Inspection on 19/09/07 for The Briars

This inspection was carried out on 19th September 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Briars 21/09/06

The Briars 06/02/06

The Briars 03/05/05

The Briars 22/09/04

The Briars 28/04/04

Similar services:

Craigmore House

1 Lanark Close

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

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

CARE HOME ADULTS 18-65 The Briars 24 Pearl Street Salburn-by-Sea TS12 1DU Lead Inspector Brenda Grant Unannounced Inspection 19th September 2007 09:30 The Briars DS0000000096.V351010.R01.S.doc Version 5.2 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 The Briars DS0000000096.V351010.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 Adults 18-65. 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. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Briars Address 24 Pearl Street Salburn-by-Sea TS12 1DU 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) 01287 622264 Mr V Game Mrs M Game Mrs Marin Game Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2006 Brief Description of the Service: The Briars is a single-fronted, Victorian terraced house, which blends in well with the surrounding properties. There is a small garden to the rear of the property. The home is situated in an established residential area of Saltburn, close to shops, community facilities and a short distance from the seafront and the Valley Gardens. Accommodation is provided in four large single rooms, each containing a wash hand basin. Communal facilities consist of a comfortable, family style lounge, a dining room and a kitchen, and there is an office for the use of the manager and staff. The dining room is a large functional room, which is also used as an activities room and residents have access to all domestic facilities. At the time of the inspection the fees charged by the home was £390 per week. Residents who did not attend day care placements were charged an extra £39.20, per day, Monday to Friday. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection. We assessed the information from: the Annual Quality Assurance Assessment that was completed by the manager, one survey form that had been completed by a relative of a resident and we carried out a visit to the home. The visit took place over one day, six hours in total. Discussion and observation took place with residents, staff and the manager. We looked around the home as well as examining a number of records which included those for; residents and staff files, health and safety and maintenance checks, complaints, accidents and medication. The findings from the inspection were of the manager and staff providing a good care service, creating a comfortable, homely atmosphere and making every effort to meet the needs of individual residents. What the service does well: What has improved since the last inspection? Bedroom doors had been fitted with smoke seals, to comply with a recommendation made by Cleveland Fire Brigade. The Complaints Procedure had been updated, to make it easier for residents to understand how to make a complaint. The Briars DS0000000096.V351010.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. The summary of this inspection report can be made available in other formats on request. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 2 Resident’s individual aspirations and needs are assessed before they are admitted to the home. EVIDENCE: There had been a new resident admitted to the home since the last inspection. A care manager had carried out an assessment of the person’s needs and the assessment documentation was shared with the home. The assessment included details of the person’s personal, health care and social needs. The information also included particulars about the person’s abilities. Resident’s files, that were examined, contained a full assessment of the person’s needs. There was evidence that the resident and their relatives had been fully involved with the assessment process. The assessment details allowed the home to determine if the person’s care needs could be met by the service. The manager said, before admission, residents were given details about the home and they were invited to visit the home to have a look around the building and meet staff and the other residents before they decide if they want to live at The Briars. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 6, 7 & 9 The home has Care Plans, for each resident, which are regularly reviewed. The plans also contain Risk Assessments that include how risks are managed. Resident’s files inform how they are supported and assisted with making decisions and living their lives independently, as they are able to, within their capabilities. EVIDENCE: A sample of Care Plans were examined. The plans had information of the person’s care needs and how care was to be delivered. There were also details about the person’s preferred lifestyle, choices and likes and dislikes. Care Plans included Risk Assessments, detailing how risk would be minimised to an acceptable level. Areas of risk were discussed with residents, to avoid limiting residents with their preferred chosen activities. Risk Assessments were reviewed at the same time as Care Plans. Residents were fully involved with The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 10 their Care Plans. One resident, when asked if s/he knew about his/her Care Plan said, “I know what is in the records and everything is okay”. A member of staff said, when there were reviews or changes to Care Plans, residents and their relatives were always involved and they had the opportunity to give their views about how care was delivered. Staff said, they supported residents with making decisions and choices were offered to residents. One resident we spoke with said, staff helped him/her “To do lots of things”. One relative’s survey confirmed residents were supported to live the life they choose and the care service met the different needs of people living at the home. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12, 13, 15, 16 & 17 Staff appropriately support and care for residents. Residents are offered choices of daily activities and residents can live their lives as they wish. Mealtimes are enjoyable. It was not clear that residents are encouraged to have a varied and healthy diet. EVIDENCE: Residents had opportunities for personal development and residents were encouraged to be independent and maintain practical life skills. Residents helped with some daily tasks around the home. One resident said, “I do some cooking and I like keeping the place clean and tidy” and another resident said, “I pull the weeds out of the garden and sweep the leaves up”. Most residents, within Risk Assessments and supervision from staff, were assisted with daily living jobs around the home. The manager and a member of staff said, The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 12 residents were encouraged and assisted to take up opportunities that would help residents to maintain their independence. Residents said, they could choose when to get up and go to bed and do what they wanted each day. One resident who got up at around 6 am every morning said “I have always been an ‘early bird’ and I go to bed when I am tired”. On the day of the inspection ‘site’ visit two residents were at their day care placements and two residents stayed at home. The manager said, “Where possible we encourage residents to be involved with the community and go to college but it depends on the resident’s individual needs”. The two residents who were at the home had decided to go out to a local café for lunch. Staff supported residents with getting to the café and helping them to choose and pay for their meal. The home kept records of all resident’s day care attendances and activities. Residents were encouraged to be involved with various activities that ranged from: going for a walk, visits to the cinema and theatre, shopping, going to the pub and having day trips out. A resident said, “We sometimes go out in a taxi or the bus to go to Middlesbrough and other places”. One resident said, “We will soon be going to Flamingo Land, that will be good”. Activities, residents were involved with, were as a group or on an individual basis. Staff supported residents with choosing, planning and going on an annual holiday. Residents said, this year they had enjoyed a holiday to Scotland. The relative of a resident confirmed, s/he was always kept up to date with important issues that affected the resident. Staff said, they assisted and encouraged residents to keep their family links and friendships. We observed, there was a good relationship between staff and residents and staff spoke to residents in a respectful way. One resident said, of the staff and other residents, “I like everybody” and a member of staff said, “I love it here”. A member of staff said, the home made sure residents had the right to privacy. Residents had a key for the lock of their bedroom door and they could lock their doors if they wished. In a survey a relative of a resident confirmed, the home always respected individual’s privacy and dignity. The manager told us, “The cordless phone was available for residents who wanted to talk to people in the privacy of their bedrooms”. The manager said, residents were involved with deciding what meals they would like to have. One resident said, “The food is good”. Another resident, who sometimes helped with cooking the food, said, “It turns out nice”. There was no set menu. The home’s record did not include details of all food served to residents therefore it could not be determined if residents had a healthy and varied diet. However, the manager and a member of staff commented that residents benefited from having plenty of fresh and home-made food. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 18, 19 & 20 There is satisfactory support for health and personal care and there is suitable recording of medication. EVIDENCE: The manager and a member of staff said, they supported residents with all personal and healthcare needs. Most residents could manage their own personal care but there were times when staff needed to give prompts. Staff said, personal care is always carried out in a sensitive manner and to the resident’s preferences. Residents chose their own clothes and resident’s appearance reflected their personality. The home kept records of all healthcare needs and for resident’s appointments with healthcare professionals. There was information relating to the outcome of medical appointments and Care Plans were altered accordingly. Records demonstrated there were regular checks for dental, optical and other healthcare related treatment. A resident said, “They make sure I am always The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 14 healthy and feeling okay” and a relative, in a survey, confirmed individual’s health care needs were properly monitored and attended to by the care service. Medication Administration Records were examined. The record had signatures of the staff who administered the medicine to the resident and there was a record of all medicines at the home. The Briars had a satisfactory facility for storing medicines. Staff’s files confirmed staff had completed training for safe handling of medicines. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 22 & 23 Residents are confident their views are listened to and they are protected from abuse, neglect and self-harm. EVIDENCE: The home had a satisfactory Complaint’s Procedure. It informed who would deal with complaints and the expected time when a complainant would be sent a written response. A relative, who completed a survey, confirmed s/he knew how to make a complaint and s/he had confidence the home would take appropriate action when it was needed. There had been no complaints during the last 12 months. The home had a copy of the Redcar & Cleveland Inter-Agency Policies, Procedures and Practice Guidance, ‘No Secrets’, for safeguarding adults. A member of staff said, s/he was aware of the guidelines and s/he had completed training for the protection of vulnerable adults. Staff’s files confirmed staff had completed safeguarding training. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 24 & 30 The home environment is homely, comfortable and safe and repairs and maintenance work is carried out. EVIDENCE: Residents lived in a very homely and comfortable home. Residents said they helped to choose the colour schemes in communal areas and their own bedrooms. Each bedroom had different furniture and personal possessions and was to the individual taste of the resident. Below the lounge window the wall had suffered from dampness and wallpaper was peeling off. It needed to be redecorated. A first floor shower room, where a wall had been repaired, needed to be decorated. The manager told us that work would soon be carried out. The garden, at the back of the home, had a patio area with flower-beds and there were pot plants, it was well maintained. A resident said, “I always The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 17 help with the gardening”. The patio had plenty of seating, available to residents, to sit outside in warm weather. The Briars had plenty of space for residents to move around inside the home. Residents were seen freely moving around all communal areas. The premise was well maintained and clean, tidy and free from offensive odours. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 34 & 35 Residents are protected and supported by the home’s recruitment procedures and staff are appropriately trained to care for the residents at the home. EVIDENCE: Staff files had records confirming staff had completed all of the required induction and basic training. The manager had made arrangements for staff to keep up to date with that training particularly for: fire drills, first aid and infection control. The manager and a member of staff said, staff were encouraged to discuss different issues about resident’s illnesses and how the illnesses could be managed. When there was not enough information, to give staff a clear overview about an illness, specialist health care professionals were asked for further advice. The information was shared with staff, so they had greater awareness and knowledge of resident’s specific needs. Staff files had lots of certificates and information; they were not kept in any specific order. It was difficult to look through them and check if training updates had been carried out and when further training was required. There was four female and The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 19 one male staff. Residents benefited from the home having a small staff group who worked well as a team. Residents were supported and protected by the home’s recruitment policy. Staff files contained all of the required information, confirming there were satisfactory references and checks before a person was employed at the home. The manager said, the home did not have one reference, for a new member of staff, but there was another reference and a Criminal Record check was satisfactory. She told us, that person only worked under her supervision and s/he did not work alone with residents. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 37, 39, 40 & 42 Residents benefit from a well run home and they are included with developments and changes that take place. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager had many years of experience of managing a care home. She had gained qualifications for: Registered Manager’s Award (Units - RM1 and RM2), City and Guilds Advanced Care Management and Foundation in Care. A member of staff said, they were always well supported by the home’s manager. The manager said, she made sure residents were involved when there were developments and changes to the service. Records showed resident’s views were taken into account and there were regular residents meetings. The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 21 The home had carried out a quality assurance survey where residents could comment about the home and how they would like the service to be improved. The results of the survey had not been compiled in a report but the information was shared with the residents. The manager did not carry out regularly carried out monitoring checks and audits of the service. As a result general Risk Assessments had not been reviewed. Staff had completed training regarding health and safety but they needed to be updated of fire safety. A number of health and safety records were examined. Records for: accidents, fire, gas and electrical equipment confirmed there were regular checks and maintenance work carried out. The Briars DS0000000096.V351010.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 2 X 2 X The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 23 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 YA17 Regulation 17 Requirement The home must keep a record of food provided for residents in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory. The home must redecorate underneath the lounge window where wallpaper is peeling and the first floor shower room that has had the wall repaired. The results of the quality assurance survey must be detailed in a report and state what measures the home will take to improve the service. The home must regularly review general Risk Assessments, to make sure they are kept up to date. Staff must be updated for their training in Fire Safety. Timescale for action 31/10/07 2. YA24 23 31/10/07 3. YA39 24 30/11/07 4. YA40 13 31/10/07 5. YA42 18 30/11/07 The Briars DS0000000096.V351010.R01.S.doc Version 5.2 Page 24 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. 2. Refer to Standard YA1 YA35 Good Practice Recommendations The registered manager should produce a resident guide in a format suitable for the residents for whom it is intended. Staff training files should be kept in a more orderly fashion, so that it can be easily determined what training staff have completed and of the training that needs to be updated. The manager should carry out regular monitoring checks and audits of the service. 3. 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