CARE HOMES FOR OLDER PEOPLE
Brookside Green Lane Braybrooke Market Harborough, Leics LE16 8LQ Lead Inspector
Sara Morrison Unannounced 27 June 2005 10:00 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 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 C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Brookside Address Green Lane Braybrooke Market Harborough Leics LE16 8LQ 01858 465899 01858 465899 NA Mr John Clarke Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Linda Clarke Care Home 7 Category(ies) of OP Old Age registration, with number of places Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 08.02.05 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 C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 3 hours during one morning and was carried out as part of the regular inspection visits required by law. Prior to the inspection time was taken to review the information on file and plan the inspection visit. The method of inspection was to track the lives of several service users. This was achieved by speaking to them and staff, reviewing the records and viewing the home and observing the relationships and routines. No requirements or recommendations were made at this inspection. What the service does well: What has improved since the last inspection?
Since the last inspection the advice of the pharmacist has been sought and the medication system has been improved. The home now uses one pharmacist who supplies all the medication and dispenses it into 28-day easy to use packs. The pharmacist also supplies a pre-printed sheet for staff to record when medicines are administered. Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 6 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 C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 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 standard(s) None of the standards in this section were reviewed at this inspection. EVIDENCE: Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 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 standard(s) 8, 9 & 10 The health care needs of service users are well met ensuring problems are quickly identified and treatment sought promptly. EVIDENCE: Service users said that the chiropodist visits regularly. For routine appointments such as the optician, dentist and regular health checks. S ervice users said that the owner takes them to the relevant clinic. Service users receive assistance with their personal hygiene when this is required and staff said that the manager encourages service users to be as independent as possible. Staff said that in many cases the condition of service users has improved since moving in and they have regained some of their skills. Service users confirmed that they now feel better than when they first came to the home and are able to get about more and feel more confident. Through discussion with service users and observation of the interaction it was evident that staff treat service users with respect preserving their privacy and dignity. Service users said that they are encouraged to make choices and never feel pressured to do anything that they don’t want to do.
Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 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 standard(s) 13 & 15 Service users are enabled to maintain contact with the local community and family and friends ensuring social contact and interaction that enriches their lives. EVIDENCE: Service users said that a coffee morning is held once a month and people from the local community also attend. A barbecue is planned for the 30th June to which family, friends and local people are invited. Staff and service users said that visitors are welcome at any time and are free to make themselves a drink. Comments from relatives confirmed their satisfaction with the home and the welcome and hospitality that is offered to them by the owners and staff. Service users said that the food is good. One person said that she has put on some weight since coming to the home and that the record of her weight taken by staff each month would confirm this. The only point made by one service user in the written comments was that occasionally she would like a curry for lunch. Staff said that they follow a menu plan but would provide alternatives to the menu at the request of service users. The member of staff was overheard to
Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 11 offer a choice of dessert at lunchtime, two people asked for rice pudding instead of raspberries and cream. Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not reviewed at this inspection. EVIDENCE: Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The standard of the environment within this home is extremely high providing service users with an attractive and homely place to live. EVIDENCE: All parts of the house that were viewed were tastefully decorated. The furniture is of good quality as are the soft furnishings, fittings and equipment. Pictures ornaments and flowers are all around the house contributing to the interest and homeliness. A new ‘medi’ bath was fitted 3 months ago and service users said that this is much easier to use. Staff said that service users enjoy this new facility and can have a bath whenever they choose. An ‘all year round’ conservatory that has an aviary and large rabbit hutch built onto one side leads on to a well established and well kept garden. The garden leads onto a brook and field and gives a wonderful view of the surrounding countryside. There is a paved patio area with benches and numerous colourful
Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 14 hanging baskets and pots all around the building. Service users said they enjoy the garden and were seen to make use of this area. A cleaner is employed one day each week. This person said that she is employed via an agency and has been coming to the home for over a year. She said that there is always of good supply of cleaning materials and equipment is in good order. There was a high standard of cleanliness throughout the home. Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The staff have a good understanding of the service users’ support needs. This is evident from the positive relationships, which have been formed between the staff and service users. 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 although they often spend time sitting with service users when staff are in the home. A member of staff said that she never feels like she is coming to work, but considers that she is part of a large family. This person said that she is well supported by Mr and Mrs Clarke who have explained her duties and are clear in their expectations of how service users are to be treated. The member of staff said she considers that Brookside offers an excellent service. Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The home is run in the best interests of the service users providing good outcomes and a good quality of life. EVIDENCE: The manager is currently undertaking a National Vocational Qualification (NVQ) level 4. The home is run like a large family and service users are treated as cherished relatives of the owners. The manager has taken action to address the recommendations made at the last inspection and these are now met. The advice of the pharmacist has been sought regarding the storage of oxygen and the medication system. The home now uses just one pharmacist who dispenses the medication into 28–day packs and provides a printed administration record. The owners said they were pleased that this had been raised at the last inspection as the new system is much improved and is a safer method of managing the drugs.
Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x x x x Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 18 No 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 Regulation Requirement None made 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. Refer to Standard None made Good Practice Recommendations Brookside C51 C08 S12724 Brookside V234412 270605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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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