Inspection on 04/11/08 for Brookside

This inspection was carried out on 4th November 2008.

CSCI found this care home to be providing an Good service.

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 13/11/06

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 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brookside Green Lane Braybrooke Market Harborough Leics LE16 8LQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rajshree Mistry     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 35 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 35 Information about the care home Name of care home: Address: Brookside Green Lane Braybrooke Market Harborough Leics LE16 8LQ 01858465899 F/P01858465899 lindaclarke1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Dawn Clarke Type of registration: Number of places registered: Mr John Clarke,Mrs Linda Dawn Clarke care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximumm number of service users who can be accommodated is: 12 The registered person may provide the following category of service only:- Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling into any other category - Code OP Date of last inspection Brief description of the care home 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 and on the border with Northamptonshire. Brookside is comfortable, homely and set in attractive surroundings for up to twelve people who choose to live in a residential care home. There are ten single bedrooms and one double bedroom, and Care Homes for Older People Page 4 of 35 Over 65 12 0 Brief description of the care home all 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 £405 to £480. 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. The Commission for Social Care Inspection, inspection report is available at the home. Care Homes for Older People Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We as it appears throughout this Inspection Report refers to The Commission for Social Care Inspection. This key inspection consisted of preparation by reviewing the last inspection report dated 13th November 2006 and the review of the annual service user dated 15th October 2007. We looked at the information we had about the management of Brookside, having recently increased the number of registered places to twelve people and information that affected the wellbeing of the people living at Brookside. The Care Homes for Older People Page 6 of 35 registered manager sent us the completed annual quality assurance assessment document, that reflects their assessment of the standards in the home. We sent out twelve surveys to the people living at Brookside, of which ninety percent were returned. All the responses we received and the comments indicated people were involved in choosing Brookside, were happy with the level of care they received, the home environment and the quality of food and social opportunities and events. We sent out seven staff surveys of which forty percent were returned. The responses and comments received indicated that staff were recruited, trained and supported by good systems and management to care for the people living at Brookside, which promoted peoples wellbeing and independence. The comments received have been included throughout the relevant sections in this inspection report. We visited Brookside on 4th November 2008, starting at 10:10hrs and finishing at 16:10hrs. The Registered Manager, who is also a joint Responsible Individual and Owner, assisted us during the site visit of the service. The main method of inspection we used was case tracking. This means looking at the range of care people receive that ensures their needs are met whilst their independence is maintained and promoted. This was done by selecting three people who have different care needs and included a new person and a person that has lived at Brookside for a number of years. We spoke with the three people we identified to case track along with other people living at Brookside. We read the care files containing information about peoples care needs, lifestyles and how these were respected. We spoke with the staff on duty, read their recruitment and training files. We made observations of people, how they were treated and the interaction with staff. We looked at the living accommodation from the communal areas, bathrooms and individual bedrooms. We read the information people receive about Brookside, policies and procedures and specific records that demonstrated the day-to-day management of Brookside. The Commission for Social Care Inspection had a focus on Equality and Diversity, and issues relating to these are included throughout the main body of this inspection report. What the care home does well: Brookside is a well established care home, set in an idyllic location and looks out onto green fields. The registered manager is also the joint responsible individual and owner, is committed to continuously providing a good quality of care, good living environment and is available at all times. The quality of care is reflected from the discussions had with people living at Brookside, who expressed they were well cared for and received a hotel-like hospitality. People are involved in choosing to live at Brookside from the initial visits, assessment and admission process to care planning to make sure their care needs, having their preferences and choice of lifestyle met. People have can choose to retain the health care support or can be registered with the local surgery. We observed people were treated with respect, were making their own decisions about daily living, visitors and participating in social events and opportunities. There is a stable staff team, recruited and trained to competently meet peoples care needs and promote independence as far as practicable. People we spoke with spoke highly about the staff. People appeared relaxed and were seen doing as they pleased throughout the day. Brookside offers a range of social and leisure opportunities from word quiz to outings, meal at a pub, barbeques and entertainment. Visitors are welcome at any time. Brookside has a very high standard of decor, furnishing and fixtures that create a warm and homely atmosphere. There are a range of seating areas, small clusters of chairs to allow people to enjoy each others company and conversation, to the conservatory area, which looks out onto the garden and the fields at the back of the home. The corridors were bright and well lit for people to move around freely. The bedrooms have ensuite facilities, are individually decorated and people are encouraged to bring personal items to make it homely and comfortable for them. There are two bathrooms are fitted with walk-in seated bath, which promotes peoples independence. The comments we received in the surveys and directly from people and staff during the site visit included: Excellent quality and good variety I cam to have a look round and decided to stay Its one of the nicer homes The lifestyle we have here has exceeded our expectations well, its like a hotel service, you only need to ask, but I do what I can Provides a homely environment for all residents This is an excellent home, we are treated very well I must say Care Homes for Older People Page 8 of 35 I have never had to make a complaint You cant ask for a better group of staff than we already have What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 9 of 35 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 35 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good information about the service, are involved in the assessment process to make sure their needs are met. Evidence: We read the information people receive about Brookside known as the service user guide and the statement of purpose, which has been updated to reflect the additional numbers of registered places. The information is set out clearly and in an easy read style, detailing the aims and objectives of the service, range of services and facilities offered, the staff skill mix and the management of the home. There is information about peoples involvement, opportunity to express their opinions, concerns and complaints using the homes complaints procedures. The contact details for the Commission for Social Care Inspection and the local advocacy services are included. We spoke with three people who we identified to case track, a number of other people Care Homes for Older People Page 12 of 35 Evidence: that were sitting in the lounge and visiting relatives. The several people told us their relatives had visited the home and made the initial inquiries, whilst others told us they visited themselves. The information we received from the registered manager before the site visit stated people are encouraged to visit and offered a months trial stay.. The information we received from the people we spoke with was consistent with the responses we received from the surveys. The comments received directly from people and in the surveys included: I visited a number of homes in the neighbourhood of Market Harborough and decided this home was the one for me I came to have a look round and decided to stay I visited the home and chose to move in straight away The family did the leg work My daughter found this home for me and she was right to choose it Its one of the nicer homes We read the care files for three people, all having different care needs and included a new person. The care files had copies of the assessments of needs carried out by the registered manager, which covered information about the individual, medical history, medication, level of ability, allergies and any special dietary needs. The contact details of relatives and family, general practitioner and social worker, where applicable. The assessment was comprehensive and took into consideration peoples preferences, interests and choice of lifestyle. Where people were financially supported by social services, a copy of the assessment of care needs and care plan completed by the social was found on file. The registered manager showed us the file with peoples individual signed contract with the terms and conditions of their stay contract, which showed a formal agreement was in place. People we spoke with said the registered manager had visited them and asked questions to help her make sure the home would be able to look after them. This supported the information we had received from registered manager before the site visit and demonstrated people are involved in the assessment process to make sure their care needs and lifestyle would be met at Brookside. We spoke with staff, who told us they receive information from the registered manager about any new person moving into the home and have the opportunity to meet them Care Homes for Older People Page 13 of 35 Evidence: at the initial visits. Staff confirmed they can read the care file and speak with the individual person to make sure they understand their routines, likes and dislikes, including their preferred form of address. This supported the staff survey responses received that indicated staff receive up to date information about the needs of the people living at the home and have a good system of sharing information between staff. Comments received from staff included, It gives family feeling rather than an institution. It makes sure they are comfortable that they have compassion and care as needed and superb food. Brookside does not provide intermediate care services. Care Homes for Older People Page 14 of 35 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are treated with respect, having their individual health and personal care needs met by staff that promote independence. Evidence: We spoke with two of the people we case tracked and a number of other people living at Brookside. All spoke positively about the quality of care and support they receive on a daily basis, when needed, which allows them to maintain their independence. They said, the lifestyle we have here has exceeded our expectations and well, its like a hotel service, you only need to ask but I do what I can. People told us they have sat with the registered manager and discussed what help they need. The care plans we read showed people were involved in developing the care plans. We saw assessments of risk carried out for moving and handling and the risk of falls and the safety measures identified were clearly written in the care plans. Peoples individual preferences were records as well as instructions for staff to follow to ensure peoples health and safety, such as: Care Homes for Older People Page 15 of 35 Evidence: make sure .... always wears his glasses; always ensure .... uses his walking stick make sure ... has her walking stick close with her or close by like pyjamas changed every 2 days and clean clothes to be put on pillows ... will ask for assistance undressing as she has difficulty with zips Staff we spoke with gave examples of how they support people and promote their independence by allowing them to do as much for themselves as possible. This demonstrated that whilst care plans were followed, staff recognised the importance to promoting and maintaining peoples independence. This supported the information we received from the registered manager and the homes principles of promoting independence and quality of life. The registered manager told us Boots Chemist now supply the medication in blistered packs every month, which is a safe and secure system. The medication is stored in a locked cupboard along with the medication records, photographs, names, known allergies and the contact details of the general practitioner. The manager told us she is trained to give medication and only trained staff are allowed to give medication. This supported the response we received from staff on duty who do not handle medication. We checked the medication and the medication records for two people we case tracked. The records accurately reflected the medication left in the blistered packs. People we spoke to confirmed the staff bring the medication to them individually. Two people were positively happy with the arrangements for their medication, as they did not have to remember to take them as it was brought to them. The two staff we spoke with said they do not handle peoples medication. This demonstrated the medication management system was in good order and people received their medication on time from trained staff. The registered manager told us there was no controlled medication taken by anyone living at the home. We advised them to ensure that the controlled medication storage meets the new regulation should this be required in the future. Two people told us that they chose to stay with the same general practitioner surgery whilst others chose to use the local surgery. The records completed by staff on a daily basis showed people did attend health care appointments from seeing the general practitioner, chiropodist, dentist and the optician. One person from the group sitting in Care Homes for Older People Page 16 of 35 Evidence: the lounge told us they recently had the flu jabs from the visiting nurse. We saw another person returning with their family after attending an appointment at the hospital. Staff told us that they would take people to attend appointments if necessary. This supported the information we received from the registered manager and the survey responses demonstrating people had access to health care support when required. Throughout the day we observed staff treating people with respect, addressing people by their preferred names, which was made known to staff as part of the care planning process. We saw people living at the home and staff knocking on the doors before entering, which indicated people showed respect to each other. People we spoke with said they had been treated very well by the staff and the manager and had not experienced anything else. The comments received included this is more like a family than a business. They gave examples of how staff respected their privacy and dignity when entering their rooms, assisting with bathing or dressing. This supported the response we received in the surveys confirming peoples rights, choice and dignity is respected. Care Homes for Older People Page 17 of 35 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples wellbeing is promoted through variety of activities, social interests, contact with family, friends and have a good choice of meals. Evidence: The information we received from the registered manager before the site visit stated people enjoy a range of leisure activities from dominoes, word game, bingo, sing-along to cream teas, regular trips out for a meal at a pub and barbecues in the summer. The survey responses received indicated there are activities arranged by the home and comments included the activities that are in place I dont usually take part in because I prefer to do something different and Brookside frequently organises activities such as meals out, bingo, drives and barbecues and these are always popular. People we spoke with throughout the day said they do have social activities, from word games, bingo and going out to a pub for a meal. This confirmed the information we had already received and showed participate in social events. The registered manager told us that she would like to appoint a dedicated activities co-ordinator to ensure social activities and events are planned with greater involvement from the people living at the home. Care Homes for Older People Page 18 of 35 Evidence: We observed several people choosing to spend time in their bedrooms, one person had gone out with family, another enjoyed sitting in the conservatory looking out onto the garden and the fields beyond and another person said I enjoy knitting, keeps my mind and hands busy, having knitted a number of blankets. Several people told us about the two new kittens they have at the home, seen playing around their feet in the lounge. We were told that the kittens will be eventually named once their develop their characters having lost a cat. People said they had visitors come to see them often and enjoyed the coffee mornings, where people from the local area came for coffee. One person said the people from the Church collect them from the home to take to the Church, which showed they still continued to practice their religion. Peoples interests were recorded in the care files and the activities people participated in were recorded in the daily records, which showed peoples interests are accommodated. People told us they make their own choices about their day, what and how they wish to spend it. One person said we like to sit here and ruminate, and sometimes we watch strictly come dancing. We observed staff responding to peoples requests and acting upon requests, which showed people were in control of their lives. Staff told us that people are independent, have their own preferred routines, which are respected and promoted. Staff said that when they were employed the registered manager was keen to ensure staff promoted peoples wellbeing and encouraged them to do as much for themselves as possible. This demonstrated staff promote peoples rights, autonomy, choice and independence. The care files detailed peoples preference of food including any known allergies such as allergy to sea food, specially salmon or special dietary needs such as low fat and low sugar diet. The cook prepares the meals at the home. Several people told us the meals were excellent, all home made and not out of tins or packets. We saw the meals being served at the two dining tables, whilst one person had chosen to eat their meals in the privacy of their bedrooms. The meals were hot, appeared nutritious and well presented. The surveys responses we received in the main supported the choice and variety of meals people received and included comments like excellent quality and good variety. We received a comment in the surveys stating I done enjoy the fish and chips we have on Saturday from the local chip shop, I would prefer a home cooked hot meal on Saturday. We shared this comment with the registered manager who said people always do have a choice and an alternative meal if they preferred. The registered manager said she would raise the issue of meals at the next residents meeting and remind people they always have a choice or an alternative meal available to them. This demonstrated the registered manager valued the comments and looked to assure people that they can always have an alternative meal if they choose. Care Homes for Older People Page 19 of 35 Care Homes for Older People Page 20 of 35 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident to complain and protected by staff recruitment processes and training to ensure people are safe from harm and abuse. Evidence: We read the complaints procedures, which is included in the information people receive about Brookside. The complaints procedure clearly sets out the process of how to complain and details the contact details for the Commission for Social Care Inspection and the local advocacy service. The information we received from the registered manager stated they had not received any complaints about the service. It told us that people have an opportunity to express concerns at the care plan reviews and the residents meetings.The minutes of the last residents meeting stated people had no concerns or complaints. The surveys responses received indicated people knew how to make a complaint and who they should speak with if they were unhappy. The Commission for Social Care Inspection has not received any concerns or complaints about Brookside. We spoke with people living at the home, who told us they did not have any complaints, were confident to tell the registered manager if there were any concerns and always had the opportunity to raise concerns at the residents meeting. Staff we spoke with and staff survey responses indicated they were confident to receive Care Homes for Older People Page 21 of 35 Evidence: concerns from people and know what to do with the concerns they receive. This demonstrated people were confident to complain, having procedures in place and staff that know what to do with any concerns or complaints that they receive. The comments we received directly from people and in the surveys included: I have never had to make a complaint I would not wait to make a complaint, I would just tell Linda We have the monthly residents meetings where Linda will as us if there are any concerns or complaints or how things could be improved You can tell Linda if theres a problems, because its never a problem to her, she gets it put right straight away You cant ask for a better group of staff than we already have. The staff are kind, caring gentle and respectful Brookside has received a number of compliments in the form of letters of thanks and cards. We read some of the letters and cards received, all thanking the manager and staff for the care people received. Comments included thank you so much for making mum so happy here. People said they felt safe with the staff working at the home, having familiar faces and staff that know them individually. The staff we spoke with demonstrated a good understanding of safeguarding issues, which means promoting the wellbeing of people using the service from harm and abuse. Staff were aware of the types of abuse that could occur and were confident to report any suspicions and poor practice to the manager using the whistle-blowing procedure. The staff we spoke with confirmed they started work after checks were carried out. The staff files we looked at contained evidence of pre-employment checks such as references, criminal records bureau checks and protection of vulnerable adults checks. There was one staff file that had only one reference and the registered manager gave assurance that the second reference was received but may have been misplaced following the office being relocated. We saw staff had completed the induction training using the skills for care induction, which includes training in health, safety and safeguarding procedures. The most recent staff member recruited is due to start their induction training and currently works alongside experienced staff. Care Homes for Older People Page 22 of 35 Evidence: The information we received from the registered manager before the site visit stated that 90 of staff had attained national vocational qualification (NVQ), new staff recruited had already attained NVQ 2 or 3 and is looking to identify further training in mental capacity act and protection of vulnerable adults. This demonstrated staff recruitment and training processes protects the people living at the home. The registered manager told us the home does not handle peoples money. People we spoke with said they manage their own money and in some instances, family supported people to manage their money. Care Homes for Older People Page 23 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, comfortable, clean and well maintained home that promotes their wellbeing. Evidence: The information we received from the registered manager before the site visit stated the home is well maintained and comfortable, routine maintenance, gardener and the building complies with the requirements of the local fire service. We also received information about the improvements made at the home, having increased the number of registered places to accommodate up to twelve people, new bathroom with a walkin bath and a lounge/dining room. New security systems have been installed to the two main entrances to the home. We received good responses from the surveys indicating the home is fresh and clean and comments received included provides a homely environment for all residents. The manager told us since completing the information that was sent to us, she had recruited an administrator for the office and a cleaner, who will be responsible for the cleanliness of the communal areas. The registered manager said she recognised the need to recruit a cleaner following the increased number of people living at Brookside. This demonstrated the registered manager ensured the staffing reflected the needs of the people and the day-to-day running of the home. Care Homes for Older People Page 24 of 35 Evidence: Brookside has a warm and welcoming atmosphere, having complimentary decor, furnishing and fittings that creates a homely ambiance. People were seen sitting in the lounges in small groups and clusters, in the conservatory or preferring to spend time in their rooms. This showed there was thought in promoting conversation, wellbeing and independence of people. Several people said how clean the windows in the home and in the conservatory, as the sun was shining into the home, thus making the point of the standards in the home. The external grounds were well maintained, having improved wheelchair access to the home with the second main entrance. With permission, we looked at a number of bedrooms. All the bedrooms were spacious, had ensuite facilities, benefiting from a high standards of co-ordinated decor, creating individualised bedrooms. All the bedrooms were personalised with peoples belongings such as ornaments, photographs and pictures. All areas of the home were clean, tidy and had a warm and welcoming ambiance. We shared with the registered manager the comment received in the staff survey where it was suggested that the home should have a hoist available. The registered manager said that at present there was no-one living at the home who needed the use of a hoist and at no time had staff raised this as an issue. The registered manager gave assurance that if a hoist is required then it would be available and she would raise this as a discussion point at the next staff meeting. People told us they felt the home was exceptionally clean and benefiting from the new comfortable armchairs and bone china cups and saucers purchased recently after it was raised as an issue at the residents meeting. People told us that the owners continuously look to improve the home, fixing and repairing things quickly if they are not working or are broken. People described the laundry arrangement, whereby the dirty laundry is collected by staff and returned to their rooms after being washed, dried and ironed. One person told us they like to make their own bed and keep their bedroom tidy but were happy for the staff to do the heavier cleaning. We saw staff collecting peoples laundry, wearing gloves and aprons, which showed infection control procedures were in use. Staff we spoke with said they always have a good supply of protective clothing and demonstrated awareness of health, safety, infection control practices followed that protects both the staff and the people living at the home. We saw the training certificates in the staff files including the food hygiene certificate for the cook, which showed staff receive training for the work they do. This supported the information we received from the registered manager before the site Care Homes for Older People Page 25 of 35 Evidence: visit and the staff survey responses. Care Homes for Older People Page 26 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by good staff recruitment processes and training that ensures care needs met and independence is promoted. Evidence: The people we spoke with said they like the staff working at the home, felt they supported them with their daily living and treated them with respect and said: you can tell Linda if theres a problems, because its never a problem to her, she gets it put right straight away and you cant ask for a better group of staff than we already have. The surveys responses received from the people living at Brookside, all indicated staff listened, acted upon what they said and felt the staff were always available. The information we received from the registered manager before the site visit stated 90 of staff had attained the national vocational qualification (NVQ) level 2 in care and above and had appointed new staff who had already attained NVQ level 2 or 3 in care. We looked at the staff rota and spoke with the staff on duty, who were happy with the staffing levels, felt having the registered manager on-site ensured consistency and good communication. Staff spoke about the new communication book, which has been introduced to share information about the wellbeing of people important events such as appointments. This supported the staff surveys response, whereby staff felt Care Homes for Older People Page 27 of 35 Evidence: communication between staff was good. We spoke with the staff on duty, of which one said they were due to start their induction training. Staff told us they were recruited and appointed upon receipt of references, criminal records bureau check and protection of vulnerable adults checks. One member of staff said they had completed the induction workbook, through skills for care, which was consistent with the information we received from the registered manager before the site visit. We looked at four staff recruitment and training files, all contained evidence of criminal records bureau check and protection of vulnerable adults checks, three out of the four staff files had two written references. We brought this to the attention of the registered manager, who said having only recently had the newest person start and relocating the office, the second reference may have been mislaid. The registered manager gave assurances that the second reference would be located immediately. The newest member of staff told us they had already attained NVQ 2 and want to start NVQ 3. We looked at the training certificates for the four staff. The certificates of training ranged from induction to moving and handling, safe handling of medicines, first aid, advance health and social care and food hygiene certificate. The registered manager told us having appointed a new administrator, time is spent trying to identify and access training in mental capacity act, food hygiene and updates in protection of vulnerable adults procedures. Staff we spoke with told us they use the communication book to share information. Staff told us they do meet with the manager but had not attended any planned team meetings. The registered manager told us at the start of the site visit that staff supervisions have not taken place and team meetings, although had taken place, no record of the meeting was kept. Care Homes for Older People Page 28 of 35 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well managed home, have the opportunity to express views to influence the service that promotes their health, safety and wellbeing. Evidence: The information we received from the registered manager before the site visit stated that they had completed the national vocational qualification level 4 in care management. The registered manager appears to be competent, experienced, attentive towards the people living at the home and the staff. They oversee the dayto-day management of the home by keeping up to date with changes and developments. The staff we spoke with said the registered manager was very supportive and promotes the principles of care, respecting peoples rights, choices and independence. This was supported by the responses in all the surveys received, as they indicated peoples independence was promoted and staff were supported by the manager of the Care Homes for Older People Page 29 of 35 Evidence: home. People we spoke with told us that they have residents meetings where they hear about new staff being recruited, planning of social events and have an opportunity to express concerns and issues that need to be addressed. They felt the registered manager was open and approachable, which was evident from the observations we made during the site visit. We were told about the new comfortable armchairs and bone china cups and saucers purchased after it was raised at one of the residents meetings. We read the minutes of the last residents meetings that informed people about the new staff, meal times and seating, replacement of easy chairs and staff to check peoples hearing aids. The registered manager told us people can discuss matters at any time including at the care plan review meetings. This demonstrated people are encouraged and have an opportunity to express their views and are consulted about planning of social events and any changes in the home. We saw the responses received from the stakeholder surveys, which were completed by service users, family/relatives, social workers and health care staff. The surveys were a collection of questions and tick box responses, of which the majority of the responses were either good or excellent. We asked the registered manager what the findings were and the action plan, if any. They told us that they had analysed the responses, but people were not informed of the findings from the survey. The registered manager gave us the assurance that the results from the survey would be shared with people at the next residents meeting. The responses in the surveys we received from staff and the people living at the home were positive and included: Linda and ... are always looking to improve, new ways of working and easier ways, where possible that suits service users and staff This service fully understands the needs of the service users and is always relayed to staff. Communication works very well at Brookside and am very happy to have a happy home to work in Linda and .... are always looking to improve and their service to staff and service users is admirable Ive been in care work for ..... and this is one of the best in my opinion This home is more like a family than a business Care Homes for Older People Page 30 of 35 Evidence: Brookside has received a number of compliments in the form of letters of thanks and cards. We read some of the letters and cards received, all thanking the manager and staff for the care people received. Some cards we read stated: thank you so much for making mum so happy here. The direct comments we received from people during the site visit were: This is an excellent home, we are treated very well I must say You can tell Linda if theres a problems, because its never a problem to her, she gets it put right straight away You cant ask for a better group of staff than we already have. People told us they look after their own money independently or with the help of family. The registered manager confirmed the home does not handle peoples money and if necessary encourage people to be supported by their family. The staff survey responses indicated staff do have time with their manager to discuss work matters and training. However, the staff told us that they had not had any formal supervision, which supported the staff records we viewed, whereby only two staff out of four had received any supervisions and appraisals. The registered manager admitted that staff meetings and staff supervisions were behind, and having appointed an administrator she anticipates the formal supervision meeting to take place regularly. We saw the assessments of risk carried out for individual people as part of the assessment and admission process. These included risk assessments for moving and handling and falls. The safety measures identified from the assessments were written in the care plans and staff demonstrated their awareness of the safety measures by making sure people walked with their walking stick, for example. The staff training records showed staff had received training in health, safety, manual handling and completion of the national vocational qualifications. The records relating to the people living at the home, staff and the management of the service are kept securely and in good order. This information was organised and easily accessible with the exception of the second staff reference. This showed that there are good systems of management and organisation. The information we received from the registered manager before the site visit detailed the programme of maintenance, servicing, testing of equipment and checks that are in place. The joint responsible individual/owner is responsible for the maintenance of the home and is available on site should any maintenance or repairs be needed. From the Care Homes for Older People Page 31 of 35 Evidence: observations made of the home during the site visit it was evident that the maintenance of the home has the same priorities as to the quality of care people receive. Care Homes for Older People Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 33 of 35 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 36 A formal system of staff supervision should be in place to help staff focus on improving outcomes for people using the service and to identify training needs and development Care Homes for Older People Page 34 of 35 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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