Inspection on 22/11/06 for Browfield Residential Care Home

This inspection was carried out on 22nd November 2006.

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

Browfield Residential Care Home 05/11/08

Browfield Residential Care Home 11/01/06

Browfield Residential Care Home 08/08/05

Browfield Residential Care Home 14/03/05

Browfield Residential Care Home 22/09/04

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

CARE HOME ADULTS 18-65 Browfield Residential Care Home 159/161 Walmersley Road Walmersley Bury Lancs BL9 5DE Lead Inspector Lucy Burgess Unannounced Inspection 22 November 2006 12:30 nd Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 1 Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 2 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 Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 3 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 Adults 18-65. 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. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Name of service Browfield Residential Care Home Address 159/161 Walmersley Road Walmersley Bury Lancs BL9 5DE 0161 797 8457 F/P 0161 797 8457 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) Mrs Jacinta Rosaleen Ormerod Mrs Margaret Elizabeth Motby Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (4) Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 5 SERVICE INFORMATION Conditions of registration: 1. That the home is registered to a maximum of 14 service users to include: Up to 10 service users in the category MD (Mental Disorder excluding learning disability or dementia under 65 years of age). Up to 4 named service users in the category MD (E) (Mental Disorder excluding learning disability or dementia over 65 years of age). 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 11th January 2006 Date of last inspection Brief Description of the Service: Browfield is a residential care home providing accommodation and support for up to fourteen people who are recovering from a mental illness. Fees range from £287.00 to £530.00 this is dependant on assessed needs. The home is registered to provided support for up to 4 people over the age of 65 years. The property comprises of two large terrace houses, which are adjoining. Accommodation is provided on three levels and includes 10 single bedrooms and 2 double rooms. There are 3 lounges and a dining room. The home is situated on a main road approximately 1 mile from Bury town centre and is easily accessible for public transport. Local shops, pubs and other amenities are situated nearby. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day for a period of 5 hours. The inspector took the opportunity to look round the home, view records as well as talk with residents and staff. Discussion and feedback was also held with the Provider. The home is registered to provide accommodation for up to 14 people. At the time of the inspection there were no vacancies. A pre-inspection questionnaire was completed and feedback surveys were received from 2 Community Psychiatric Nurses (CPN) and 3 GP’s. Comments have been included within the report. All the key standards were inspected. What the service does well: What has improved since the last inspection? The Manager has addressed all the requirements and recommendation made during the last visit. The home has been encouraging and supporting residents to increase their social and leisure activities. Opportunities both in and away from the home have been provided including day centres, voluntary works and leisure. A number of the residents have also enjoyed an annual holiday. With regards to the staff, on-going training continues to be provided making sure that staff have the knowledge and skills needed to meet the needs of residents. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 7 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. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Relevant assessment information is gathered prior to individuals moving in. The enables the prospective residents and staff to make an informed decision about the suitability of the placement ensuring needs can be fully met. EVIDENCE: The home follows a clear process when offering placements to prospective new residents. Opportunities to gather information about the individuals’ needs as well as visits and over nights to the home are encouraged. This provides the staff, existing residents and prospective residents opportunity to meet and spend time with each other before deciding whether the placement is suitable. Information was examined for the newest resident. This included assessments information including risks and vulnerability. Records had been made of the day visits and overnight stays detailing how the person had settled and interacted with other residents and staff. The resident was spoken with during the visit. The resident had clearly been involved in deciding to move into the home and appeared to be settling well and had developed good relationships with others within the home. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are aware of their care plans and are involved in reviewing and updating information about their needs and wishes. The home encourages residents to be as independent as possible, helping to keep risks to their health and well-being to a minimum. EVIDENCE: Each of the residents has a care file and individual diary. The care plan covers a wider number of areas in relation to the emotional, social and physical wellbeing of residents as well as areas of risk and neglect. Plans are reviewed on a six monthly basis or more frequently if needs change. From the information examined it was found that both the manager and resident had signed the plans. Where specific needs have been identified records show what action is required and the outcome, details are also outlined with regards to a contingency plan should concerns be identified along with the personnel involved. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 11 Where risks have been identified, such as smoking, suicide, self harm, behaviours, self-neglect, bathing etc plans have been expanded to outline what action is to be taken to minimise the risk. There is also a ‘crisis plan’, which shows what early warning signs staff should look out for in relation to changes in a persons’ behaviour/mental health. A management strategy is in place along with the contact details of relevant professional that assist in supporting the resident. Further records are also maintained for monitoring purposes. These include daily diaries, meals and weights, professional visits and appointments, missing person’s information, hospital transfer notes and formal CPA reviews with mental health consultants. Contact has also been made with an advocacy service. Information is provided should resident wish to seek advice from someone independent of the home. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are afforded the opportunity to make choices and exercise their independence following lifestyles of their choosing. EVIDENCE: Each of the residents follow routines and lifestyles of their choosing and information is detailed within the care files. Whilst some are actively involved with outside activities other choose to remain closer to home. The manager and staff have identified further opportunities for residents to participate in other activities. These have included 2 residents attending a local day centre with a further 3 having expressed an interest. One resident now has a job volunteering at a local charity shop. Others things have included bingo, pool and table football, bowls, baking and cooking, video nights, visiting the local pub, library and visiting the local Jubilee Club. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 13 Several of the residents have also enjoyed a holiday in Blackpool, which was supported by staff and another resident went away with her partner. A trip was also arranged to Blackpool Illuminations. Two of the female residents have been encouraged to lose weight and have achieved success. Both said that they were pleased with what they had done and felt their health was much better. Residents also maintain contact with family and friends and visitors to the home are made very welcome. The inspector spent some time chatting with a group of residents who were relaxing in one of the lounges. Residents appeared to have good relationships with each other and openly sit and chat. The newest resident also appeared to have settled well and enjoyed the company of others. In relation to meals, a four weekly menu is in place. Additional menus had been developed for those individuals who were following a low fat diet to aid weight loss. Menus offer variety and choice. Meals are taken in the dining room and all residents eat together unless away from the home. Records are made of meals taken and weight. This is done as part of the health monitoring undertaken within the home. Where additional supplements may be required appropriate arrangements are made. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given the level of personal and healthcare support they want and need, enabling them to exercise choice and be as independent as they wish. The system of storing and administering medication was found to be safe. EVIDENCE: The health and reviewed. The and social care changing needs personal care needs of residents are regularly monitored and team has access to advise and support from relevant health workers. Where concerns have been identified in relation to the appropriate action is taken to address the matter. Care plans and risk assessments detail the health needs of residents and the support to be provided. Where individuals require support in meeting their personal care needs this too is recorded. One of the ground floor rooms has an adapted en-suite so that support can be provided safely. In relation to the mental health needs of residents this continues to be monitored by mental health professional and community psychiatric nurses (CPN). Formal reviews are held in line with the CPA programme so that the health needs of residents can be formally monitored and medication reviewed. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 15 The inspector spoke with a visiting CPN who expressed that he felt the home provided a stale environment for residents and that staff understood the needs and behaviours of residents. Feedback surveys were also received from 3 GP’s and 2 CPN’s, each stated that they were satisfied with the overall care of residents that the home communicates clearly and works in partnership. Residents also have access to other NHS entitlements such as being registered with a local GP and accessing the dentist, opticians and hospital where specific treatment is required. Staff will provide support to appointments. The medication system was examined and was found to be managed safely. Records are made of all items brought into the home as well as those returned to the supplying pharmacy. Mar sheets are held for each resident along with a photograph, information was completed in full and up to date. At present the home does not hold any controlled drugs however adequate arrangements are in place should this be required. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt that their views were listened to and acted on. Procedures, supported by staff training ensures residents are protected from abuse, neglect and self-harm. EVIDENCE: As previously identified Browfield holds policies and procedures with regards to complaints and protection. A copy of the Inter Agency Procedure for the Protection of Vulnerable Adults is also available. Through feedback and discussion with residents and staff no issues or concerns have been raised within the home or directly with CSCI. All but the newest members of the team have completed training in the area. The Manager is aware that formal training is required for some members of the team with regards to vulnerable adults. Arrangements for this are to be made. With regards to service user finances, the provider is appointee for 11 residents. All personal allowance are provided on a weekly basis and held by residents. Records are made of all transactions to show that money has been provided. A random sample was checked and found to correspond with the records held. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable providing pleasant accommodation for those who live there. EVIDENCE: Browfield is a large property that is in keeping with those around it. All but two of the bedrooms are single, with only one having en-suite facilities. Continual refurbishment and redecoration takes place ensuring that the home is maintained to a reasonable standard. Improvements have been made to the environment. Recent work has included repainting of the halls, stairs and landings and one of the residents bedrooms has been redecorated as well as having new carpets and furniture. The home has a dining room and three lounges, two of which are the designated smoking areas. A separate office is also provided. In relation to washing and bathing facilities there are two bathrooms as well as the en-suite bathroom with walk-in shower on the ground floor. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 18 Time was spent with residents who were relaxing in one of the lounges. Individuals have the freedom to come and go freely and were observed accessing all areas of the home including the office areas. Individuals have the freedom to come and go freely The home employs designated domestic staff that undertake a majority of the domestic tasks, however additional tasks are carried out by the support staff. One of the residents said that ‘they are thorough with the cleaning’. The environment was seen to be clean and odour free. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staffing is provided each shift to meet the needs of residents. Satisfactory recruitment practices along with on-going training and support ensure that residents are supported safely. EVIDENCE: The management of the home remains stable. Support is provided from 11 carers and a domestic staff. Two members of the team have recently started work at the home. Cover is provided throughout the day and evening with an on-call service should additional advice and support be required. Generally 2 staff are available throughout the day and evening in addition to the domestic, manager and the provider. Nights are covered by a wake-in staff member, with additional support available via the on-call should this be required. Staff personnel files were examined for the newest members of the team. Information included an application form, references, health declaration, criminal record checks and copies of identification. Relevant checks in relation to the protection of vulnerable adults had also been carried out prior to the staff commencing work. This is good practice ensure the residents are Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 20 protected. The Manager should ensure however that information provided on the application form in relation to references and employment history correspond. One staff member had provided the name of a referee from a care home she had previous worked at however this was not detailed on the application for. A reference had also been received addressed to ‘whom it may concern’, the manager must again verify the authenticity of the information. In relation to training the Manager has developed a programme of training, which has been implemented for this year. Courses have included infection control, first aid, moving and handling, vulnerable adults and health and safety. Further courses are to include refreshers of mandatory courses along with diabetes, challenging behaviour, violence and aggression, vulnerable adults and anxiety and depression. As a number of the residents are also ageing, training has been identified in ‘loss and bereavement’. This is to provide staff with some insight into the care that residents may require. Where possible residents would continue to be cared for at the home should this be appropriate. A number of the staff have also completed training in NVQ. Information provided on the pre-inspection questionnaire stated that 6 staff have completed the course and a further 2 are currently working through the programme. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to be appropriately managed. Residents’ views are listened to and taken into account when reviewing the service provided. Relevant checks are carried out in relation to health and safety ensuring the welfare of residents is promoted. EVIDENCE: As already stated the management of the home is very stable. The Manager actively undertakes training to inform her role and has previously completed management training as well as NVQ assessor training. In June/July of this year the home achieved Investor in People (IiP) status. The Manager has distributed feedback surveys to residents, relatives and health and social care professionals who are actively involved with the home. Feedback received has been collated and included as part of the homes business and development plan. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 22 Where areas of development/improvement have been identified the Manager has addressed it. Further action is taken in ensuring that the premises is well maintained and safe. Annual checks by external bodies are carried out as well as in-house checks. Certificates were seen for the gas, electric, fire equipment, emergency lighting, small appliances and fire alarm. Records were not available with regards to water temperature. These should be provided. Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 24 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 Refer to Standard YA34 YA34 Good Practice Recommendations That verification of authenticity is sought for those references that are addressed ‘to whom it may concern’. That referees identified within the application form should correspond with information provided within the employment history. That records are available for inspection in relation to water temperatures. 3 YA42 Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Browfield Residential Care Home DS0000008421.V297672.R01.S.doc Version 5.2 Page 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. 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