Care Home: Brockwell Court Care Home

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What the care home does well A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. People living at the home were comfortable and well cared for and all of them said that the food was good. The environment was in the main nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. What has improved since the last inspection? There was one requirement and five recommendations from the last inspection report. All of these have been addressed. The activities programme has been reviewed. A Personal Activities Leader has been appointed and the home plan to involve relatives more when planning activities. The complaints procedure has been displayed in a more prominent position and the peripatetic manager intends to raise the awareness of the complaints procedure through meetings. The three environmental issues have all been addressed. The block paving outside of the main entrance has been replaced to provide safe access. The fishpond has been refurbished and is now more attractive. The bathrooms have been reviewed and the flooring replaced where appropriate. In addition there have been several other improvements which were not included in the last report. Some corridor carpets have been replaced, a new assisted bath has been installed and many areas of the home have been redecorated. Staffing levels are kept under review and are rostered in appropriate numbers to meet the needs of the people who live in the home. What the care home could do better: A system should be in place to make sure that when people are admitted as an emergency, sufficient information is provided during the assessment process to enable them to make a decision about whether they wish to go to live in the home. A system should be in place to monitor the en suite facilities on a regular basis, to make sure that cleanliness is maintained. The training programme with regard to NVQ Level 2 in Care should continue until a minimum of 50% of care staff have achieved this qualification. A suitable, competent and qualified person should be appointed to manage the day to day running of the care home. The postholder should then apply to the Care Quality Commission for registration as a manager. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brockwell Court Care Home 9 Cobden Street Consett Durham DH8 6AH     The quality rating for this care home is:   two star good service 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. Lead inspector: Susan Lowther     Date: 1 9 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Brockwell Court Care Home 9 Cobden Street Consett Durham DH8 6AH 01207501851 01207501864 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Alliance Care (Trendlewood) Ltd (wholly owned subsidiary of Four Seasons) Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 75 Number of places (if applicable): Under 65 Over 65 0 75 dementia old age, not falling within any other category Additional conditions: 75 0 The maximum number of services users who can be accomodated is: 75 The registered person may provide the following category of service only: Care home with nursing - Code N 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, maximum number of places 75 Dementia Code DE, maximum number of places 75 Date of last inspection Brief description of the care home Brockwell Court Care home is a purpose built home in the centre of Consett. It is within easy reach of the shops, library and town centre amenities. The home provides twenty-four hour nursing and personal care for older persons. There is a separate unit Care Homes for Older People Page 4 of 27 Brief description of the care home for people who have dementia. The home offers single room accommodation which all have en-suite facilities. There are sufficient toilet and bathroom areas located throughout the home, some with specialist adaptations for people who are less mobile. Several spacious lounge and dining areas are also available. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection of this home took place on the 19th May. Records were examined and a tour of the building took place. Time was spent talking to staff, the people who live in the home and their relatives. The manager supplied some written information to the Care Quality Commission before the inspection on a self assessment document called an Annual Quality Assurance Assessment (AQAA). Care Homes for Older People Page 6 of 27 The inspection focused on key standard outcomes for people who live in the home and to check whether the requirement and recommendations from the previous report had been met. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The fees charged at the time of this inspection were between 434 pounds and 50 pence and 463 pound per week. The cost of hairdressing, chiropody, newspapers and personal toiletries is not included. What the care home does well: What has improved since the last inspection? What they could do better: A system should be in place to make sure that when people are admitted as an emergency, sufficient information is provided during the assessment process to enable them to make a decision about whether they wish to go to live in the home. A system should be in place to monitor the en suite facilities on a regular basis, to make sure that cleanliness is maintained. The training programme with regard to NVQ Level 2 in Care should continue until a minimum of 50 of care staff have achieved this qualification. A suitable, competent and qualified person should be appointed to manage the day to day running of the care home. The postholder should then apply to the Care Quality Commission for registration as a manager. Care Homes for Older People Page 8 of 27 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessment procedures are in place to ensure that the home can meet the needs of the people who go to live there. Evidence: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. Most of the people who responded to the survey said that they had received enough information about the home before they went to live there. However one person said that they had been admitted as an emergency and therefore did not receive as much information as they would have liked. Care Homes for Older People Page 11 of 27 Evidence: The home does not admit people for intermediate care therefore assessment of Standard 6 is not required. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good systems are in place to ensure that health and personal care needs of people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. Evidence: The peripatetic manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Four were examined during the inspection. These were comprehensive and contained individual plans of care. This is to make sure that staff meet all of the needs of the people who live in the home. Most of the people spoken to during the inspection said that they are happy with the care received and the level of information given. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. One healthcare professional who returned a survey stated Generally provides a good standard of care. Care Homes for Older People Page 13 of 27 Evidence: Medication is administered by staff who have been appropriately trained. The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. People spoken with said that staff always treat them with dignity and respect. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities are varied and provide recreation for most of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. Evidence: Most of the people said that activities are suitable. The last inspection report contained a recommendation about activities. The home have reviewed the activities provision since the last inspection and the now have a Personal Activities Leader who spends time with people on an individual basis to find out what activities they would like to do. Outside entertainers visit on a regular basis and a church service is held once per month. Relatives said that they could visit at any time and that they are always made welcome. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. Care Homes for Older People Page 15 of 27 Evidence: The lunch looked nice. Staff who were helping people were doing this in a discreet and dignified manner. People spoken with confirmed that they have a choice and that there is always sufficient food available. Evidence was seen in care plans to confirm that nutritional needs are assessed and other professionals consulted if required. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: The last inspection report contained one recommendation about complaints. Some people indicated at that time that they were unaware of the complaints procedure. Information about complaints, how and who to make them to, has now been placed in a more prominent position and is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the Service Users Guide. The peripatetic manager has said that he intends to raise awareness of the complaints procedure through meetings. There have been two complaints recorded since the last inspection. These were investigated by the home. Most of the people spoken with said they would know how to make a complaint. However they did say that over the previous few months this had sometimes been a problem due to fluctuating management arrangements. However they were aware of the current management arrangements and confirmed that they would know who to approach. One person said, I would speak to the boss. When asked if they knew who that person currently was they confirmed that they did. The peripatetic manager has confirmed that he will remain in the home until suitable permanent manager is appointed. Care Homes for Older People Page 17 of 27 Evidence: The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: During a tour of the building the inspector saw that many of the rooms are decorated to the persons own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. A good standard of decor and furniture is provided throughout the home. The requirement and recommendations from the last report have been addressed. The block paving has been replaced outside of the main entrance and the fish pond has been repaired. The flooring in the bathrooms seen was appropriate. Several other improvements have also been made. A new assisted bath has been installed, new carpets have been laid in some corridors and many parts of the home have been redecorated. There was a range of equipment seen around the home to support people with bathing and mobility. The inspector found the home to be clean, tidy and free from offensive odours. The people who returned surveys indicated that this is normally the case, although one Care Homes for Older People Page 19 of 27 Evidence: person did indicate that at times the ensuite could be cleaner. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. Staff spoken with confirmed that there are generally sufficient staff on duty. However when people call in sick at short notice it can sometimes be difficult to find a replacement. One person who returned a survey did indicate that the home is sometimes short of staff. Staff did say that the situation had improved since the peripatetic manager had commenced. He confirmed that he keeps staffing levels under review as recommended in the last report. This is based on the changing dependancy needs of the people who live in the home. People said that staff were usually around and answered the call bells quickly. One person was very positive and said,I am always attended to immediately, staff are always pleasant. The home had staff files in place, which provided evidence that the appointment of a new staff member is in the main made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. Care Homes for Older People Page 21 of 27 Evidence: There is a commitment at the home to having a trained workforce. Some of the staff have an NVQ at level 2 or above. The peripatetic manager confirmed that due to recent recruitment this does not meet the standard of 50 . However he said that some people were to be enrolled on a programme in the near future. As well as mandatory training, recent training has also taken place in adult protection and health and safety. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. All of them confirmed that there is plenty of training for them. One person who had just commenced confirmed that they had been well supported and was not left alone until they were confident. Another said, The current induction seems to cover all aspects of the job role that is required. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the home is without a registered manager, people can be assured that the peripatetic manager has the skills and experience to carry out the role. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: Since the last inspection the registered manager has left the home. It is being managed by a peripatetic manager. This person has previously managed a care home for several years. The company consider him to be qualified and competent to run the home. Staff said that before this person came into post, several temporary managers had been in place over a period of a few months, which had caused some staff to feel unsupported. However all of the staff spoken with said that they now feel well supported and that the peripatetic manager is approachable. One person said, The manager is there to give support when it is required and discuss problems. Regular meetings are held and there are a number of systems in place to consult with Care Homes for Older People Page 23 of 27 Evidence: people living at the home. Relatives and the people who live in the home can approach the staff at any time. The regional manager carries out regular audits covering all environmental and care aspects which may result in improvements being made. The peripatetic manager also carries out audits and the results are considered when the regional manager visits. This may result in improvements being made. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are well supported. Personal finances are kept in the home for people who request this. Signatures are obtained and receipts are kept to ensure peoples financial interests are safeguarded. The peripatetic manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Care Homes for Older People Page 24 of 27 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 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 1 3 A system should be in place to make sure that when people are admitted as an emergency, sufficient information is provided during the assessment process to enable them to make a decision about whether they wish to go to live in the home. A system should be in place to monitor the en suite facilities on a regular basis, to make sure that cleanliness is maintained. A suitable, competent and qualified person should be appointed to manage the day to day running of the care home. The postholder should then apply to the Care Quality Commission for registration as a manager. 2 21 3 31 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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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