Inspection on 30/06/05 for Little Brook House

This inspection was carried out on 30th June 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 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 Brook House 23/09/08

Little Brook House 27/09/06

Little Brook House 21/11/05

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 30/06/05 9.55am 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 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 H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Little Brook House Address 101 Brook Lane, Warsash, Hampshire, SO31 6FE Telephone number Fax number Email 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 CRH 20 Category(ies) of OP registration, with number of places Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/11/05 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 and extensive well-kept grounds. Two conservatories to the rear of the property overlook the gardens and many service users spend much of their time in this area of the house, enjoying the setting. This also acts as a dual purpose, and encourages social interaction between service users. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two annual inspections and was unannounced. The visit lasted four and a half hours and was conducted by an inspector accompanied by a member of the business services team. During the inspection a number of service users were spoken with as well as three members of staff, samples of the home’s records were viewed and a partial tour of the premises undertaken. The registered manager was on leave and the staff team leader assisted throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home operates generally sound recruitment procedures, however not all staff records were complete with the necessary information available for inspection and to ensure the protection of service users. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 6 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 H54 S57924 Little Brook House V226743 300605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 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 standard(s) 3 and 6 Service users have their needs assessed prior to admission. EVIDENCE: Pre-admission assessments are gained from social services and appropriate professionals where applicable. For private funding, the manager ensures that a full needs assessment is undertaken prior to admission to Little Brook House and these were found to be appropriate. A sample of the home’s records, including documentation regarding a recent admission, was viewed and these contained the information required within the standards. The team leader reported that following a recent admission the home was no longer able to meet the changing needs of one service user who had also expressed a wish to leave. Social Services had been contacted and were due to visit to assess the service user’s needs in relation to finding a more suitable placement. No intermediate care is provided at Little Brook House. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 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 standard(s) 7, 9 and 10 There is a clear and consistent support planning system in place to provide staff with the information they need to satisfactorily meet service user’s needs. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service user’s medication needs are met. Working practices within the home promote service user’s privacy and dignity. EVIDENCE: A sample of four service user care plans was seen and these contained information in relation to service users’ abilities and needs, the aims and method of care. These covered areas such as washing and dressing, mobility, recreation and leisure. Details also included service users’ known likes and dislikes and preferred individual routines such as when to take baths. Records of outcomes were signed and dated and there was evidence of regular reviews by the team leader. The staff members on shift completed daily reports on each service user. Risk assessments concerning each service user were on file and documented the degree of the identified risk and action to be taken to minimise the risk. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 10 For example, how to manage the risk of falling presented by a service user using the stairs or stair lift. The home had a policy and procedure for the management and administration of service user’s medication. The policy supported service users who wished and were able to manage their own medication and individual risk assessments were on file in relation to this. Most medication arrived from the pharmacy in sealed blister packs with pre-printed administration record sheets that senior staff signed after giving the tablets. All medication was stored in a suitable locked metal trolley. The team leader confirmed that any changes to service users’ medication were signed for by the prescribing doctor and recorded in the service user’s care plan. Staff received medication training through Swindon College and the home was looking at the possibility of training through a pharmacy. Through conversation with service users it was confirmed that staff treated them with respect and upheld their right to privacy. Staff were observed knocking on people’s bedroom doors and giving assistance in a calm, patient and friendly way. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 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 standard(s) 12 and 15 Service users have opportunities to engage in social and leisure activities that suit their needs and interests. The dietary needs and preferences of residents are well catered for with a varied selection of food available. EVIDENCE: Service users were observed meeting in the communal areas and in their own rooms for conversation and playing board games. Those spoken with expressed satisfaction with the leisure activities on offer and confirmed they were able to move around the home as they pleased and receive visitors. One service user was learning to play the guitar. The team leader reported that staffing levels were sufficient to provide time in the afternoons for staff to engage in conversation and go for walks with service users in the garden. An exercise session was held every other Thursday and a music entertainer visited every six weeks. There had been a trip to Exbury gardens within the last month and there were plans to visit Marwell. A menu board is available and a record of meals provided is kept. Meals appeared varied and appealing and service users commented that the food in the home was very good. At lunchtime service users gathered in the dining room for an unhurried meal and staff were observed giving appropriate assistance and offering alternative choices of meal. The dining room provided an attractive setting, however some service users commented that the lighting was poor in places. The team leader said that the management were aware of Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 12 this and were looking into ways of improving the lighting without spoiling the ambience. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 13 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 standard(s) 16 and 18 The home has a suitable complaints procedure to ensure that service users views are listened to and acted upon. Training, policies and procedures are in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home had a written policy and procedure including timescales for responding to complaints. A record was kept of actions taken and the outcomes of any complaints, showing that the home had responded appropriately and kept relevant people informed. Service users confirmed that they knew who to complain to if they were unhappy with or concerned about any aspect of the care provided, and said they had no complaints. A written policy and procedure for responding to the allegation or disclosure of abuse was in place. The procedure gave guidance that included the identification of various forms of abuse, roles and responsibilities of staff and external agencies and actions to be taken. The team leader demonstrated knowledge of the procedures such as reporting and recording any incidents. Staff at the home had attended training in abuse awareness the previous year. It was not possible to ascertain whether further training was planned for new staff, and this will be further assessed at the next inspection. However a staff member recruited in the previous nine months had commenced NVQ training that included abuse awareness (see also the sections on Staffing: standards 29 and 30; and Management: standard 35). Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 14 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 standard(s) 25 and 26 The home provides service users with a comfortable, clean and safe environment. EVIDENCE: A plan to fit covers to all the radiators in the home was seen to be nearing completion. Care plans contained individual risk assessments in relation to radiators and en-suite water temperatures. Thermostatic control valves were fitted in bedrooms and hot water tank temperature maintained at sixty degrees centigrade to prevent risks of Legionella. At the previous inspection it was noted that all bedrooms are individually and naturally ventilated with windows that are fitted with restrictors to prevent falls. All bedrooms are centrally heated. At the time of the inspection a high standard of cleanliness was observed throughout the premises. Written policies regarding cleaning and infection control were seen on file. The laundry facility is situated adjacent to the kitchen but with additional access through an exterior door. The team leader confirmed that laundry is not carried through the kitchen to be washed. The washing machine was fitted with an appropriate programme to meet Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 15 disinfection standards. The laundry floor had an impermeable finish and this and the walls were readily cleanable. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Service users are supported and protected by suitable numbers of trained staff. The home’s recruitment practices are in need of up-dating as some appropriate checks had not been carried out, potentially leaving service users at risk. EVIDENCE: The home’s staff rota showed a senior carer and a carer on each of the early and late shifts. Nights are covered by one awake staff and another sleepingin. A cook and a cleaner are also on duty during the mornings. The registered manager is usually on duty within the home until 5pm on weekdays and shares on-call duties with the team leader. A sample of the home’s records for five members of staff was seen and each of these contained details such as proof of identity, including a recent photograph, two written references and training certificates. Completed application forms indicated the person’s previous employer. The team leader confirmed that candidates’ employment histories, and any gaps in this, were explored as necessary during interview. Criminal Records Bureau (CRB) checks were on record for those seen. However, CRB checks for three staff employed since 26 July 2004 were no longer valid as they had been carried over from a previous employer and did not include checks against the Protection of Vulnerable Adults (POVA) register. This is a requirement under recent legislation. The registered manager was Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 17 not available to comment, but the team leader said she thought that this was now being addressed. The home provides staff with copies of the General Social Care Council (GSCC) code and standards of practice. There is a staff manual that includes information about disciplinary procedures, whistle blowing and dress code. Staff training certificates were on file and there was a written record of when training took place for each member of staff. For example, the team leader reported that in the last year she had completed training in manual handling, fire safety, health and safety, food hygiene, abuse awareness, and was due to do first aid refresher training. Four members of staff were currently registered on NVQ2 training and this would also provide training in abuse awareness. A recently recruited member of staff confirmed that she had received induction and fire safety training and was commencing an NVQ2. Due to the registered manager not being present at the 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 be explored at the next inspection. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 The home’s systems for obtaining service users views, safeguarding service users’ financial interests, and promoting safe working practices all serve to protect service users’ and ensure the home is run in their best interests. EVIDENCE: The team leader reported that an annual quality assurance questionnaire is sent round to all service users. The results of this will be assessed at subsequent inspections. Service users confirmed that they had regular meetings with the registered manager on the last Friday in every month and were happy to discuss any concerns or issues at these times. This arrangement reflected an open culture within the home that enabled service users to feel confident in airing their views and making suggestions for improvements. Staff reported that the management were approachable and supportive. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 19 The home looks after some service users’ money and this is kept in a locked safe to which only the registered manager has access. However, during the manager’s absence the team leader confirmed she is given sufficient access to enable service users to withdraw or deposit their money. Financial records were kept on computer to which only the manager had access. This standard will be further assessed at the next inspection. Evidence was seen that safe working practices are promoted and maintained in the home. Statutory training was provided for all staff and records were on file with regard to the testing and servicing of equipment and appliances. For example, up-to-date service certificates were seen in relation to the fire alarm and extinguishers, electrical mains and portable appliances, bath hoist and stair lift, and the aid-call system. Water bacteriological tests had been carried out and records kept of plumbing and heating works. Contracts were in place for the disposal of clinical waste. Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 21 NO Are there any outstanding requirements from the last inspection? 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 29 Regulation 19 (1) Schedule 2 Requirement All staff recruited since 26/07/04 must have updated Criminal Records Bureau (CRB) checks that include checks against the Protection of Vulnerable Adults (POVA) register. Timescale for action 01/08/05 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. 1. Refer to Standard Good Practice Recommendations Little Brook House H54 S57924 Little Brook House V226743 300605.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, 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 H54 S57924 Little Brook House V226743 300605.doc Version 1.30 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. 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