CARE HOMES FOR OLDER PEOPLE
Brookside Green Lane Braybrooke Market Harborough Leics LE16 8LQ Lead Inspector
Ms Sarah Jenkins Unannounced Inspection 16th November 2005 08:05 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.V261054.R01.S.doc Version 5.0 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.V261054.R01.S.doc Version 5.0 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.V261054.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 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 and one double room, 4 of which 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. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 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 two 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 an hour preparing for the inspection and visited the home for three hours during the early morning period to observe practices by staff and to meet with service user. She was also able to meet with some visitors who expressed full satisfaction with the home. At the time of the inspection the inspector had received five comment cards from Service Users’ relatives, and one from a Service User, comments were all positive. The homes self-assessment form was not yet available. What the service does well:
The service provides good outcomes for service users in a family atmosphere. 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. 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. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 6 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. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 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.V261054.R01.S.doc Version 5.0 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): 3 Service Users are enabled to have an informed choice about the home before they move in. EVIDENCE: Although no new residents have recently been admitted, the admissions process was discussed with the Registered Manager and found to meet the Standards. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Care plans detail Service Users individual needs and wishes. EVIDENCE: Service Users expressed full satisfaction with their care. There was evidence in records that they and/or their advocates are involved in the setting up of the care plans and the regular review of these. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14 Service Users are happy with their lifestyles and feel they have plenty of choices about how and where they spend their time. 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 benefited Service Users self esteem, and their confidence to express themselves. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 11 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 Service Users are protected from abuse by the close caring family atmosphere, but there is a need for greater staff understanding of the larger issues and county council procedures. EVIDENCE: Service Users feel confidant that staff will listen to them, and that any concerns they may have will be responded to in a positive way. There needs to be further training for staff on Protection of Vulnerable Adults issues and procedures. This is already planned for some in the National Vocational Qualification training. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 12 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): 19,26 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 committed to providing high standards in the maintenance, decoration and furnishings of the home, without loosing the essential “lived in” quality. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 13 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): 29,30 Staff training does not yet fully meet the Standards. EVIDENCE: Two members of staff work 16 hours each during the day between Monday and Friday. The owners cover the remaining hours. The owners confirmed that they take time off when staff are on shift. On occasions one staff member is on duty alone, with the Registered Owners “on call”. The Registered Manager stated that given current care needs of Service Users she felt that this was adequate, and the staff member interviewed confirmed this view. Staff training is ongoing to fully meet the Standard. Current staff are undertaking their National Vocational Qualification, level 3 award. External Training for staff in the administration of medicines has been difficult to arrange, but was due to be undertaken during the week of the inspection. Staff spoke of a professional recruitment process, and the relevant records were mainly available although staff application forms could not be produced at the time of the inspection. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 14 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): 31,35,38 The home is run in the best interests of the service users providing good outcomes and a good quality of life. EVIDENCE: The manager has recently completed her National Vocational Qualification (NVQ) level 4, and continues to run the home in the best interests of the Service Users. Service Users generally manage their own finances and the inspector was told that where this is not so, that a relative has power of attorney. There were no Health and Safety issues identified at the time of the inspection. Policies and procedures were available to staff in respect of most Health and Safety issues, advice was given about staff lone working. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 2 Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? N/A 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. x Standard x Regulation x Requirement None made at this Inspection Timescale for action 17/11/05 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 3 4 Refer to Standard OP30OP18 OP29 OP38 OP38 Good Practice Recommendations Staff should receive further training in the Protection of Vulnerable Adults, and the Local Authority procedures. The full information on staff as detailed in the Regulations, which is gathered through the recruitment process should be available for inspection Policies and procedures should be available to staff on lone working issues. There should be evidence of the risk assessment process and review of staffing levels undertaken by the Registered Manager on an ongoing basis. Brookside DS0000012724.V261054.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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