This inspection was carried out on 30th November 2009.
CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Brookwood Manor Ltd Holbrook Hall Park Little Waldingfield Sudbury Suffolk CO10 0TH two star good service 13/03/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Claire Hutton Date: 3 0 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Brookwood Manor Ltd Holbrook Hall Park Little Waldingfield Sudbury Suffolk CO10 0TH 01787248062 01787247525 brookwoodmanor@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Brookwood Manor Ltd care home 28 Number of places (if applicable): Under 65 Over 65 28 dementia Conditions of registration: Date of last inspection Brief description of the care home 0 1 3 0 3 2 0 0 9 Brookwood Manor, Great Waldingfield, is registered to provide care for 28 older people with Dementia. The home is located between Sudbury and Lavenham on the B1071. The Home is a large period building set a distance back from the main road and can be reached by a single-track road. There is sufficient parking for several cars and the homes is surrounded by mature grounds and then open fields. The building has been converted into a care home and has a shaft lift to access the first and second floors. The home consists mainly of single bedrooms with three bedrooms being shared. There are two lounge areas and one dining room. There are ample bathroom and toilet facilities positioned appropriately around the home. On the second floor there is a small laundry. Fees for this home range from £500.00 to £650.00 per week.
Care Homes for Older People Page 2 of 9 What we found:
We became aware on 21st October 2009 that this home was in liquidation. We had not been notified by the home of any financial difficulties. On 3rd November 2009 an application was made in the high court and this home moved back into administration. The Insolvency Practitioner for Brookwood Manor is Baker Tilly and they notified us on 9th November 2009 that a management company called Healthcare Management Solutions Limited had been appointed to manage the home. From the date we were aware that the care home went into liquidation we made a safeguarding referral to Suffolk Social Services to ensure the ongoing protection of the vulnerable adults who live at the home. We have liaised closely with Suffolk Social Services through their safeguarding procedures and are aware of their quality monitoring visits they have made to the home and have received detailed feedback. We arranged to meet with the management company on 30th November 2009 to discuss their plans for the home with specific reference to finances and management, but unfortunately their representatives did not attend the meeting at the care home. Therefore we did not continue with our inspection on that day. We revised our plan and have written to the Insolvency Practitioners on 9th December 2009 for more information and assurances about the running of Brookwood Manor. However as yet we have not received a response to this letter. We are aware that the manager left the service on 16th December 2009 and that a new manager has been appointed. In addition we have received information that the shaft lift, as of 22nd December 2009 is not operational. We also received concerns about staffing levels over the Christmas period that have continued into the New Year. Therefore we decided to visit the home on 12th January 2010 to look at the experiences of people who currently live there and to see if their welfare and care was satisfactory. This report covers those findings. What the care home does well:
Currently the home has 22 residents with one person in hospital. We found that the staffing levels were consistently 4 care staff during the day and 2 at night. There was one occasion that this fell to 3 care staff during the day and that was Christmas day. Further comment on this matter is in the next section of this report. We looked at the support staff employed such as catering and cleaning. The manager said she had just started to recruit 2 new care staff who they had found suitable at interview and an advert for a part time cook had been advertised. The manager told us that she would like a replacement secretary as this post became vacant before Christmas. The manager was going to discuss this with Healthcare Solutions. We believe that the current staffing levels are satisfactory. However there should be an agreement reached to use agency staff in very difficult situations such as when one staff member worked 22 hours without a break. The service notified us promptly that the shaft lift was not operational. The newly appointed manager told us that a part is being found and is due to be installed mid January 2010. In addition to the lift parts the manager told us that she was able to order
Care Homes for Older People Page 3 of 9 a new carpet shampooer, a new hot trolley and she was awaiting a new computer to gain access to the internet. We also saw a plumber at the home repairing a leak. Therefore she was satisfied that the needed investment in equipment to enable the smooth running of the home was being actioned in a timely manner. In the meanwhile a bedroom on the first floor is a temporary lounge. We found that some residents had been relocated to ground floor bedrooms. Two residents wanted to remain in their rooms and 3 residents were in the temporary lounge. The 2 residents in their rooms were regularly attended to as we saw staff visiting them and staff has recorded when they had visited and given care and support. We sat with the 3 residents for an hour and observed their experiences. Care staff had left them with the local radio playing and 2 people had a magazine in the their hands. Also 2 people had a soft toy that appeared to bring them comfort as they engaged with the object on occasion. In the hour we observed the residents we found that most of that time was spent either asleep, withdrawn or in a negative state of anxiety or discontent. When a staff member came in their interaction with each resident was good, asking them how they were, listening and responding saying that lunch was on its way. The staff member asked each resident in turn if they wanted a drink and returned promptly with a drink for each of them. During the short time the staff member was with the residents and for a few minutes following the residents were engaged and alert. One person chatted to their soft toy and 2 engaged with the music on the radio by tapping their foot with the beat. However, left alone the residents soon reverted back to being withdrawn. We met the Activities person who works part time. She had just been at Age Concern getting information and ideas to develop at Brookwood. She just purchased some art materials, scrapbooks and was going to visit the people in the upstairs temporary lounge as she had a bottle of bubbles to amuse and distract the residents. Also in the afternoon we saw that the new pharmacy company used by the home were visiting to give additional training to staff on the new system. Later in the day an estate agent was showing prospective purchasers around the home. We expressed our concern that the agent was moving around the large home unaccompanied by staff and the resident group were vulnerable and needed their privacy and dignity safeguarded. The manager responded quickly to our concern and allocated a member of staff to accompany the estate agent. What they could do better:
Due to the shaft lift not being operational there a small number of residents whos social care needs are not satisfactorily being met. This was even more difficult to achieve on Christmas day when there were just 3 staff on duty. Staff would have liked to have spent individual time with residents to have opened their presents, but found this difficult. We recommended to the manager that whist there is a temporary lounge in a bedroom on the first floor staff spend some time each morning and afternoon in engaging the residents in an activity. We made suggestions directly to care staff and the activities person who were keen to develop the ideas to meet individual needs. We saw that lunch was brought up on a tray. One person required their food to be pureed due to swallowing difficulties. The meal of meat and gravy, sweet corn, cauliflower,
Care Homes for Older People Page 4 of 9 broccoli and mash potato was processed together in a brown soft mixture. One resident who ate this thought they had only been given a bowl of mash potato for lunch and wanted the rest of their meal. We know that people would find a meal more appetising and more satisfying if each part of the meal were processed separately and arranged on the plate to look like meat, potato and veg. They would then experience a more normalised mealtime of the different flavours and feel more satisfied. Also on the tray was medication and the member of care staff administered this. We then checked the records and spoke to the staff who confirmed that one staff member dispensed and signed for the medication and a different member of staff administered it. This is not following the homes medication procedures. Staff were operating in this manner to save time due to the shaft lift being out of use and were doing this for only the residents located upstairs. This practice is not safeguarding the wellbeing of those residents. We looked at 3 care plans of the residents located upstairs and found consistently that these had been reviewed monthly up to September 2009. However when we explored individual care needs such as the needs around vision we found plans stated that two of these people should wear glasses daily to help them see. Each month of the review had said no change to plan. But we observed that these residents were not wearing glasses. We asked staff about this and 2 different staff believed that their glasses were broken. And every 6 months vision call an optician service came and updated prescriptions. We looked at the list for their next visit which was 26th January 2010 and only one of the two people were due to see the optician and we were told the other would have to wait for the next visit. However, in addition to this health care issue, the care plan was out of date regarding these residents vision needs and requires updating. We spoke to the manager about the care plans and she said that this formed part of her action plan to analyse and change care documentation. She expected to keep the current model, but supplement it with up to date templates and she had a meeting planned with the rep from the company who sold the care plan format. We asked for a copy of the action plan that the manager had prepared following her questioned if they were able to take private clients as she was under the impression she could. The action plan states increase private clients this will be achieved during January 2010 by improved general advertising and marketing. However, given the temporary management arrangements and the fact that the home is currently without a shaft lift, this was of significant concern. We do not wish to see the home occupancy increase until both suitable management arrangements are in place and the shaft lift is repaired and fully operational. We have written separately to the Insolvency Practitioner for assurances on this matter and if we do not receive a response we will consider what further action we need to take to restrict numbers to safeguard people. 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 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 21 23 The service must provide 29/05/2009 sufficient working bathing facilities to meet the numbers and needs of the residents at Brookwood. Therefore we require a plan that sets out work scheduled with timescales. This will ensure the needs, privacy, dignity and well being of the residents is met. 2 21 23 (2)(j) The home must supply 12/03/2007 sufficient numbers of fully functioning assisted bathrooms to meet he needs of the residents. The owners of the home are 29/05/2009 required to visit the home at least once a month interview people at the home and inspect premises and records and produce a report that is available for inspection. This will ensure that the owners are aware of how their care home is being conducted and allow them to take measures on the quality of service being provided. 3 33 26 Care Homes for Older People Page 6 of 9 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, 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 1 7 15 The residents care plans 26/02/2010 must be reviewed at least once a month or when needs change. This will ensure staff are aware of up to date health and welfare needs of residents. 2 9 13 Residents medication must be administered in line with the homes policy and procedure. This will ensure the safety and well being of all residents is safeguarded 26/02/2010 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 12 Those residents, for whatever reason who are unable to participate in the main social gatherings should be offered opportunities for social engagement to ensure they are not isolated. Care Homes for Older People Page 7 of 9 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 2 15 Those residents who are on special diets such as processed food (soft diet)should have meals prepared in such a way as to make them appealing, appetising and satisfying. Care Homes for Older People Page 8 of 9 Reader Information
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