Care Home: 10 Brooklands

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What the care home does well 10 Brooklands is friendly and relaxed. The Manager runs it well and makes sure that people who live there are happy. Staff listen to what people want and if they are unhappy, sort it out. They feel at home and enjoy living in a comfortable house. People are able to make up their own minds about what they do. They can be themselves and have lots of chances to meet other people, enjoy their hobbies and learn more skills. People are able to see their family and friends when they want. The meals in the home are good. People are given the support they need and staff are polite and friendly. This is written down in a care plan to make sure that staff are clear about how to help. Staff look after peoples health and help them to see a doctor or specialist if they need to. There are enough staff to support people when they need it. Staff understand people, fit in with what they need and make sure they are looked after and safe. What the care home could do better: People might be safer if the home made changes to the way they looked aftermedication. It might be better for some service users if the way they are monitored is looked at more often. Random inspection report Care homes for adults (18-65 years) Name: Address: 10 Brooklands 10 Brooklands Tunbridge Wells Kent TN2 3AD three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Helen Martin Date: 3 0 0 4 2 0 1 0 Information about the care home Name of care home: Address: 10 Brooklands 10 Brooklands Tunbridge Wells Kent TN2 3AD 01892537076 Telephone number: Fax number: Email address: Provider web address: lm.weatherly@btinternet.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Lynne Melanie Weatherly Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Lynne Melanie Weatherly care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 5 The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 10 Brooklands is registered as a Care Home for up to 5 adults with a learning disability. Mrs. L. Weatherly is the Registered Provider and Registered Manager. The ethos of the home is to provide service users with care and accommodation in a home like environment with support to live as full a life as possible within the wider Care Homes for Adults (18-65 years) Page 2 of 12 Brief description of the care home community. Service users are encouraged to have confidence in managing their own lives, to develop their own potential and to learn general life skills. They may be supported to a point where they feel safe and confident enough to move to an independent living situation supported by people they are familiar with. The owner has been involved with caring for people with a learning disability for many years. 10 Brooklands is a two-storey semi detached house in a quiet residential area of Tunbridge Wells with an enclosed garden to the rear. There is easy access to local facilities and Tunbridge Wells centre with a bus route close by and a railway station within walking distance. The front drive has space to park two cars with additional on street parking. Care Homes for Adults (18-65 years) Page 3 of 12 What we found: This Random Inspection was undertaken on 30th April 2010. This report should be read in conjunction with the previous Annual Service Review dated 20th February 2008 together with the last Key Inspection report of 30th April 2007, which looked at all core standards. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The focus of this Random Inspection is to assess how the home continues to provide an excellent quality service. This Random Inspection included a visit to the home in Tunbridge Wells on 30th April 2010, where the Registered Manager, the Deputy Manager and five Service Users were spoken with. Some judgements about the quality of the service provided were taken from observation and conversation. Some records and documents were looked at together with the premises and facilities of the home. All of the above have been included within this inspection process and some of the gathered evidence is mentioned within this report where appropriate. During this Random Inspection of 30th April 2010 we found the following: Some people have been living at 10 Brooklands for some time, whilst others have moved in more recently. Before they move in, people are assessed by the home to make sure that staff can meet their needs. Assessments are recorded and care plans for the support that people need are developed from these. Individual plans of care and support are developed for each service user. These aim to identify the action required from staff to meet peoples personal, social and health care needs. Three care plans were looked at. These are detailed, clear and easy to follow. Daily notes and risk assessments are completed. Information is reviewed regularly. Service users are supported to take risks as part of maximising their independence. Staff spoken with demonstrated a good understanding of these and the individual needs of service users. People are protected from increased harm in their daily living activities through risk assessment. People who live in the home are encouraged to participate in the running of the house. They are supported to make individual choices and decisions and are encouraged to achieve as much independence as possible. There are service users meetings, where issues such as the choice of meals or activities are discussed. People who live at 10 Brooklands are treated as individuals who have different interests and aspirations. They enjoy a full lifestyle with a variety of activities, which are agreed with them and appropriate to their interests and abilities. Service users activities include art and craft, drama, computers, dance, needlework; they enjoy pantomime rehearsals, line dancing, involvement in the church, one to one time and local day centres. People are supported to take part in social outings and events. Service users benefit from being able to access local facilities. There is a car for the house and access to another. Care Homes for Adults (18-65 years) Page 4 of 12 Contact between service users and their families and friends is encouraged and supported. Service users enjoy the opportunity to go on holiday with family or friends of their choice. People are encouraged towards independent living skills and supported with domestic tasks. Service users benefit from being supported with cooking and menu planning. Service users regularly invite guests for meals at the home. Weekly meetings include discussion about the choice of meals and who to invite. Service users choose their own menus. At the time of this visit, friends of one service user had been invited to dinner. Service users are supported with any special diets. All service users spoken with enjoyed living in the home. One service user said that they liked it here, had a nice room and liked the staff; they explained where they worked, what they did and how much they enjoyed it; another service user described how they helped at meal times, enjoyed going out and loved their room; another service user was helping the kitchen, whilst another was having friends to dinner. People who live in the home are well supported. They are given the personal assistance they need to maximise their independence, whilst at the same time respecting their dignity and privacy. A good rapport was observed between service users and staff, who were attentive and respectful during the visit. Service users have access to health and social care professionals, such as GP, optician and dentist. They are supported to consult specialists where necessary. Systems are in place for the administration of medication, which aim to protect service users. Service users are encouraged towards self administration as far as possible. Two service users use weekly electronic dispensers. Some medication is stored in individual service users rooms and lockable facilities are provided. One such lockable facility was seen to house other items in addition to medication. The Deputy Manager assured the inspector that all medication in service users rooms would be kept separately in a lockable facility by 30th June 2010. Medication stored centrally is kept in a metal lockable facility, although this is not a cabinet specifically designed to hold drugs. Medication requiring refrigeration is stored in a separate fridge, although this is not a fridge specifically designed to hold drugs. Medication in the fridge is not stored securely as it is not a lockable facility and fridge temperatures are not checked or monitored. Most medication is provided from the pharmacy in an easily monitored dosage system. Some drugs which cannot be stored this way and some provided directly from health care specialists are double dispensed by staff into weekly dossette boxes. The pharmacy currently does not provide pre printed administration records for the home. The Deputy Manager explained that they make their own records. The latter are not signed by two members of staff as double checked. The Deputy Manager stated that they would request pre printed administration records from the supplying pharmacy. Entries on records are completed appropriately. Records are kept for when to administer medication prescribed on a when required basis. The Deputy Manager stated that they would look at the systems in place in conjunction with the latest guidelines provided by the Royal Pharmaceutical Society. Care Homes for Adults (18-65 years) Page 5 of 12 A requirement has been made that the Provider complete their stated intention to review the system for the administration of medication in order to reduce the risk of errors and to supply the Commission with an action plan. Service users are at ease with staff who listen to their views and concerns. Any complaints can be discussed in service users meetings and are minuted. Written policies regarding safeguarding vulnerable adults are available for staff. The Manager has a good understanding of safeguarding procedures. The Deputy Manager stated that they were in the process of developing assessments for care plans regarding the Mental Capacity Act and Deprivation of Liberty and in the process of organising training for staff; confirmation of this will be sent to the Commission. The Deputy Manager explained that the home holds no money or valuables for services users centrally. Service users are provided with lockable facilities and are able to look after their own money. They are supported with budgeting by staff. The home and garden is clean and tidy. Communal areas in the house and service users rooms are attractively decorated, the latter being highly personalised, reflecting individuals interests, choice and taste. The home accommodates service users over two storeys, with two bedrooms being on the ground floor. There is one ensuite room, one designated facility and the remainder share a walk in shower. There is no bath in the home. Service users spoken with enjoyed their showers and did not express a wish for a bath. There is no lift available. The Manager stated that although two service users use a wheelchair when they are outside, all service users are able to manage the short distances and stairs involved in the home. The Manager stated that service users do not need a staff call system and can easily reach staff at night if they need to. The Manager explained the system in place for the use of a baby alarm for one service user. It was said that this was discussed and agreed some time ago. The service users choice regarding this is recorded in their care plan. The Provider is recommended to record a review of this system together with health and social care professionals and the service users choice. Service users benefit from the support of staff who are enthusiastic and committed to promoting their welfare. Staff spoken with were clear about their roles and demonstrated a good knowledge and understanding of individual service users needs and wishes. A good rapport was observed between service users and staff, who were attentive and respectful during this visit. Service users are encouraged towards independent living skills and supported by staff with domestic tasks. The home is fully staffed. Staffing numbers depend on the needs and wishes of service users. There is one member of staff sleeping in at night. There is an on call system for staff. Care Homes for Adults (18-65 years) Page 6 of 12 Recruitment procedures are in place, which aim to protect service users and appoint suitable staff to meet their needs. One staff file looked at showed appropriate pre employment checks such as written references and a criminal record disclosure. Another staff file did not contain a second reference or any photographic identification. The Deputy Manager assured the inspector that identification had been checked and would ensure this was kept on file. Subsequent to this inspection confirmation was received that a second reference had been obtained. People who live in the home benefit from the knowledge and experience of a well qualified Manager and Deputy Manager. There was an open and friendly atmosphere in the home and the people who live there were relaxed, spending time with the staff and manager. The views of service users are sought about the support they receive; they are involved in the running of the house as much as possible. There are regular weekly house meetings which include a variety of issues such as health and safety, repairs, activities and any complaints. All the meetings are minuted. Annual questionnaires are provided for service users, their families and friends and regular reviews take place. The Manager stated that the next questionnaires would be sent out by 30th June 2010. Records indicate the testing and maintenance of systems and equipment within the home, including procedures for food hygiene. Records show fire drills and emergency lights checks. There are individual smoke detectors but these are not linked to a central alarm bell system. There is a fire risk assessment. The Deputy Manager stated that the system had been approved by an external fire contractor for the home, but that they would contact the Fire Authority by 30th June 2010 to confirm that the system in place is appropriate; confirmation will be sent to the Commission. What the care home does well: What they could do better: People might be safer if the home made changes to the way they looked after Care Homes for Adults (18-65 years) Page 7 of 12 medication. It might be better for some service users if the way they are monitored is looked at more often. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 12 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home In order to reduce the risk of errors, the Provider must complete their stated intention to review the system for the administration of medication, in line with guidance from the Royal Pharmaceutical Society. This must include storage facilities, temperature monitoring, double dispensing and administration records. The Provider must supply the Commission with an action plan. 15/07/2010 Care Homes for Adults (18-65 years) Page 10 of 12 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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