Care Home: Brookside Care Home

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What the care home does well The service was generally well managed and provided a safe and comfortable environment for the people living there. The premises were maintained to a clean and hygienic standard. It is a small operation and offers `family style` care. People told us they liked the staff and said they were `kind` and `caring`. Assessments of need were completed prior to admission to the service to ensure that the service was able to meet individual needs. Most people using the service praised the meals and said they enjoyed the food; one person said the meals were `very good`. Staff told us that they received enough information to do their job and that training was `good`. What has improved since the last inspection? The service was keeping better records of complaints and it was clear how these had been addressed. Staff had improved their knowledge of safeguarding procedures and were clear what to do in the event of any allegation of abuse. Care planning records now included detailed and specific instructions on how to deal with mental health needs. What the care home could do better: Staff should receive training on mental disorders. There should be a wider range of activities including visits out of the premises. Key inspection report Care homes for older people Name: Address: Brookside Care Home 39-41 Chestnut Grove Borrowash Derby Derbyshire DE72 3JP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Morrow     Date: 0 8 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Brookside Care Home 39-41 Chestnut Grove Borrowash Derby Derbyshire DE72 3JP 01332666522 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): j_odimay@hotmail.com Olugbolahan Adesanya,Mrs Josephine Olaide Adesanya Name of registered manager (if applicable) Mrs Josephine Olaide Adesanya Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Mr and Mrs Adesanya may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories:, Dementia, aged 54 years of age and over - Code DE Mental disorder, excluding Learning Disability or Dementia aged 54 years of age and over - Code MD The maximum number of service users who can be accommodated is: 11 Date of last inspection Brief description of the care home Brookside is situated in a quiet cul-de-sac in a residential suburb on the outskirts of Derby, and is a home that is converted from two semi-detached houses. Residents are Care Homes for Older People Page 4 of 25 Over 65 0 0 11 11 2 2 0 6 2 0 0 9 Brief description of the care home on two floors, with lounges and dining areas situated on the ground floor along with one of the bedrooms; all other bedrooms are on the first floor and include two shared rooms. Lift access to the first floor is available. The service is registered as a care home for 11 people with Dementia or mental disorder aged over 54 years and not falling within any other category. This was changed when the current providers, who were registered on 26 June 2007, took over the service and decided to target their activities on a younger age group, the previous registration being for people aged over 65 years. Nursing care is not offered at the service. Verbal information provided by the service in June 2010 stated that weekly fees were £364.00 Copies of inspection reports are available on request from the service and on the Care Quality Commissions website: www.cqc.org.uk Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection visit took place over one day for a total of 5 hours and concentrated on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last inspection carried out in June 2009. The manager/owner, two staff and three of the ten people currently using the service were spoken with during the inspection visit. One visiting professional was contacted by telephone after the inspection visit. Eleven surveys were returned to the Care Quality Commission; four from staff, two from relatives, one from a visiting professional and four from people living in the home. Case tracking methodology was used, which means that the records of one person were looked at in detail and feedback was sought from relevant staff and visitors to find out what impact the service had for the persons well being and quality of life. Care Homes for Older People Page 6 of 25 Care records, staff records and a random sample of policies and maintenance documents were examined. We also looked at the records of one person who had recently gone missing from the service and had not been located at the time of the visit. A partial tour of the building was undertaken. Written information in the form of an Annual Quality Assurance Assessment (AQAA) was provided by the service prior to the inspection visit and informed the inspection process. This document is referred to as the AQAA throughout the report. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was sufficient admission information available to ensure that peoples needs could be met. Evidence: The AQAA stated accurate assessment of the needs is carried out before admissionpre-admission viewing and service users guide given. We examined one persons care file and this had an assessment in place that gave sufficient information to establish that needs could be met and there was information available from the assessment and care management process. Risk assessments were in place on the file for nutrition, dependency levels, falls and pressure sores. Those people spoken with confirmed that their care needs were met and one said they look after me well. Care Homes for Older People Page 10 of 25 Evidence: Both relatives surveys received responded that the service always met needs and a visiting professional commented that the service managed mental health needs well. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs were well met by clear care planning and medication procedures. Evidence: We looked at one persons care records. We saw a care plan for physical areas of health such as personal hygiene, mobility and eating and drinking that gave sufficient detail for care to be provided and was being updated on a monthly basis. There was also a care plan related to the mental disorder relevant to the person and this was up to date and gave clear instructions to staff on how to manage the mental health needs. There were records that showed input from a range of other professionals; optician, General practitioner (GP) and chiropodist. A visiting professional spoken with commented that the service was pretty good at dealing with functional mental illness. The AQAA supplied by the service stated that they enable residents to maintain the maximum possible level of independence, choice and control and respect residents Care Homes for Older People Page 12 of 25 Evidence: right to privacy. However, a survey received from a visiting professional commented that there was little choice for people and they are told what to do. There is a lack of dignity. This was discussed with the manager and she provided confirmation that staff had undertaken dignity in care training in April 2010 and was not aware of any issues raised by external professionals or visitors. Other comments seen commented on privacy and dignity being respected; for example, a recent thank you letter stated that the person concerned was treated with respect and had the very best of care and dignity. We observed staff interactions with people during the visit and these were polite and friendly. People that staff were caring. Surveys received from people using the service confirmed that privacy and dignity was upheld and a relatives survey commented its a caring and lively environment. We looked at two peoples medication administration record (MAR) charts for accuracy of recording. These showed that staff were signing the charts appropriately and the amount of medicines received was recorded. Photographs were in place on the charts to aid identification. One persons MAR chart was then examined in more detail and was completed accurately, with medicines being administered from the blister pack as signed for. There were no controlled drugs in use at the time of the inspection visit. Storage of medicines was satisfactory and examination of a random sample showed that the medicines stored were within expiry dates. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Meals, activities and contact with the community were well managed, which enhanced peoples quality of life. Evidence: Observation during the inspection visit showed that routines were flexible and some people opted to remain in their own rooms or were able to go out independently. All surveys received from people using the service responded that there were always activities arranged. A musical quiz took place during the inspection visit and one person told us they were taken out into the local area. However, there were few outings arranged outside of the area and those people who required assistance told us they didnt get out much. Discussion with the manager identified that no one currently had an advocate and that the manager was familiar with the implication of the Act and its safeguards. The AQQA told us that the service had identified that one way it could improve was by implementing the principles of the Mental Capacity Act 2005. Training records showed that the manager had led a training session for staff on the Act in March 2010. Those people spoken with enjoyed their meals. Three surveys received from people Care Homes for Older People Page 14 of 25 Evidence: using the service responded that they always liked the meals and one responded that they usually did. One survey commented the meals are very good. We examined the menus and these showed that there were nutritional choices available. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear safeguarding procedures and management of complaints ensured that people were safe and their concerns listened to objectively. Evidence: The services training record stated that safeguarding training had occurred in March 2010 and staff interviewed confirmed this. Staff also told us they were clear about what to do if there were any allegations of abuse and in discussion were knowledgeable about the need to report any issues raised. Staff surveys received also confirmed that they knew what to do if concerns were raised about the service. The previous inspection visit in June 2009 established that the service had a satisfactory safeguarding procedure and a copy of the Derby and Derbyshire Local Authority Social Services procedures. We discussed a recent incident of a person being missing with the manager. All appropriate authorities, including the Care Quality Commission, had been informed and the correct procedures had been followed. The service also had a policy that gave clear instructions to staff on what to do if a service user was missing. One safeguarding incident had been referred to the Local Authority and the manager had addressed the issues raised. The AQAA told us that there had been one complaint received at the service in the last Care Homes for Older People Page 16 of 25 Evidence: twelve months. We examined the complaints record and it was clear from the record what action had been taken to address the issues raised. All the surveys from people using the service and relatives responded that they knew how to make a complaint. One complaint had been received at the office of the care Quality Commission and the manager had responded appropriately to the concerns raised. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises were well maintained that ensured people living there had safe and comfortable accommodation. Evidence: The AQAA told us that The home is well maintained and people living there are safe and comfortable. There is an infection control action plan, to ensure that all staff undertake infection control training. Staff spoken with confirmed that they had discussed infection control practice as part of another health and safety course but there were no training records to indicate this area had been covered in tis own right. Staff were knowledgeable on how to prevent the spread of infection and confirmed that there was always a plentiful supply of protective equipment, such as gloves and aprons. The building was odour free and was clean, tidy and well maintained. All four surveys from people using the service responded that the home was always fresh and clean. We saw the kitchen and laundry area and these were clean and tidy. The service had been given a four star very good award from the Local Authority Environmental Health Department for its food hygiene practice that was valid until 2011. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient well-trained staff to ensure peoples needs were met. Evidence: The AQAA told us that staff were Undertaking relevant training to maintain and improve their knowledge and skills and contribute to the learning and development. We examined two staff records and these showed that mandatory staff training had taken place in the last twelve months as well as courses related to the needs of service users such as dementia, nutrition and dealing positively with challenging behaviour. However there had been no courses on metal illness other than dementia, although people using the service had a range of mental health needs. Staff surveys confirmed that relevant training was undertaken and one commented that training was something the service did well. Staff spoken with confirmed that there were a range of training courses and one said they were confident in their ability to deal with peoples needs. The AQAA stated that four of eight members of staff had a National Vocational Qualification at level 2 or above. The service was therefore meeting the target of having 50 of staff with an NVQ2. Care Homes for Older People Page 19 of 25 Evidence: The staff rota for 22nd June 2010 - 19th July 2010 was examined. This showed that the practice of staff undertaking twelve hour shifts and doing cooking as well as care continued. However, the manager stated that there was now a domestic member of staff who undertook cleaning and laundry duties. The manager maintained the view that there was sufficient time in the day to provide the care required and have social time with people as well. Staff we spoke with also said they were happy with the arrangements. We looked at two staff recruitment records and this showed that all necessary checks were in place, including Criminal Record Bureau (CRB) checks, two written references and identity information. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service was well managed in the best interests of people using it. Evidence: The manager was registered with the Care Quality Commission and had a number of relevant qualifications including the Registered Managers (Adults) Award. She had a good range of previous managerial and mental health experience. All four staff surveys received responded that the manager regularly met with them to discuss their work and to provide support. Personal allowance transactions were recorded. We examined two peoples financial records and these corresponded accurately with the cash held. The cash was stored securely. There were receipts available for individual purchases. The AQAA told us that We continue to improve and develop using a formal quality assurance and monitoring system covering all aspects of our service. We examined quality assurance information and a satisfaction survey for relatives undertaken in Care Homes for Older People Page 21 of 25 Evidence: October 2009 made favourable responses. Recent thank you cards also made positive comments such as very happy with the service and thanked the service for its care and consideration. Health and safety issues were generally addressed. We looked at a sample of maintenance records that showed that electrical wiring was checked in October 2008, the fire fighting equipment in September 2009 and portable electrical appliances in March 2010. The AQAA supplied by the service also confirmed this. We saw staff training certificates, and staff we spoke with, confirmed that courses had been undertaken in food hygiene, moving and handling, fire safety, infection control and first aid in the last twelve months. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 12 30 The service should arrange more opportunities for people who require assistance to go out into the community. The service should ensure staff receive training on all mental health issues related to the service user group. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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