Inspection on 28/06/07 for Brookview Nursing and Residential Centre

This inspection was carried out on 28th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Brookview Nursing and Residential Centre Brook Lane Alderley Edge Cheshire SK9 7QG Lead Inspector Joan Adam Unannounced Inspection 28th June 2007 09:30 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 Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookview Nursing and Residential Centre Address Brook Lane Alderley Edge Cheshire SK9 7QG 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) 01625 582328 01625 590313 ANS Homes Limited Maureen Southern Care Home 55 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (43), of places Physical disability (1) Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 55 service users to include: up to 43 service users in the category of OP (Old age, not falling within any other category aged 65 years and above) Up to 12 service users in the category DE(E) Up to 1 service user in the category PD (Physical disability) Date of last inspection 10/02/06 Brief Description of the Service: Brookview Nursing Home is a purpose built three-storey building constructed in 1990/91. The home is a short distance from the centre of Alderley Edge and close to bus and rail links. The ground floor has facilities for residents who have dementia and has its own secure garden. The first and second floors are for elderly residents who require nursing care. Bedroom accommodation consists of a majority of single bedrooms and some double bedrooms all having ensuite facilities. There are lounge and dining room facilities on all floors. The current fees for the home are from £776 to £861 per week. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place on 28th June 2007 and 11July 2007 and took nine hours. It was carried out by an inspector of the Commission The visit was just one part of the inspection. The home was not informed of the date the visit was to take place, but a few weeks prior to the visit the manager was asked to complete a questionnaire to provide the inspector with some information about the service. The manager was also asked to distribute questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. Five responses were received from relatives. All were positive about the standard of care in the home. Comments such as “I feel lucky that my relative is living at Brookview”” “the staff are very caring and know how to look after people” “ the home is excellent and I wouldn’t live anywhere else” During the visit the inspector spoke with the manager, staff and residents. The premises and various records held by the home were looked at. Feedback was given to the registered manager at the end of the inspection. What the service does well: Brookview provides information about the home so that prospective residents have enough information to make a choice about living at the home. All residents are assessed prior to admission so that the staff know they can meet their needs. Care plans are in place so that the staff know how to care for the residents living at Brookview. Care plans are updated and reviewed on a monthly basis following discussion with residents and relatives. Comments such as “Relatives may visit without restriction-even bringing in a dog- very important” “ the staff are excellent and I have rarely seen anyone without a smile on their faces, they are all capable and caring and extremely kind to the residents” The home is staffed with people who are trained to look after older residents and training is given to all grades of staff. Residents are offered choice in their daily lives and the standard of catering is good. Residents are treated as individuals and their privacy and dignity is respected Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 6 Recruitment procedures, staff training and staff supervision ensure that residents are protected from harm. Residents’ financial interests are also safeguarded. The home is clean and comfortable with a warm and welcoming atmosphere. Residents say that they like living at Brookview. What has improved since the last inspection? What they could do better: The home should continue to maintain and improve the standard of service offered to the residents. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 8 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 Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are given sufficient information about the home and care costs so that they can decide if the home will meet their needs. Residents are fully assessed prior to admission so that care staff are able to meet their care needs. EVIDENCE: Brookview has updated its Statement of Purpose and Service User Guide, which are information leaflets about the home and its facilities, to inform prospective residents of the changes in the facilities offered at the home. The assessments of two residents that had recently been admitted to Brookview were inspected. The registered manager or a senior nurse carries out assessments. The content of the assessments was good and contained all Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 10 the information needed to provide care. This assessment included information about the resident’s social history and preferences in relation to daily living and diet. Residents spoken with said that they had been visited by a member of staff prior to them being admitted to the home. Brookview does not provide intermediate care. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are met by staff who enable them to maintain their privacy and dignity. Medication is well managed. EVIDENCE: The care plans of six residents were looked at. A new care planning system has been introduced by the company called QUEST and staff have had training on how to use the documents. QUEST identified where residents were independent of need and looked at lifestyle choices. Support plans were completed where necessary for each area of lifestyle choice. All residents’ details have been transferred to the Quest format within the last few months. Care plans identified areas of need such as pressure area care, mobility, continence, nutrition, tissue viability and general dependency. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 12 The care plans contained concise information to provide care staff with the necessary information for them to look after a person’s needs. Two care plans that had recently been transferred to the new documentation had not been reviewed since April. This was discussed with the senior nurse on duty and these had been updated on the second day of the inspection. There was written evidence to confirm that there had been consultation with residents or their families/advocates. The home had a warm and friendly atmosphere and the staff were seen to interact well with the residents. Staff were seen to knock on doors and wait before entering bedrooms and bathrooms. Residents comments “ the staff are excellent” “ nothing is too much trouble “ “ I cant fault the home and staff” were made. Relatives comments such as “ The staff are extremely caring and capable, and extremely kind to the resident”” staff are friendly, cheerful-very important” Medication management and storage arrangements were looked at. The home used a monitored dosage system. Medication administration records were completed correctly and medicines were stored appropriately. One resident had medications delivered to the home that had not been recorded correctly. It is recommended that this problem be addressed. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available are flexible and varied to suit residents’ expectations, preferences and capacities. EVIDENCE: Residents could make choices of where they wanted to spend their day. Some were sitting in one of the lounges and some were in their bedrooms. Visitors were made welcome at any time. A number of areas of good practice were noted including the promotion of equality and diversity. The home has had a vacancy for an activities co-ordinator for some time and residents and relatives made comments such as “ the activities have been an issue in the last few months” However, a new activities co-ordinator is now in post and an improved programme has been implemented following discussion with the residents. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 14 Group activities are on offer and one to one sessions are provided fro the residents who are not able to join in the group activities. Musical entertainment, exercise to music, arts and crafts, painting, flower arranging, bridge group, card making, reminiscence, pre-lunch drinks club are available at the moment. A local school ( Alderley Edge School for Girls ) have given concerts for residents at lunchtime which all have enjoyed. Work is commencing on the gardens to improve access for the residents within the next few weeks as the residents and relatives have expressed concerns that the garden needs to be more “ user friendly”. Ryleys School for Boys have a “roots and shoots “ club and the pupils will be coming to the home to work with the residents to plant the raised beds that will be built in the near future. Menus in place at the home are varied and residents said that the food was good and wholesome. Comments made by residents are “ good food” “ no problems at all with the food. ” “ We have home baked scones and cakes” Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaints procedure in place and the residents are protected from abuse. EVIDENCE: The complaints procedure is displayed and residents said they would know how to complain. The complaints procedure is also contained within the Service User Guide (information leaflet) so that residents are aware of their rights. The home has received complaints since the last inspection and have dealt with them appropriately. Residents said they would feel comfortable talking to the manager if they had any problems regarding the home. Brookview has policies and procedures relating to the protection of vulnerable adults. The staff spoken with displayed a good understanding of adult protection procedures. Staff have completed a training course on adult abuse and these training sessions will continue for new staff. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Brookview provides a comfortable and clean environment for those living there and visiting. EVIDENCE: A partial tour of the home was undertaken. All the shared areas and a selection of bedrooms were seen. Bedrooms were well personalised with residents’ own furniture and mementoes. The home was cleaned to a high standard. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 17 Since the last inspection the ground floor of the home has been completely refurbished and is now a unit for people who have dementia. The nurse’s station in the corridor is enclosed in glass forming a barrier between the staff and the residents it also gives an institutional feel. At present, the first and second floors are being totally refurbished to improve the environment for all the residents living there. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and skill mix are sufficient to meet the needs of the residents, Residents are protected by the home’s recruitment practices and staff training. EVIDENCE: There are adequate numbers of staff on duty to meet the needs of the residents living there. In conversation care staff demonstrated that they were knowledgeable about the care needs of residents. They also indicated that they enjoyed working at Brookview. Training at the home is on going and copies of courses undertaken were seen on the staff files and on the training matrix. These included moving and handling, health and safety, fire awareness, first aid, food hygiene, medication updates and protection of vulnerable adults. Trained staff have received training on end of life pathways. This is not a full list of training provided at the home and more training and up-dates are planned. A programme is in place to enable staff to achieve NVQ level two in care and fifty seven per cent of care staff have achieved this qualification. The housekeeping staff have achieved NVQ level 1. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 19 Staff files were looked at for three newly employed staff members and all of these contained appropriate checks prior to commencement of employment. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. The views of service users are obtained to influence the running of the home. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. She is a registered nurse and has experience of management. She has a diploma in management. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 21 Residents and relatives said that they felt the home was well run and that the manager and staff were very welcoming and friendly. The systems for the recording of any monies or valuables held were good. Health and safety procedures at Brookview are good. Fire drills and risk assessments are in good order. The pre inspection questionnaire provided information to confirm that equipment and installations at the home are serviced on a regular basis. The home employs a handyman who attends to maintenance issues such as checking fire equipment, water temperatures and other health and safety matters, providing a safe environment for staff and residents. Audits take place on a monthly basis with regard to care plans, medication, staff files, resident’s finances, and health and safety. The area manager visits the home on monthly basis and audits completed by the home manager are validated. A regulation twenty-six report is completed and a copy sent to CSCI. Resident/relative meetings and staff meetings are held at the home on a regular basis and minutes can be seen by all who attended. The home has a quality assurance system in place and questionnaires are sent out to residents and relatives to gain their views on the service provided by the home. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP9 OP19 Good Practice Recommendations All care plans should be reviewed and updated on a regular basis. Drugs received in to the home must be recorded. Consideration should be given to removing the glass wall at the nurse’s station on the ground floor so that there is not a barrier between the residents and staff. Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brookview Nursing and Residential Centre DS0000069137.V331106.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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