Inspection on 21/02/07 for Brownhill House

This inspection was carried out on 21st February 2007.

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

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

Other inspections for this house

Brownhill House 17/04/09

Brownhill House 23/12/08

Brownhill House 11/12/07

Brownhill House 29/12/05

Brownhill House 12/04/05

Brownhill House 21/09/04

Brownhill House 28/06/04

Brownhill House 04/02/04

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

CARE HOMES FOR OLDER PEOPLE Brownhill House Lower Brownhill Road Maybush Southampton Hampshire SO16 9LA Lead Inspector Christine Lawrence Key Unannounced Inspection 21 February 2007 10:00 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 Brownhill House DS0000039229.V330452.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. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brownhill House Address Lower Brownhill Road Maybush Southampton Hampshire SO16 9LA 02380 771808 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) Southampton City Council Mrs Nita L Crawford Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (14), Physical disability (25), Physical disability of places over 65 years of age (25) Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Orthopaedic intermediate care may only be provided to a maximum of 16 service users and may only take place in the orthopaedic care unit. A maximum of 9 people may be in receipt of general rehabilitation care on Beech One unit only. When rehabilitation care is being provided on Beech One to less than 6 service users one dedicated member of staff must be available at all times. When there are between 6 and 9 service users accommodated in this unit, two dedicated staff members must be available at all times during the waking day. Service users in the PD category must be 55 years of age or over 4. Date of last inspection 29 December 2005 Brief Description of the Service: Brownhill House operates as an older persons resource centre under the management of Southampton City Council. It is located in a suburb to the west of Southampton. The home makes provision for three separate services. It can accommodate fourteen older people; three beds are allocated for longterm residential care with a further eleven for respite care. A new purpose built wing has been opened and can accommodate sixteen people admitted directly from the orthopaedic wards of the local hospital for a period of rehabilitation and discharge planning following orthopaedic surgery. This service is classified as intermediate care. The anticipated length of stay in this unit is six weeks, following which, most service users return to their own homes. The general rehabilitation unit is situated on the first floor of the house and can accommodate nine people who have been assessed as needing some assessment and rehabilitation. The service users who are admitted to this unit are both from home and hospital and have been assessed as needing a period of supervision and rehabilitation before going back into the community. The anticipated length of stay in this unit is six weeks. All accommodation in the home is single occupancy with sixteen rooms having en-suite facilities. The charges for Brownhill House are £371.00 per week for permanent residents. Respite care stays are as assessed and there is no charge for intermediate care (rehabilitation) up to 6 weeks. Information about the home, including the last inspection report, will be provided on request. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10.00 and finished at 17.00. The inspector looked at various records in the home and also used information sent to the Commission by the manager before the visit. Information from the previous inspection was also referred to. The inspector spoke with several residents. A tour of parts of the building was undertaken and the inspector observed medications being given out. Comment cards and surveys were sent out to residents and their relatives and visitors. Twenty nine were returned and information from them is used for this report. The inspector made observations of staff interacting with residents and spoke to staff on duty as well as the manager and the administrator. What the service does well: What has improved since the last inspection? One toilet has been made more spacious as required from the previous inspection. The staff records were full with all necessary checks. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Brownhill House DS0000039229.V330452.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 Brownhill House DS0000039229.V330452.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs and they will be encouraged and helped to maximise their independence and return home whenever possible. EVIDENCE: An assessment pack, which is comprised of various documents, is used to decide if somebody is suitable to come into one of Brownhill House units. This helps the home to identify what somebody’s needs are and also allows for goals to be achieved with the individual. The agreed goals section is signed by the resident as well as the person carrying out the assessment. Four different records were looked at for this inspection and they showed that detailed assessments are undertaken. The rehabilitation units have separate facilities and care staff. The organization provides specific training courses for these staff relating to Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 9 rehabilitation. The care staff work alongside health care professionals based in the building such as physiotherapists, occupational therapists, rehabilitation nurses and other health care professionals are involved as required. The health care professionals are separately managed and employed but everything seen during this inspection indicated that everyone works together well. Time spent in the rehabilitation units is time focussed – usually 6 weeks. Brownhill House DS0000039229.V330452.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: The plans seen for this inspection are based on the assessments as noted under standard 3. The plans are clearly drawn up with the involvement of the individuals staying at the home and wherever possible they are encouraged to sign their agreement. The care plans are relevant and up to date with comments from care staff and health care colleagues. Some of the comments are quite technical regarding the orthopaedic rehabilitation clients but the manager assured the inspector that care staff working on this unit would have covered this during their rehabilitation course. Information about nutrition, falls and pressure areas is included within care plans and there are appropriate risk assessments if required. Residents at Brownhill House usually continue to see their own GP if required but temporary arrangements can also be made. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 11 The inspector observed medications being given out in one of the units. This was done appropriately and the records were properly completed. Staff who give out medications have received training. Some people staying at the home are either self-medicating or are being supported in that aim with some residents having pharmaceutical care plans. There are policies and procedures in place and pharmaceutical input is regular. There are portable phones available to ensure that residents can receive or make calls in private and any post is handed directly to residents. Staff are aware of how an individual would prefer to be addressed and those spoken to confirmed that privacy and dignity were a very important part of the care that was provided at Brownhill House. Brownhill House DS0000039229.V330452.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be responded to and that they will be enabled to maintain contact with friends and family. Residents will be encouraged to make choices and they will benefit from nutritious food. EVIDENCE: The assessment pack includes information about any religious preference. All residents spoken to said that they can make decisions about what their daily routines are although where appropriate people said they were following a programme for their rehabilitation. People watch television, both in their own rooms and in communal areas. Lots of people have daily newspapers and there are various games and in house activities. There are occasional entertainments. Because most people only stay for a short while not everyone gets to see or do the same things. Residents can see their visitors in private if they wish. Residents said that their visitors were made welcome. There are some small limitations on visiting in the rehabilitation areas reflecting the need for residents to focus on their programmes, for instance at mealtimes. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 13 The home does not get involved with anyone’s finances and the inspector was informed that all residents manage their finances as they did prior to admission. The inspector joined a group of residents in the respite/short term care unit for lunch. The food was well presented and tasted good. Mealtimes in all three units are sociable and the settings are pleasant. The inspector observed staff helping and supporting residents with their food if necessary. The meal was not hurried and some residents chose to stay at the table for a hot drink and others moved into the lounge area or their rooms. The following comments were made in surveys completed by residents for this inspection “…the meals are very good and well presented…” “…I always have enough food…” “…varied and well cooked and usually a choice…” “…lovely food…” “…you could not wish for better meals…” “…very good…”. Of the twenty nine people who completed the surveys most ticked ‘always’ in response to the question Do you like the meals in the home?, a few ticked ‘usually’ and only one person said ‘never’. The manager is aware that sometimes people aren’t happy with a meal. She has made improvements since being in post regarding the number of heated trolleys available to take the food to the units and she is trying to set up a specific quality check for satisfaction regarding meals. Brownhill House DS0000039229.V330452.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. EVIDENCE: Most of the people who completed surveys said they would know how to make a complaint. The records seen show that there is a process which is followed. There have been 7 complaints in the last 12 months which were investigated within 28 days. The manager said she tries to create an atmosphere where things are sorted out at an early stage so they do not become a complaint. Letters of thanks and compliments are shared with staff. Adult protection training forms part of the rolling programme of courses provided to staff. Staff spoken to were very clear about their responsibilities to report any concerns and there are policies and procedures in place relating to adult protection, service users money and valuables and whistle blowing. The manager provided information that there have been no adult protection alerts. Brownhill House DS0000039229.V330452.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well-maintained and clean environment. EVIDENCE: The inspection included a tour of much of the building and areas seen were well maintained and decorated. Anyone staying at Brownhill House can access the grounds including a patio area, to benefit from sunshine. There are systems in place to identify any repairs that might need doing. Staff spoken to said they would bring anything they noticed to the attention of the senior person on duty. Of the twenty nine people who completed surveys two people ticked ‘usually’ to the question Is the home fresh and clean? And twenty seven ticked ‘always’. The following comments were also made:- “…good clean home…” “…cleaned nicely everyday…” “…really excellent…” “…thorough daily cleaning and fresh towels daily…” “…meticulous cleaning of every area…” “…my room is always Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 16 clean and tidy…” “…beautifully…”. There is still a need to improve the laundry but the manager has identified this as a priority for work to be done. At this inspection she was not able to say when the work will start but agreed to keep the commission informed about progress. Hand washing facilities are good, including alcohol gel points throughout the building. Brownhill House DS0000039229.V330452.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: Rotas are maintained which show who is on duty when and where, and in what capacity. The manager is confident that sufficient staff are on duty at all times and there was no evidence to suggest that residents needs are not being met. Regular agency staff will be used to cover shifts if required. Only two members of staff have left since the last inspection and many of the staff have worked at Brownhill House for many years. There are two laundry assistants, five housekeepers, four kitchen assistants and two cooks. Ten care staff currently have a national vocational qualification (NVQ) and more NVQ opportunities are planned. The records of three staff were examined for this inspection. They showed that references are sought, application forms completed and interviews are undertaken. Criminal record bureau checks are a routine part of the employment process. The General Social Care Council codes are given to staff and there are terms and conditions of employment in place. There is a rolling programme of training and staff spoken to confirmed that they are encouraged and enabled to undertake training. The Common Induction Standards from Skills for Care are now being used at Brownhill House. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: Louise Crawford has been in post since February 2006. She is an experienced and qualified manager (level 4 NVQ). She is very clear about the different areas of care and support that are provided in Brownhill House and she runs the home to meet the stated purpose, aims and objectives. She has a clear job description and the lines of accountability both within and external to the home are clear. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 19 Quality assurance is considered important and the system for undertaking this is currently being reviewed by Southampton City Council. The current system includes seeking feedback from service users. The staff at Brownhill Home do not get involved with any residents’ money and there are appropriate policies and procedures regarding gifts to staff and safekeeping of valuables. Accident recording is in keeping with the Data protection Act and health and safety training is provided to staff. Risk assessments are undertaken within the building and as employer, Southampton City Council has provided policies and procedures relating to health and safety. Service and maintenance contracts are appropriate. Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 20 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 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 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 3 Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brownhill House DS0000039229.V330452.R01.S.doc Version 5.2 Page 23 - 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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