Inspection on 21/11/05 for Little Brook House

This inspection was carried out on 21st November 2005.

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

Other inspections for this house

Little Brook House 23/09/08

Little Brook House 27/09/06

Little Brook House 30/06/05

Little Brook House 16/11/04

Little Brook House 07/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Little Brook House 101 Brook Lane Warsash Hampshire SO31 6FE Lead Inspector Laurie Stride Unannounced Inspection 21st November 2005 09:45 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 Brook House DS0000057924.V259059.R01.S.doc Version 5.0 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 Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Little Brook House Address 101 Brook Lane Warsash Hampshire SO31 6FE 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) Little Brook House Limited Mrs Janet Cooper Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Little Brook House is a registered care home for the provision of personal care and accommodation for 20 older people. The home is located in the rural area of Warsash, Hampshire, with Southampton as the nearest large city. The name of the house derives from the brook, which runs through the garden area of the property. The 300 year old home was formerly a farmhouse, the original building having been modernised and extended to include further accommodation. The building is well maintained, tastefully decorated and furnished and has extensive well-kept grounds. Two conservatories to the rear of the property overlook the gardens. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two annual inspections and was unannounced. The visit lasted approximately six and a half hours, during which the inspector spoke with eight service users, the deputy manager, a senior carer and briefly with the registered providers. A partial tour of the premises was undertaken and samples of the home’s records were inspected. The registered manager was not available and the deputy manager assisted throughout the inspection. The inspector looked mainly at the key standards not assessed at the last inspection and therefore this report should be read in conjunction with the previous report. There was one requirement made as a result of this visit. What the service does well: What has improved since the last inspection? 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 Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 6 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 Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 7 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): None of these standards were assessed on this occasion. EVIDENCE: Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 8 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): 8 There are clear systems in place for meeting service users’ healthcare needs. EVIDENCE: Through discussion with service users and the deputy manager and inspection of a sample of care plans, it was evident that service user’s healthcare needs were being met and kept under review. There are four doctor’s surgeries currently providing primary health care to the residents of Little Brook House. An optician and a dentist visit the home or service users can choose to see their own. Oral hygiene is also promoted through a visiting Tooth Wizard who provides denture care. A good working relationship was reported with the district nurse who provides professional advice about the promotion of continence and related aids and equipment. The district nurse is also contactable for advice if needed regarding pressure sores, although there were no reported current risks in this respect. The community psychiatric nurse is available to assess service users psychological health as necessary. A doctor was seen visiting the home during the inspection. Visits to the home by healthcare professionals and other medical appointments are documented with outcomes. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 9 The home monitors service users’ nutrition and regularly checks people’s weights. There is an exercise group held every other Thursday and service users can take walks in the garden. Staff members encourage self-care as much as possible in order to maintain people’s independence. A sample of three care plans contained health-related information and risk assessments for individual service users. Service users confirmed that they were satisfied with the overall care provided. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 10 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): 13 and 14 The home supports service users to maintain contact with friends and relatives and to exercise choice and control in their lives. EVIDENCE: There is a visiting policy for Little Brook House that includes clear guidelines. Visitors to the home are able to visit as they wish throughout the day and at reasonable times during the evening. Service users confirmed that they can see visitors in private and can choose not to have visitors. It is also the home’s policy to provide a private facility for service users to discuss private matters with the staff and management if they wish. Community links are usually maintained through service users’ family, friends or representatives. Arrangements were in place for one service user to maintain links with a Church. Service users confirmed they were able to exercise choice and control in their everyday lives and were observed moving around the communal areas without restriction. The home encourages new service users to bring an agreed amount of personal possessions with them in order to help them to settle in. The deputy manager reported that she reviews individual care plans with the service user and reminds them that they can access their personal records whenever they wish. Some service users manage their own finances and all can access their personal money when they want. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 11 Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 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): None of these standards were assessed on this occasion. EVIDENCE: Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 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 The home provides a pleasant, clean and comfortable environment for service users. EVIDENCE: A partial tour of the premises was undertaken and the home appeared to be very clean, comfortable and free of any potential hazards. There are no parts of the building that are inaccessible to current service users as there are four stair lifts throughout the home. The home would not however be suitable upstairs for wheelchair access as there is no lift installed. Routine maintenance is undertaken as required. The attic area has been converted to provide office space for the owners, the manager and an administrative assistant and accommodates secure filing cabinets and other office equipment. Two conservatories overlook the large landscaped and well-maintained garden that is accessible to service users. The deputy manager reported that there had been no requirements as a result of a recent visit to the home by the environmental health officer. Service users’ comments indicated that they were pleased with the environment and liked the accommodation provided. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 14 Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 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 and 29 Service users benefit through the home encouraging staff to undertake care related qualifications. The home’s recruitment practices are a matter of concern as some appropriate checks are still not being carried out, potentially leaving service users at risk. EVIDENCE: Through discussion with a member of staff and the deputy manager it was confirmed that the home encourages staff to undertake NVQ in care training. The deputy manager reported that, out of thirteen care staff, two had completed NVQ level 2, another three were currently working toward obtaining the award and a further two staff members were about to commence the training. A senior carer who had completed the NVQ level 2 had started working toward level 3. Other training was also discussed with staff who confirmed they had recent training in first aid, health and safety, abuse awareness, food hygiene and infection control, and fire safety. New staff are given an induction period and there was evidence that this aspect of training was being further developed. This will be assessed in greater detail at subsequent inspections. Due to the registered manager not being available at this and the last inspection and the lack of available records, it was not possible to evidence whether there was a clear programme of planned training for each member of staff. This will therefore be explored at the next inspection. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 16 While there was evidence to indicate that a previous requirement identified at the last inspection was to some extent being addressed, the home’s recruitment practices were still not in line with the standards and regulations and therefore put service users at risk. A sample of five staff member’s records were seen and showed two recently recruited staff members had been employed at the home before satisfactory written references had been obtained. There was also a lack of evidence to show that POVA First checks (Protection of Vulnerable Adults) had been obtained prior to employment. The deputy manager stated that in one case a POVA First check had been confirmed over the telephone however could not be evidenced. In the case of another staff member references had been obtained but there was no evidence of a satisfactory POVA First check for employment at the service. In all three instances a full employment history had not been obtained. A Notice of Immediate Requirement for action was issued at the time of the inspection. This requires the service providers to take immediate action to address the issue identified and to ensure the safety of service users. During the inspection it was noted that the home left a senior carer who was under 21 in charge of the home on occasions. This is not in line with the National Minimum Standard as staff member’s who are below the age of 21 cannot be proved to have the necessary experience to be left in charge of a care home. This will be addressed separately. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 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 and 36 There are clear management systems in operation within the home, however the supervision of care staff needs to be held on a more formal and consistent basis. EVIDENCE: The registered manager was not available at the time of this visit and the deputy manager was in charge and assisted with the inspection. The deputy manager was able to confirm that the registered manager was in the process of obtaining an NVQ level 4 management award and took part in other training as part of continuous learning. The registered manager has previous experience of managing care services and is not responsible for managing any other establishments. There are clear lines of management accountability in the home and staff reported that the management team are open, accessible and supportive. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 18 Staff confirmed that they have supervisions with the manager, however these appeared to be currently held on an infrequent basis. A sample of three personnel records showed that the last formal recorded supervisions were held approximately six months ago, although it appeared that staff had access to informal supervision if needed. It is a requirement that each staff member receives regular supervision in line with the standard and records of this are kept. Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X X Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 20 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 OP29 Regulation 19(1) Schedule 2 Timescale for action The registered person must 21/11/05 ensure that staff are employed in the home only once a POVA First and two satisfactory written references and a full employment history has been obtained. Each time a member of staff is ready for employment without their full CRB declaration being available the registered person must inform CSCI of the home’s decision. (This is a partially repeated requirement from 30/06/05) All staff members receive regular recorded supervision. 31/12/05 Requirement 2 OP36 18(2) 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 Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 21 Little Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Brook House DS0000057924.V259059.R01.S.doc Version 5.0 Page 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. 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!