Care Home: Brook House

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Westmead

What the care home does well This service benefits from consistency of ownership, management and staffing. There is a good management structure and staff are well trained and supported in their roles. This means that people receive care from competent and well informed staff which suits individual needs and respects people`s rights and preferences. People`s views are sought and their opinions listened to and acted upon. Residents` health personal care and health needs are well catered for; medication is well organised and external professional assistance is sought whenever it is needed. The quality of life that people experience at Brook House is good, and if people choose they can take part in a range of activities and entertainment that are provided. However if on the other hand they wish to spend their time in their own rooms in peace and quiet they are also able to do so. The home is in a lovely rural setting with pleasant views and accessible gardens to look out on or to venture into in the better weather. The accommodation is designed with residents` comfort and safety in mind, is maintained to a very good standard and is very homely. People spoken to, and the surveys, reported a very positive view of the service. Staff are described as "kind and thoughtful" and that they "look after us and help when needed". Someone commented that the home is the "best around Oswestry" and another that the service and staff treated them "like a Queen". What has improved since the last inspection? The information provided to people about the home has been updated and ensures that people get a good picture of what the home provides. The manager has kept the staff group up to date with training, and staff have undertaken distance learning courses in medicines management, infection control and dementia. Alterations are being made so that residents have more choice as to whether they have a bath or a shower, and the external paths have been improved so that people in wheelchairs can access the garden. What the care home could do better: No requirements or recommendations have been made as a result of this inspection. The home continues to monitor its own performance and make improvements to benefit the residents. Key inspection report Care homes for older people Name: Address: Brook House Woodhill Morda Oswestry Shropshire SY10 9AS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Deb Holland     Date: 2 3 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Brook House Woodhill Morda Oswestry Shropshire SY10 9AS 01691654167 01691656128 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs K V Cosens Name of registered manager (if applicable) Wendy May Johnson Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 32 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 (OP) 32 Date of last inspection Brief description of the care home Brook House is a private residential home providing personal care to 32 older people. The home is in a quiet rural area, not far from the village of Morda and Trefonen and only a few miles away from the town of Oswestry. Brook House stands in its own attractive and well maintained grounds with outlooks over gardens and surrounding fields. Care Homes for Older People Page 4 of 26 Over 65 32 0 Brief description of the care home Accommodation is provided on ground and first floors, with a passenger lift providing access between first floor bedrooms and communal areas on the ground floor. The home makes their services known to prospective service users in the statement of purpose and service user guide. The inspection report is mentioned in these documents and is given out on request. Care Homes for Older People Page 5 of 26 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: three star excellent 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: This report is from a key inspection of Brook House. We, the Care Quality Commission, considered a range of information in order to complete this report. This included an Annual Quality Assurance Assessment, which is an annual report that the service has to make to us by law. This contained information about what the home thinks that they do well and what they hope to achieve in the future. We provided residents and staff with some surveys and ten residents and ten staff returned these to us. We also looked at information we have received from the home called notifications which again the service is required to do by law when particular incidents happen. We visited the service during a morning and over lunch. We spent time looking at records, for instance those relating to residents care, to staff recruitment and training, to health and safety. We examined the care provided to three people in detail. We spoke to those people to find out what they thought about the care they received and to one of their relatives who was visiting. We looked at the quality questionnaires that Care Homes for Older People Page 6 of 26 the home had sent out recently and the opinions that people have about the service provided. We looked at parts of the accommodation and looked at the systems that are in place to keep people safe. Our overall conclusion is that the home continues to provide excellent outcomes for people who live there. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 26 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 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking for a placement at Brook House are provided with good information on which to base their decision, and the service ensures through good assessment processes that they can meet peoples needs. Evidence: The service provides information for people in a combined Statement of Purpose and Service User Guide. This is comprehensive while being easy to read and has been kept up to date with details of staff training, recent changes in legislation, and key policies, such as that relating to gifts to staff. When someone approaches the service the homes owner or manager will visit the potential resident at home or in hospital to undertake a full assessment of what the persons needs are and whether those needs can be met at Brook House. One file showed that this process had been repeated when someone was admitted to hospital and their needs changed, prior to a successful re-admission. Assessments are Care Homes for Older People Page 11 of 26 Evidence: detailed, cover all the required areas and include a personal profile as well as small but important matters such as how many pillows someone prefers and whether they like a nap in the afternoon. Care Homes for Older People Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed and focused on the needs of individuals. People are well cared for, their health is monitored and links with health professionals are good. Residents are respected and treated well. Evidence: We examined the care of three people in detail. There are clear links between assessments and care plans, with a lot of detail so that staff know what care to provide, and how to go about it whilst promoting independence. All the feedback provided through surveys and on the day of inspection was very positive about the care provided and the work done by staff at the home. Survey responses stated that people always receive the care that they need and that medical care is always sought when it is needed. Care plans and records show that the home seeks professional support external to the home when this is needed. Care plans include risk assessments where necessary, so that staff are guided as to how to keep people safe, for instance when helping them to move around or bathe. If a resident is nutritionally at risk, the home documents an assessment and care plan specifically to promote an appropriate diet and the use of supplements if necesssary, and monitors the persons Care Homes for Older People Page 13 of 26 Evidence: weight regularly. Someone who had lost weight through injury and hospitalisation was being supported in this way and they were slowly gaining weight. Staff are well trained and therefore well aware of the needs of their client group and how care should be provided. The AQAA provided by the home stated that staff are well trained and have time to treat residents with respect and as individuals and this statement is supported by the views of residents and their representatives. The home has a monitored dosage system for medication administration and we observed that medication is well organised, with good records which reflect that people get their prescribed medication when they should. All staff who adminster medication have done a thorough distance learning course and have been assessed as competent to do so. People who are able to, and who wish to self medicate, particularly those at the home for respite care, are supported to do so. Care Homes for Older People Page 14 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life and social activity are geared around the needs and wishes of service users. The home is staffed at a level that allows particular needs to be met. Visitors are welcome and the food is nutritious and well received. Evidence: People living at Brook House have the choice to join in communal life, or to keep themselves to themselves. Individual interests, likes and dislikes are identified on admission. Responses to our surveys told us that there are opportunities for engaging in activities such as weekly craft sessions, Chairobics, having singalongs, playing games such as dominoes or cards and a monthly bingo session. Entertainment includes people who play the piano, the guitar and the harp as well as local childrens and adult choirs. The home has also had people in to talk about their products such as lingerie, aloe vera and lavender. Equally people can chose to spend their time quietly in their own rooms if that is what they prefer. The home welcomes visitors and includes family and friends on a day to day basis and in events such as the Christmas Fayre and the summer strawberry tea. People were invited to join the home in celebrating its 25th anniversary in 2009, and residents created a fabric collage featuring the home which is now on display. Care Homes for Older People Page 15 of 26 Evidence: Food is an important issue in any residential home; people reported to us that they either usually or always liked the meals and the home has made efforts to incorporate the comments made in their own quality questionnaires into the design of the menus. Choices and alternatives are available and special diets are catered for. People who we spoke to told us that the food was good and plentiful and the meal seen on the day of inspection looked appetising and was well received. The home uses an nutrition assessment tool which helps identify and monitor any particular needs in this area. Care Homes for Older People Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Concerns and complaints rarely occur but procedures are in place to resolve them effectively and promptly. Adult protection is given high priority and the open door culture for staff and service users helps to protect them from abuse. Evidence: The home ensures that people know about its complaints procedure and it is included in the Service User guide, along with the contact details for CQC. The service aims to ensure that any small concerns are dealt with promptly so that formal complaints just do not happen. This approach appears to be working as neither the home or CQC have received any complaints since the last inspection in 2007. The manager, owner and administrator are available to residents and their families and the well established senior care team are also very able to deal with any issues that are raised. Staff are generally well trained and have all attended the local training relating to protecting vulnerable adults from abuse. The homes manager is well aware of recent legislation relating to peoples rights under the Mental Capacity Act and has included information about this in the Service User guide. One survey returned by a resident stated that they felt safe living at Brook House and this was confirmed by people spoken to on the day of inspection. Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is of a very high standard, well maintained and undergoes regular refurbishment and improvement. Health and safety issues are well recorded and practical safeguards are evident throughout the home to ensure the safety of service users. Every effort is made to create a home from home. Evidence: The extensions and refurbishments to Brook House over the years have been carefully thought through to best meet the needs of the service user group. This continues with changes to bathrooms to ensure that people have choice between bathing and showering. The whole house is clean, light and airy with lovely views over the garden and open fields. Individual bedrooms are very pleasant with the vast majority having en-suite facilities and it was evident that people are encouraged to bring and treasure their own possessions to make the rooms their own. A significant amount of effort is put into maintaining the environment to such a high standard, both inside and out. Improvements to the paths in the grounds mean that it is safer and easier for people to access and enjoy the garden when weather permits. All areas of the house were clean and fresh with no offensive odours. All the staff work across care, cleaning and laundry and clearly are committed to high standards. Care Homes for Older People Page 18 of 26 Evidence: The bathrooms and toilets are situated conveniently throughout the home and all were well maintained and pleasant areas to use. The home has sitting rooms at either end of the house and both of these are able to have log fires in the winter months to further enhance service user comfort and create a homely feel. All staff have received training in infection control, audits have been undertaken and the homes manager has obtained, and is applying, the new code of practice which will apply from October 2010. We saw the checklist used by the maintenance man and this helps to ensure that the environment is kept safe. It was noted that a first floor window was open wide and suggested that an assessment is done to establish whether any of the first floor windows pose a risk to the current client group. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with care by a stable, well trained and supported staff team. People are kept safe by the checks made by the home before employing staff. Evidence: Recruitment at the home is thorough and all the employment checks required to ensure that only people suitable to work with vulnerable elderly people are recruited are maintained on file. Care is taken by those responsible for the recruitment of staff to ensure that those employed are able to provide good quality care to the service users. The files of two recently appointed members of staff were seen to be satisfactory, with evidence of them having been introduced to the work and the home carefully and being provided with essential basic training. Staff turnover is very low and no agency staff are used and residents benefit from having care from a well established, competent and experienced team. Feedback from staff surveys was very positive with people reporting being supported in their roles and being provided with appropriate training. Staff commitment to the home was demonstrated during the snow early in 2010 when people made particular effort to get the home and some stayed overnight. The commitment to training and qualification of staff is very good. The ratio of staff qualified to the appropriate NVQ level is well above required levels and the training provided recognises the skills and knowledge staff require to continue meeting the Care Homes for Older People Page 20 of 26 Evidence: needs of the service users. Staff are provided with both mandatory and further training such as the distance learning courses provided by the local college in medicines management, infection control and dementia care. The manager reported that the plan is for staff to do a similar course in Nutrition and Health in the near future. People who commented on the staff team either through surveys or on the day of inspection were very positive, saying that they are kind and thoughtful and that nothing appears to be too much trouble. Staffing rotas are organised so that availability of staff matches times of peak demand, such as mealtimes, or in the mornings when people are getting up and needing support. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. People can be confident that the home is run in a way that promotes their well being and aims to keep them safe. The views of residents and their relatives are valued and acted upon. Evidence: Brook House benefits from consistency in terms of Mrs Cosens having been the owner since 1984; the homes manager Wendy Johnson worked at the home prior to becoming registered in 2007; the homes administrator has worked there almost as long as the home has existed and there is very little turnover within the staff group. The service also benefits from being kept up to date and looking to the future in terms of legislation and best practice. Ms Johnson is well experienced to run the home and has gained accreditation at NVQ4 in care, has the Registered Managers Award and is an NVQ Assessor. She keeps up to date with relevant training and changes in legislation, such as the Mental Capacity Act and not least is exploring what the implications of the Health and Social Care Act 2008 Care Homes for Older People Page 22 of 26 Evidence: are for the home. It was demonstrated at inspection that everything asked for was immediately to hand and well organised. There is also a team of well trained senior carers who support each shift. Quality assurance systems are in place and the views of residents, families and friends are sought and acted upon. As well as our own surveys, which reflected positive views of the service from residents, families and staff, the home have done their own quality questionnaire recently and taken account of the information gathered through this. The home does not handle any financial matters or personal monies on behalf of residents. The health and safety of residents and staff are promoted through awareness and good practice underpinned by up to date training and a system of checks to ensure that equipment is functioning properly. The homes maintenance person ensures that the environment is kept safe and records routine checks of bed rails, bath water temperatures, the fire alarm, emergency lighting and wheechairs. Weekly fire alarm tests are combined with drills across the various staff shifts. Checks and certificates from outside contractors for the passenger lift, hoists, fire and electrical systems are also kept up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!