Inspection on 30/01/06 for The Browning Care Home

This inspection was carried out on 30th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Browning Care Home 21/01/08

The Browning Care Home 13/04/06

The Browning Care Home 04/05/05

The Browning Care Home 09/02/05

The Browning Care Home 24/09/04

The Browning Care Home 09/12/03

The Browning Care Home 11/09/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Browning Care Home 19 Browning Road Banbury Oxfordshire OX16 9LA Lead Inspector Annette Miller Unannounced Inspection 30th January 2006 14:45 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 The Browning Care Home DS0000013189.V281435.R01.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 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. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Browning Care Home Address 19 Browning Road Banbury Oxfordshire OX16 9LA 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) 01295 261496 01295 701027 Mrs Heather Ackrill Care Home 4 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (4) of places The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 4. 4th May 2005 Date of last inspection Brief Description of the Service: Browning Care Home is the family home of Mr and Mrs Ackrill and is registered to provide personal care for up to four residents aged 65 years and over. Mrs Ackrill is the registered owner and manager and she and her husband are the main carers. Mr Ackrill deals with all administrative matters concerning the business. The home is on the outskirts of Banbury, where there are clubs for older people The home has a combined lounge and dining room on the ground floor used by residents, and also by Mr and Mrs Ackrill. Bedroom accommodation is situated on the ground and first floors. The residents’ bathroom is on the first floor and has a washbasin, bath and toilet. A stairlift is provided. Mr and Mrs Ackrill’s bedroom is on the first floor and there is a staff shower room and toilet on the ground floor. There is a small garden at the back of the house accessed through the kitchen. . The Browning Care Home DS0000013189.V281435.R01.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 carried out by one inspector from 2.45 pm to 7 pm. During this time a tour of the building took place and documents were examined. The inspector spoke to one resident and a visitor. The manager and her husband were present throughout the inspection and the inspector would like to thank them and the residents who were all very welcoming. What the service does well: What has improved since the last inspection? What they could do better: The home must have a Service User Guide and a copy must be given to all prospective residents. The manager is an experienced carer but has no formal qualifications in either management or care and a personal development plan is needed to show how these qualifications will be achieved within a reasonable timescale. A carer was recently appointed before all the necessary recruitment procedures had taken place and this is a serious matter. An immediate requirement was made that staff must not be employed until all the relevant information and checks are obtained. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 6 No formal fire training has been provided for staff and advice from Oxfordshire Fire Service must be obtained as to what training is required in this small home and the frequency it should occur. 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 Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 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 The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 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 The home does not have a Service User Guide and prospective residents cannot, therefore, make an informed decision about admission to the home. EVIDENCE: The home’s Statement of Purpose has been reviewed recently and a copy supplied to the Commission for Social Care Inspection (CSCI). However, the Service User Guide was not available and completion of this is overdue. The home is required to have a Service User Guide and copies must be available by 30th April 2006, to give to prospective residents and for a copy to be submitted to CSCI. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10. The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. Personal support is offered in such a way that promotes and protects residents’ privacy and dignity. EVIDENCE: GPs and district nurses regularly visit the home to provide health care to residents. One resident who is totally dependent for all aspects of her care requires a specialist pressure relieving mattress and a district nurse is arranging for this to be provided. Another resident has regular visits from specialist nurses who give support and advice on her specific nursing needs. The home does not have sit-on weighing scales and none of the present residents are capable of standing on normal domestic scales. The manager said that district nurses periodically assess residents using the body mass index score (an alternative to weighing) to check that residents are well nourished. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 10 A resident confirmed she is seen by doctors and nurses in the privacy of her room and thinks her medical and nursing care is well managed. A ceiling hoist has been installed to move her safely from bed to chair. One resident has a telephone in her room. There is also a cordless telephone for use by all residents. Residents’ clothes are laundered at the home and returned promptly to ensure they always have their own clothes to wear. The manager said that residents are asked on admission their preferred term of address. The manager and her husband provide 24-hour care and showed a good understanding of the importance of treating residents with respect, such as knocking on bedroom doors and waiting before entering, which the inspector observed during the course of the inspection. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 14 and 15. Residents have choice and control over their lives that meets their expectations and wishes. The meals in this home are good offering both choice and variety and catering for special dietary needs. Visitors are welcome at any reasonable time. EVIDENCE: There was only one resident who was able to express an opinion about her care and this person thought the home provided a pleasant environment in which to live. She prefers to stay in her room where she has her own TV, telephone and personal possessions around her. Another resident was sitting contentedly in the home’s comfortable and cosy lounge playing the card game ‘patience’. Two residents were unable to express a view due to mental health problems. A visitor was in the home and confirmed she could visit whenever she wished. The manager said that local community groups do not visit because this is not something that the present residents request. There are clubs in the vicinity specifically for older people, but none of the present residents have asked to attend. During the inspection the residents were enjoying the regular visit to the home by a local hairdresser. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 12 Three meals are offered each day, together with snacks if needed. The manager prepares meals individually based on each resident’s likes and dislikes. The inspector saw that supper for one resident consisted of salmon and salad, followed by fruit cut into small pieces as requested by the resident. Two residents are fed and pureed meals are provided as both residents have difficulty in swallowing. The manager has attended a basic food hygiene course and the training certificate was provided for inspection. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: Browning Care Home is a family home and has suitable equipment for the present needs of residents. For example, a stair lift is provided, as well as ceiling hoists in two bedrooms to move residents safely from bed to chair. One of the four bedrooms used by residents is very small and can only accommodate a bed, bedside cabinet and chair; during the day the resident goes to the pleasant lounge. This bedroom was registered before the current standards and regulations came into force. However, the manager has previously stated that when the room becomes empty it will no longer be used as a resident’s bedroom. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 15 A fire officer last visited the home in 2003 and there are no outstanding requirements from this visit. The home has not had an Environmental Health inspection, even though the manager and CSCI has asked for a visit to be made. Since the last inspection a thermostatic valve has been fitted to the washbasin to limit any risk to residents of sustaining scalds from water that is too hot, but the hot water to the bath is not similarly controlled. The manager must ensure that this situation is risk assessed and the outcome of assessment recorded. If bathing facilities are accessible by vulnerable residents a thermostatic mixing valve should be fitted to prevent the water temperature being greater than 43ºC. Radiators in bedrooms have been fitted with guards to prevent residents touching hot surfaces. At the time of inspection the standard of cleanliness was extremely good and a visitor commented that the home always smelled fresh when she visited. At present the only internal route to the laundry is through the kitchen. This is unsatisfactory because soiled linen should not be taken through an area used to prepare food. There is access round the side of the house and this route should be used until the laundry machines are moved to the garage. The manager’s husband is planning to start this work in March 2006. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 29 Since the last inspection the standard of vetting and recruitment practices has declined with appropriate checks not being carried out. This has the potential to place residents at risk. EVIDENCE: Two staff files were inspected and some important information and checks were missing. Also, a carer was recently appointed to work one evening a week to provide cover the manager and her husband when they go out, but recruitment procedures had not been fully completed. An immediate requirement was made that no person is to be employed until such time as the necessary information and checks have been obtained. The inspector also found that a volunteer who has visited the home for many years is sometimes left alone in charge of residents and this must not happen as the necessary recruitment information and checks have not been carried out. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 17 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 and 38. The manager has considerable experience in providing care for older people, but does not have a management qualification or a care qualification and this could potentially have a detrimental affect on the way services are provided. There has been good progress in meeting National Minimum Standards relating to health and safety, although some further work is needed to provide assurance that the home is a safe place in which to live. EVIDENCE: Mrs Ackrill is the registered owner and manager of Browning Care Home and lives in the home with her husband. They are the main carers providing 24hour care. The manager has considerable experience of caring for older people but has not obtained formal qualifications in either management or care, although is considering starting level 3 NVQ in care. This intention was also stated at the The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 18 last inspection on 4th May 2005. Registered managers are expected to undertake level 4 NVQ training in care as well as management and the home’s manager must submit to CSCI a personal development plan showing how she plans to undertake this training and the timescale for completion. Mr Ackrill had started level 4 NVQ in care at the time of the last inspection but has not yet submitted any modules towards achieving this award. He does not have any care qualifications. The manager has a current first aid certificate and she and her husband have also attended moving and handling training in May 2005. Training has also taken place in administration of medication, dementia care and protection of vulnerable adults. There are no formal quality assurance measures in place based on seeking the views of residents. The manager said she finds out what residents think during conversations with them, as well as talking to visitors. The manager does not accept responsibility for residents’ personal finances, or become involved. Residents, or a representative, are responsible for all personal finances. Small electrical appliances have not been tested for safety and the manager should seek advice from Environmental Health to establish what checks are needed. Members of staff have not received fire safety training and this must be arranged in line with the recommendations of Oxfordshire Fire Service regarding the content and frequency of such training. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 19 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 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 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 X 17 X 18 X 3 X X X X X 2 2 STAFFING Standard No Score 27 X 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 2 The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 20 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 OP1 Regulation 5 Requirement Timescale for action 30/04/06 2 OP29 19(1) & Schedule 2 3 OP31 10 4 OP38 23(4) The home must have a Service User Guide and supply a copy to all prospective residents and to CSCI. The registered person must not 30/01/06 employ a person to work at the care home unless the information and documents that are required are obtained prior to the person’s appointment. The registered person must show 30/04/06 in a personal development plan how she intends to achieve the level of training that is required to undertake her duties. A copy of the plan must be submitted to the Commission. The registered person must seek 30/03/06 the advice of the Fire Service regarding the level of fire training that is required. The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 21 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 3 Refer to Standard OP25 OP26 OP33 Good Practice Recommendations If bathing facilities are accessible to vulnerable residents consideration should be given to fitting a thermostatic mixing valve to the hot water supply to the bath. Soiled linen should not be carried through the kitchen and an alternative route to the laundry should be found until the laundry machines are moved to the garage. Consideration should be given to obtaining formal feedback at least annually from residents, relatives and social and health care professionals about the services the home provides. The advice of Environmental Health should be sought to establish if checks are needed on portable electrical appliances. 4 OP38 The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 The Browning Care Home DS0000013189.V281435.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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