CARE HOME ADULTS 18-65
The Briars Residential Home 29 Spa Lane Hinckley LE10 1JA Lead Inspector
Kim Cowley Unannounced Inspection Wednesday, 18th January 2006 12:30 The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 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 Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 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 Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Briars Residential Home Address 29 Spa Lane Hinckley LE10 1JA 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) 01455 613749 Mr Roy William McCormick Mrs Ann O`Neill Mrs Ann O`Neill Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No further conditions of registration apply. Date of last inspection 13th June 2005 Brief Description of the Service: The home is situated on a main road close to Hinckley town centre, and provides care and support to seven adults who have a learning disability. Each resident accesses a day service, college placement or work experience. The home offers opportunities for residents to develop their independent living skills, in promoting community participation and involvement. The home is furnished and decorated to a high standard and offers good quality and comfortable accommodation. Communal areas are substantial and homely and there is a large garden at the back of the house. All residents have good size single bedrooms and there are two fully equipped bathrooms and a shower room. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a weekday. When undertaking inspections the Commission for Social Care Inspection (CSCI) focuses on the outcomes for residents living in a home. In order to do this, the inspector ‘case tracked’ three residents. This means the inspector checked their care records, and met with them. The inspector also talked to the Owner, the Owner/Manager, and two of the carers. Further care and other records were examined. Two requirements were made and the staff team was commended. What the service does well: What has improved since the last inspection?
All care plans have been evaluated and updated where necessary. The Manager said that in future they will be reviewed at least every three months during formal staff meetings and updated as necessary. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 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 Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 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 Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This Standard was inspected at the last inspection on 13.06.05. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This Standard was inspected at the last inspection on 13.06.05. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This Standard was inspected at the last inspection on 13.06.05. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Improvements are still needed to medication administration policies and procedures in the home. EVIDENCE: Arrangements for medication administration were examined as areas in need of improvement were identified at the last inspection. Since then some issues have been addressed: • The home has a new contract pharmacist and better systems are in place for recording medication administration, including a returns book. This has not been used yet by the Manager said when it is both parties involved in the return will sign it. Staff are no longer sub-dispensing medication as they are now using blister packs. Syrups and creams are now being dated when they are opened. • • The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 12 However improvements are still needed in the following areas: • A GP has been contacted about the use of homely remedies for one resident. The Manager said the GP is happy with the way they are being used, but is unwilling to prescribed them or give written authorisation for them to be used. The Manager said she will contact the family concerned, who approve of the homely remedies, and ask them to give written permission for the homely remedies to continue to be used, as they are effective for the resident in question. A list of staff authorised to give medication has been updated and is displayed in the office. However staff and the Manager need to sign this to show the authorisation is approved by both parties. The times medication is given are still not clearly stated on the medication administration record. It is suggested that the contract pharmacist is asked to supply administration sheets with the times already printed on them. • • The home must ensure its policies and procedures for the safe handling of medication meet requirements, seeking advice from their contract pharmacist where necessary. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This Standard was inspected at the last inspection on 13.06.05. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This Standard was inspected at the last inspection on 13.06.05. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 The staff team are friendly and professional and have good relationships with the residents. Staff files need auditing to ensure they contain all the required information. EVIDENCE: The home has an established staff team from a variety of backgrounds including social care, education, and nursing. There are a minimum of two staff on duty during the day and one sleeping in during the night. The Owner/Manager and Owner both cover shifts and are responsible for overseeing the running of the home. As well as carers, a driver and administrator are also employed. The staff are friendly and down to earth and were seen to interact with residents in a warm and professional manner. All residents interviewed praised the staff and the following comments were made: ‘The staff are very good.’ ‘The staff work properly with me.’ ‘If I get upset the staff talk to me.’ ‘All the staff make us laugh.’ ‘The staff never get cross and they never tell us off.’
The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 16 ‘I’ve got a key worker called June. She does baking with me on a Friday. It’s a one-to-one session.’ The staff team are commended. The Manager said that most recruitment is usually carried out by word of mouth and the home has only had to advertise once since it opened. Residents are involved in staff recruitment. They have the opportunity to meet candidates and provide feedback to the Manager about who they feel would be best for the home. Staff files were examined. They were well presented and organised, but need auditing to check that all the documentation required under Regulation 19/Schedule 2 is in place. Staff are encouraged to take up training opportunities. Two staff are currently doing a computer course so they can help residents who want to learn IT skills. NVQs are in place and LDAF training is being introduced this year. Staff have reviews two to three times a year when their training needs are identified and relevant courses planned. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This Standard was inspected at the last inspection on 13.06.05. The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 18 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 X 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 4 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X X X X X X X X The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 19 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 YA20 Regulation 13(2) Requirement Timescale for action Policies and procedures for the 18/03/06 safe handling of medication must meet requirements, with advice being sought from the contract pharmacist where necessary. Staff files must be audited and 18/03/06 missing documentation put in place in order to meet Regulation 19/Schedule 2. 2 YA34 19 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 The Briars Residential Home DS0000001675.V279248.R02.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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