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Inspection on 03/03/10 for Brunswick House Nursing and Residential Home

Also see our care home review for Brunswick House Nursing and Residential Home for more information

This inspection was carried out on 3rd March 2010.

CQC found this care home to be providing an Poor service.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Manager continues to make improvements in the organisation and management of the staff and the ways in which they work. Staff told us that the team are working well together and that the way they work is more organised. They said that they are clearer about their roles and that they continue to receive good support from the Manager. Residents told us that the staff are respectful and kind. We observed staff supporting residents in a gentle and respectful way. Staff told us that the staffing levels and the improved organisation of work means that the residents are now all able to get up at a reasonable time and to have breakfast when they wish to. They said that the residents are also able to have baths as planned. These are improvements since the last Inspection. The staffing levels had been reduced by the management company but, following a meeting with the Commission and Social Services, they increased the staffing levels in December 2009. Some of the outstanding issues with regard to the accommodation have started to be addressed. For example, the second lift has been serviced and new buttons fitted to the control panel. The main lift has been out of use for several months but we were advised by the administrator that the engineers are due to start work on the lift the following week. The hot trolley which posed a risk to residents has been removed from the Grant Hadley unit. The Manager told us about training that has taken place since the last Inspection and further training that is planned for the care staff and nurses. The Home has an enthusiastic activities co-ordinator who has recently started working. The Manager said that they have also recruited another member of staff to assist withactivities.

What the care home could do better:

There are still improvements that need to take place with regard to staffing at the Home. The senior staff told us that they often have to work additional hours in order to complete all of the necessary reviews and updates of the care plans. At the last meeting with the management company they said that they were recruiting for a deputy manager. At the time of our visit we were told by the Manager that this is not now taking place. The Home needs to have a deputy manager to strengthen the management team, to free up some of the Managers time to carry out other tasks that are required of a Homes Manager and to share the out of hours support provided. The receptionists hours have been reduced and so the administrator now covers the reception desk most afternoons and for one morning a week. This reduces the administration support that the Manager has. There have only been two domestic staff on duty each day for several months and this is not enough for the size of the Home. The management company have recently given the Manager permission to recruit for a temporary cleaner but currently there are still only two domestic staff. Despite the domestic staff working hard they are only able to provide a basic cleaning service due to the size of the Home. The Manager said that a new stair carpet is due to be fitted to replace the one that is frayed and worn. There are other carpets around the Home that are worn and have holes in. She also said that there are plans to clean the outside paved areas and steps to ensure that they are no longer so slippery. There are also plans to fence of a part of the garden so that there is a small secure garden for residents to use. The area outside the patio doors in one of the bedrooms is still very slippery and has a hosepipe trailing over the area and down the steps. We were told that a problem with the water supply to part of the Home has developed. The engineers arrived whilst we were at the Home. The Manager has contingency plans for ensuring that the residents needs are met if the problem cannot be immediately rectified.

Random inspection report Care homes for older people Name: Address: Brunswick House Nursing and Residential Home 81 Bacton Road North Walsham Norfolk NR28 0DN zero star poor service 30/09/2009 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: 0 3 0 3 2 0 1 0 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 Telephone number: Fax number: Email address: Provider web address: www.brunswick-house.co.uk 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 0 1 1 2 0 0 9 Brunswick House is a care home providing personal care and nursing care for up to seventy-five people. The Home 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 units: Grant Hadley, the first floor of Brunswick and the ground floor of Brunswick. The Home provides nursing and residential care. The home also has a day centre in the grounds. Care Homes for Older People Page 2 of 10 Brief description of the care 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. In October 2009 the Home went into administration and is now being run by the administrators. They have appointed a management company to oversee the management of the Home. Care Homes for Older People Page 3 of 10 What we found: The Home was inspected in September 2009 and again in December 2009. At both Inspections the quality rating was considered to be POOR although it was clear that some improvements had been made. The local authority have currently suspended placements at the Home. The Manager of the Home was appointed in September 2009 and is currently in the process of registering with the Commission. The Home went into administration in October 2009 and the administrators appointed Healthcare Management Solutions Ltd to oversee the management. This report refers to an unannounced visit that two Inspectors carried out on the 3rd March 2010. During this visit we spoke to the Manager, to residents and to staff. We also looked around some areas of the accommodation. There are currently 52 residents living at the Home. What the care home does well: The Manager continues to make improvements in the organisation and management of the staff and the ways in which they work. Staff told us that the team are working well together and that the way they work is more organised. They said that they are clearer about their roles and that they continue to receive good support from the Manager. Residents told us that the staff are respectful and kind. We observed staff supporting residents in a gentle and respectful way. Staff told us that the staffing levels and the improved organisation of work means that the residents are now all able to get up at a reasonable time and to have breakfast when they wish to. They said that the residents are also able to have baths as planned. These are improvements since the last Inspection. The staffing levels had been reduced by the management company but, following a meeting with the Commission and Social Services, they increased the staffing levels in December 2009. Some of the outstanding issues with regard to the accommodation have started to be addressed. For example, the second lift has been serviced and new buttons fitted to the control panel. The main lift has been out of use for several months but we were advised by the administrator that the engineers are due to start work on the lift the following week. The hot trolley which posed a risk to residents has been removed from the Grant Hadley unit. The Manager told us about training that has taken place since the last Inspection and further training that is planned for the care staff and nurses. The Home has an enthusiastic activities co-ordinator who has recently started working. The Manager said that they have also recruited another member of staff to assist with Care Homes for Older People Page 4 of 10 activities. 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 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 1 4 That the Statement of Purpose is updated To ensure that prospective residents are provided with accurate information about the Home 26/02/2010 2 7 15 The records within the care plans need to be kept up to date To ensure that accurate records are kept of the care provided to the residents 30/10/2009 3 8 12 That the residents personal 23/09/2009 care needs are met in a way which promotes their privacy and dignity THIS REQUIREMENT WAS MADE DURING THE RANDOM INSPECTION ON 18TH SEPT 2009 To ensure residents needs are met 4 8 12 It is required that the care home is conducted so as to promote and make proper provision for the health and welfare of residents To ensure that the residents personal and healthcare 30/10/2009 Care Homes for Older People Page 6 of 10 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 needs are met 5 9 13 It is required that clear guidance is available for the administration of PRN medication To ensure that residents receive medication at appropriate times 6 12 16 That meaningful activities are available for the residents to take part in if they wish to THIS REQUIREMENT WAS MADE DURING THE RANDOM INSPECTION ON 18TH SEPT 2009 To ensure that residents have a choice to take part in meaningful activities 7 18 13 That all staff receive Safeguarding vulnerable adults training To provide increased protection to residents from abuse 8 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 9 27 18 To increase the staffing to 20/10/2009 ensure that the needs of the residents are met PLEASE NOTE THAT THIS IMMEDIATE REQUIREMENT WAS ISSUED Page 7 of 10 30/10/2009 30/10/2009 31/12/2009 Care Homes for Older People 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 ON 18TH SEPTEMBER 2009 DURING THE RANDOM INSPECTION AND HAD A TIMESCALE OF 48 HOURS IN WHICH TO BE MET. THE DATE FOR THIS HAS NOT BEEN EXTENDED. To ensure that the needs of the residents are met 10 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 11 30 18 that the staff receive training 31/01/2010 which is relevant to their role To ensure that the staff have appropriate skills to carry out their roles effectively 12 38 13 That action is taken to 09/10/2009 address the outstanding health and safety issues THIS REQUIREMENT WAS MADE DURING THE RANDOM INSPECTION ON 18TH SEPT 2009 To ensure that the residents are safe 22/09/2009 Care Homes for Older People Page 8 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 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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