Inspection on 21/10/08 for Brunswick Court

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Adequate 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

Brunswick Court 29/10/07

Brunswick Court 10/11/06

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 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brunswick Court 62 Stratford Road Watford Hertfordshire WD17 4JB     The quality rating for this care home is:   one star adequate 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: Marian Byrne     Date: 2 2 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 23 Information about the care home Name of care home: Address: Brunswick Court 62 Stratford Road Watford Hertfordshire WD17 4JB 01923218333 01923212109 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Post Vacant Type of registration: Number of places registered: BUPA Care Homes (AKW) Ltd care home 91 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability terminally ill Additional conditions: The home may admit one (named) terminally ill service user who is under 65 years of age. This home may accommodate 15 people with physical disability between 50 and 65 years of age. This home may accommodate 16 older people who require personal care. This home may accommodate 2 Services Users between 50 and 65 years of age, for Palliative Care. Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 4 of 23 Over 65 91 91 4 0 15 0 Brief description of the care home 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. Information regarding the service is available n the Statement of Purpose and Service user Guide. For these and a copy of the most recent CSCI inspection report and for up to date fees contact the manager of the home. Care Homes for Older People Page 5 of 23 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: one star adequate 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 inspection was carried out by one inspector over one day. We carried out the inspection by spending time with the newly appointed manager, we spoke to staff, residents and visitors. We spent time observing staff careing for the residents, we also inspected records this included care plans and staffing records. The service returned their Annual Quality Assurance Assessment (AQAA) this is a legally binding document where the home assess their performance for the past year against putcomes for service users. It also gives us some numerical data. Care Homes for Older People Page 6 of 23 Care Homes for Older People Page 7 of 23 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 23 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 23 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 live in this home can be sure that their needs will be assessed and that, their care is reviewed at six weeks. People are welcome to visit the home prior to deciding if they want to live there. Evidence: We looked at the assessments of three people who had recently been admitted to the home. We found full details of assessment of needs had been carried out. We found a social history had been gathered. By doing this the home will get a better picture of the person and therefore will be able to meet the needs of the prospective resident. Care Homes for Older People Page 10 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the people who live in this home can be sure that their needs will be recognised and met. Evidence: Prior to starting the inspection the Manager told us that the care plans were under review and that they were being replaced by Quest 2. This is an internal care planning system used by BUPA. Initally we looked at care plans that had been reviewed. They contained good information on the health care and social needs of the residents. There was, where possible, a social history of the individual. This is important in helping staff understand the needs of the person and can allow staff to ensure that the person has what is important to them. The resident and their families are invited to join in, in drawing up the care plans. This is important as it promotes the independence and autonomy of the resident. All the residents looked well cared for and were nicely presented in freshly laundered clothes. Care Homes for Older People Page 11 of 23 Evidence: While the care plans contain good information and instructions to staff we found that the instuctions were not always followed an example of this is one resident who is diabetic and on dialysis three days per week, their care plans states that their blood sugars should be monitored every day we found that for August 2008 there were 15 days blood sugar reading missing and for September 2008 we found that there were 13 days when blood sugars were missing. We spoke to the resident who assured us that they felt well looked after and she appeared well. We also found charts that should record the food and fluid intake of the residents were not filled in regularly with inputs and outputs. This is important as it tracks the intake of those who cannot regulate their own intake of food and fluid. The new Manager was aware that the unit we observed this on was not well managed and had taken steps to improve the welfare of the residents on the unit. Had this not happened we would have judged the outcomes of this area as poor. We observed a resident being assisted to eat their lunch by another residents visitor. We looked at this persons care plan and found that she has difficulty swallowing and should be assisted by trained staff. We left an immediate requiremet on both of these incidents. We observed residents being assisted to eat by staff who did not sit down instead they stood over them in a manner that did not allow the person they were assisting to relax and enjoy their food at their own pace. We flound the medication to be stored, administered and recorded appropriately. With the exception of the above we found that the dignity of the residents was promoted. Care Homes for Older People Page 12 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the people who live in this home can be sure that their wishes as to how they live their lives on a daily basis will be recognised and enacted. Evidence: As part of the inspection we sat in on the activities of the morning. On the day of the inspection the activity was bingo. There were 20 residents in the room and only one member of staff. Some of the residents were clearly enjoying themselves while other had fallen asleep. It was clear that the residents would have benefitied from more staff input as some residents appeared to have difficulty following what was going on and had given up. The resident who had fallen asleep and was at a very awkward angle in their chair and was cramped when they woke up. Some of the residents had family guests join them for lunch in the dining room. They clearly enjoyed this and the staff were welcoming to the guests. While it is very good for the residents to have visitors at all reasonable times staff must be clear what their roles are and ensure that they do not take part in activities that are inappropriate. An example of this is where a visitor was assisting a resident to eat lunch. It was not that residents visitor. There is a wide range of food on offer 24 hours per day. The menu is Care Homes for Older People Page 13 of 23 Evidence: displayed prominently in several places in the home. Residnts told us that they were happy with the quality of the food and they could have snacks whenever they wanted. Care Homes for Older People Page 14 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the people who live in this home can be sure that they will be protected from abuse and that their complaints will be taken seriouly and will be investigated within BUPAs complaints procedures. Evidence: Complaints are taken seriously and are investigated under BUPAs complaints policy. Staff are aware of safeguarding residents and are aware of the whistle blowing policy. However not all the safeguards that are in place are followed which could put people at risk e.g. as commented on earlier, trained staff should assist residents that need assistance with eating. Residents who need assistance with eating should be assisted by trained staff. The resident already mentioned in this report who has swallowing difficulties and could have been put at risk. Care Homes for Older People Page 15 of 23 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 live in this home can be sure that it will meet their needs. Evidence: On the day of the inspection the home was clean and fresh. the home is well maintained, rooms were individually decortated to reflect the taste of the resident. Floors in three of the dining rooms had been replaced with wooden floors. Care Homes for Older People Page 16 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home can be sure that staff will be recruited appropraitely and that they will be trained to meet their needs. Evidence: The staff we spoke to told us that they enjoy working at Brunswick Court and that they feel well supported by the Manager. We found that there were sufficient staff on duty to meet the needs of the residents. The home has a core of well trained staff who know the residents and how meet their needs. We observed most staff to be kind and caring. We saw them administer care with kindness and affection. The training records we looked at showed that staff had had training in moving and handling, health and safety, food hygiene and short courses in dementia care. We were aware that some of the residents had both speech and sight impairment we noted that staff did not have any training in how to adminsiter care to residents who have such impairments. We saw staff assist residents to eat, they stood over them to do this rather that sit beside them. This is important as the residents who need assistance need to be given their food slowly and encouraged to eat. Care Homes for Older People Page 17 of 23 Evidence: We looked at the recruitment files of the four most recently staff. We found records to show that the recruitment process had been followed and we saw evidence of proof of identity and security checks. These included two recent references and a Criminal Records Bureau clearance. Care Homes for Older People Page 18 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents who live in this home can be sure that the home will be run in their best interests and that their health and safety will be promoted. Evidence: The new Manager has recently been appointed and had been in post for about six weeks at the time of the inspection. She has the appropriate qualifications to be a home manager and will register with this Commision in due course. Dispite only being in post a short time she was in a position to answer all the questions we put to her on the day to day running of the service. She was able to point out weakness in areas of the home and she told us what she intended to do about this. We were told this prior to the inspection which showed us that she is au fait with the performance of the home. This is very important for the welfare of the residents. BUPA conduct annual quality assessments on residents satisfaction with the care they receive. This is colated and is available to the residets and their representatives. The Care Homes for Older People Page 19 of 23 Evidence: Annual Quality Assurance Assessment was completed and returned to us in a timely manner. In this form we ask the home to assess how they have performed over the last year. This is a legal document and must be completed. This is some of what the home says it does well - night bites - this is a 24 hour menu available to all the residents, new wooden floor in three dining rooms, compliance with complaints proceedure and one nurse has completed tissue viability training. We found evidence that BUPAs health and safetys policies are followed, these are robust and ensure the safety of the residents in the home. Care Homes for Older People Page 20 of 23 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 21 of 23 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 1 8 12 The health and welfare of the 31/12/2008 residents must be promoted by ensuring proper records are kept as directed by health professional. The home must do this because failure to keep appropriate records could put the resident at risk 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 Care Homes for Older People Page 22 of 23 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 © (2008) 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 23 of 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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