Inspection on 13/11/06 for Brookside

This inspection was carried out on 13th November 2006.

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

Brookside 04/11/08

Brookside 16/11/05

Brookside 27/06/05

Brookside 08/02/05

Brookside 24/11/04

Brookside 22/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Brookside Green Lane Braybrooke Market Harborough Leics LE16 8LQ Lead Inspector Ms Sarah Jenkins Unannounced Inspection 13th November 2006 08:00 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 Brookside DS0000012724.V317201.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. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookside Address Green Lane Braybrooke Market Harborough Leics LE16 8LQ 01858 465899 01858 465899 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) Mr John Clarke Mrs Linda Dawn Clarke Mrs Linda Dawn Clarke Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total of service users must not exceed seven. One named service user with a Sensory Impairment, as the primary need for care may be resident in the home as detailed on the registration report of 01/03/2006 16th November 2005 Date of last inspection Brief Description of the Service: Brookside is an attractive house situated in the picturesque village of Braybrooke, with views across the open countryside. It is close to the town of Market Harborough, Leicestershire. The home provides care in very comfortable, homely and attractive surroundings for up to seven residents, who are in need of residential care. There are five single bedrooms and one double bedroom, 5 rooms have ensuite facilities. The home has attractive gardens, aviaries, and bird tables, which are well maintained and can be viewed from the large conservatory. Mr and Mrs Clarke, who live in separate accommodation within Brookside, own the home. The range of fees at the home are from £375-£395. There are additional charges made for hairdressing and private chiropody but phone calls and newspapers are included in the fee. Full details of the home and any extra costs can be obtained from the Registered Owners in the form of the Statement of Purpose and the Service Users Guide. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. Where Service Users may be suffering from confusional states, establishing their choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector spent three hours preparing for the inspection and visited the home for four hours during the early morning period to observe practices by staff and to meet with service users. She was also able to meet with a visitor who expressed full satisfaction with the home. At the time of the inspection the inspector had received three comment cards from Service Users’ relatives, two from local General Practitioners and two from Service Users. Comments were all positive. The homes self-assessment questionnaire also informed the inspection process. This site visit included a thematic enquiry. This consisted of asking a number of standardized questions to a sample of the service users. This was part of a national pilot scheme. We informed the Registered person and sought the agreement of service users in advance of asking the questions about the care that they receive. What the service does well: The owners are very committed to providing a good quality service that is highly personalised. This quality of care was reflected in the conversations that the Inspector had with Service Users who demonstrated self-esteem, and who were confident and assertive. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 6 There is a relaxed and friendly atmosphere, visitors are welcomed and made to feel “at home”. Service users were very pleased with the service, and commented on the kindness of the staff and the owners. The standard of the environment is exceptional. The house is well situated on the edge of the village, and is well maintained and decorated, with pleasant gardens and outlook. People from the village are welcomed to join in with various activities at the home for example garden barbecues. 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. The summary of this inspection report can be made available in other formats on request. Brookside DS0000012724.V317201.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 Brookside DS0000012724.V317201.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): 1,2,3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service Users needs are fully assessed before admission and they are enabled to have an informed choice about the home before they move in. EVIDENCE: The admission process was reviewed through records and discussion with service users. The Registered Manager shares detailed information with prospective service users and their relatives, both through discussion and documentation. The process was found to be flexible; service users were enabled to make visits to the home and to stay for a trial period if they chose Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 9 to. A full assessment of prospective service users needs was undertaken prior to admission. The Statement of Purpose was in need of updating with more specific information as detailed in Schedule 1 of The Care Home Regulations. A copy of the Service Users Guide was not available at the time of the inspection. Pilot Study: Of the three service users interviewed about their admission, in relation to the pilot study, all three considered that they had not actively “chosen” the home as they had been assisted by relatives who had undertaken the research and then recommended to them to visit. Once they had seen the home they were fully satisfied and decided to stay. They felt that the decision had been made in their best interests and were happy with the information that had been given to them at the time although they did not recall if they had been given written information or not. One of the three was fairly sure she had received written information but was not sure what had been in it. (A copy of the Service Users Guide could not be found at the time of the inspection) The service users did not deal with the finances relating to their stay in the home and were happy for this to be sorted out on their behalf by relatives. Service users were confident that matters relating to their stay in the home had been properly and formally sorted out and they said that their relatives probably had their contracts (copies of their individual contracts are available on their files). Service users did not know whether their fees had been changed. Two of the three did not know whether they had been given an updated service user guide since their arrival in the home, the third had arrived recently. Service users said that they thought that their care needs had been properly assessed prior to, and during their admission to the home. They could not generally remember what records had been kept about them although they were confident that some important things had been written down such as the medicines that they took. Overall they emphasised that the whole process of admission and care at the home had been fully satisfactory and that they had been well looked after from the start even though they could not remember what records had been kept. Brookside DS0000012724.V317201.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. Service users health, personal and social needs are well met at the home EVIDENCE: Service users expressed full satisfaction with the assistance they were given with their needs at the home. There was evidence of service users and/or their advocates’ involvement in the updating and review of care plans. Service users and staff reported that health care was very good. There is a quick response from staff,and sensitive support for service users regarding any aspect of their health care. Medication is well managed and fully auditable. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 11 Staff were observed to be respectful towards service users who were recognized as individuals, and offered a sensitive understanding of all their needs. The elements of respect and sensitivity were evident in the observed relationships, and in records where staff showed understanding and discretion in their reporting and the ways in which issues were followed up. The inspector judged that the extent to which care was person centred, needs understood and care delivered with a real understanding of service users individual physical and emotional needs, was exceptional. Brookside DS0000012724.V317201.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. Service Users are happy with their lifestyles and feel they have a good quality of social life. EVIDENCE: Service Users spoke positively about their lives at the home. The family atmosphere gives them a group identity and they take an interest in each other and the staff. Inevitably living in such a close-knit community has its occasional minor irritations but Service Users feel that their individual preferences and choices are respected and that they are enabled to be as independent as possible in the circumstances. Residents had a marked understanding and consideration of each other within the community and it was noticeable that this small family type home had Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 13 benefited Service Users self esteem, and their confidence to express themselves. There was evidence of service users being involved in regular activities in the home and also in the local community. Barbecues and parties are held and people from the village support these activities. Service users expressed complete satisfaction with the level of activity. Service users said that they were happy with the food quality and quantity at the home and that their individual preferences were respected. Choices were offered. There was lively discussion over breakfast time between the Registered Owner and the service users and service users were observed to be happy and confident in this discussion. Brookside DS0000012724.V317201.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. Service users are well protected by a committed and caring staff team, and the close communication and sensitivity of this “family” type home. EVIDENCE: No complaints have been logged in the complaints book. From observations, service users raised any issues they had with staff immediately, and there were prompt and effective responses from staff. It is the inspectors judgement that close communication with service users and an ethos that encourages service users to be forthright about their wishes in this small home, pre-empts formal complaints being made. Staff have undertaken training in Safeguarding adults which they have felt to be useful, and showed an understanding of the issues. The Registered Manager is hoping to further update her awareness shortly through the homes newly established access to the internet. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 15 Pilot Study: Three service users were interviewed about Complaints. Up to date copies of the Complaints procedure were available but service users felt this was completely unnecessary, as they felt fully confident to raise any issues they may have in person with the Registered Owner and or Registered Owner/Manager, or other staff if the Registered Owners were not available. They also showed full confidence that their concerns would be properly addressed. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 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. 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. The standard of the environment within this home is high providing service users with an attractive and homely place to live. EVIDENCE: Service Users rooms were personalized to their taste and provided attractive surroundings. They expressed full satisfaction with their rooms, and with the general environment of the home. The home was pleasantly decorated and furnished, with an atmosphere that was very homely, clean and comfortable. It was evident that owners are Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 17 committed to providing high standards in the maintenance, decoration and furnishings of the home, without loosing the essential “lived in” quality. The Registered Owners have recently improved the home through the provision of a further en-suite WC. There is now only one room without this facility and the feasibility of providing this last en-suite is currently being looked at. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 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. 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. Service users needs are met by competent well-trained staff. EVIDENCE: Staff training has been addressed since the last inspection and all staff are involved in on-going training, including relevant National Vocational Qualifications. Staff were fully satisfied with the training that they receive at the home. A further full time staff member has been employed since the last inspection. The staff complement is now one full time staff member and two part time staff members in addition to the regular full time hours worked by the Registered Owners who live in and are on call. The Registered Manager has reviewed lone working arrangements and continues to risk assess lone working although this rarely occurs in reality as Registered Owners are usually on the premises and available. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 19 The recruitment process is effective and a recently recruited staff member confirmed that she is receiving appropriate induction training as she “shadows” experienced staff. The staff files now have the required information including staff appraisal and supervision, but could be better organized to enhance access to information. Service users and a visiting relative praised the quality and responsiveness of staff who were felt to be “very friendly”. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 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. 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 this service. The home is run in the best interests of the service users providing good outcomes and a good quality of life. EVIDENCE: The Registered Manager has completed her National Vocational Qualification 4 and expects to complete the Registered Managers Award within a few months. She shows herself to be fully competent and experienced in her role, and is always open and responsive to advice. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 21 The Registered Owners/Manager promote the principles of care respecting and valueing people as individuals with individual needs and wishes. Staff are sensitive and aware of how to do this in terms of best practice and service users show trust and confidence in the quality of care that they receive. In this small community the Registered Manager keeps closely in touch with the needs of her staff and service users, and although the purpose and need for records is fully understood, it has been felt to be difficult to maintain these to the greatest potential at times. Some records need updating (Statement of Purpose and Service Users Guide) and some could be better organized (staff records). The Registered Owner is in the process of finding ways to enhance record keeping through the use of the computer to assist this process. The home does not handle service users monies, which are, where necessary dealt with by their advocates. Health and Safety issues appear to be well managed and records maintained. Quality Assurance up to now has mainly been achieved through the closeness of the Registered Managers contact with service users and their relatives. However advice is being sought on more formal processes and these are expected to be in place shortly. With the Registered Owners obvious commitment to high standards of care, the process of a systematic Quality Audit is likely to enhance the standard of the service to achieve the very best outcomes for service users. Brookside DS0000012724.V317201.R01.S.doc Version 5.2 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 2 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 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 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 23 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 OP1 OP33 Good Practice Recommendations The Statement of Purpose should be regularly updated with the information as detailed in Schedule 1 of the Care Homes regulations. Formal Quality Assurance systems should be implemented Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Brookside DS0000012724.V317201.R01.S.doc Version 5.2 Page 25 - 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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