Care Home: Brooklands 1

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What the care home does well The recent building works to expand and upgrade the home shows the commitment of the proprietors to improve the service. There is a good training programme in place and the numbers of staff trained to National Vocational Qualification Level 2 in Care exceeds the national minimum standard. People living at the home say the food is good, that they know how to complain and that the staff members treat them well. The home has a range of quality audit systems in place to make sure that the home`s procedures are followed. The proprietors are focussed on improving the quality of the service through staff training, quality monitoring and listening to the views of the people living in the home and their representatives. What has improved since the last inspection? The building phase of the expansion of the home is completed and the arrangements are progressing to make best use of the increased space. The new kitchen and new laundry room are completed and in use. Overhead projectors and screens have been purchased to aid staff training. Several improvements have been made to make sure that the safety systems are to the highest standards, such as in-line gas cut outs linked to the home`s fire alarm and a mister system in high risk areas to prevent the spread of fire. The nutritional needs of people are better monitored, and extra snacks are provided to make sure that individuals have all the nutrition they need. The care staff team has attended a variety of training on the needs of people with dementia, so that they are better able to care for the people living in the home. What the care home could do better: Care plans need to be developed as soon as possible after admission, and a system needs to be developed to make sure that care records are up to date before key staff members take leave. The complaints procedure needs to be available in formats suitable for everyone living at the home, such as large print or spoken word, so that all the people living in the home has equal access to information. The proprietors need to consider providing dedicated staff to manage the laundry, so that care staff team is able to spend more time with the people living in the home. The proprietors have identified through the self-assessment form how they intend to continue the improvements to the home in the coming year. CARE HOMES FOR OLDER PEOPLE Brooklands 1 14 Dashwood Road Banbury Oxfordshire OX16 5HD Lead Inspector Kate Harrison Key Unannounced Inspection 28th March 2008 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 Brooklands 1 DS0000046595.V359189.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. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brooklands 1 Address 14 Dashwood Road Banbury Oxfordshire OX16 5HD 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) 01295 268522 mail@brooklandsnh.co.uk Brooklands 1 Limited Julie Richardson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number Dementia of places Learning Disability 10 Physical Disability Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit one named service user under the age of 65 years. Date of last inspection 13th December 2006 Brief Description of the Service: Brooklands 1 is a privately owned care home located within five minutes from Banbury town centre, providing 24 hour nursing care to residents. The home has recently been extended by the acquisition of the property next door, and there are plans to upgrade the original building. The home has good access to the main shopping area, churches, bus and rail stations, library, hospital and doctors surgeries. The accommodation is spread over three floors, served by two passenger lifts. The home is registered to provide accommodation for 40 people, and the accommodation is arranged in 28 single rooms and 6 double rooms. There are lounges and dining areas on each floor. There are small garden areas at the front of the building and a central garden area. The weekly fees at present range from £542 to £800. Brooklands 1 DS0000046595.V359189.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 the people who use this service experience good quality outcomes. This inspection of the service was an unannounced ‘Key Inspection’. We arrived at the home at 11.30 hours and were in the service for 5 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the home’s manager, through the Annual Quality Assurance Assessment, (AQAA) and any information that we received about the home since the last inspection. We saw those areas of the home used by people living there and looked at records and documents relating to their care. We also looked at staff recruitment files and at training records. We asked the views of the people who live in the home, and of people we saw during the inspection or who responded to questionnaires that we had sent out, and their views are reflected in this report. This inspection was a thorough look at how well the home is meeting the standards set by the government and in this report we make judgements about the outcomes for the people living in the home. From the evidence we saw and from comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals with different religious, gender or cultural needs, and those with dementia needs. This report identifies the need to improve the ways the home’s documentation is presented, so that people with physical disabilities, such as poor eyesight, can access the information. What the service does well: The recent building works to expand and upgrade the home shows the commitment of the proprietors to improve the service. There is a good training programme in place and the numbers of staff trained to National Vocational Qualification Level 2 in Care exceeds the national minimum standard. People living at the home say the food is good, that they know how to complain and that the staff members treat them well. The home has a range of quality audit systems in place to make sure that the home’s procedures are followed. The proprietors are focussed on improving the quality of the service through staff training, quality monitoring and listening to the views of the people living in the home and their representatives. Brooklands 1 DS0000046595.V359189.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. Brooklands 1 DS0000046595.V359189.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 Brooklands 1 DS0000046595.V359189.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. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment of people’s health and welfare needs is carried out before they move into the home, and they are assured that their needs will be met. EVIDENCE: Usually one of the proprietors or the registered manager visits the individual at home or in hospital, after the initial contact, and carries out an assessment of the needs of the individual. Following the visit the proprietor confirms in writing that the home is suitable to meet the individual’s needs, and depending on individual circumstances invites the individual and their representatives to visit. We looked at care records to check how people are assessed before they move into the home. The home’s pre-admission assessment forms were completed, and all the necessary information was available from hospital and from the local authority. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 9 The proprietors are updating the home’s brochures following the expansion, and intend to provide a copy of the service user guide in all private rooms so that this information is always available for people living in the home and their representatives. The updating of the service user guide in other formats is also in hand. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 10 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 health and personal care needs of people living in the home are met, and the manager takes swift action when lapses are identified. EVIDENCE: We looked at care plans and other care records to see how people are cared for in the home. The home has a key-worker system in place to try to help with continuity of care and to give individuals a named member of staff to refer to. The care plans for one individual were well organised, with risk assessments and care plans written to make sure that the individual’s health and welfare needs were met. Although there was a ‘summary of care needs’ recorded for another individual who had been admitted some weeks previously, risk assessments and care plans had not been developed, and when we saw the individual it was clear that not all the actions needed to meet the individual’s needs had been taken. The key worker responsible for the individual’s care was on annual leave and there was no system in place to make sure that an effective hand over of responsibility took place. We made a requirement to develop care plans for the individual with immediate effect, so Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 11 that the individual’s health and welfare needs would be fully met, and the requirement was quickly met. More equipment has been provided to meet the needs of the increased numbers of people at the home. Medication is supplied by a local pharmacy and the pharmacy carries out quality monitoring visits regularly. We saw the medication records showing how medication is received, administered and stored. The administration recording has improved to include the recommendations made at the last inspection. The majority of people living in the home who responded to our survey said that staff members ‘always’ or ‘usually’ listen and act on what they said. Relatives who spoke to us said that they observed staff members being ‘very kind’ to people during their visits. The proprietor has identified ways to improve the service in the annual quality assurance assessment returned to us. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 12 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. The improvements in the environment have made it easier for people living in the home to remain independent. EVIDENCE: The registered manager confirmed that there is an activities schedule for the home (though it was not available) and there is an activities organiser who has attended courses on dementia, and who works four days a week. There are regular ‘music to movement’ sessions; entertainers come into the home and during the summer months there are outings to places of interest to the people living there. People are supported to go to nearby church services as they wish. The proprietor has identified in the annual quality assurance assessment the need for increasing the number of hours that activities are provided, due to the increased numbers of people living in the home. All the people living in the home who responded to our survey said that they do what they want to during the day. People are encouraged to retain their independence, and the new layout of the home means that people who are able to can walk around the home and spend time in different areas. The Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 13 home is being developed to be more suitable for people with dementia, and reminiscence items and other appropriate items are available to help staff members communicate better with individuals. Visitors are welcome at the home and several were in the home on the day of the inspection visit. Those who spoke to us said that they were always welcome, and that they found the staff team very helpful. People living at the home told us that the food is good, and one individual described the food provided as ‘excellent’. The menu is varied and staff members help those who need it in a professional way. More nutritious snacks have been introduced so that the people living at the home will find it easy to maintain their nutritional state when they do not want to eat at usual times. The dining area is being developed so that mealtimes can become more of a social occasion for the people living in the home. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 14 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 living at the home know that their concerns will be listened to and acted on, and staff members are knowledgeable about safeguarding people living in the home from harm. EVIDENCE: The home’s complaints procedure is easy to use and is displayed in the front hall. People living in the home who replied to our survey said that they knew how to make a complaint. We spoke to one individual who said that because of a disability she/he did not have access to the complaints procedure, and the home should make sure that the complaints procedure is available in formats suitable for everyone living at the home, such as large print or spoken word. A record of complaints is kept, and one new complaint was made to the home since the last inspection. We recently received information about a complaint, and the proprietor promptly started an investigation, which is not yet completed. The home has policies and procedures about safeguarding people living in the home from harm, and the registered manager is aware of the local protocols. All new staff members receive information during induction, and training has been provided on the topic on four occasions in the last year. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 15 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. People living at the home benefit from the recently improved environment. EVIDENCE: The home has recently been greatly extended to provide increased accommodation and communal space, and the proprietor is developing the health and safety checklists and documentation to include the new areas. A new kitchen and laundry have been provided. The new equipment in the laundry is designed to eliminate harmful germs. As the new laundry is located in the basement the proprietor is developing a lone worker policy for night staff members to improve the security. There is new equipment in the laundry, with easy access to hand washing and drying facilities. Maintenance staff members are employed, and are responsible for maintaining equipment, carrying out checks and responding to maintenance requests from Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 16 individuals. People living in the home who responded to our survey said that the home is ‘always’ fresh and clean. A new nurse call system is in place, and the proprietor has made arrangements to adjust the settings so that the noise does not unduly disturb people in the rooms adjacent to the call points. The improved garden areas are due to be completed in the near future so that people living in the home can freely use the areas. The proprietor has identified in the annual quality assurance assessment the ways to improve the home, including the completion of the refurbishment and the commissioning of the new Snoezelan, where individuals can relax. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 17 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. People living at the home have confidence in the well-trained care team, and they are protected by the home’s recruitment procedures. EVIDENCE: The home recognises the importance of having a trained, skilful and motivated care team. The home supports the care staff to enroll on the National Vocational Qualifications (NVQ) programme, and 67 of the care staff team has gained the NVQ Level 2 in Care. Training is encouraged throughout the home, and two universities audit the training support provided by the home for its students. The home has a good induction training programme in place, and continuing training for care and nursing staff is organized and supported. The responses to our survey show that people living at the home have confidence in the staff team. We checked the recruitment procedure and all the information necessary to meet regulations was available about staff recently recruited. There is a staff rota showing the numbers and skill mix of staff available over the 24 hours. More staff members have been recruited to meet the needs of the increased numbers of people living at the home. During the day there are two registered nurses and six carers, and three carers and one registered nurse at night. More staff members have training and skills to manage the Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 18 needs of people with dementia, and we saw good practice in managing individual’s behaviour during our visit. The care staff team is responsible for managing the laundry at present, and consideration should be given to providing dedicated housekeeping staff for this task. This would mean that more trained people are available in a flexible way to support people living in the home, for example through one to one conversations or individual impromptu activity. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 19 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. People living at the home are protected by the home’s policies and procedures and by the responsible attitude of the home’s managers. EVIDENCE: We received the home’s self- assessment information in good time, and it was fully completed and in detail. The registered manager is a registered mental health nurse, and is completing a course to gain her Registered Manager’s Award. She is strengthening the processes to make sure that care planning is carried out as soon as possible after an individual’s admission. The proprietors take different management responsibilities to compliment the registered manager’s skills. With the proprietors’ support the registered manager is developing a strong team to meet the needs of the increased numbers of people living at the home. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 20 The home has a quality audit system to make sure that all the policies and procedures are followed. An annual quality assurance survey is carried out, and the results are published in the home’s newsletter. The results of the January 2008 survey are available, and the proprietors are looking to implement the learning gained from the exercise. The home does not keep cash for anyone living at the home, and lockable facilities are provided in private rooms for individuals to keep items securely. The home works to its health and safety policy statement and one of the proprietors is responsible for health and safety in the home. Several members of staff have also had training in managing health and safety issues, and in first aid. A fire risk assessment is in place and fire safety is discussed at induction for all new staff members, and followed up with appropriate training. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP16 OP26 Good Practice Recommendations That a system be developed to make sure that care records are up to date before key staff members take leave. That the complaints procedure is available in formats suitable for everyone living at the home, such as large print or spoken word. That dedicated staff be provided to manage the laundry. Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 23 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 Brooklands 1 DS0000046595.V359189.R01.S.doc Version 5.2 Page 24 - 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. 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