance hall, adjacent to the lounge and dining room. These are in almost continuous use, with residents seen queuing to use them on occasions. This has implications on the privacy and dignity of residents and screening needs to be put in place in this area. Those bedrooms seen were in a good state of decoration and contained many items personal to the resident. During discussions, residents stated that they could bring in small items and these included armchairs, small items of furniture, pictures and ornaments. All areas of the home seen during this inspection were clean and tidy. No unpleasant odours were detected. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 18 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 Quality in this outcome is good in some areas and poor in others. This judgement has been made using available evidence including a visit to the home. There is evidence that the home does not employ staff in sufficient numbers to meet the needs of residents. The home has good recruitment procedures in place that help to protect residents. The home has good training opportunities in place. EVIDENCE: Staff rotas for the week of inspection were provided. These showed that the home routinely employs 1 qualified nurse and 4 care staff between 07:00 & 15:00, and 1 qualified nurse and 3 care staff between 15:00 & 20:00. Mrs Sullivan stated that a further carer is employed between 10:00 & 14:00. This is an additional shift, over and above the staffing notice, that is used at the manager’s discretion to assist residents with eating and personal care at times when it is most beneficial to residents. One qualified nurse and 2 care staff are employed between 22:00 & 07:00. These staffing levels are in accordance with the Norfolk Health Authority staffing notice, in place on 1 April 2002. However, these are minimum levels and have been in place for a considerable period and do not necessarily reflect the changing needs of older people receiving nursing care and should be viewed in this light. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 19 Mrs Sullivan is mindful of the need to ensure a good skill mix on each shift and ensure that staff rosters are developed accordingly. Previous inspections have referred to staffing levels that do not meet the needs of the residents at the home. Consistently during this inspection, the comments received from residents, visitors and some staff suggested that insufficient staff are employed and examples of how this impacts on care were given. Most commonly, the examples included needing to wait for staff to assist residents to the toilet; no time to spend in conversation as staff were so busy; having to “fit in” with staff in the mornings where personal care is needed. The staffing provision was discussed with Mrs Sullivan and Mrs Scott. The dependency of residents needs to be kept in continual review and the reasons why staff are not able to meet the toileting, personal and social needs of residents in accordance with their wishes needs to be explored and resolved. The action plan dated 1 March 2006, refers to the staffing levels being based upon assessed dependency of residents. However, care plans are task orientated and include little in the way of social, emotional and spiritual elements. These issues need to be included in any dependency assessment if the home is to deliver an holistic approach to care. It cannot be expected that all social, emotional and spiritual needs can be met by the part-time activities co-ordinator, rather that this element of care should be allowed for throughout the day and at weekends. The dependency assessments should also include a review of the number and type of aids needed and available to staff. Two staff files were looked at in detail. Both file contained information in line with good practice. In both instances, completed application forms were seen and 2 written references had been obtained. Both had been subject to Criminal Records Bureau and Protection of Vulnerable Adults disclosure. Good interview records were seen, together with copies of their job descriptions and contracts. There was evidence that both staff had received a copy of the General Social Care Council Code of Conduct. At the time of inspection, 3 care staff had achieved an NVQ in care, with a further 6 having commenced in March 2006. Once all staff currently studying NVQ have completed their courses, 11 of the 13 care staff will be NVQ trained. This exceeds the levels as set out in the National Minimum Standards. Staff described additional training they had received recently and this was appropriate to the client group. All staff spoken to were committed to providing the very best care for residents at the home. They were knowledgeable, caring and kind. Interaction between residents and staff was observed and found to be respectful and appropriate. It was evident that staff have a strong loyalty towards the residents at this home. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The manager is currently subject to the registration process. She is experienced and qualified to manage the home. The home has audit processes in place that include seeking the views of residents and their representatives. Residents are safe-guarded against financial abuse by good procedures regarding their monies looked after by the home. The home strives to protect the health, welfare and safety or residents and visitors to the home. EVIDENCE: Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 21 Mrs Sullivan was appointed manager at this home in October 2005 and has applied to be registered as the manager. The Commission is currently processing her application. This is in accordance with the action plan dated 1 March 2006. The home has an annual audit that is undertaken by an officer of the company. A copy of the summary has been received by the Commission and shows that the audit is based upon the functions of the home to provide a quantitative result. These results generate an action plan. There is no evidence of resident, relative or other agency involvement in the annual audit. Further monitoring takes place each month and is generally undertaken by Mrs Scott, the Regional Manager. This process generates a report with matters arising that require action by the home and includes the views of residents, their representatives and staff, obtained through face to face discussion. 100 of residents who completed comment cards stated that their views are listened to and acted on. The arrangements for looking after resident’s monies were seen. Good practices were noted that would help to prevent financial abuse. Each resident has an account record that is countersigned for each transaction. Running totals are kept and the balance checked each time a transaction is made. Regular audits also take place. Risk assessments were seen on 2 resident’s files relating to the use of bed rails. There was evidence that they had been regularly reviewed. Other risk assessments, including those relating to manual handling, were seen on files and were updated regularly. During the course of this inspection, an unannounced inspection took place by Environmental Health and arrangements at the home were reported to be appropriate. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 22 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 1 8 3 9 X 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 2 X X X 3 X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 23 Yes 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 OP7 Regulation 12(1)15(1 ) Requirement The registered persons must ensure that care needs are set out in sufficient detail, so that staff can consistently follow them. This requirement is repeated. Timescale for action 04/08/06 2. OP7 12 3 OP10 4(a) 4 OP27 18(1)(a) The registered persons must 04/08/06 ensure that records of personal care delivery are completed and accurate, to demonstrate care delivered in this area is consistent with assessed need. This requirement is repeated. The registered persons must 04/07/06 ensure that the privacy and dignity of residents is protected, with particular attention to the communal toilets located in the entrance hall. Screening is required. The registered persons must 05/06/06 keep staffing levels under continuous review to ensure they are sufficient to allow residents to make choices about their daily living and will also meet all care needs. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations It is recommended that the programme to install lockable facilities to all rooms continue. It is also recommended that residents who have not yet had these facilities provided, are offered them and they are made available without undue delay. Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Norfolk Area Office 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 Brooklyn House Nursing Home DS0000015621.V291965.R01.S.doc Version 5.1 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!