Inspection on 10/11/06 for Brunswick Court

This inspection was carried out on 10th November 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brunswick Court 21/10/08

Brunswick Court 29/10/07

Brunswick Court 17/05/06

Brunswick Court 14/11/05

Brunswick Court 18/05/05

Brunswick Court 08/11/04

Brunswick Court 01/07/04

Brunswick Court 23/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Brunswick Court 62 Stratford Road Watford Hertfordshire WD17 4JB Lead Inspector June Humphreys Unannounced Inspection 10th November 2006 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 Brunswick Court DS0000019341.V319979.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. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brunswick Court Address 62 Stratford Road Watford Hertfordshire WD17 4JB 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) 01923 218333 01923 212109 BUPA Care Homes (AKW) Ltd Care Home 91 Category(ies) of Old age, not falling within any other category registration, with number (91), Physical disability (15), Physical disability of places over 65 years of age (91), Terminally ill over 65 years of age (4) Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. This home may accommodate 15 people with physical disability between 50 and 65 years of age. This home may accommodate 2 Services Users between 50 and 65 years of age, for Palliative Care. This home may accommodate 16 older people who require personal care. The home may admit one (named) terminally ill service user who is under 65 years of age. 17th May 2006 Date of last inspection Brief Description of the Service: Brunswick Court is a purposed built residential and nursing home. It is managed by BUPA care homes Ltd. It is situated in a residential area within easy reach of Watford town centre. The Watford Junction rail station and the main bus route are within walking distance, as is motorway access via the M1, and M25. The home has ample parking at the front of the property, and in the basement area located at the rear of the building. The front entrance leads to a large reception area, which allows access to the main building by means of security locks. Security within the building is good. The administrative offices are located on the ground floor. The kitchen, laundry and staff room are in the basement. The en-suite bedrooms are large in size and are located on three floors with access via a lift. The bedrooms on the ground floor are allocated to service users requiring nursing care. Brunswick Court offers ample communal spaces on every floor, including a dinning room and two lounges. The garden is located at the side and rear of the building. The courtyard area has a landscaped woodland area with easy access for wheelchair users. The estimated weekly cost of a placement is between £650.00 and £865.00 per week. Cost is dependent on if the service required is nursing or residential, private or local Authority funded. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was second unannounced inspection during this year (2006). The report of the first inspection conducted on the 17thMay, provides greater detailed information regarding the level of service provided. The manager was newly appointed in June 2006, and there have been many positive changes since the last inspection. Brunswick Court is a large care home, but despite its size, it manages to provide a good standard of care to people with varied, complex needs. The requirements and recommendations made at the last inspection were all met, with exception of the manager being registered with the C.S.C.I. What the service does well: • • The service provides both residential and nursing care meeting the needs of a range of people who require varying levels of support. Service users appear to have a good relationship with staff; they feel listened to and supported within the home. One person said, “They know what I’m like, and it’s done. No trouble Mealtimes are unhurried and social, and staff are attentive to individual needs. The home is well decorated, with the opportunity for service users to personalise their own space. Personal care is offered to service users in a sensitive and unobtrusive manner. • • • What has improved since the last inspection? The introduction of a continued programme of redecoration means the home environment is generally bright clean and tidy. A good choice of hot and cold food is available, with specialist diets being catered for with ease. Service users were pleased that the chef contacts them individually to find out the food that they like to eat. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 6 Dementia care training is now offered to all staff as part of induction, and greater in depth training for senior staff. The home has a good ethos of trying to involve residents in all aspects of their life. The service has introduced a recording system for the amount of contact that staff have with each person each day. This has demonstrated that contact is regular and that residents feel ‘listened to, and cared for’. 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. Brunswick Court DS0000019341.V319979.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 Brunswick Court DS0000019341.V319979.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 (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. Standards not inspected. Refer to inspection report dated 17th May 2006 EVIDENCE: Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 9 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 (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. 7 and 10 Key standards 8 and 9 were inspected in May 2006. Please refer to the report dated 17/05/06. Service users changing needs are identified within a named file but the information is not stored in an easily accessible format. EVIDENCE: Four care plans were looked at as part of the inspection process. Whilst the individual files held a range of significant information, the detail (of which some information was out of date) made reading a lengthily process. Time was spent discussing a possible format, which includes the most important information that is needed for staff to support individuals on a day-to-day basis. The remainder of information although important should be separated from the main care plan or in the case of medical charts i.e. monitoring of pressure soars this should be clearly noted on the front index of the file. The Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 10 staff are clearly committed to providing a high standard of service having already made considerable effort to improve care plans. The reason for re looking at care plans is that the service is planning to apply for a variation of registration to care for people suffering from dementia; and the current care plans would not provide sufficient clarity to care for people with such high complex needs. The service users who had contact with the inspector had been helped to achieve a high standard of personal care; which included attention to their hair, nails, teeth and clothing. Staff spoken to as part of the inspection, were able to give examples of how they try wherever possible to promote independence, and respond to the individual needs of service users. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 11 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): 12 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Company (BUPA) employs an activity co- coordinator. A weekly programme of activities was on display. The inspector spent time talking to the co-ordinators (presently two people sharing the role). There appears to be a varied programme offered with regular consultation with service users on the activities offered. Care plans recorded activities that service users enjoyed, and case notes recorded if the person had enjoyed the activity on the day when they participated. The inspector observed service users involved in an art session in the afternoon. Although everyone was seen to participate, the majority of service users who were wheelchair bound were leaning on their laps to draw and colour. This appeared uncomfortable and limited the quality and possible enjoyment of the activity. The possible use of a table would also improve the ability of participants to interact. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 12 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): 16 and 18 Quality in this outcome area is (adequate). This judgement has been made using available evidence including a visit to this service. The recording of complaints needs to be improved, despite individual service users stating that they feel listened to. EVIDENCE: The home has a comprehensive complaints procedure in place, which details that all complaints are responded to within 28 days. A record was available, and names and dates were noted in a log. The manager confirmed that the 4 complaints made since the last inspection had been fully investigated. Letters and e- mails were shown has evidence. However it was not clear from the log that this had happened, or that a reply had been provided to the service user. The log should detail the actions taken and the outcome. Comments were received from the service users regarding the relationship they hold with the staff and how they feel listened to and supported within the home. One person said, “They know what I’m like, and it’s done. No trouble”. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 13 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): 19, 25 and 26 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. The environment is safe and there is a schedule in place to redecorate the environment to ensure it is well maintained. Each service user’s individual space within the home is well maintained, reflecting individual choices and preferences EVIDENCE: The current inspector has completed three inspections at the home over a period of 12 months, and has found that due to a continued programme of redecoration the home is generally bright clean and tidy. The service provides care to older people who often have very high needs, and at the last inspection a requirement was made with regard to an unpleasant odour in the immediate entrance to home. This has now been eradicated, but there continues to be a Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 14 smell of urine in various areas of the building. This was discussed with the manager and she agreed to take appropriate action to try to amend this. The 1st floor bathroom, which is currently in use, was found to be very cluttered which could be a hazard when bathing a resident. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 15 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): 30 Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Key Standards not inspected. Refer to inspection report dated 17th May 2006 Staff training is not adequately monitored or recorded. EVIDENCE: Evidence was available to demonstrate that statutory training is being undertaken including adequate induction. However it was difficult to ascertain what staff had completed in the last 12 months, and a training matrix or recording system in place would greatly improve accessibility to information. The manager is in the process of appointing a training co coordinator to assist her with this work. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 16 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): 31 Quality in this outcome area is (adequate). This judgement has been made using available evidence including a visit to this service. Since the last inspection in May both a new manager and deputy have been appointed. It is too early to assess the impact on the standard of management and administration, but both senior members of staff appear to be effective in supporting the staff team. Priority must be given to the manager applying for registration with C.S.C.I. EVIDENCE: Staff are managed and supported effectively and understand their roles and to whom they are accountable. The manager has been in post since June and appears to be committed to improving and developing the service. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 17 The home is under a new manager who has been in post since June 2006. The process for registration (for the home manager) with the Commission for Social Care Inspection (CSCI) has yet to commence, but the manager confirmed that she was in the process of completing the application form. There has been no registered manager since March 2005 and this must be given priority. The 1st floor bathroom, which is currently in use, was found to be very cluttered which could be a hazard when bathing a resident. The manager must monitor the use, and tidiness of the bathroom. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 2 Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The manager must ensure that all service users have a current and up to date care plan, which is an easy reference for staff. A clear record of complaints must be held in the home with actions, and all documentation available. The odour associated with urine must be addressed. The manager must apply for registration with the CSCI. (Outstanding over the previous inspections). The manager must ensure that the upstairs bathroom is kept tidy and uncluttered to prevent a possible accident. Timescale for action 31/03/07 2. OP16 22(1) 01/02/07 3. 4. OP26 OP31 16(2)(k) 8(1)(a) 31/12/06 31/03/07 5. OP38 13 (a) 01/12/06 Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 20 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 OP12 OP30 Good Practice Recommendations Provide sufficient facilities (tables) to enable service users to participate in comfort when undertaking recreational activities. Training is adequately recorded (training matrix) to evidence the training staff has undertaken. Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Brunswick Court DS0000019341.V319979.R01.S.doc Version 5.2 Page 22 - 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!