Care Home: Brooke House Care Home

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What the care home does well Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, both in the home and in the community appropriate to their peer group, and to enjoy all the rights and responsibilities of citizenship. The service provides a stable environment with enthusiastic and motivated staff who have the necessary skills, experience and support to meet the complex needs of the people who live at Brooke House. The service is still relatively new but has built up a good reputation with external health and social care professionals.The home has good quality assurance procedures in place and the views of people who live at the home are regularly sought. What has improved since the last inspection? The home has met all the requirements made following the previous inspection. The home has developed further links and relationships with local community projects, colleges and external agencies for the benefit of the people who live at the home. The manager now has the Registered Managers Award and is completing the NVQ level 4 in care. What the care home could do better: There were no requirements or recommendations made following this inspection. The home agreed to ensure that the contact arrangements for the local social services team are included with the safeguarding adults and whistle blowing information provided to staff. CARE HOME ADULTS 18-65 Brooke House Care Home 123 Millbrook Road East Freemantle Southampton Hampshire SO15 1HQ Lead Inspector Janet Ktomi Unannounced Inspection 8th May 2008 10:00 Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 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 Brooke House Care Home DS0000037569.V363139.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 Adults 18-65. 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. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooke House Care Home Address 123 Millbrook Road East Freemantle Southampton Hampshire SO15 1HQ 023 8023 5221 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) heron.house@craegmoor.co,.uk Craegmore.co.uk Park Care Homes (No 2) Ltd Mrs Suzanne Welsh Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (10) of places Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2006 Brief Description of the Service: Brooke House is a registered residential care home providing what Craegmore describe as ‘a transition service within a hostel style service catering for up to ten adults who have a learning disability and/or mental health problems and who may also have a diagnosis of Autism and/or Asperger’s Syndrome’. The aim of the service is to support people in developing life skills to live more independently in supported accommodation, or need assessment prior to moving on into longer-term accommodation. Brooke house does not intend to provide permanent housing. Brooke House is an extended older property located close to the city centre of Southampton and is within easy access to all main amenities, transport links and local shops. All bedrooms are for single occupancy and equipped with wash hand basins. Communal facilities comprise a lounge, large dining room and kitchen. WC’s and bathrooms are located around the home. The home is owned by Park Care Homes (No 2) Ltd and managed by registered manager Mrs Suzanne Welsh. The home’s fees are dependant on the assessed needs of the person and average £1,304.08 per week. Brooke House Care Home DS0000037569.V363139.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 3 star. This means the people who use this service experience excellent quality outcomes. This report contains information gained prior to and during a visit to the home undertaken on the 8th May 2008. As people living at the home have autistic spectrum disorders the home was telephoned the evening prior to the inspectors visit so that the people living there would not be disturbed by an unexpected inspection. All core standards and some additional standards were assessed. Compliance with the three requirements made following the previous inspection was also assessed. The visit to the home was undertaken by one inspector and lasted approximately seven hours commencing at 10am and being completed at 5 p.m. The inspector was able to spend time with the registered manager and staff on duty and was provided with free access to all communal areas of the home, documentation requested and people who live at the home. Information from the Annual Quality Assurance Assessment (AQAA) completed by the registered manager prior to an Annual Service Review undertaken in January 2008 is also considered. During the visit to the home the inspector was able to meet with and talk to many of the people who live at the home. Following the visit to the home the inspector telephoned the Southampton learning disability team. What the service does well: Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, both in the home and in the community appropriate to their peer group, and to enjoy all the rights and responsibilities of citizenship. The service provides a stable environment with enthusiastic and motivated staff who have the necessary skills, experience and support to meet the complex needs of the people who live at Brooke House. The service is still relatively new but has built up a good reputation with external health and social care professionals. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 6 The home has good quality assurance procedures in place and the views of people who live at the home are regularly sought. 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. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home would only admit people whose needs it could meet and who are compatible with the people who already live at the home. EVIDENCE: The manager explained the homes admission procedure; people living at the home discussed with the inspector how they had come to live at the home and the process by which they had moved into the home. Staff discussed their views of the admission process. Pre-admission assessments were seen in the four care plans viewed. The manager stated that when the home has a referral for a new admission, and initial information indicated that the person would meet the homes admission criteria then the manager and deputy would visit the person in their existing home for an informal ‘chat’. The admission process would then be commenced with several more visits to the person by the manager and deputy, information would be obtained from professionals and other relevant people including family and visits by the person to Brooke House would be arranged. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 9 The inspector viewed pre-admission assessments in care plans and these were detailed containing all the information necessary for the home to decide if they are able to meet the person’s needs. The assessment covers health needs, cultural needs, communication and physical needs, behaviours and risks associated with all needs. Care staff stated that they felt they had enough information about new people to enable them to meet their needs and had the opportunity to meet the person on pre-admission visits to the home. Staff also stated that they felt they had sufficient skills and experience to meet the needs of the people living at the home. The manager stated that if a new person has specific health or care needs staff would receive training to meet these needs before the person moved into the home. People living at the home stated that they had met the manager and deputy before moving to the home and that they had had visited the home before moving in. People who had lived at the home for a longer time stated that new people visited the home before they moved in. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service are in control of their lives and they direct the service. Staff are committed to supporting people to lead purposeful and fulfilling lives as independently as possible. People who live at the home make their own informed decisions and have the right to take risks in their daily lives. EVIDENCE: Four care plans were viewed with the inspector observing care staff making recordings in care plans for everyone living at the home towards the end of the am shift. Risk assessments and the ways in which risks should be managed were seen in care plans. The inspector spoke with staff and the people who live at the home about their care plans, how decisions are made and observed how people who live at the home are encouraged and supported to be active and independent. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 11 The four care plans viewed were person centred and are agreed with the individual who had signed the care plan and risk assessments. Care plans had been reviewed with the person whose plan it was on a monthly basis. Care plans contained information about, and risk/management plans in respect of, health needs as well as social and independence skills training. The home uses a key worker system with people living at the home stating who their key worker is and key workers discussed their role as key worker. People living at the home confirmed they had been involved in their care plans and reviews. Each care plan contained risk assessments relevant to the needs identified in the person’s pre-admission assessment and care plan. Management of risk positively addressed safety issues whilst aiming for improved outcomes for people using the service in terms of skills development and independence. Observation during the inspection visit and discussions with people living at the home confirmed that they are able to make decisions and that these are respected and acted upon by the home. During the inspectors visit to the home there were discussions about holidays and where individual and small groups of people may wish to go on holiday. The home stated in their AQAA that weekly resident meetings are held and people living at the home confirmed this. Throughout the inspection visit people were observed making suggestions and their views being sought by the manager and staff. The previous report stated that some practises and routines appeared to be institutional for some of the people who live at the home. It also stated that the kitchen was kept locked with only some people given a key. This was discussed with the manager who confirmed that generally the kitchen is unlocked and available to people however for infection control reasons there may be times when no staff are in the kitchen area and at night that the kitchen may still be locked. Some people confirmed that they have a key to the kitchen. Throughout the inspection the kitchen was unlocked and people were observed moving in and out and helping themselves to drinks and fruit. People also stated that they choose what they spend their personal money on and showed the inspector items they had purchased. The support people receive in relation to their personal finances is recorded in care plans and varies between the people living at the home depending on the level of support required. The inspector viewed the arrangements in respect of personal finances and the procedures and records are appropriate and well maintained. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, both in the home and in the community appropriate to their peer group, and to enjoy all the rights and responsibilities of citizenship. EVIDENCE: The inspector viewed activity programmes, care plans, discussed with people how they spent their time and observed how people spent the day whilst the inspector was visiting the home. Everybody has an individual weekly programme of activities that includes a range of day services, college, work opportunities and leisure activities, intended to help develop and maintain life skills and provides opportunities for Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 13 socialisation away from the home. A list of planned activities for individual people was seen on the wall in the dining room. Activities are recorded by care staff in daily records held within peoples care plans. Discussions with care staff and people confirmed that they enjoy these activities and had been involved in the development of their individual plans. The home also undertakes ad hoc activities as suggested/requested by the people who live at the home. On the afternoon of the inspection visit a group decided to go bowling. During the inspection visit people were noted to be able to spend their time as they wished. People were encouraged to participate in routine domestic activities and the home has a small budget to pay people who have undertaken ‘work’ around the home. On the day of the inspection visit one person was attending to the garden fence and was observed being paid for his work. The location of the home is close to Southampton town centre with easy access to local bus and train services. People said they regularly attend local pubs and restaurants and staff support is provided if necessary. Care staff confirmed to the inspector that there are lots of opportunities for outings and external activities. People said they are involved in assisting care staff with food shopping and use local health facilities. Staff rotas confirmed that sufficient staff are provided at evenings and weekends to facilitate leisure activities. Some people are more independent and have bus passes. The home has a house car and care staff confirmed that they have had to provide their driving licences before being able to drive the house car. As previously mentioned there was much discussion about holidays during the inspectors visit. These were being planned, individually and in small groups. People confirmed that they are able to invite friends to visit them at the home. Family members are also welcome at the home. The home’s routines tend to be organised around the people who live there and if they are not home when main meals are served these are made available when they return home. People were observed having their breakfast at various times throughout the morning depending on when they got up. All the bedrooms have a lockable door, with people confirming that they have a key to their bedrooms. The home has a non-smoking policy, with people who do smoke being aware that they must do so outside. The home does not employ separate catering staff so care staff take turns to cook. People living at the home are encouraged to assist with meal and snack preparation and clearing away after meals. People stated that weekly menus are planned at the residents meetings. Staff encourage healthy eating with fresh fruit freely available in a bowl on the kitchen table and less healthy snacks being stored securely. People were observed requesting and being given packets of crisps from the store. Records showed that meals are varied and nutritious. People commented that they liked the food at the home and that they could ask for something different if they did not want what was available. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People receive personal care and support in the way they prefer and their health needs are met. Medication is appropriately managed in the home. EVIDENCE: The inspector viewed information about health needs and how these will be met in care plans, discussed health needs with people and staff. The deputy manager showed the inspector the management arrangements and records for medication. Following the inspection visit the inspector telephoned external health professionals with links to the home. Most of the people who live at Brooke House are largely independent in their personal care and require minimal support. Care plans contained information as to the level of support people required including the need to provide tactful reminders. The manager stated that the aim is for people to be as independent as possible and to develop routines which are then transferable when they move into more independent accommodation. Male and female staff are employed so choice would be available if support were required. People with Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 15 additional mobility needs have bedrooms on the ground floor with the necessary aids seen in the bathroom. All service users are registered with local GPs and support is provided from care staff to make and attend appointments. Care plans contained a record sheet that indicated that people have seen chiropodists, opticians, dentists and doctors when required. People stated that if they are ill then staff will arrange for them to see a doctor. Following the visit to the home the inspector telephoned the Southampton community learning disability team and district nurses who confirmed that the home contacted them when issues indicated this and that advice of health professionals was acted upon. Discussions with the manager, staff and people who live at the home indicated that health needs are met and they are aware of how to access advice and support. Care staff confirmed that they have received training relevant to the specific health needs of people who live at the home. At the time of the inspection visit all medication was stored appropriately. The medication administration records were viewed and had been fully completed. The home uses a pre-dispensed system for tablets with liquid medication, and medication that cannot be placed in the MDS system dispensed at the time of administration. Not all people living at the home receive regular medication. None of the people living at the home self medicates, therefore all medication is administered by care staff who have received training and been deemed competent. Within care plans were guidelines and information about when as required medication should be administered. The deputy manager stated that if appropriate, following risk assessments, people would be supported to develop the skills to self-administer their medication as part of their independence training. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows people who live there to express their views and concerns in a safe and understanding environment. EVIDENCE: The provider has a complaints policy. There is also information as to how to complain available around the home. The complaints policy should ensure that all complaints are appropriately investigated within twenty-eight days. The home maintains a complaints book and the manager stated in the AQAA that the home has received eight complaints in the past year of which seven have been upheld. Staff spoken with were aware of what procedure they should follow should a person who lives at the home or their representative make a complaint. People stated they would tell staff if they were unhappy about something at the home. Throughout the visit to the service the inspector observed people who live at the home giving their opinions and suggestions to the staff and staff responded appropriately to these. Most of the people who live at the home are well aware of their rights and able to express these. The home has an adult protection policy together with whistle blowing policies. These policies and procedures were read during the inspection. The policies are produced nationally by the provider. The safeguarding adults policy did not contain the necessary contact details for the local social services team and these should be available with the procedure for all staff. Staff spoken with during the inspection were all aware of safeguarding and confirmed that they Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 17 had received training. All would report concerns to senior staff however none seemed aware that they could themselves report concerns directly to the local social services department. The home has whistle blowing information on the hall wall however this only includes contact details for senior staff within the provider organisation not the local social services department. This was discussed with the deputy manager who stated that she would add the contact details for the local social services team to the whistle blowing information and ensure that all staff are fully aware of this. The manager and staff confirmed that staff have received adult protection training. People living at the home told the inspector that their bedrooms contained a secure lockable facility where valuables or money may be stored. Staff have also undertaken relevant training in managing challenging behaviour and this is an important part of the homes induction process. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a comfortable, clean, homely house suitable for their individual and collective needs. EVIDENCE: The inspector viewed the communal areas of the home with the manager and viewed one bedroom. The inspector discussed their private accommodation with other people who live at the home. The home is safe, generally well maintained and at the time of the short notice inspection visit clean and free from offensive odours. The home meets service users’ needs in a homely and domestic way. Bedrooms are all single with communal areas, lounge and kitchen and dining room appropriate for the people who live at the home. The home has a rear garden, which is mainly laid to lawn with seating. The home is situated close to local amenities and transport links and is maintained with the help of a maintenance department Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 19 employed by the provider. The home has a no smoking policy therefore people who smoke must do so outside in the back garden. People who live at the home are encouraged to participate and supported in keeping the home and garden clean and tidy with some expressing more interest in this than others. People stated that they had been able to bring personal items with them when they moved into the home. One person confirmed that he has a special fire alarm in his bedroom due to a hearing impairment. The inspector viewed one bedroom and this was individually personalised containing my items chosen by the person whose room it was. The home is redecorating one person’s bedroom and his key worker was helping him choose the colours for the walls from a colour chart. The communal space provided is domestic in nature and appropriate in size and furnished to meet peoples needs. There is a kitchen, large dining room and lounge. The dining room also provides space for indoor activities and has a computer with internet access. The home does not have separate area for visitors to be received in private. The home has a reasonable sized level rear garden that people stated they are able to enjoy during the warm weather. The home is able to accommodate people with mobility needs and has the necessary aids and equipment to support the people living at the home. The home has a shaft lift to access the first floor however people said this is rarely used. On the day of the unannounced inspection the home was noted to be clean, tidy and free from offensive odours throughout. The people who live at the home and care staff undertake all domestic and laundry activities. The home has policies and procedures in place for the control of infection. The manager confirmed care staff have received initial and update training in respect of food handling, health and safety, infection control and hygiene issues. Supplies of liquid soap, disposable gloves, aprons and paper towels were seen during the inspection. Laundry facilities are separate to food preparation areas and are able to wash to high temperatures if required. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by a consistent staff team who are provided in sufficient numbers with the necessary skills to meet people’s individual and collective needs. EVIDENCE: The inspector viewed recruitment and training records as well as discussing staffing with the manager, staff and people who live at the home. People stated that they liked the care staff, that they were helpful and they could ask their help with any problems. People were able to name their key workers. Interactions observed during the inspectors visit indicated that people and staff have a warm friendly relationship with people feeling able to express themselves in all respects. There are twelve permanent care staff employed at the home. Staff rotas and discussions with staff confirmed there are generally sufficient staff on duty. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 21 Staffing rotas are designed to ensure staff are available at times when people are at home. Staff spoken with felt that the staffing levels and arrangements were appropriate to meet the peoples needs and that activities relating to social and leisure were organised during the evenings and weekends. Staff will be accompanying people on the holiday’s they were planning. Both male and female staff are employed. The home has not needed to use agency staff as staff cover each others annual leave and occasional sickness. The manager described the homes recruitment procedures and the recruitment records for three people recruited since the previous inspection were viewed. These evidenced that full and comprehensive procedures are followed with all the necessary pre-employment checks undertaken. The manager also discussed the homes induction procedures and records relating to induction. The induction is comprehensive and includes shadowing experienced staff and training in managing challenging behaviour. The inspector spoke with staff who confirmed that full recruitment procedures had been undertaken and that their induction had given the correct level of support and training to feel confident and meet the needs of the people who live at the home. The manager provided the inspector with details of the NVQ training and qualifications held by care staff. The home employs twelve care staff, five have an NVQ of at least level 2 and a further three are undertaking this qualification. The homes duty roster contained dates of mandatory and service specific training for staff to attend. There was a training matrix seen on the office wall with the manager stating that training is audited by the provider company to ensure that care staff attend mandatory and service specific training. Care staff stated that they felt they had the necessary skills to meet people’s needs. Training certificates were seen in staff files. The inspector viewed supervision records within staff files; this indicated that staff do receive formal supervision and staff confirmed this. A list on the office wall detailed dates of appraisals and outstanding supervisions that are done by either the manger or the deputy manager. The manager confirmed that she sees staff most days but that although discussions occur these are not always recorded as supervision sessions. The deputy manager stated that much of her job is supervision and working with staff. Care staff stated that they felt able to approach the manager with any concerns. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 41 and 42 People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interests of the people who live there. EVIDENCE: The manager stated in the AQAA that she has completed her Registered Managers Award and is now in the process of completing the NVQ level 4 in care. The manager stated to the inspector that she now has only two units to complete and anticipates completion by September 2008. Staff and people who live at the home stated that the manager was approachable and they could discuss issues with her. Throughout the inspection visit the manager demonstrated a good understanding of management issues and individual knowledge of the people who live at the home. Interactions observed with Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 23 people who live at the home were professional and warm. Following the inspection visit the inspector telephoned the area community learning disability team. The professional spoken to was positive about the home and the manager. The manager confirmed that she has the necessary time to manage the service. The AQAA was well completed and returned to the commission when it was requested. People who live at the home are continually consulted about day-to-day issues at the home and there is a weekly residents meeting. Staff meetings are also held. People who live at the home stated that they felt staff and the manager listened to them. The manager detailed the external quality audits that the provider Craigmoor undertakes via clinical governance. These include monthly audits as directed by the provider. The inspector viewed audits undertaken and the audit for May 2008 was infection control. The provider directs managers of other homes in the area to undertake monthly visits under Regulation 26 with copies of the reports provided to the manager seen. An annual review of the service is also undertaken by the provider with action plans provided to the home to address issues identified. These were seen with the home having achieved ninety-six percent compliance rate in March 2008. The AQAA indicated that the home lacked some essential and relevant policies and procedures. These were identified to the manager who showed the policies and procedures, which were all present, to the inspector. Records were viewed throughout the inspection and these were seen to be well completed and those requiring confidential storage were stored securely. There were no concerns in respect of health and safety identified during the visit to the home. Certificates relating to the servicing of equipment and services (electric, gas, water) were viewed. Substances potentially hazardous to health were stored securely. Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 3 3 3 X Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Brooke House Care Home DS0000037569.V363139.R01.S.doc Version 5.2 Page 27 - 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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