Inspection on 12/06/07 for The Brooklands

This inspection was carried out on 12th June 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 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

The Brooklands 08/06/06

The Brooklands 25/05/05

The Brooklands 16/09/04

The Brooklands 27/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Brooklands (The) Coombs Road Bakewell Derbyshire DE4 1AQ Lead Inspector Nancy Bradley Unannounced Inspection 12th June 2007 09:00 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 Brooklands (The) DS0000019949.V337929.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. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooklands (The) Address Coombs Road Bakewell Derbyshire DE4 1AQ 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) (01629) 812023 01629 814105 Christian Homes for the Elderly Mrs Diane Margaret Ashbrook Care Home 19 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (9) of places Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To register one bed for DE(E) for the individual named in the notice of proposal for the duration of their stay. 8th June 2006 Date of last inspection Brief Description of the Service: The Brooklands is a Christian Residential Home and is run by a non-profit making organisation. It is in an old building, which has been adapted to residential home use, and is situated in its own grounds on the outskirts of Bakewell. It is registered to provide services for 19 people, including 10 for older people with dementia. A choice of lounges and dining rooms is provided. The current scale of charges is £355.00 to £385.00 per week. Additional charges are made for hairdressing, toiletries podiatry and newspapers. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection and took place over six and half hours. The inspector spoke with the Registered Manager, care staff and made a tour of the building. Records were examined relating to the four residents and the general operation of the home. Additionally, time was spent in preparation for the visit, looking at the previous report and “Have Your Say” questionnaires. The pre-inspection questionnaire was not available until the day of the inspection. The Registered Manager provided the inspector with a copy of the documentation returned to the Commission for Social Care Inspection. Currently the home is caring for nineteen residents. A number of family and friends were present during this visit. At the time of the visit none of the residents managed their own financial affair; their own families maintaining responsibility for this The majority of the residents’ families had completed the “Have Your Say” questionnaire, on their behalf, stated they were quite settled at the home, the staff were kind to them and they were happy for them to be there. One service user family stated they had been given a copy of the home’s Statement Of Purpose and Service user Guide, however they were not aware of the last inspection report from the Commission for Social Care Inspection. The report is kept in the office, which limits accessibility. The majority of the residents were unable to contribute directly to the inspection however during the tour of the home and during lunchtime the inspector observed life at The Brooklands. What the service does well: The residents are admitted to the home following a full assessment of their individual needs. The home is run around the needs of the residents and daily routines are flexible. The residents are supported in maintaining contact with family and friends. Families spoken to felt their family members are treated with respect and this was especially important as several of the residents are very frail and have poor mental health. The residents are receiving a nutritious and balanced diet. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 6 Residents live in a homely environment, attractive surrounding and are cared for by a dedicate staff team. The home has had very few staff changes and this has contributed to the home providing a good level of care. The resident’s health and safety is promoted. 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. The summary of this inspection report can be made available in other formats on request. Brooklands (The) DS0000019949.V337929.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 Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that potential residents needs are fully assessed and met prior to admission. EVIDENCE: The records of four residents were examined. The majority of the residents who are admitted to the home have their needs assessed through the care management system. There was evidence on file to show that care needs assessments are reviewed on a regular basis by the referring agency. As discussed with the Registered Manager any areas of identified risk and specific care needs must be reviewed on a regular basis by the referring agency and risk assessments updated. Completed questionnaires and discussions with residents families present during the visit confirmed they had received information about the home, were Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 9 consulted about the home and were able to visit prior to their family member moving in to the home. Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a care planning and review system in place, however current practice leaves residents vulnerable. Resident’s privacy and dignity is respected and maintained. EVIDENCE: Although the home had completed an assessment of need and care plans were in place these were too concise, and had not always been signed by the resident or their representative. A care plan for one resident did not show the use of a cocoon for sleeping. As discussed with the Registered Manager, this needs to be an assessed need by a multidisciplinary team, recorded in the care plan and a risk assessment in place, otherwise this may be seen as a form of restraint. The home must have the update information on the cocoon including any contra indicators regarding its use. Individual risk assessments on residents need to be reviewed and incorporated into the residents care plans. The risk assessment for one resident stated a minimum of two care staff when the resident required the bathroom. However Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 11 accident reports on file did not fully support this. The resident had fallen three times in one week with one care staff attending to her needs. The health needs of the residents were recorded in care plans. Information relating to visits from health care professionals such as G.P, dentists, podiatrists and opticians were recorded. Although the home had obtained appropriate medical assistance for one resident with pressure sores there were no details in the residents care plan or risk assessment in place. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. There was a clear audit trail of all prescribed medication used at the home. The Registered Manager confirmed that only nominated staff who have received training on medication can administer medication The home operates and monitors all medication, as none of the residents are able to administer their own medication A list of authorised staff signatures needs to be kept with medication records. The Registered Manager agreed to address this. The staff were observed routinely knocking on residents bedrooms and bathrooms before entering. The residents spoken with considered that the staff working at the home were good and that their privacy and dignity was respected. Conversations between residents and staff were appropriate and respectful taking account of any communication difficulties the service users may have. Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were arrangements in place to enable resident to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. EVIDENCE: The residents and families spoken with during the visit stated that the daily routines were flexible with residents getting up when they wanted to. The pre-inspection questionnaire listed a range of activities offered and on the day of the visit, the hairdresser was due and several residents were involved in the memory club. There was evidence in the lounge of craft activities and items from the memory club. Care staff spoke with during the visit stated they also read books, newspapers and talk with residents. Activities listed in the pre inspection questionnaires were outings, shopping walks, organist and vocalist, games T.V. and clothing sales. However from discussions with families and from completed questionnaires more appropriate group activities especially in the afternoons would be welcomed. The residents’ activities book was examined and showed that the residents had regular visits from family and friends. Currently there are no restrictions on Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 13 when visitors arrive and the home has an open door policy. However on the day of the visit they were arriving at 9am when residents were still getting up and having breakfast. Also at time of the visit there was on issue of contact for one resident. In discussion with the Registered Manager it was not clear from the care plan as to what contact or restrictions to contact were in place. The Registered Manager stated that once every two weeks the local church visits and conducts a service at the home. The Registered Manager stated that the home is not responsible for handling resident’s finances. The residents are all encouraged to personalise their rooms as they wish and bring in their own possessions. Evidence of this was seen during the tour of the home. Both residents and families spoken to during the visit were happy with the meals provided. The inspector observed lunch and from direct observation it was clear that they all residents enjoyed the meals. The dinning room was attractively set out with residents being given a choice of were they sit. Residents’ individual preferences were considered and condiments are offered. The home has a four-week menu with two choices available for the main meal and three for desert. Meals offered were well balanced, varied and nutritional. The kitchen food store was sufficiently stocked and the cook bakes all the cakes. Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to safeguard resident’s welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: The home has its complaints procedure on display giving information too both residents and families. The procedure contains the current contact details address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wish to do so. From completed service user questionnaires and from discussions with the residents’ families confirmed that they are fully informed about the complaints procedure and would have no hesitation in putting their concerns to the Registered Manager. On examination of the complaints record all complaints are responded to within a twenty-eight day period. The Commission for Social Care Inspection has received no complaints about the service since the last inspection. The homes policy on safeguarding adults requires updating to reflect the change of emphasis from abuse to safeguarding of adults. The policy needs to be linked in to local safeguarding procedures as operated by Derbyshire County Council Social Services Department. The Registered Person stated that Safeguarding of Adults is covered in the staff induction programme and they have in the passed engaged a private company to deliver this training. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 15 The Registered Manager confirmed the majority of the staff have undertaken training in safeguarding of adults, with the exception of newly appointed staff. The Registered Manager is looking to register the staff on a social services safeguarding of adults course. There has been no reported incident of safeguarding of adults since the last inspection. Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The implementation of an improvement, plan would ensure the service users live in a safe, comfortable environment. EVIDENCE: Although the home is set in attractive surroundings, and is homely in appearance the building is in need of repairs and refurbishment. The inspector undertook a full tour of the home accompanied by the senior member of staff on duty. • Majority of the windows were rotten with the paint peeling off. • Carpets throughout the home were thread bare, well worn, uneven in part were they had lifted, and some did smell. All residents had access to these areas. • Furniture in some rooms needed to be replaced. • Several rooms need to be decorated as the paintwork has faded and wallpaper was coming off. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 17 • Although residents do not have access to the rear stairs it was quite evident the there had been a major water leak. The wallpaper and plaster were coming away. The one room which has a turn knob fitted to the outside door at the residents requested should be recorded in the residents care plan. The home has an effective infection control policy and procedures in place. Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27.28.29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has recruitment and selection procedures in place that ensures the safety of the residents. EVIDENCE: The staff rotas seen confirmed that staffing levels were being met. From completed service user questionnaires, direct observation and discussions with the care staff confirmed there were sufficient staff in the home to meet the needs of the service users. Information received from the pre-inspection questionnaire shows that the home has a total of fifteen care staff. Currently the home has nine staff holding a NVQ level 2 or above which gives them a sixty percent of care staff that are qualified. On the day of the visit two staff were being assessed for the finial units of NVQ 2 and 3, both were successful. The home has recruitment and selection procedures in place to protect service users from potential harm. Several staff recruitment records were examined and these were in line with Schedules 2 and 6 of the National Minimum Standard. As discussed with the Registered Manager when gaps in employment are investigated this should be formally recorded on interview minutes. As part of providing a full employment history all applicants should provide the day, date month and year. One applicant had only provided the year. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 19 From discussions with the Registered Manager and from examination of records the home is providing good training and development opportunities. Details of staff training together with training planned were provided by way of the pre-inspection questionnaire. It was not that staff are receiving appropriate training on dementia care. Brooklands (The) DS0000019949.V337929.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was generally well managed, with staff seeking the views of the service users on the running of the home. The health and safety of residents is promoted. EVIDENCE: The Registered Manager has only been at the home for a few months, having previously worked at another home within the Christian Homes Group. The manager is registered with the Commission for Social Care Inspection. She has achieved the Registered Manger’s Award and has several years experience and skills in running of a residential home. The personnel finances of four residents were examined and found to be satisfactory. Families maintain financial reasonability for residents’ monies, with the home holding residents’ day-to-day pocket money. Personal money is kept securely. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 21 A quality assurance policy is provided, which sets out the standards and procedures for reviewing the quality of care and services provided by the home. This is based on a programme of self-review and consultation with residents and their families. The Registered Manager acknowledged that quality assurance procedures could be improved with further consultation being undertaken with stakeholders. The information on the home’s health and safety procedures and maintenance was provided by way of the pre-inspection questionnaire. This confirmed that all the relevant checks had been undertaken. Brooklands (The) DS0000019949.V337929.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 X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 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 3 X 3 X 3 X X 3 Brooklands (The) DS0000019949.V337929.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 Care plans must include all residents’ needs, and kept updated following changes in their assed need. Care plans must be completed with involvement of resident’s relatives, or the referring agency where possible. Care plans must be reviewed regular intervals and be clearly shown as such. Detailed risk assessments must be complied on all residents. Risk assessments must be regularly reviewed to reflect changes in residents care. A risk assessment must be completed on the use of a cocoon for sleeping. The use of the turn knob must be recorded in the residents care plan. All residents’ health needs must be clearly recorded in their health care plan. Suitable activities must be offered to all residents. The homes policy on adult protection must be revised and DS0000019949.V337929.R01.S.doc Timescale for action 31/07/07 2. OP7 15 31/07/07 3. 4. 5. 6. 7. 8. 9. 10. OP7 OP7 OP7 OP7 OP7 OP8 OP12 OP18 15 15 15 13 and 15 13 13 16 13 31/07/07 31/07/07 31/07/07 31/07/07 31/07/07 31/07/07 31/07/07 31/07/07 Brooklands (The) Version 5.2 Page 24 11. 12. OP18 OP18 13 23 13. OP33 24 updated to reflect current practice. The homes policy on Safeguarding Adults must make reference to local procedures The home must be suitable for the needs of the service users and be maintained both internally and externally The home must consult with stakeholders as part of its’ review into the quality of care 31/07/07 31/07/07 31/07/07 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 OP7 OP18 Good Practice Recommendations Residents’, or their representatives’, involvement in care plan reviews should be confirmed by means of a signature. This is a previous recommendation. All staff should undertake a refreshing course in the Safeguarding of Adults. Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Brooklands (The) DS0000019949.V337929.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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