Inspection on 07/01/09 for Brookwood EMI Home

This inspection was carried out on 7th January 2009.

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

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

Other inspections for this house

Brookwood EMI Home 23/01/08

Brookwood EMI Home 18/07/07

Brookwood EMI Home 18/07/06

Brookwood EMI Home 30/01/06

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brookwood Residential Home 12 - 14 Greenfield Lane Balby Doncaster South Yorkshire DN4 0PT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ramchand Samachetty     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Brookwood Residential Home 12 - 14 Greenfield Lane Balby Doncaster South Yorkshire DN4 0PT 01302310295 01302853518 NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Atheray Organisation Limited Name of registered manager (if applicable) Mrs Rosemary Jane Winifred Sharp Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (3) and Dementia - Code DE (25) Date of last inspection Brief description of the care home Brookwood provides personal and residential care for up to 28 older people, 25 of who may also have dementia. The two Victorian semi-detached houses provide 28 single bedrooms. It is situated in the Balby area of Doncaster. It is close to local shops, a church, a library, public house Care Homes for Older People Page 4 of 26 care home 28 Over 65 0 3 25 0 Brief description of the care home and other local facilities. The home provides two dining rooms, two lounges and a quiet room. Access between the floors is through a passenger lift and staircases. There is a garden to the front and rear of the home, part of which is enclosed for the safety of people using the service. On 23 January 2008, the range of fees charged by the provider were between are three hundred and ninety pounds and four hundred and twenty-six pounds per person per week. Items not covered by the fee included newspapers, hairdressing and private chiropody. Further information about Brookwood and its services can be obtained from the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was carried out on 7 January 2009, starting at 10.00 and finished at 17.30 hours. The manager, Mrs Rose Sharp was present throughout the inspection. The service is registered to provide care for up to 25 older people with dementia and three older people, not falling in any other category. There were only 15 people living at the home at the time of this inspection. The manager stated that the fees charged by the home, at the time of the inspection, ranged between three hundred and ninety pounds and fourteen pence and four hundred and twenty-six pounds and fifty-five pence per resident per week. There were separate charges for private chiropody and hairdressing. All the key national minimum standards for Care Homes for older people were Care Homes for Older People Page 6 of 26 assessed. The inspection included a tour of the premises, examination of care documents and other records, including those pertaining to complaints, staff employment, staff rota, medicines management and maintenance of equipment and quality assurance methods. We checked some of the information contained in the Annual Quality Assurance Assessment that was submitted to us before this inspection. We considered the outcomes of the relative ss survey that had been recently carried out by the service. We also considered the views of people who were using the service and staff who worked at the home. We considered the comments expressed to us by other professionals involved in the care of people who live at the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We gave feedback about our initial findings to the manager. We would like to thank all the people living at the home, the manager and her staff for their assistance with this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service were provided with sufficient information about the home in order to help them choose it. Assessments of needs were carried out before people were admitted and this helped to make sure that their needs could be met. Evidence: The registered manager stated that the homes statement of purpose and service user guide had been reviewed. These documents were provided to people who used the service, their relatives and people who enquired about the home. The relatives of one person who had been recently admitted to the home said that they were given sufficient information to help them choose the home. The care files of two people who had been admitted to the home in the last six months were checked. They showed that full assessments of their care needs had been carried out before their admission. This helped to establish that their care needs could be met Care Homes for Older People Page 10 of 26 Evidence: at the home. The home does not provide intermediate care services. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service and their relatives were satisfied with the care being provided. The health and personal care of people who lived at the home was well planned and delivered and this promoted their wellbeing. However, there were minor shortfalls in the way care provided was recorded and this may affect its evaluation. Evidence: People who used the service and their relatives told us that they were happy with the care and support that was provided at the home. They said that staff were friendly and caring. Relatives said that their loved ones were well looked after. People who lived at the home and who could express their views said that staff always provided their personal care in private. We noted that staff interaction with people in their care was courteous. We found that people living at the home to be in good attire. One person said that staff had helped her choose her dress and a matching cardigan that she liked. We looked at the care plans of three people who used the service. We noted that a Care Homes for Older People Page 12 of 26 Evidence: new and much improved care plan documentation had been introduced. It allowed for comprehensive information to be recorded and used in order to plan and deliver the care that was required for each person. Care plans were based on the identified needs, risks and preferences of individuals. They outlined the actions that were required to ensure that the care needs of each person were appropriately met. The care plans included detailed pen pictures (life history) of individuals concerned. This information was used in planning a persons care and daily activities. We looked at the records of care that was provided. In many instances, they consisted of generalised statements, like good diet taken and settled well. These statements did not reflect the actual care that was being provided. They lacked information that could assist in proper evaluation of care. We noted that care plans, including the management of risks, were regularly reviewed. Actions were then taken to amend some care plans. The new care plans also contained a section for recording the interventions of visiting health care professionals, in relation to each persons care. These records showed that staff were proactive in ensuring that people living at the home had appropriate access to community health care services as necessary. We looked at the way medicines were handled and administered at the home. We checked a sample of medicines administration record (MAR) sheets. They were satisfactorily maintained. Medicines received at the home were appropriately recorded. Medicines administered were properly signed for. However, in a couple of instances, the reasons for non-administration of an item of medicine which was prescribed to be given when required were not clear and consistent. None of the people living at the home were administering their own medicines. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were able to benefit from the recreational and social activities that were offered to them and this helped to improve their quality of life. Evidence: During our visit, we observed people who lived at the home, spending time in lounges, watching television and listening to music. We also noted members of staff spending time, talking with a few people. One person said that she liked the company of staff as she did not have frequent visitors. Relatives told us that they felt the routines at the home were flexible. Their loved ones could be assisted to get up and retire to bed at times that suited them. They were also helped to spend time in the way they wanted. Most people living at the home were not alway sable to make decisions about their daily activities. Staff, in consultation with relatives, would help them in making decisions as necessary. We noted that staff had developed a reality orientation board to assist people with getting to know, and to talk about, the day, time,the weather and events in general. Staff also explained that both indoor and outdoor activities were held at the home. Records of activities showed that group activities like, reminiscence sessions, sing-alongs, board games were regularly carried out. There had been some outings to local areas of interest and some people had been helped to attend church Care Homes for Older People Page 14 of 26 Evidence: services. We noted that staff had also provided time on a one to one basis, to people who were frailer and unable to participate in some group activities. Relatives told us that they were always welcomed at the home. They said that staff, in particular, the key workers, communicated well with them about their loved ones. People who lived at the home and their relatives stated that the meals provided at the home were excellent. People said that they were offered good menu choices for breakfast, lunch and dinner each day. A few people told us that they had enjoyed a cooked breakfast on the morning of our visit. The lunchtime meal, which was the main meal of the day, was observed. It consisted of steak and kidney pie, haddock and parsley sauce, vegetables and other condiments, deserts and a choice of tea, coffee and water. Staff were observed helping a few people to eat their meals. In discussion, we noted that the nutritional needs of some people had been appropriately assessed and catered for. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service were appropriately protected from harm and abuse. Staff were able to use existing policies and procedures to safeguard people in their care and to respond to their views and concerns. Evidence: There was a complaint procedure in place and copies of it had been provided to people who lived at the home and their representatives. People said that they were aware of the procedure and would use it if they needed to do so. However, they were confident that staff would deal with any concern they had, in an appropriate manner. We saw a record of issues and minor concerns that relatives had raised with staff and the action that had been promptly taken to address them. The manager had stated, in the Annual Quality Assurance Assessment document that was sent to us before the inspection, that the home had received two complaints in the last twelve months. We checked the way these complaints had been managed. In both instances, investigations had been carried out and the outcomes had been communicated to the complainants. The home had also the use of an adult protection policy in order to promote the safety and wellbeing of people who use its services. Staff said that they were aware of the local adult safeguarding procedures. We noted that all care staff had received training Care Homes for Older People Page 16 of 26 Evidence: on the protection of vulnerable adults. The manager confirmed that the home has not made any referral to the local safeguarding team. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who lived at the home and their relatives were satisfied that the accommodation was safe, clean, comfortable and pleasant. This helped to maintain and promote the health and wellbeing of people who lived there. Evidence: We checked the premises in the company of senior staff. The building comprised of two floors and there were a set of stairs and a passenger lift to facilitate access between them. The manager confirmed that the passenger lift had been regularly serviced. The communal areas included three lounges, two dining areas and a conservatory and people were able to choose where they spend their time. The manager stated that a number of bedrooms, communal and service areas had been refurbished since the last inspection. This included seven bedrooms, where new carpets and new furniture and soft furnishings had been provided. The dining rooms had been refurbished with new dining furniture and had been decorated. The laundry facilities had also been upgraded with new equipment. Bathrooms and the shower room had also been upgraded. People who lived at the home and their relatives told us that the home was very pleasant and comfortable. There was a public telephone in the main entrance hall and people who lived at the Care Homes for Older People Page 18 of 26 Evidence: home could use it to make private telephone calls. We viewed a few bedrooms with the permission of people who occupied them. The rooms were clean, tidy and odour free. A few people had brought in some memorabilia in order to personalise their bedrooms. People said that they were happy with both the communal and private accommodation. We noted that both communal and private areas in the home were kept clean and tidy. The surrounding grounds were also well maintained for the time of the year. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient and adequately trained staff were employed to provide care and support to people who lived at the home. This helped to protect and promote their health and wellbeing. Evidence: At the time of this inspection, there were 15 people in residence at the home. Besides the registered manager, there were three care workers on duty on all day shifts. There were also three care workers scheduled to work at night. There were other support staff and they included the cooks, domestics and laundry workers. The manager stated that she was using guidance of the Residential Forum in deploying care staff. We looked at the duty rota and it showed that appropriate levels of care staff were consistently deployed on duty. In discussion, a few people who could express their views said that they were well looked after by the staff. They stated that they always received help when they needed it. We observed that care workers were spending time with people in their care, often on a one to one basis, in a relaxed and unhurried manner. The manager explained that there was a key worker system in place. Staff who were key workers said that they were able to help ensure good communication between Care Homes for Older People Page 20 of 26 Evidence: relatives, people who lived at the home and themselves. This also helped to improve the way care was provided to people. We looked at the files of two care workers who had been recruited to work at the home since the last inspection. The appropriate recruitment and selection procedures had been used. All the pre-employment checks, including written references and disclosures had been sought and obtained. New staff had been provided with induction and training to make sure they had the necessary skills to provide care. The manager stated that care staff had been offered training on a number of topics since the last twelve months. These included refresher training. We checked the list of training courses that had been provided to staff. It included courses on manual handling and moving, health and safety, fire safety, first aid, food hygiene, adult safeguarding and mental capacity. Staff told us that they were satisfied with the training that they were receiving and felt they were well supported in the work they did. The manager confirmed that all the care staff (100 ) had achieved their National Vocational Qualification (NVQ) level 2 in care. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate management arrangements were in place to ensure the proper day-to-day running of the home. This helped to maintain and promote the health and safety of people who lived and worked at the home. Evidence: Relatives and staff told us that the home was well managed and this made it a good place to live and work. The registered manager had achieved her Registered Managers Award. she has experience of working in residential care for older people. In discussion, staff stated that they felt well supported in the work they were doing. They said that they were provided with opportunities for training and development. They also confirmed that they were receiving regular supervision. Notes of supervision were also seen in the staff files that we checked. The manager explained that staff had use of various quality monitoring tools to help Care Homes for Older People Page 22 of 26 Evidence: improve the service. These included monthly audits of care documents, medicine records, health and safety measures and satisfaction surveys and meetings of people who live at the home and their relatives. We checked a sample of the audits that were undertaken and the surveys that were carried out. The outcomes were appropriately recorded and actions were taken to address the issues that were raised. The registered provider was also conducting appropriate monthly unannounced visits to the home. Reports of these visits showed that they were also used to improve both the management and the quality of the service. In discussion, staff told that they had regular meetings and this helped the care team and management to work together to provide the service. The manager had submitted the homes Annual Quality Assurance Assessment to us prior to this inspection. It showed that all appliances, utilities and equipment used at the home were appropriately serviced and maintained. Appropriate risk assessments and health and safety measures, including infection control and fire precautions, were in place and this helped to maintain the health and wellbeing of people who lived at the home. Arrangements were in place to support people living at the home with the management of their personal allowances. These arrangements were appropriately set out in individual care plans. All financial transactions undertaken on behalf of people concerned were recorded, witnessed and signed for and receipts were kept. We noted that a sum of money was made available for people who needed their money outside office hours. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The record of care provided should be improved in order to reflect the actual and agreed plan of care for each person who uses the service. A protocol for the administration of medicines prescribed to be taken when required should be developed and used to ensure clarity and consistency of practice. 2 10 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!