Please wait

Please note that the information on this website is now out of date.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

Inspection on 08/12/05 for Brookside

Also see our care home review for Brookside for more information

This inspection was carried out on 8th December 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Comment cards received from residents, and direct contact with residents during the inspection, revealed very high levels of satisfaction with the home. One told the inspector "what I like is, there`s no do`s and don`ts here." Written and spoken comments about staff were universally complimentary, and the home had received seven letters of compliment since the previous inspection. One resident with complaints about the food was clearly very much in a minority, but there had been an attempt at easing this situation for them. The care leaders seen projected a determination to understand and improve the life experience of the residents, this positive attitude being reflected in care records and plans. These in turn commenced on the basis of comprehensive information gathering and assessment, which ensured the home only admitted those people whose care needs could be met. There was evidence of excellent working relationships with health and social agencies in the community. A visiting district nurse spoke of their surgery`s high regard for the nature of care provided by the home, to the extent of always preferring to support the home`s care of a resident with deteriorating health, rather than seek hospital admission, if the latter could possibly be avoided. Care records showed that staff are alert to indicators of possible ill health, and prompt to access medical attention. Social and emotional needs are also recognised in planning residents` care, and the activities co-ordinator has promoted a wide range of activities and events in and outside the home.

What has improved since the last inspection?

In response to previous requirements, appropriate improvements have been made to care documentation and its maintenance. Housekeeping staff have been brought up to date with infection control training and, related to this, arrangements have been made to replace the flooring in a number of toilets and bathrooms to make them more comfortable and hygienic. Installation of a shutter between the kitchen and dining room, linked to the fire precautions system, was almost complete, to meet Fire Officer requirements. The external windows had been surveyed, leading to a programme of servicing. This has made a number of windows easier and thus safer to open and close, which in turn is likely to make many windows used more often than was the case. As recommended, the activities co-ordinator has become more directly involved in the care planning process.

What the care home could do better:

To consolidate good practice in respect of infection control, it is a requirement to refurbish a sluice room that was showing considerable deterioration and thus presented risks to good hygiene. A further environmental shortcoming was a need to cover a very few radiators missed from a previous programme of covering radiators, so that they do not pose a risk of people burning themselves on very hot surfaces. Medication practice in the home was mainly excellent, but unfortunately safety was undermined by two examples of slack recording procedures, which can quickly be put right but have given rise to a requirement. Similarly, recruitment of staff is carried out on a very sound basis, but the regulatory requirement of keeping photographs of all staff was not currently being adhered to.

CARE HOMES FOR OLDER PEOPLE Brookside Ruskin Avenue Melksham Wiltshire SN12 7NG Lead Inspector Roy Gregory Unannounced Inspection 10:00 8 & 9 December 2005 th th 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 DS0000028405.V268945.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 DS0000028405.V268945.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brookside Address Ruskin Avenue Melksham Wiltshire SN12 7NG 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) 01225 706695 01225 703181 The Orders Of St John Care Trust Miss Eleanor Joan Walton Care Home 50 Category(ies) of Dementia - over 65 years of age (13), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (13), Old age, not falling within any other category (37) Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 13 service users with mental disorder or dementia at anyone time. 11th April 2005 Date of last inspection Brief Description of the Service: Brookside is a purpose-built residential home for 50 elderly people, 13 of whom may have needs associated with dementia or other mental health issues. The home was formerly owned and run by the local authority, but has for some years been provided by the Orders of St John Care Trust, one of a number of homes provided by them in Wiltshire, Oxfordshire, Gloucestershire and Lincolnshire. Miss Ellie Walton was registered as manager of the home in June 2004. Accommodation is all in well-proportioned single rooms, located on two floors, with a passenger lift to the first floor. All bedrooms have wash hand basins. The home has seating areas rather than identifiable lounges. In addition there is an attractive enclosed garden that has benefited from recent attention to make it accessible to all service users. Two rooms are used exclusively for short stay residents. The home is situated in a residential area, a short walk from Melksham town centre, where shopping and social facilities are available. There are good bus links to neighbouring towns, whilst the home has its own adjacent car park. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday and Friday, 8th & 9th December 2005. The inspector, Roy Gregory, was at the home for a total of 11 hours & 40 minutes. The registered manager, Miss Walton, was available for most of this time, whilst the inspector also spoke with two care leaders, the activities co-ordinator, the administrator, and members of the care and support staff teams. During the inspection there were also conversations with a visiting district nurse and a mental health social worker. A number of residents were spoken with, including sharing a lunch at table with three of them. All the home was toured, with a small number of individual rooms being seen. Prior to the inspection, a “pre-inspection questionnaire” was received from Miss Walton. Additionally, ten “comment cards” were received from residents, and one from a relative. During the inspection, documentation looked at included care records, training and recruitment documentation, and fire precautions records. Medication storage and records were examined in detail, together with a discussion with the care leader with primary responsibility for this area of practice in the home. A number of instances of care giving were observed, and also a staff shift handover and a meeting between a relative and a care leader. What the service does well: Comment cards received from residents, and direct contact with residents during the inspection, revealed very high levels of satisfaction with the home. One told the inspector “what I like is, there’s no do’s and don’ts here.” Written and spoken comments about staff were universally complimentary, and the home had received seven letters of compliment since the previous inspection. One resident with complaints about the food was clearly very much in a minority, but there had been an attempt at easing this situation for them. The care leaders seen projected a determination to understand and improve the life experience of the residents, this positive attitude being reflected in care records and plans. These in turn commenced on the basis of comprehensive information gathering and assessment, which ensured the home only admitted those people whose care needs could be met. There was evidence of excellent working relationships with health and social agencies in the community. A visiting district nurse spoke of their surgery’s high regard for the nature of care provided by the home, to the extent of always preferring to support the home’s care of a resident with deteriorating health, rather than seek hospital admission, if the latter could possibly be avoided. Care records showed that staff are alert to indicators of possible ill health, and prompt to access medical attention. Social and emotional needs are also recognised in planning residents’ care, and the activities co-ordinator has promoted a wide range of activities and events in and outside the home. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 6 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 DS0000028405.V268945.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 DS0000028405.V268945.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, 4 &5. (Key Standard 6 is not relevant to Brookside.) The standard of assessment is effective; prospective residents and their families are involved in the process, including by way of visits. They can be confident that the home will identify needs and restrict admission to those whose needs can be met. EVIDENCE: The Standard for assessment of new prospective residents was met at the previous inspection. On this occasion there was discussion about reassessment of residents after they have been admitted to hospital. Miss Walton said hospitals could be very insistent on such re-assessment taking place at an early and possibly inappropriate stage. With the local community hospital, however, she described a close working relationship, whereby the home could offer increasing input to the resident’s in-patient care, for example by key worker visits and seeing to laundry, leading to a well planned readmission to the home. In a current instance, a resident’s key worker had been to the hospital to directly observe bed/chair transfers as a part of reassessment, and there was liaison in place with the occupational and physiotherapist to ensure a smooth and supported re-admission. A visiting district nurse said that at the surgery where she was based, there was no Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 9 question about the abilities of Brookside to meet the care needs of residents, to the extent that the surgery would support the home in maintaining care whenever possible, in order to avoid an admision to hospital in the first place. In respect of a person admitted for respite care on the day of inspection, a care leader engaged in a sensitive interview with a relative, thereby confirming and supplementing information already gained at assessment. It could be seen how information gained became incorporated into care planning documentation in order to ensure a match between the expectations of residents and their families, and the care provided. Feedback from residents showed satisfaction that their care needs were identified and met. A social worker was seen showing a prospective resident around the home, with support from a care leader. A resident who had moved in about three months previously recalled having had three meals at the home to help familiarise with it before moving in. Their pre-admission assessment had involved separate visits by the manager and a care leader. The resident considered the home was meeting the purpose of admission: “It’s home already.” Occasionally the home may be asked to admit a person on a respite basis as an emergency, without benefit of a prior assessment. Such an eventuality had recently caused upset to existing residents, because of non-anticipated behaviours by a person admitted in a hurry at the request of the community mental health team. Other arrangements had been made for them the following day. Miss Walton considered the referral to have been made in good faith, on the basis of trusting relationships between the home and community resources, but she was aware that such instances had sometimes occurred in other homes within the Trust as a result of emergency admissions, with reliance upon the initial assessment of an external professional. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Individual plans both reflect and direct care in line with identified need, and with evidence of resident involvement and agreement. Health needs are recognised and backed by excellent working relationships with health agencies and with the supplying pharmacy. Medications practice is of a high order, but recording can be improved and thus made safer by attention to detail. EVIDENCE: Care plans seen were of a high standard, with evidence of regular and meaningful review. Observations, and discussions with residents and with care staff, confirmed the plans directed and reflected the care given. For example, one resident spoke of their agreement about how and why nighttime checks would be carried out, another confirmed provision of large-print reading material as identified and planned for. The inspector overheard a resident expressing a degree of unhappiness to a visitor; subsequently their care plan showed care staff were asked to be alert and responsive to emotional issues, and in staff handover it was apparent that a member of staff had checked and spent time with the resident. The latter had agreed to accept encouragement to spend a little time with other residents, and this in turn became a delegated task at shift handover, in line with the care plan. A resident described their involvement in a recent care plan review, which they appreciated. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 11 There were good records of both routine and singular referrals to and attention by GPs and district nurses, and excellent liaison with health agencies was apparent. The tissue viability nurse for the area had visited the home by invitation in November 2005 and conducted a certificated training course for staff, as well as approving the incorporation of tissue viability planning into the care planning system. Miss Walton was additionally considering a general risk assessment about risk of pressure area damage, to underpin practice. A district nurse told the inspector she had never needed to attend a pressure sore at Brookside, where she considered provision for health care to be above average. Weights were being consistently recorded, and where a weight reading had been missed, a reminder had been issued to the key worker and acted upon, showing effective oversight of practice. Where residents had requested GP visits, these had been arranged without delay, whilst records showed care staff were efficient in recognising ill health indicators and making appropriate prompt referrals. There were also good records of planning for medical appointments; for one resident, for example, appointments were in place for audiology, rheumatology and chiropody. Good practice was observed in respect of provision for hot weather, in line with Department of Health “Heatwave” advice, including having bought air coolers and emphasised provision of cool drinks. Staff had been required to sign that they had read the related action plan. All care plans contained a plan in respect of medication. One care leader takes primary responsibility for medications ordering and practice, whilst administration of medicines as a task is restricted to care leaders and acting care leaders. They are subject to competency testing every six months. One resident was self-administering medications, a practice subject to reviewable risk assessment. The care leader said that in any such cases, she carried out frequent checks on accuracy of self-administration, and records showed there had been instances of inviting residents to transfer responsibility to staff. A resident recalled such a discussion, and considered it to have been a relief. A monitored dosage system was in use, supported by the supplying pharmacy. There were records of pharmacist audit visits in July and November 2005, during which a misadministration issue had been discussed. This had led to an agreed policy between the home and pharmacy, whereby all a resident’s medications are now returned to the pharmacy at the point of admission to hospital, to ensure that on return from hospital the correct medication regime at that time is established and prescribed. There was also good practice in evidence in respect of checking respite residents’ medicines directly with their GP surgery. There was daily checking and handover of controlled drugs. All use of prescribed topical creams was recorded. The care leader was in the process of arranging for “as needed” prescriptions to be supplied in smaller quantities, to Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 12 avoid over-stocking or going out of date. There were good arrangements for those medications falling outside of routine administration rounds, or requiring storage outside of the blister packs, with further evidence of a close and effective working liaison with the pharmacy. The care leader agreed that where hand-written additions are necessary in the medicines administration record, these must be signed and dated, and there should not be confusion about date columns in the records. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Residents have access to varied organised activities, by personal choice and related to needs and expressed preferences. High quality meals are served. EVIDENCE: Notice boards indicated “What’s on for December”, showing a total of 24 events, including concerts, services, Christmas festivities, a quiz and bingo. A singing group from the nearby school performed in the dining room during the inspection. Latterly a total of 18 residents had joined in two minibus trips out to see the Christmas lights. There were standing publicised arrangements for fortnightly communion services, and monthly attendance of the mobile library. Notices also included “This week’s activities”, such as skittles, singing and exercise. These notices showed there was a planned activity for each half day, and indicated when the activities co-ordinator would be in. The latter confirmed she had support from care staff in provision of activities. The importance of “one to one” time was recognised and planned for. The activities co-ordinator kept records of participation and response, and was actively involved in careplanning of activity needs. These plans showed evidence of review, for example one person’s expressed wish to join activities had been noted, but on review it was recognised and recorded that they now needed encouragement to participate. Some residents told the inspector the notice boards contained a lot of useful information, but were cluttered to read. It may be helpful to distribute activities and events information directly to bedrooms, in large print. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 14 A resident considered the appointment of an activities co-ordinator had made a big difference to life in the home, with a good variety of events in and outside the home. Meals were highly regarded by the vast majority of residents, as indicated by comment cards received, talking with residents, and meals satisfaction forms compiled as part of the Trust’s own quality assurance system over the preceding three months. At the midday meal there was unhurried but prompt service, responsive to individual wishes about both content and quantity. Second helpings were offered. A cook spoke of ensuring a good service to a vegetarian resident, who in turn confirmed with appreciation the attention they received. One resident has expressed major dissatisfaction with the quality of meals, to the home and to the inspector. In response the home had made alternative individual arrangements for them that could be put in hand at any time requested. A resident told the inspector they found it very rare for there to be no acceptable choice available at a meal, whilst another valued not only the meals themselves, but also the social context in which they are taken. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Careful and full record keeping enables ready investigation of any area of complaint, and underpins the identification and handling of situations where residents might otherwise be at risk of abuse. EVIDENCE: There had been four complaints considered within the complaints procedure since previous inspection, three of them related to the same incident in the home when the privacy and dignity of some residents was affected. The fourth was a financial issue that was not upheld. In each instance appropriate enquiries and written responses were made in a timely manner. In the same period, the home received seven letters of compliment. Staff receive abuse awareness training as part of the Trust’s induction, and this is followed up by in-house training, as shown by training records. The “No Secrets” guidance to local vulnerable adults procedures is issued to all staff. There had been no instances of recent involvement with these procedures, but in the case of a resident who had caused some disruption to the lives of other residents, staff record keeping was both objective, and appreciative of the perceptions of all involved. One resident felt very secure in the home environment and saw that as a main reason to be living there. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26 Residents benefit from a programme of ongoing renewal and good routine care of the environment. However, there are risks to safety from unguarded radiators, and risks to health from a sub-standard sluice room. EVIDENCE: Following requirement at the previous inspection, the windows have been surveyed, leading to a number being serviced to enable easier opening. A programme of re-carpeting was in place to commence in January 2006 in the dining room and downstairs corridors. Individual rooms seen, and communal areas, presented well in terms of décor and cleanliness. Several toilets were due to be upgraded, along with having new flooring in accordance with previous requirement. However, it was identified that the suite of toilets near the dining room, and an upstairs bathroom, had unguarded radiators, posing a risk of burn injury. Housekeeping and other staff had received infection control training from a health protection nurse. For better protection in this regard, the home needed attention to the sluice rooms, particularly the downstairs sluice where there Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 17 was crumbling grouting and badly deteriorated fittings, including the window, posing risks of harbouring infection. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Provision of both care and support staff is adequate in numbers and quality to meet residents’ needs. Training is regular and appropriately targeted to ensure competency, whilst recruitment is based on safe practice. EVIDENCE: Brookside has a very good record of staff retention, and care staff numbers are concentrated at key parts of the day. Thus, whilst the baseline availability of staff on rota is five in the mornings and four on later shifts, an additional carer is made available up to 10:30 a.m. and between 6:00 and 9:00 p.m. The Trust has introduced a “care support” role within the wider housekeeping role, in order to further free up care staff time. Miss Walton has effectively involved staff in determining how this role can be best used within the home, as well as also canvassing care staff about how dependency levels might best be reflected in how care hours are used. Care notes suggested that frequency of baths, and other examples of one-to-one attention, were not compromised by staff availability. At the time of inspection there were no staff vacancies. For those staff recruited since the previous inspection, there were sound records of interview, and an example of an alternative reference having been sought for clarity. There were records of Trust and in-house induction. Newly recruited night staff shadowed day staff initially in order to have a good understanding of the home and its functions. Personnel records needed improvement by ensuring there is a recognisable photograph on file of every member of staff. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 19 Both the home and the Trust have put an emphasis on development of dementia awareness training for all staff. On the first inspection day, all care leaders were attending a training course that the Trust has developed jointly with The Alzheimer’s Society. There are also in-house video training resources and a workshop run by the Trust, whilst the home has accessed direct input by Community Psychiatric Nurses on working with dementia and mental health issues. Staff training records were easily accessible and demonstrated attention to the upkeep of “mandatory” training, and planning for future identified training needs. About half of the care staff complement have achieved NVQ in care to at least level 2, whilst ancillary staff also receive encouragement to undertake NVQ training. Through comment cards and conversation, residents expressed appreciation of staff attitudes and competence. A relative wrote: “All the staff are extremely thoughtful and caring and very friendly.” Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 & 38 Brookside is fortunate in having a very capable and committed manager who enjoys the confidence of staff and residents. Arrangements for the accounting and safekeeping of residents’ monies are sound. Consideration of health and safety arrangements at this inspection was limited to fire precautions, which were compliant with Fire Officer requirements. EVIDENCE: Miss Walton is qualified to NVQ Level 4 in care. Her presentation of information to assist inspection was impeccable, whilst her discussion of current issues for the home and the care field in general, was both insightful and resident-based. A resident considered Miss Walton set a good example to all the staff, to which they responded. Another said it was clear that suggestions or observations from residents, for example at residents’ meetings, were fully considered at manager level, and that Miss Walton would refer matters on to Trust management if necessary. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 Page 21 It is Trust policy to encourage all residents or their families to set up direct debit arrangements for the payment of fees. About half of the residents were making use of safe keeping arrangements for personal monies, whilst some accessed money by writing cheques to the residents’ amenities fund. All requests for cash go through the administrator, to avoid any necessity for care leaders or others to become involved. There are sound double-signed procedures in place to provide the necessary level of security to residents. Minutes of residents’ meetings (the most recent was 14th October 2005) showed that the status and use of the residents’ fund was an agenda item. There were already notices in the home to announce the proceeds of a bazaar held five days before this inspection. Fire records were good, with evidence of fire instructions to staff having been brought up to date, and staff following up on this training. The installation of new shutters between the dining room and kitchen, required by the Fire Officer, was almost complete, and fridges had been removed from corridors, as also required by the Fire Officer. Brookside DS0000028405.V268945.R01.S.doc Version 5.0 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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X 3 X X 3 Brookside DS0000028405.V268945.R01.S.doc Version 5.0 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. 1 2 Standard OP9 OP25 Regulation 13 (2) 13 (4)(a,c) 13 (3) Requirement All hand-written additions to the MAR sheets must be doublesigned for accuracy, and dated. The identified non-covered radiators must be made safe from presenting risk of burn injury. The downstairs sluice room must be refurbished to accord with recognised infection control guidelines. There must be a recent and recognisable photograph kept of each member of staff. Timescale for action 09/12/05 31/01/06 3 OP26 31/03/06 4 OP29 19 (1)(b) 09/12/05 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 Refer to Standard OP9 OP12 Good Practice Recommendations Ensure date columns in MAR sheets are used in a consistent way. Consider alternative means of making residents aware of planned events and activities. DS0000028405.V268945.R01.S.doc Version 5.0 Page 24 Brookside Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brookside DS0000028405.V268945.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!