Care Home: Brookthorpe Hall Care Centre

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What the care home does well The service has a process in place to make sure that it only admits people that it is sure it can care for. The care planning process has been improved so that the care and support required is identified and staff are provided with appropriate and clear guidance. People`s specific risks are assessed and well managed. Medicines are managed safely and records are well maintained. Appropriate recruitment checks are carried out to help protect the vulnerable people the service care for from abuse and harm. The environment is clean, well maintained and safe. What the care home could do better: Improve the standard of records kept for people who are on short stays (respite care). In particular make sure that people`s risk to pressure sores is appropriately assessed and monitored. Random inspection report Care homes for older people Name: Address: Brookthorpe Hall Care Centre Stroud Road Brookthorpe Glos GL4 0UN one star adequate service 07/04/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Janice Patrick1 Date: 0 9 0 6 2 0 1 0 Information about the care home Name of care home: Address: Brookthorpe Hall Care Centre Stroud Road Brookthorpe Glos GL4 0UN 01452813240 01452814394 admin@brookthorpe.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Michaela Brisland Type of registration: Number of places registered: Conditions of registration: Category(ies) : Frampton Residential Homes Limited care home 32 Number of places (if applicable): Under 65 Over 65 0 30 learning disability old age, not falling within any other category Conditions of registration: 2 0 That service users under 65 years of age must be over 50 years of age. Two beds can be used for service users under the age of 65 years of age. Date of last inspection Brief description of the care home Brookthorpe Hall is registered to provide personal care for 30 older people, with an additional category for two people with a learning disability. This service does not provide nursing care. The service is situated off the main road into Stroud from Gloucester. Bus stops are situated within walking distance from the home. There is Care Homes for Older People Page 2 of 9 0 7 0 4 2 0 0 9 Brief description of the care home also a local public house within walking distance. The building is very spacious and provides easy access with a staircase and shaft lift accessing all four floors. All bedrooms have washing and toilet facilities. There are extensive grounds that everyone can access and ample car parking. The fee range is between five hundred and ninety five pounds and six hundred and twenty five pounds per week. Hairdressing and Chiropody (footcare) are not included in these charges. The service makes a wide range of information available for people who use the service and for those who visit. Care Homes for Older People Page 3 of 9 What we found: Before we visited the service we considered all the information we had gathered since the last key inspection which was carried out on 7th April 2009. We revisited the last key inspection report containing any outstanding requirements. We looked at the information sent to us by the provider telling us how these are being complied with. We reviewed the notifications the service have sent to us since April 2009. These inform us of any deaths and occurrences that effect service users. We considered the most recent information sent to us by the home called the Annual Quality Assurance Assessment, AQAA. This document is completed by the registered manager/provider and tells us what the home considers it is doing well, how they evidence this, what improvements have been made and any plans for the next 12 months. One inspector then visited the service for a period of four hours and spoke to some of the people who live there and staff. We inspected a selection of care records, staff recruitment records and medicine records. We also walked around the building and noted its general condition and infection control arrangements. We (the Care Quality Commission) looked at the care records of two people. These told us that a pre admission assessment is carried out by staff of the service before someone moves in. One person had been visited and an assessment of their needs carried out and information about the second person had been gathered by other means as this person had been an emergency admission. Managers told us that this information is then passed on to staff so that on admission, all required preparations will have been made and staff are aware of the individuals basic needs. Following admission people are helped to settle in and the type of support they require, their preferences and health needs are explored in more detail with them. If this is not possible then close relatives or a representative will be encouraged to get involved on their behalf. This information is recorded and the care that is to be delivered is set out in written care plans. We read the care plans for both of these people. What was documented gave staff clear guidance on how the care was to be delivered. It was also quite obvious that staff had taken the trouble to find out peoples specific preferences. The service have developed a booklet, which explains to people, their right to access the records held about them and how to do this. This, and other policies and procedures are explained on admission. We were particularly impressed to see that the daily record is now written with the persons involvement. The managers explained that this is helping them to record more accurately, how an individuals day has been. Since the last key inspection the service has been developing the process of how it captures the required information in relation to peoples personal care, welfare and health care and how it records this. During this visit we could see improvements to this. A current review by the service has identified that some of the written records need to be condensed. For example there was more than one care plan explaining the needs and support for personal hygiene. Staff feel this is resulting in unnecessary record keeping. The format used for recording and planning the care for people on short stays (respite) is Care Homes for Older People Page 4 of 9 the reverse and requires more detail but the staff have already identified this and the format for recording these peoples care will become more like that used for people who live in the service permanently. This demonstrates that the service is being constantly proactive in its auditing and reviewing of how it operates. Both sets of care records demonstrated that peoples appetite and nutritional risk is monitored, as is their risk to developing pressure sores and their potential to fall. We did recommend that people who are admitted for a short stay should have these evaluated as regularly as the people who are living in the service permanently i.e. monthly or as their condition dictates. For example, one persons planned short stay had developed in to a much longer admission than expected. The persons pressure sore risk assessment however had not been reviewed since their admission. During our visit one person fell and staff dealt with this in a supportive but professional and knowledgeable manner. The emergency services were contacted and attended but the outcome was that the person was not seriously injured. We saw that peoples mobility and risk of falling is assessed and guidance for staff in relation to peoples safe moving and handling is documented. We inspected the medicine administration records (MARs) for the two people we were looking at. These were well maintained with no signature gaps. This implies that people are getting their medicines as prescribed and they are not being missed. We saw two staff signatures alongside each instruction (hand written or not) on the MAR indicating that the instruction had been checked by two staff alongside the actual prescription during the time the stock had arrived. We also checked all stocks and records of controlled medicines held by the service, which at the time of this inspection, were correct. The deputy manager explained that she continues to audit the records and stock once monthly and we saw records to this effect. We had fairly limited conversations with three people who told us they were happy at the home. We observed people being supported and treated in a respectful manner. Staff were giving people opportunities to make decisions and choices for themselves as and when they spoke to them. We inspected the recruitment files of two new staff members who had been recruited from overseas. Both staff had started work in the home after receipt of appropriate checks through the Independent Safeguarding Authority (ISA) and after references had been received. The registered provider had also carried out other checks to reassure herself regarding the terms of the persons visa. Both staff had completed a medical declaration. The registered provider told us that both staff were being provided with basic induction training. The evidence we saw suggested that one staff member was further ahead in completing this than the other, that some trainings were still yet to be booked or had been completed prior to starting at Brookthorpe Hall. This improved recruitment practice means that the previous requirement made to ensure people are safeguarded through adequate recruitment checks has been met. We walked around the building and observed that the same good decorative order had been maintained since our last inspection. The environment was clean and fresh and the usual high standard of presentation was observed in the dining room. The deputy manager told us that a decision still needs to be made about the replacement television, Care Homes for Older People Page 5 of 9 which people have said is too small for the size of the lounge. She also confirmed that the use of both lounge areas may alter in the near future. We were told that this is in response to feedback from the people who use them. We noted that several windows were in poor condition externally but we also saw some new replacement windows. Some of these windows are large and it was explained that this is work in progress as finances allow. The service have reviewed their fire evacuation procedures and with the guidance of an external fire safety expert are in the process of implementing a system that will help staff evacuate people safely. The service have always had cleaning schedules in place and on this visit we saw that this services usual arrangements were in place to help maintain good infection control. We were shown the efforts of a recent gardening group which had been started by the deputy manager and saw people being helped to visit the garden a little later on in our visit. Since the last annual quality assurance assessment was submitted by the provider, there has been a change in how and who organises activities. At the moment the care team share this role but one identified person will be doing this as soon as a replacement can be found for her present role as a carer. We saw advertisements on the home notice board telling people of future events, which included visits by outside entertainers. We were informed that the deputy manager has started the process to apply to us to be the registered manager. The current registered manager is still working for the service but through personal choice, the management decisions have been made by the registered provider and deputy manager. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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