Care Home: Brook Lodge

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What the care home does well Brook Lodge provides a small cosy home to the residents where they are part of the family and assisted in a very individual and flexible way. Residents can please themselves about routines and activities and if too frail to go out are looked after well by the family and staff who help. Comments from one resident and two relatives included "I am pleased to be living here. I am very well looked after", and "My mother has no mobility or speech. The care she receives is second to none. There should be more places like Brook Lodge." The home also keeps good records to show they are monitoring the health and welfare of the residents. Care plans are detailed and kept up to date and medication is given out correctly. The two current residents do not want very much in the way of entertainment but are able to see their relatives whenever they can. They also have meals to suit them and can say what they would like to have. Soft diets are also catered for. Residents have their own rooms and can sit in the family lounge for company. The home is unpretentious but has an adapted bathroom to make it easier for the residents. Staff are kind and considerate and take good care of the residents. What has improved since the last inspection? There were no requirements made at the last inspection by the Commission. The provider has upgraded the home in places. What the care home could do better: There are no major concerns about this home. Some minor recommendations are made for further staff training and to ensure daily reports are confidential. CARE HOMES FOR OLDER PEOPLE Brook Lodge Walcott Road Bacton Norwich Norfolk NR12 0HB Lead Inspector Mrs Dorothy Binns Key Unannounced Inspection 10th February 2009 11:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brook Lodge Address Walcott Road Bacton Norwich Norfolk NR12 0HB 01692 650383 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) brooklodge52@aol.com Mr John Brooks Mrs Diane Brooks Mr John Brooks Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2007 Brief Description of the Service: Brook Lodge is a large family home situated in the village of Bacton on the Norfolk coast. The home provides accommodation for three residents who share facilities and services with the proprietors and their family. The accommodation consists of three single bedrooms with shared use of the family lounges and dining room. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good quality outcomes. Care services are judged against outcome groups which assess how well a provider delivers the service. The report gives a brief overview of the service and current quality judgements for each out come group. This was a routine unannounced inspection and took about four hours. As well as talking to the person who runs the home, a member of staff was seen and relatives and one resident returned survey forms sent out to them by the Commission. Records and procedures were also examined. The provider also provided the Commission with documentation about how the home was progressing and any contact or reports since the last inspection were also taken into consideration. This a small family run home where up to three residents can live with the family in a large bungalow. What the service does well: Brook Lodge provides a small cosy home to the residents where they are part of the family and assisted in a very individual and flexible way. Residents can please themselves about routines and activities and if too frail to go out are looked after well by the family and staff who help. Comments from one resident and two relatives included I am pleased to be living here. I am very well looked after, and My mother has no mobility or speech. The care she receives is second to none. There should be more places like Brook Lodge. The home also keeps good records to show they are monitoring the health and welfare of the residents. Care plans are detailed and kept up to date and medication is given out correctly. The two current residents do not want very much in the way of entertainment but are able to see their relatives whenever they can. They also have meals to suit them and can say what they would like to have. Soft diets are also catered for. Residents have their own rooms and can sit in the family lounge for company. The home is unpretentious but has an adapted bathroom to make it easier for the residents. Staff are kind and considerate and take good care of the residents. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are fully assessed before coming into the home to make sure they can be catered for and will be comfortable in the home. EVIDENCE: There are only two residents in this small home and both care files were examined. Both had an assessment in place of the persons needs and abilities. One contained information from the hospital to help the home to look after the person. Neither of the residents had been assessed by social services but the manager carries out a full assessment herself of what care is required. Reviews of care keep assessments up to date. Mrs Brooks visits people before they come to the home to see if she can cater for their needs. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents are individually cared for and the records show that they are carefully monitored. Medication is safely dealt with. EVIDENCE: Care plans were in place based on the assessment of need and the care was regularly reviewed to ensure it was going well. Plans were detailed and laid out what tasks were needed. Daily reports were written on how the residents were progressing. The daily notes about both residents were written on the same sheet and should be separate to be confidential. The files showed evidence of visits from district nurses and the GP and the manager reported that the optician and chiropodist come on a regular basis. One resident in the survey said They look after me when I am ill - they get the doctor in for me. Staff also monitor what people eat and whether they are off colour showing they are noticing changes in people. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 10 Skin tissue is monitored and the record showed good links with a district nurse who was coming daily for one person. Both residents have medication administered by the home and there is a medication policy. The manager deals with all medication and the records were completed correctly. One staff seen confirmed that she does not give out medication but is to learn so she can help the manager. Both residents have a private room and can see their visitors there. People are attended to in private in terms of their personal care. Neither of the residents were available to talk to at the inspection but one completing the survey and two relatives completing the survey were happy with the way people were treated. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents feel comfortable in the home and are supported to do what they want. The routines are flexible and staff help them to have good contact with their relatives. EVIDENCE: Currently there are few activities except within the home as the residents are frail and also one has a daughter next door who she goes out too all the time and the other has a regular visit from relatives who live in the village. Staff said they played cards and sat with the residents. The hairdresser visits. Relatives are free to come and go as they like. The resident who filled in the survey form said the staff go to the shop when I need things and help me with my paperwork when I need it. Relatives returning the survey form said that the home always helped their relative to keep in touch with them and would make phone calls on their behalf and welcome them in the home. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 12 Routines are flexible and Mrs Brooks said residents can please themselves. One person gets up quite late and meals times are varied to suit the resident. Bathing is carried out when it suits the resident and the impression given is that staff do whatever is best for the resident and they are not expected to conform to any routines. Meals are family meals and there is no formal menu but Mrs Brooks described how one resident needed feeding and had a soft diet. She was observed being fed. Residents are asked what they like and choices are catered for. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People using the service can be assured that their concerns will be listened to and that the home has polices in place to protect residents. EVIDENCE: The home has a complaints procedure in the brochure and it is also pinned up on the wall. Because of the small size of the home Mrs Brooks says she deals with things as they occur and has not had any complaints. She sees the relatives regularly and is happy to adjust the care if they bring any matter to her attention. No complaints have reached the Commission. The home has a safeguarding policy and the telephone number of the local adult Protection Unit that deals with allegations of abuse. Mrs Brooks has done some training on this subject but the staff have not and this is recommended. One staff seen was very aware of abuse proceedings and had felt able to report an allegation in another home showing she was not afraid to speak up. The home also a gifts and wills policy to protect the residents and a whistle blowing policy. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents benefit from a comfortable and cosy family home. EVIDENCE: This is a large family home, all on one level, unpretentious and homely with an aviary and garden. Everyone mixes in together including the children of the owner who are teenagers. Residents do have their own quite good sized rooms and have televisions in there but they also sit in the family lounge in front of a wood burning stove. It was not very warm in the bedrooms on the day of the inspection but no one was in their rooms and Mrs Brooks said she would turn up the heating if they were in there. There is an adapted bathroom with hoist and a shower and there are handrails in the corridor. One hot tap in a downstairs toilet was not working and needs to be repaired. Some redecoration has taken place since the last inspection and some parts are still to be done. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 15 There is a separate laundry with a washing machine that has a hot wash, and two driers. There is an infection control policy in place though the home is not dealing with soiled laundry currently. There are no odours in the house. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are looked after well by Mrs Brooks and her staff and feel comfortable and at ease. EVIDENCE: Mrs Brooks is the main carer but she has two staff recruited a long time ago who help her. Their files showed that a criminal record check had been made and one staff interviewed said she had to provide two references. One staff helps in the morning and the other does morning and some afternoon duties. Mr Brooks is a carer in the evenings and weekends so there are always two adults on the premises. There are no waking staff but Mrs Brooks says she gets up if required. Some training is provided with an induction course available for new staff. One staff is doing her NVQ and the other a care diploma. Both have had food hygiene training and moving and handling. Mrs Brooks has been on numerous courses including dementia and safeguarding adults. She has her NVQ4 qualification. Those responding to the survey felt they were well looked after by staff. I am very well looked after, and The care (my relative) receives is second to none were comments made. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is run for the benefit of the residents and health and safety issues are taken seriously. EVIDENCE: Mrs Brooks has been running this home for years and has now completed her managers qualification. She brings a homely and relaxed touch to the residents in this her own home. There is a full quality assurance system which covers a review of policies, the building, as well as looking at the care provided. Questionnaires were in evidence for both staff and residents. It was not clear whether it would be used as in a small home of this size and in a family home, opinions are being Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 18 given and jobs done as they go along. However policies were seen to have been reviewed in 2008. The home does not deal with residents money. Both have relatives who visit regularly and take them shopping. Policies and procedures for health and safety were checked. Water temperatures are checked regularly and the boiler service was up to date. Fire alarms are checked weekly and a fire drill was carried out in January. The fire extinguishers have also been inspected recently. The environmental health officer inspected in 2008.A full buildings risk assessment has been carried out. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x x x 3 Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP18 OP19 Good Practice Recommendations The daily log of care should be more confidential with a separate sheet for each resident. It is recommended that staff are sent for training on safeguarding people from abuse The hot tap in the toilet needs attending to. Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brook Lodge DS0000027583.V374172.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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