Inspection on 26/07/06 for Little Brocklesby House

This inspection was carried out on 26th July 2006.

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

Little Brocklesby House 16/02/06

Little Brocklesby House 30/11/05

Little Brocklesby House 03/02/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Little Brocklesby House High Street Great Limber Lincolnshire DN37 8JL Lead Inspector Mr Ken Hague Key Unannounced Inspection 26th July 2006 09:00 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 Little Brocklesby House DS0000054666.V305257.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. Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Brocklesby House Address High Street Great Limber Lincolnshire DN37 8JL 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) 01469 561353 01469 561353 Little Brocklesby House Ltd. Mrs Sheila Casey-Evans Care Home 36 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (31) of places Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide are for service users of both sexes whose primary needs fall within the following categories Old Age not falling into any other category - OP (31) Dementia - Over 65 years of age - DE(E) (5) The maximum number of service users to be accommodated is 36. 2. Date of last inspection 16th February 2006 Brief Description of the Service: Little Brocklesby House is a two storey care home located in the village of Great Limber, which has a pub and a post office/general store. It is situated ten miles from Grimsby . The home is located down a private driveway, away from the main road and is set in nine acres of parkland on the edge of the Lincolnshire Wolds. It was built during the mid Victorian period and has retained many original period features internally which help make it homely. Bedrooms are located on both floors; the upper floor is accessed by a sweeping staircase or passenger lift. The home provides care for residents over the age of 65 years and can accommodate up to 5 residents who have dementia. Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours. The registered manager was present throughout the inspection. The commission received no residents’ feedback forms (“have your say documents”) from residents at the care home. The registered manager had prepared these forms to be issued on the day of the site visit. The Inspector spoke to all three residents who were being case tracked as part of the inspection. Three other residents not part of the case tracking process were involved in discussions. The Inspector sat in two lounges for a period of time observing the interaction between residents and care staff and the manner in which assistance was provided to residents. Resident’s comments and opinions are reflected within this inspection report. The company supplied a pre-inspection questionnaire, which was studied prior to the site visit. The registered manager had a detailed, discussion with the Inspector on the 21st of July 2006. Feedback was given at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents. A sample of care records was inspected. The Inspector explained to the registered manager the changes introduced in the inspection process since April 2006 What the service does well: What has improved since the last inspection? Improvements have been made to the hot water system. Thermostatic valves have been fitted to all hot water outlets to ensure the temperature meets the National Minimum Standards. Carer Plans and care records have been improved since the last inspection. Little Brocklesby House DS0000054666.V305257.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. Little Brocklesby House DS0000054666.V305257.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 Little Brocklesby House DS0000054666.V305257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is Excellent. This judgement has been made using the available evidence including a visit to this service. The home completes an assessments prior to admitting any resident to the care home ensuring that all their needs are identified and the care home has the resources to meet individual resident’s needs. The home does not provide intermediate care services. EVIDENCE: The registered manager stated on the 24th of July 2006 that the assessment process has been reviewed and that she is confident that all residents of the home have a comprehensive assessment on their individual file. Three residents files were inspected as part of the case tracking process. They were all found to contain detailed assessments including risk assessments. The member of staff who carried out the assessment and the resident or relative had signed these documents. The registered manager stated that an intermediate care service is not provided by the care home. Little Brocklesby House DS0000054666.V305257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is Excellent. This judgement has been made using the available evidence including a visit to this service. The home identifies the health, personal and social cares needs of each resident and records them on their care plan. This enables staff to meet their needs in a manner, which is described within the individual’s care plan. The medication policy of the home is being followed. Staff respect the dignity and privacy of residents. EVIDENCE: The care records for the three residents being case tracked all contained a care plan, which set out the total needs of the residents. This included health care needs. There were recordings on files detailing, chiropody, dental care and eye care. There was evidence found in daily records and care plans of input from community health care services, hospital consultants, GPs and district nurses. The registered manager stated that residents are offered the opportunity to self-medicating should a risk assessment shows this to be appropriate. Residents confirmed that self medication had been discussed with them. The register manager stated that staff, have been trained to administer Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 10 medication. Staff training records supported this statement. A recent pharmacy report provided further evidence that staff, are following the medication policy of the company. Residents told Inspector they find staff very helpful and kind one resident stated “I do feel they respect my privacy and dignity”. Little Brocklesby House DS0000054666.V305257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home provides organised activities. Family and friends are encouraged to visit the home and keep contact with residents. The home offers a menu, which provides choice and meets the dietary needs of individual residents. Residents are able to have choices and control over their own lifestyle. EVIDENCE: The Pre- inspection questionnaire contains a list of activities offered by the care home. The registered manager confirmed that these activities do take place. Residents were able to discuss the activities of the home and their individual choice of activity. Staff described in formal interviews the opportunities and social entertainment offered by the care home. It is recommended that the care home reviewed the information recorded on individual care records to ensure that it demonstrates the activities of the individual resident and the choice made by the resident. Residents and staff stated that family and friends are encouraged to visit the home. Visiting was observed to be occurring during the site visit. The home has a visiting policy known to residents, which is displayed in the foyer of the care home. Little Brocklesby House DS0000054666.V305257.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home listens to resident’s views and wishes and acts on them. There are procedures in place to protect residents from any possible abuse. Staff have received appropriate training to protect residents from being harmed. EVIDENCE: The registered manager confirmed on the 24th of July that no complaints have been received by the home. The commission for social care inspection has received no complaints in the last two years regarding the home. There has been no vulnerable adults investigations carried out at the home. The training records confirm that all staff are being trained in the recognition and prevention of abuse. The complaints policy was displayed in the care home entrance on the day of the site visit. The registered manager confirmed that this policy is included in the service users guide given to all residents. Little Brocklesby House DS0000054666.V305257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is Good. This judgement has been made using the available evidence including a visit to this service. Residents live in a maintained clean environment. Staff are following the infection control policy of the care home. EVIDENCE: The training records and discussions with the registered manager provided evidence that staff have been trained in infection control. The staff stated in formal interviews that the home was a clean environment in which to work. They could not identify any health and safety issues within the care home. A full tour of the care home was not carried out there was sufficient evidence provided prior to the site visit to substantiate that these standards were met. Thermostatic valves have been fitted since the last inspection to all hot water systems to ensure the hot water temperature meets National Minimum Standards. The home identifies the maintenance work to be carried out during any one year and therefore has a rolling a maintenance program. However Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 14 timescales are not included in this plan. The responsible individual of the company confirmed that there were plans to clean or replace carpets in some areas of the care home. It is recommended that the records which identifies future maintenance includes, timescales for the work to be completed. Little Brocklesby House DS0000054666.V305257.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is Good. This judgement has been made using the available evidence including a visit to this service. The home is staffed with appropriate numbers of care staff who are sufficiently trained to be able to answer the needs of residents who fit within the registration category of the care home. The managers of the care home are following the home’s recruitment policy consistently. Staff supervision is being carried out in accordance with the National Minimum Standards. EVIDENCE: The registered manager confirmed on the 24th of July 2006 that staffing levels are maintained as recorded on the staffing rota with staffing hours increased where there is a change in individual residents needs. The registered manager confirmed she had a training plan for the next 12 months, which identified the courses available, and the individual needs of staff. Training records demonstrated that staff training is being carried out this included training in the recognition and prevention of abuse. No complaints have been received by the home or the Commission for Social Care Inspection in respect of staffing levels in the last two years. The registered manager confirmed on the 24th of July that the company continues to follow its recruitment policy, which meets the National Minimum Standards. The inspection of files for new members of staff recruited since the last inspection confirmed this statement to be correct. However evidence of the identity of a member of staff was not being kept after criminal record bureau checks (CRB) had been obtained. The Care Home Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 16 Regulations state that proof of identity must be placed on individual staff members files. The registered manager agreed to take action immediately to rectify this problem. The register manager stated that she is providing appraisals and supervision in accordance with the National Minimum Standards. Members of staff confirmed this statement to be accurate. Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. The home is well run, with good leadership and guidance from the registered manager who has worked for many years in the provision of community care. Staff, are being provided with supervision and appraisals in accordance with the National Minimum Standards. EVIDENCE: The home was a registered manager with many years experience in residential care. There have been no concerns of complaints made regarding the management of the home in the last two years. Residents and staff have consistently stated at inspections that she is approachable and supportive. The home holds residents meetings and individual residents files contain details of their wishes and choices in every aspect of their daily living. Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 18 Residents confirmed in discussions during the site visit that they feel staff assist them to be as independent as possible and take into account their views and opinions. The registered manager and staff confirmed that appraisals and supervision are being carried out a frequency set out in the National Minimum Standards. There were no health and safety issues identified at the site visit. The registered manager stated she was confident that all staff are following the infection control policy of the care home. The registered manager stated that staff are following the financial procedure for the management of resident’s money. Staff were able to discuss this procedure in the formal interviews. Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 19 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 4 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 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 4 x 3 x 3 x x 3 Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 20 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 Little Brocklesby House DS0000054666.V305257.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 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 Little Brocklesby House DS0000054666.V305257.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. 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