Random inspection report
Care homes for older people
Name: Address: Brunswick House Nursing and Residential Home 81 Bacton Road North Walsham Norfolk NR28 0DN two star good service 11/02/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lella Hudson Date: 1 8 0 9 2 0 0 9 Information about the care home
Name of care home: Address: Brunswick House Nursing and Residential Home 81 Bacton Road North Walsham Norfolk NR28 0DN 01692405818 01692404423 brunswick_house@hotmail.com www.brunswick-house.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Brunswick House Care Home Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 75 Number of places (if applicable): Under 65 Over 65 0 75 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 10 0 1 1 0 2 2 0 0 9 Brunswick House is a care home providing personal care and nursing care for up to seventy-five people. Brunswick House Care Home Ltd is the registered provider. The services offered within the home are described in the Statement of Purpose and Service User Guide. The Home was built in the 1980s and is located in the town of North Walsham and is close to all local amenities. Brunswick House is a large detached property on two levels and stands in its own grounds with an extensive parking area. It is divided into three
Care Homes for Older People Page 2 of 10 Brief description of the care home units: Grant Hadley, the first floor of Brunswick and the ground floor of Brunswick. Each unit provides nursing and residential care. The home also has a day centre in the grounds and some people living at the home attend the centre. The owners have changed the use of some rooms and they intend to accommodate only 70 people and use 6 double rooms and 63 single rooms, most of which have some en suite arrangements but not all have full en-suite toilets and showers or baths. There are three lifts within the home. The weekly fees are currently between £555 to £730 and are agreed dependent on individual residents needs. Please contact the Manager for up to date information about fees. Care Homes for Older People Page 3 of 10 What we found:
We carried out an unannounced visit to the Home on Friday 18th September 2009. This was in response to concerns and complaints that we have received about the Home over the last month. The Home was last inspected in February 2009 and at that time it was given a GOOD quality rating. During our visit to the Home we spoke to the Manager, the Operations Manager, to residents, staff and relatives. We also looked at some of the records and were shown around the Home. The Home has a dementia unit and also admits older people with nursing and residential care needs. There were 66 people living at the Home on the day of our visit. The Registered Manager leaves the Home at the end of September and we were told by the Operations Manager that a new manager has been appointed and will start work as soon as her recruitment checks have been completed. The organisation appointed an Operations Manager two months ago. What the care home does well: What they could do better:
The staffing levels in the Home have been reduced by the proprietor. There is now only one nurse on duty rather than two during the day. There are two less care staff on duty during the morning. In addition to this there have been reductions in the hours worked by domestic and catering staff as well as the activities co-ordinator. The activities coordinator has recently left the Home and the Manager said that they are currently recruiting to this post but only for 20 hours per week. During our visit the staff, relatives and residents were consistent and clear about the effect on the residents of some of the changes to the staffing levels. Staff are working very hard and are, on occasions, not even able to take their breaks. However, some residents are not supported to get up until after 11am despite wishing to get up earlier. Residents are not being enabled to get out of their wheelchairs and into an armchair due to the lack of time that staff have to assist them with a hoist. We saw some residents having breakfast at 11am as they had only just got up and did not want breakfast whilst still in bed. Residents said that they are not able to have baths as regularly as they used to. One resident said I dont get a weekly bath now and its getting worse. Another said we have to wait ages for staff to come if we ring the bell and I try to walk on my own as I get fed up waiting for the staff. There are currently no activities being offered to residents. The Manager said that two of the residents go to the day centre which is in the grounds of the Home. There is currently
Care Homes for Older People Page 4 of 10 no activities co-ordinator at the Home and the care staff do not have time to support residents with activities. One of the residents said There is nothing to do now that the activity man has gone. Another said Im bored to tears, there is nothing to do. The catering staff have been greatly reduced. Residents and relatives have complained to the Manager and to the Commission about the quality of the tea time meal and the lack of choice. During our visit all who spoke to us confirmed that the only option available at tea time seven days per week is sandwiches. Residents told us that they used to have soup and other hot choices as well as sandwiches. They also said that they used to have homemade cakes but that none of these things are now available. The chef makes the sandwiches before he finishes work at 2pm and they are left for the care staff to give to residents at tea time. The care staff are now responsible for getting tea from the kitchen and giving it out to the residents which means that they have less time to spend with residents at that time. A kitchen assistant is available to do the clearing up afterwards. Residents are not offered a hot drink during the mid morning. There is no longer a member of the catering staff available to prepare and offer mid morning drinks and the care staff do not have time to do this. Cold drinks are available on a trolley in the lounge. Relatives have complained to us that residents rooms are not being cleaned properly. We looked at the Homes complaints record and could see that complaints have been made to the Manager about this situation also. An Immediate Requirement was issued during our visit to ensure that the Home provide adequate staffing to meet the residents needs. The Manager has made a recent referral to the Safeguarding team about a resident with a pressure sore. The appropriate mattress was not available to the resident when it was needed. When we asked about this we were told by the Manager that the company who maintain the pressure relieving mattresses and specialist beds had refused to provide a service until their outstanding invoices were paid. This was confirmed by the Operations Manager. This issue had clearly been addressed at the time of our visit as the company was delivering the mattress during our time at the Home. We saw that the hoists were due to be serviced in September 2009. When we asked the Manager what date this was due to be carried out she said that the company have refused to visit to carry out this work due to outstanding invoices. We asked the Operations Manager to address this situation and he contacted the company who confirmed that this was the situation. The Operations Manager spoke to the organisations head office and to the hoist company and said that they had agreed to come to service the hoists on the 22nd September 2009. One of the three passenger lifts in the Home has not been working for several weeks. The Manager said that this was due to the difficulty in obtaining the parts for it but that the service company are addressing the problem. The other two lifts are currently working. We noticed that the carpet on one of the staircases is badly frayed on the edge of the
Care Homes for Older People Page 5 of 10 steps and may cause a trip hazard. We saw the most recent report from the Environmental Health Officer who had visited on 7th September 2009 to check whether requirements from the last inspection (June 09) had been met. He found that two had not been met and has given the Home additional timescales of one month to ensure that the seals on the fridge are replaced and that a patch of flooring in the kitchen is replaced. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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 27 18 To increase the staffing to ensure that the needs of the residents are met To ensure that the needs of the residents are met 22/09/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 1 8 12 That the residents personal 23/09/2009 care needs are met in a way which promotes their privacy and dignity To ensure residents needs are met 2 12 16 That meaningful activities are available for the residents to take part in if they wish to To ensure that residents have a choice to take part in meaningful activities 30/10/2009 3 22 23 That the necessary 30/09/2009 equipment is provided for the residents and that this is well maintained To ensure that the residents needs are met 4 38 13 That action is taken to 09/10/2009
Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 address the outstanding health and safety issues To ensure that the residents are safe 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 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
