Inspection on 18/07/06 for Brookwood EMI Home

This inspection was carried out on 18th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brookwood EMI Home 07/01/09

Brookwood EMI Home 23/01/08

Brookwood EMI Home 18/07/07

Brookwood EMI Home 30/01/06

Similar services:

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Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Brookwood Residential Home 12 - 14 Greenfield Lane Balby Doncaster South Yorkshire DN4 OPT Lead Inspector Jayne Barnett-Middleton. Key Unannounced Inspection 18th July 2006 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 Brookwood Residential Home DS0000065011.V298392.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. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookwood Residential Home Address 12 - 14 Greenfield Lane Balby Doncaster South Yorkshire DN4 OPT 01302 310295 01302 853518 NONE 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) Atheray Organisation Limited Mrs Doreen Robson Care Home 30 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (14) of places Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Brookwood is a residential care home for up to 30 residents in the category of older people. There are 16 places for older people assessed as being ‘elderly mentally infirm’ (EMI) and 14 places for older people who require residential care. Brookwood is situated in the Balby area of Doncaster. It is close to local shops, a church, a library and other local facilities. The building comprises of two adjoining Victorian semi-detached houses that are linked at both the first and ground levels. The side that is used for residents who are elderly mentally infirm, has a passenger lift to assist with access between the floors. The ‘EMI’ section is separated from the residential side by electro-magnetically operated locks on doors at both ground and first floors. There are 24 single and three double bedrooms as well as two dining and two lounge areas and a quiet room. There are garden areas to the front and rear of the Home, including an enclosed garden area for residents who are ‘elderly mentally infirm’. The Home is owned by Atheray Organisation Limited and is currently managed on a day-to-day basis by Mrs. Doreen Robson. The bed fees at the home at 22nd May 2006 are between £395 and £410 per week. Items not covered by the fee include newspapers, hairdressing and private chiropody. The homes statement of purpose and service user guide is available in all residents’ bedrooms and within the main office at the home. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced visit conducted by Jayne Barnett-Middleton. Prior to the inspection contacts made to The Commission For Social Care Inspection, the homes service history and a pre-inspection questionnaire were examined. Five residents or their relatives completed a service user questionnaire. A fieldwork visit took place from 9.30 am to 2.30pm. Opportunity was taken to make a tour of the premises, inspect a sample of records including care plans, and maintenance records and speak to the assistant manager and 6 staff. It was not possible to formally interview most of the residents due to their mental health, however, 2 residents were able to give a good opinion of the service that was offered. The inspector wishes to thank the assistant manager, staff and residents for their assistance and time throughout the inspection process. What the service does well: What has improved since the last inspection? Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 6 The new owner has continued to improve the physical environment. Since the last visit the hallway carpet and floor covering within the kitchen had been replaced. Two bedrooms had been refurbished and that there were plans to redecorate several more. All previous requirements in relation to the environment had been met. The floor covering in one dining area had been replaced and one bathroom had been refurbished to a good standard. Due to the warm weather a wall mounted electric heater, in the conservatory area, was not in use. However, the staff confirmed that the heat setting had been readjusted to ensure that a consistent temperature was maintained for residents who chose to sit there during the winter months. 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. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 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 Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 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 and 5. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Resident’s care needs were assessed prior to their admission and their individual needs were reflected in their plan of care. Residents and their relatives were invited to visit the home to meet the staff and see the facilities on offer, before making a decision to move there. EVIDENCE: Three care plans were checked all of which contained a full needs assessment, which had been carried out by an appropriate professional, prior to a placement being offered. The staff confirmed that they were provided with sufficient information about prospective residents prior to their admission, ensuring that they were able to provide the appropriate level of care during the residents’ initial weeks at the home. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 9 Five residents or their relatives, via the service user survey, confirmed that they had received sufficient information and had visited the home before making a decision to move there. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 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 and 10. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to the service. Residents’ individual needs were assessed and their changing needs were reflected in their plan of care. The care records checked were well organised and the information provided was accessible and easy to track. Residents had good access to health care services, which met their assessed needs. Daily records were maintained ensuring that the health care needs of the resident could be monitored. The Staff were not always adhering to the homes safe administration of medication policy and procedure, which potentially could place residents at risk. Residents’ were cared for in a manner that respected their privacy and dignity. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care plans were checked which detailed the residents individual physical, social and emotional needs. The format in place was detailed and included the resident’s communication needs, dietary requirements and personal care needs. Risk assessments had been devised which identified the individual risks that were presented to residents and the action required by staff to reduce the potential risks to residents, promoting and maintaining their independence. Records of healthcare visits were maintained and demonstrated that residents were receiving regular visits from their general practitioner, chiropodist and optician. Residents said that their healthcare needs were met and described the visits that they received. One resident commented, “ I get new glasses every year”. In general residents surveyed said that they ‘always’ received the medical support that they needed. The receipt and storage of medication were found to be satisfactory. Medication was securely stored and staff responsible for administering medicine had received the appropriate training. Since the last visit the manager had set up her own audit of medicines at the home. The medication administration records (MAR) were generally well maintained and medication administered had been signed for. However, there were some discrepancies, which potentially could place residents at risk. The time of one prescribed medication for a resident had been changed without medical authorisation. On one MAR record checked paracetamol had not been administered for six days, as there was none in stock. Subsequent MAR records did indicate that the resident did take the paracetomol four times per day. The staff said that there had previously been problems in obtaining some medication however that the situation was now resolved. Residents were observed to be cared for in a manner that respected their privacy and dignity. Residents seen were clean, appropriately dressed and it was evident that residents who required help to wash and dress had been assisted with this in a manner that respected their dignity. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 12 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): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The daily routines within the home were flexible promoting resident independence and choice. There was a programme of leisure and social activities available appropriate to the individual needs of the residents. Residents were encouraged to maintain contact with their family, friends and the local community as they wished. A good choice of menu was offered and special dietary needs were catered for promoting the health and wellbeing of residents. EVIDENCE: Residents said that the routines within the flexible, commenting that “ I go to bed and get up as I want “ and “ I can do as I wish”. One resident said that they preferred to spend the majority of time in their bedroom watching television and that the staff respected their choice in doing this. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 13 A programme of activities was in place for residents who wished to take part. During the morning of the visit staff were observed to be spending time with residents and listening to music. During the afternoon several residents were enjoying ball games and skittles. One resident, via the survey, said that they particularly enjoyed the professional entertainment that was provided and a recent day trip to Cleethorpes. One resident, who was relatively independent, said that they enjoyed visiting the local amenities on a regular basis. Residents were encouraged to maintain positive relationships with their family and friends. Visitors were welcome to the home at any reasonable time. One relative, via the homes questionnaire, commented “We are always made to feel welcome by the staff” A choice of menu was available and special dietary needs were catered for. The cook had a good knowledge of residents individual dietary needs and preferences. Daily records of the resident’s dietary intake were maintained and the cook said that this enabled her to monitor individual choice and served as a good record for residents who were experiencing a poor appetite. Residents spoken to on the day said that there was a “good choice” of food offered. The lunchtime meal observed was relaxed, unhurried and the food served looked appetising and was well presented. The staff was observed to be prompting residents to eat in a manner that respected their dignity. In general residents surveyed said that they always enjoyed the food provided, commenting, “ The food is always on time”. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The complaints procedure was clear and accessible. Residents and relatives were aware of how to make a complaint and residents felt confident that any concerns would be dealt with. There was an adult protection procedure in place at the home. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home. EVIDENCE: The complaints procedure was displayed within the entrance of the home and clearly outlined the action that should be taken should a resident, relative or visitor need to complain about the service provided. Residents spoken to said that they had no complaints, but said that they would talk to the manager or staff should they have any concerns in relation to any aspect of their care. In general residents surveyed said that the staff would always act on what they said and that they knew how to make a complaint. One resident commented that they were also given the opportunity to air any concerns that they may have during resident meetings that took place on a regular basis. There was an adult protection policy and procedure that promoted the protection of residents from harm or abuse. Staff had received Adult Protection training and was able to describe the types of abuse that can occur and the action that they would take should they suspect any abuse at the home. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 15 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 and 26. Previous requirements in relation to the environment had been carried out. The owner has continued to refurbish the home to bring it to a good standard. The home was clean and the laundry areas were appropriately equipped to meet the needs of the residents. EVIDENCE: All previous requirements had been met. The floor covering in one dining area had been replaced and one bathroom had been refurbished to a good standard. The new owner has continued to improve the physical environment. Since the last visit the hallway carpet and floor covering within the kitchen had been replaced. The staff said that two bedrooms had been refurbished and that there were plans to redecorate several more. The grounds to the home were very well maintained, providing a safe and pleasant area for residents to sit during the summer months. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 16 Due to the warm weather a wall mounted electric heater, in the conservatory area, was not in use. However, the staff confirmed that the heat setting had been readjusted to ensure that a consistent temperature was maintained for residents who chose to sit there during the winter months. Adequate laundry facilities were provided. The laundry equipment was appropriate, ensuring that linen could be cleaned at the correct temperature to reduce the risk of infection. Domestic staff were employed and all resident areas seen were clean with no unpleasant odours, promoting a hygienic environment. The domestic staff said that they were provided with sufficient equipment and materials to enable them to maintain a good level of cleanliness. All residents surveyed said that the home was ‘always fresh and clean’. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. Residents spoke positively about the attitude of the staff and the service that they received. Sufficient staff were provided to meet the to meet the resident’s general and specific needs. A programme of training was available and all staff had received the appropriate training, enabling them to safely care for the residents. A recruitment policy and procedure was in place, which promoted the protection of the residents. Staff files need to include the employees full employment history to ensure that the residents are fully protected. EVIDENCE: Residents spoke highly of the staff team describing them as “smashing”, “very obliging” and “ all the staff are really nice to me”. At the time of the visit, there were fifteen residents in occupancy at the home, eleven of whom were mentally infirm and were accommodated in the EMI section. Four weeks rotas were examined which evidenced that sufficient staff were provided to meet the general and specific needs of the residents. During the visit there was the assistant manager, four care staff, one cook, one Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 18 domestic and the handyman on duty. Staff said that in their opinion there was always sufficient staff on duty enabling them to provide the personal care and one to one support that the residents required. In general all residents surveyed said that there was always staff available when they needed them, one commented ‘ I only have to press my buzzer, and they answer it”. Staff confirmed and records demonstrated that mandatory training was provided including health and safety, moving and handling and first aid ensuring that the staff were up to date with good practice and legislation. Training specific to the needs of the residents for example Dementia Care was also available. Over 50 of the staff team had achieved a National Vocational Qualification level 2 or 3 in care, enabling them to develop and promote good care practice. A recruitment policy and procedure was in place. Three staff files checked contained a range of information including two references, declaration of health, qualifications and training. Two files seen did not contain the employees’ full employment history. All staff employed had undertaken a Criminal Records Bureau Check at the enhanced level to promote the protection of the residents. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 19 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): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to the service. The residents and staff were benefiting from the organisation and leadership of the management team. Forums were in place enabling residents and staff to contribute to the development of the service. Residents’ financial interests were safeguarded by the procedures at the home. In general the homes policies and procedures promoted the health, safety and welfare of the residents and staff. Accident records required more detail to fully promote the health and wellbeing of the resident. Fire records need to be maintained to evidence that fire systems are checked at the required frequency. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 20 EVIDENCE: Residents and staff spoken to said that they satisfied with the management team, stating that they were “good” and “supportive”. One resident, via the resident survey, commented “ I can always talk to the manager if I need help”. Resident and staff meetings were held enabling them to contribute to the development of the service. The staff stated that they found the meetings useful and said that they felt comfortable in voicing any opinions that they may have. A questionnaire format for relatives and professional visitors to comment on the service was in place. Questionnaires and feedback were available within the entrance of the home. Comments from completed surveys included “staff are always bright and cheerful” and “there and improvements in many areas”. Arrangements were in place for residents who were unable to manage their finances. Monies were securely stored and three records checked evidenced that residents were able to access their monies for hair care and personal items as they wished. Receipts were in place for all transactions and regular auditing of the accounts took place, safeguarding resident finances. A handyman was employed at the home and a routine programme of maintenance was in place. Procedures were in place for the maintenance and servicing of appliances and equipment, promoting and protecting the health safety and welfare of staff and residents. A procedure for the recording of accidents was in place. Accident records checked did detail the nature and time of the accident. However, some records checked did not detail the action that had been taken and any follow up treatment administered to ensure that, following the accident the health of the resident could be fully monitored. The assistant manager confirmed that fire systems were checked on a weekly basis to ensure that for example the emergency lighting is activated and fire doors would close in the event of fire. However, there was no record of a weekly check being carried out, in the fire records seen, since June 06. A fire risk assessment was in place and all staff had received fire training and regular drills, ensuring that they were clear on what action to take in the event of a fire. Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 21 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 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 X 3 X 3 X X 2 Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 12, 13 Requirement All medicines must be administered to residents, as prescribed. Any change or alteration must be authorised, recorded and signed for (Timescale of 20/04/06 not met.) All medicines prescribed for the residents must be available for administration. Staff files must include the employees’ full employment history. Accident records must fully record the action taken and any follow up treatment offered. Records of weekly fire checks must be maintained. Timescale for action 31/08/06 2. 3 4 5 OP9 OP29 OP38 OP38 12,13 19 15,13 17,23 31/08/06 30/09/06 30/09/06 30/09/08 Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brookwood Residential Home DS0000065011.V298392.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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. 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