Inspection on 05/06/06 for Stildon Brendoncare

This inspection was carried out on 5th June 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

Stildon Brendoncare 12/08/08

Stildon Brendoncare 19/01/06

Stildon Brendoncare 26/08/05

Stildon Brendoncare 07/12/04

Stildon Brendoncare 27/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Stildon Brendoncare Dorset Avenue East Grinstead West Sussex RH19 1PZ Lead Inspector Mrs J Hough Key Unannounced Inspection 5th June 2006 10:40 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 Stildon Brendoncare DS0000014746.V295686.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. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stildon Brendoncare Address Dorset Avenue East Grinstead West Sussex RH19 1PZ 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) 01342 305750 01342 328337 www.brendoncare.org.uk The Brendoncare Foundation Post Vacant Care Home 32 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (4), Old age, not falling within any other of places category (32), Physical disability (4), Physical disability over 65 years of age (4) Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only service users aged 55 years and over may be admitted. The total number of service users accommodated must not exceed 32 at any one time. 19th January 2006 Date of last inspection Brief Description of the Service: Stildon Brendoncare is a purpose built home providing personal care and nursing care for thirty-two persons over the age of sixty-five years but has a variation to enable the admission of the following: Old age not falling within any other category (32) Physical disability (4) Physical disability over 65 years of age (4) Dementia (4) Dementia over 65 years of age (4). The accommodation comprises of thirty-two single rooms all with en-suite facilities. The accommodation is arranged on two floors each having a sitting room, dining room and two large bathrooms. The home is located within a short distance of East Grinstead town centre with its shops and leisure facilities. The home is owned by The Brendoncare Foundation and the Responsible Individual is Mr Ronald Staker and the Registered Managers post for the home is at present vacant. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 7 hours and the Acting Manager Melanie Sadler was present and provided the information required. A tour of the premises took place and some of the resident’s rooms were seen. Twelve residents, three visitors and four members of staff were spoken with. Records were examined with regard to the resident’s assessments and care plans, medication, complaints, accidents and incidents and quality assurance. This was a key inspection and all the key standards were assessed. Scale of fees £750-£850 What the service does well: The home being purpose built is modern, light and spacious. The furnishings and décor are in good condition and the communal areas are comfortable and pleasant. The resident’s rooms are all single with en-suite facilities, and residents are able to bring with them small items of furniture and personal possessions making their room personal to them. Residents spoke highly of the staff saying they were courteous and caring and looked after them very well. The Brendoncare Foundation is committed to providing staff with the necessary training for them to carry out their work to a good standard. The views of the residents are taken into account with regard to their daily life and social activities. Activities are provided during the week but residents can choose if they want to participate or not. Some of the residents spoken with were happy to stay in their rooms even for meals, and staff respected their wishes. The menus showed a well-balanced diet and a good choice of food on offer each day. The resident’s spoken with all liked the food and said there was plenty to eat. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 6 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. Stildon Brendoncare DS0000014746.V295686.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 Stildon Brendoncare DS0000014746.V295686.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): 1,2,3,6 Quality in this outcome is good. This judgement was made using available evidence including a visit to this service. The home’s admission procedures ensure that the home is able to meet the needs of residents. Residents are given all the necessary information about the home and the services it provides. The home does not provide intermediate care. EVIDENCE: The Statement of Purpose for the home had been amended to reflect that the manager’s post is at present vacant. The Statement of Purpose is brief but the home has a welcome pack that includes all the relevant information although on reading the guide contained in the pack it was outdated as gave reference to the National Care Standard Commission (NCSC). Each resident signs a contract of terms and conditions that provides clear information on fees, notice of termination, personal possessions and insurance, operational policies, Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 9 comments and complaints, gifts and change to any terms and conditions. A relative of a recently admitted resident confirmed that all the relevant information was provided and an assessment of need was carried out prior to any agreement being made for admission to the home. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 10 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 is adequate. This judgement has been made using available evidence including a site visit to this service. The care plans do not reflect the good standard of care given to the residents. The staff respect the privacy and dignity of the residents. EVIDENCE: Three resident’s care notes were examined and the needs assessments were thorough but not all the needs identified were recorded on the care plans giving the actions needed by staff to meet the needs. In one case it had been identified that the resident was at risk of falling but no moving and handling risk assessment was in place. One resident’s care plan was in two different formats and it was confusing as to which ones were currently being used as both identified different needs. One resident required a special diet that was highlighted on the evaluation sheet but had not been documented on the nutritional assessment. Emotional needs were not generally recorded on care Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 11 plans and in one case where a resident was assessed as suffering from anxiety, no actions were in place for staff to understand how the anxiety maybe handled or reduced for the resident. One pressure sore risk assessment scored the resident as being a very high risk of skin damage but no evidence was documented to the actions taken to reduce the risk. Resident’s were weighed on a monthly basis and where necessary nutritional supplements were offered. When the need to use cot sides was identified there was no written evidence that the resident or their relative had agreed this. From speaking with the residents and relatives it was evident that the resident’s needs were well met although the records did not in all cases reflect the good care practice that was being delivered. The staff showed they understood the individual needs of each resident and said they gained information about the residents from the handovers at the beginning of each shift where any changes to the resident’s needs were discussed in detail. Some of the medication administration records were looked at and were up to date and well documented. The trained nurses administer the medicines unless a resident has been assessed as able to self-administer their medicines when the staff will support them to continue to do this. From speaking with residents it was clear that staff respect their privacy and dignity in all aspects of their care and staff were observed knocking on bedroom doors before entering rooms. Some of the residents said they chose to sit in their rooms and did not want to join other residents for meals or activities and the staff respected their wishes. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 12 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 is good. This judgement has been made using available evidence including a visit to this service. The residents are able to choose how they spend their time taking into account their preferences and capabilities. The residents can have visitors at any reasonable times and a good choice of food is offered daily. EVIDENCE: The activities programme is contained in the welcome pack for the home and from Monday to Thursday activities are provided for two hours in the afternoon that consists of games, arts and crafts, chats, chair exercises etc. The Friends of Stildon arrange occasional trips out to garden centres, places of interest and to the seaside. There is also a summer garden party. Outside entertainers also visit the home with music and singing and piano recitals. The Stildon newsletter written each month informs residents what is going on. The newsletter for May was about the forthcoming garden party and strawberry tea arranged for 8/7/06. There was reference to the Easter performance from outside entertainers that was a success. Two garden tea parties are arranged for June and August. On the day of inspection Kevin the activities organiser was with a group of seven of the residents who met regularly and discussed current affairs and items of interest and said the group was free to do whatever they wanted to do. The visiting arrangements in the home are open Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 13 and visitors spoken with said they are made welcome at all times. Some of the residents had their rooms furnished with their own small items of furniture and personal possessions of their choice. Residents spoken with praised the food and said there was a good choice and the menus showed that an alternative meal was available for those residents who did not like the main meal on offer. Breakfast is served from 8am with a choice of cereals, toast, fruit juices, tea and coffee. A cooked breakfast is available on request. Coffee and biscuits are served mid morning and lunch around 12.30. Afternoon tea with homemade cakes is served mid afternoon and supper at 6pm followed by a hot drink at 8.30pm. A weekly menu is circulated on a Thursday so residents can choose their meals. All meals apart from breakfast are served in the dining rooms or the resident’s rooms if preferred. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 14 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 is good. This judgement was made using available evidence including a visit to this service. The complaints procedure for the home ensures that all complaints are taken seriously and investigated. The staff are aware of their responsibilities in reporting any incidents or allegations of abuse to ensure the protection of the residents. EVIDENCE: The complaints log was examined and there had been one complaint made since the last inspection in January 2006 that had been satisfactorily resolved. There was an issue raised about how The Brendoncare Foundation handled an on-going complaint. On the evidence available it was seen that the Foundation responded appropriately to the complaint following the correct complaints procedures for the home. A discussion was held with the Acting Manager about emergency cover for night staff, following a situation where a resident was sent to hospital in the late evening without an escort from the home. The Acting Manager told the inspector that she was on call for emergency situations but it is up to the individual member of staff if they contact her or not. The home may wish to consider putting in place a written procedure for emergencies at night for all staff to follow. The home’s complaints procedure was clear in providing the information on how and to whom to make a complaint and the process that follows. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 15 Training for staff on Adult Abuse was provided and updated as required. Staff spoken to show they understood their responsibilities in protecting residents by reporting any incidents of abuse immediately to the manager or a senior member of staff. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 16 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. The residents live in a comfortable, safe and clean home. EVIDENCE: A tour of the building took place and some of the resident’s rooms were seen. The residents spoken with all liked their rooms and had them furnished with their own personal possessions and small items of furniture. All areas of the home were fresh and clean and well maintained. No programme for routine maintenance was available but areas of the home are decorated as and when they are needed and when resident’s rooms become vacant. The grounds were neat and tidy. The building complies with the requirements of the local fire service following an assessment carried out in December 2004. The Fire Safety Consultancy Ltd carried out a fire risk assessment on 5/4/06 and several recommendations were made as a result of the assessment. No requirements were made, as the company does not have legislative powers to Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 17 enforce them. The report and assessment had recently been received and no actions as yet had been taken, as head office had not yet seen the report. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 18 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 is good. This judgement was made using available evidence including a site visit to this service. The staffing numbers are sufficient to provide the residents with a good standard of care. The staff are provided with the appropriate training for them to carry out their work. The recruitment procedures for the home ensure the residents are protected. EVIDENCE: Staff rotas show that there was sufficient staff on duty to provide a good standard of care to the residents. There is one nurse plus two carers on the first floor and one nurse plus three carers on the ground floor in the morning shift and one nurse covering both floors plus two carers on each floor in the afternoon shift. At night there is one trained nurse plus three carers with the manager being on call for emergencies. As previously stated there are no written procedures in place for night staff to follow with regard to the senior person on call at night. The residents and staff spoken with all felt the staffing levels were sufficient and staffing levels were monitored taking into account the dependency levels of the residents. There are several staff vacancies at present including the managers post, a chef, laundry assistant, care staff for 21 hours, and two full time team leader posts. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 19 There has been one new member of staff employed since the last inspection and the staff file showed that all the necessary checks had been carried out prior to the nurse commencing work in the home. The home is in the process of updating all staff training on the computer. It was confirmed that all staff complete all the mandatory training that is updated as required. A training co-ordinator has been appointed and she is responsible for setting up individual staff training portfolios. The Brendoncare Foundation is committed to provide training for staff and a regular programme of training is displayed in the home for staff to attend. Future training is planned for Parkinsons Disease, dementia, first aid and health and safety. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,38 Quality in this outcome is good. This judgement was made using available evidence including a site visit to this service. Procedures and safe working practices are in place to ensure as far as practicable the welfare of the residents and staff. EVIDENCE: The newly appointed manager who was due to start work at the end of May 06 had withdrawn her application and so the post is again vacant. The present Acting Manager is also leaving so interim measures need to be put in place to manage the home and this should be put in writing to the Commission of Social Care Inspection. Questionnaires had been sent out to relatives and residents in Jan 06 from the head office of The Brendoncare Foundation and an audit of the results was Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 21 examined and showed that the questions contained in the questionnaire covered 9 areas. The residents reported a 79 satisfaction level with an 84 satisfaction level for visitors. The home has a policy not to get involved with the finances of the residents. The home only handles small amounts of spending money that is recorded for each resident and any transactions are recorded and receipts kept where appropriate. Although the home provides appraisals, job chats, group discussions and reflective practice, staff said they still did not have one to one sessions of supervision where they can discuss any confidential matters. Accidents and incidents were generally recorded appropriately and reported to the appropriate authorities. However it was noted that the Commission had not received a notification of a recent accident resulting in a resident being admitted to hospital following a fall. The handyman carries out routine maintenance checks but it was noted that water temperatures are still only being monitored in bathrooms and not to basins in en-suite facilities. Window restrictors were not fitted in some areas of the home and the Acting Manager had compiled a list of where they were needed, and sending it to head office for attention. As previously mentioned in this report staff are provided with all the mandatory training that is updated when required. Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 22 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 4 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 N/A X 3 X 3 3 X 3 Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP7 Regulation 15 Requirement The registered person shall ensure that a written plan is completed as to how the resident’s needs in respect of health, and welfare are to be met. Timescale for action 31/07/06 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 Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Stildon Brendoncare DS0000014746.V295686.R01.S.doc Version 5.2 Page 25 - 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!