Care Home: Britannia Care Home

What the care home does well The temporary accommodation at Britannia has meant that at least two people have the opportunity to have meals that better reflect their cultural needs and preferences. For people from the Malvern the move is still within easy reach for their relatives and for staff. What the care home could do better: The temporary move brings together people with differing needs. Britannia has a number of frail immobile older people. Some of the people who live at the Malvern can display behaviours that challenge other people.We have asked both services to keep their staffing levels under review and to notify us of any incidents or issues that arise. Suitable and usable washing and bathing facilities should be maintained so that people`s personal care needs are met. Individual toiletries and personal care items should be removed from communal bathrooms to help prevent the spread of infection. To miminse any associated risks, the providers should make sure there are adequate and safe arrangements in place for the storage of clinical and other waste. The area adjoining the rear fire door should be kept clear at all times so that fire safety is not compromised. The fire risk assessment in place should be reviewed to take full account of any additional risks presented by smoking. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Britannia Care Home 4 Thorn Street Girlington Road Bradford BD8 9NU one star adequate 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Sughra Nazir Date: 0 9 0 2 2 0 0 9 Information about the care home Name of care home: Address: Britannia Care Home 4 Thorn Street Girlington Road Bradford BD8 9NU 01274770405 Telephone number: Fax number: Email address: Provider web address: britcare@hotmail.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Girlington Nursing Home Ltd care home 25 Number of places (if applicable): Under 65 Over 65 0 25 0 dementia old age, not falling within any other category physical disability Conditions of registration: 25 0 25 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE and Physical disability - Code PD The maximum number of service users who can be accommodated is: 25 Date of last inspection Brief description of the care home The home offers personal care to people from a wide range of cultural backgrounds, predominantly, but not exclusively, people of Asian origin. Care Homes for Older People Page 2 of 11 Brief description of the care home It is situated in the Girlington area of Bradford, which is approximately 1 mile from the city centre. There is a very good range of amenities available locally including shops, public houses, churches, and mosques. The home is well served by public transport. The home has 3 floors; the communal rooms are on the ground floor and consist of two lounges and dining room/lounge. There are 17 single and 9 doubles rooms; none of the rooms have en-suite facilities. There are four communal bathrooms located on the first and second floors, and communal toilets are located throughout the home. There is a passenger lift to all floors and a ramp for disabled access at the front of the home. There is a small parking area at the back and street parking is available. In July 2008 the owner told us the fees ranged from £351.18 to £454.93 per week. Hairdressing and the cost of outings are not included in the fees. Information about the service is made available on request. Care Homes for Older People Page 3 of 11 What we found: Britannia Care Home has recently varied their registration to include the category of mental disorder. Due to a system fault this is not reflected in the information provided at the front of this report. An unannounced inspection was carried out at this home by two inspectors as due to an emergency situation people from another home have moved into Britannia. On January 17th 2009 there was a fire at a nearby nursing home called the Malvern. Due to the damage caused by the fire everyone living in the home had to be moved out immediately into other care services. Sixteen people from The Malvern moved into Britannia Care Home. Bradford Social Services emergency duty teams were involved in this process. Nursing and care staff from The Malvern moved with these people and continue to provide them with the care and support they need. This is a temporary arrangement until The Malvern is ready to reopen. All the people transferred from The Malvern are being reviewed by the care management teams to ensure that their needs are being met while this temporary arrangement is in place. This visit was carried out to review the arrangements in place and make sure that everyone living in Britannia is safe and their needs are being met. This was not a full inspection and we did not look at all the standards or review any requirements outstanding from previous inspections. We spoke to some people who live at Britannia permanently and to some people who have moved in temporarily from the Malvern. They all told us that they knew that people had to move because of the fire. Two people from the Malvern told us they were ok but wanted to go home. We did not look at any care files. Staff from the Malvern told us that many of the people from the Malvern are registered with the medical practice next door and that this has helped them provide support if needed. There is a qualified nurse on duty for the Malvern. Medication is stored separately and staff from both services told us there is a shared fridge for medication. Both the nurse in charge of the Malvern service and the Britannia provider told us that this arrangement was working well. Some of the shared bedrooms we looked at did not have their dividing curtains in place and we asked the provider to make sure they were restored. This will help make sure peoples privacy and dignity is maintained. Due to needs and abilities of its people Britannia is usually a very quiet home with people assisted to bed after lunch. The influx of considerably more active people does mean that the place appears very busy with people walking up and down corridors. During our short visit we did not see any evidence of people being supported to access any social activities. We saw that people from both services were served lunch in separate areas. Staff from the Malvern carried plates of hot food through to the lounge area from the kitchen. for people to eat whilst seated at individual tables. The arrangements for transporting Care Homes for Older People Page 4 of 11 food may be made safer by the use of a trolley if one was available. The meals we saw appeared appetising and people we spoke to said they enjoyed their meals. We saw that two people were enjoying meals from the other service and this worked well as it meant their cultural meeds were met. Staff told us that both sets of relatives have been made aware of the move. We are not sure what arrangements are in place for people or their relatives to complain if they are unhappy. There has been one incident reported to the Commission involving two people from the Malvern. Appropriate action was taken by the service. This temporary arrangement brings together people with very different needs. In order for the providers to make sure people are not put at risk we asked them to provide a weekly summary of any concerns or issues. The main lounges are being used by people from the Malvern and people from Britannia are using the lounge adjoining the dining area. Peoples bedrooms are clean. We saw that people from the Malvern occupy the second floor and some bedrooms on the first floor. The second floor has not been used for some time prior to this temporary move in. There is a bathroom and a shower room on both the first and second floors. The bathroom on the second floor was waiting for taps to be fitted and the shower/wet room was not in use. Before we left the provider made sure that the bathroom on the second floor was reinstated for use and agreed that water temperatures would be checked. There is a bathroom on the ground floor adjoining the lounges we saw peoples toiletries, three razors and a toothbrush. Staff said they were not sure who left them there and removed them at our request. Peoples individual toiletries should not be left in bathrooms as this presents an infection risk. There was an accumulation of clinical and domestic waste in the car park close to where people smoke. The providers said that this was due to lack of collections over the weekend and that an additional clinical waste bin would be used to reduce any risks. We looked at staffing levels in both services. Malvern staff told us there were 3 carers, a nurse and a cook on duty to meet peoples needs. We were unable to get an accurate picture of who was on duty for Britannia. This was because the information board did not match the rota or who was on duty in the home. Both providers assured us that they were confident that the staffing arrangements they have in place do not put people at risk and are sufficient to meet peoples needs. We asked both providers to send us a weekly plan detailing staffing levels for the following week. This will help us make sure that staffing levels are taking account of any changes in need and that people are safe. We may check staffing arrangements. Care Homes for Older People Page 5 of 11 The two services stated that management arrangements were separate with two separate offices used. We saw information about Britannia people in the office being used by Malvern As far as is practicable files and records should be kept separate so that peoples confidentiality is not compromised. Staff from both services told us that there were meetings between both services and that they took time to speak to people and make sure care needs are met. A number of people who usually live at the Malvern smoke. Staff told us that they all smoke outside. The fire risk assessment may need to be reviewed to make sure that proper account is taken of any additional risks posed by people smoking. We saw domestic refuse under the stairwell adjoining the rear fire door. The providers told us this was because they had been unable to place rubbish outside due to the snow. Most of the refuse was removed. The providers must ensure that this area is kept clear so that fire safety is not compromised. What the care home does well: What they could do better: 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 Older People Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 1 4 The Statement of Purpose 30/11/2008 must be kept up to date. It must include information on the use of CCTV inside the home and must make it clear that nursing care is no longer provided. This is to make sure that people have up to date and accurate information about the range of services being offered. In order to meet its stated objective of providing a multi cultural service the home must make information available in alternative formats appropriate to the needs of people using the service. Previous timescale of 30/04/07 not met. 2 7 15 The care plans must continue 30/11/2008 to be developed to make sure that they set out in detail how people?s assessed needs in relation to personal, health, and social care will be met and so that there is evidence that people or their representatives are involved in care planning. This is to make sure that people?s needs are met consistently in a way that takes account of Page 7 of 11 Care Homes for Older People their preferences. Previous timescale of 30/04/07 not met. Care plans must also show how staff must respond to individual needs including those arising from mental health problems. 3 9 13(2) Medication records must be 30/11/2008 kept up-to-date with all medication given or omitted signed for straightaway. This will help make sure that people get the medication they need and as prescribed. The rota must accurately reflect the staff available for work on that day. The numbers of care staff must be kept under review. This will make sure that people get the care they need. 31/10/2008 4 27 18 5 27 18 The home must prepare a 30/11/2008 plan setting out how it is going to make sure that there are always enough staff to meet people?s needs. Specifically the plan must state: How staffing levels will be increased to take account of increasing occupancy and changes in the dependency of people living in the home and How staffing levels will take account of the needs of the people receiving day care. A copy of this plan must be sent to the CSCI. Previous timescale of 30/04/07 not met. Care Homes for Older People Page 8 of 11 6 29 18 A full employment history 30/09/2008 must be obtained for new staff. Staff must not start work before the home has confirmed they are safe to work with vulnerable people. This will help protect people from abuse Action must be taken to 31/10/2008 comply with fire safety requirements. This will help keep people safe from harm. 7 38 23(4) Care Homes for Older People Page 9 of 11 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, Care Homes 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 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 Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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 Older People 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. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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