Care Home: Brookvale

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What the care home does well The accommodation and facilities at Brookvale are excellent providing residents with a spacious, comfortable home in which to live. The Expert by Experience who joined us on the visit felt that Brookvale is a lovely place to live and the people who live there are happy and the people who work there were warm and friendly. They also said that there was so much to do there that they may of forget to mention that they too felt they could live at Brookvale and be happy. Discussion was also held with some parents who were dropping people off for day care. Each of the parents felt happy and `have peace of mind and trust them`. Other comments included; `it`s absolute heaven`, `very relaxed`, `staff are helpful and approachable`, `facilities are brilliant`, `always kept informed`, `the residents are nice and look after each other` and `residents are given opportunities`. When asked what improvements could be made one relative said` I think they have got it all wrapped up` What has improved since the last inspection? Work has been completed on risk assessments for those residents who have high physical support needs. Some staff have received specific training and advice to enable them to carry out the necessary assessments. This will ensure staff have clear instruction on how to support residents safely. Further redecoration has been carried out in the building used by some of the younger residents, bathrooms have been refitted and rooms have new furniture. The home also has a wheelchair accessible vehicle so that accessing places away from the home is easier for those residents who rely on the use of a wheelchair. The staff team has remained unchanged providing a stable supportive environment for the residents. On-going training continues to be offered to staff making sure that they have the knowledge and skills needs to support residents safely. What the care home could do better: When reviewing the homes statement of purpose the manager needs to ensure that information is included about supporting individuals between the age of 16 and 18 years. Minor improvements have been identified with regards to residents` medication. This will ensure that information is accurate and medication is administered safely. The home was also asked to provide written confirmation about the arrangements in relation to resident`s bank accounts. When recruiting new staff the home must make sure they continue to carry out both vulnerable adults and children`s checks due to the home supporting young people between the age of 16 and 18, ensuring any new staff have been properly vetted before starting work. A copy of the staff training matrix is to be sent to us showing that staff have received continuous training relevant to needs of residents living at the home. Consideration is given to the development of an annual development plan based on information gathered from people involved with the service as well as evidencing continuous self-monitoring and development based on the current and changing needs of the service. Copies of such a plan should be shared with residents and other interested parties including us. CARE HOME ADULTS 18-65 Brookvale 167 Simister Lane Prestwich Manchester M25 2SF Lead Inspector Lucy Burgess Unannounced Inspection 16th October 2007 08:30 Brookvale DS0000008451.V348104.R02.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 Brookvale DS0000008451.V348104.R02.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. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookvale Address 167 Simister Lane Prestwich Manchester M25 2SF 0161 653 1767 0161 655 3635 admin@brookvale.org 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) Brookvale Mrs Lynne Richmond Care Home 74 Category(ies) of Learning disability (74) registration, with number of places Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the home is registered for a maximum of 74 service users who are in the category Learning Disability (LD). That within the overall number: • 3 Southview Terrace, Simister Lane, is used to accommodate no more than 3 service users. • 1 Southview Terrace, Simister Lane is used to accommodate no more than 3 service users. • 2 Southview Terrace, Simister Lane is used to accommodate no more than 3 service users. • 4 Southview Terrace, Simister Lane is used to accommodate no more than 3 service users. • 357 Heywood Road, is used to accommodate no more than 4 service users. • The Atrium, is used to accommodate no more than 14 service users. That the service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 26th March 2007 3. Date of last inspection Brief Description of the Service: Brookvale is a purpose built establishment registered to accommodate 74 younger adults with a Learning Disability. It is a Charitable Trust, which seeks to cater for Jewish people although non-Jewish service users are also accommodated. Permanent, and respite care is offered together with day care. The range of fees vary from £500 to £1000, dependent on assessed needs. The majority of the home provides ground floor accommodation. One wing is on the first floor level. In addition to the main building, there is South View, four cottages each accommodating the more independent service users, a larger house approximately 1 mile from Brookvale, which can accommodate 4 service users and the Atrium. This provides spacious accommodation for up to 14 individuals each with single en-suite bathrooms. A few individuals through their own choice share rooms. The homes facilities include an indoor hydrotherapy/swimming pool, fully equipped gymnasium, music therapy centre, computer room and a sensory light and sound room. There are extensive, well-maintained gardens, which are easily accessible to all service users. This includes a cycle path and crazy golf pitch. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home by two inspectors. The inspection was carried out over one day, between the hours of 8.30am to 5.00pm. An Expert by Experience also joined the inspectors. Their role was to look at the lifestyles and routines of residents as well speak with residents and staff. Their feedback has been added to the report under ‘lifestyles’. During the visit the inspectors looked at paperwork, improvements to the environment as well as having discussions with staff and managers about their roles within the home. Several parents were also spoken with. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. The home is registered to provide accommodation up to 74 people. From the information provided there were 65 permanent residents and 5 short term placements at the time of the visit. The home accepts referrals for people who would like respite care or day services. All the key standards were looked at during this inspection visit as well as the action identified during the last visit. What the service does well: The accommodation and facilities at Brookvale are excellent providing residents with a spacious, comfortable home in which to live. The Expert by Experience who joined us on the visit felt that Brookvale is a lovely place to live and the people who live there are happy and the people who work there were warm and friendly. They also said that there was so much to do there that they may of forget to mention that they too felt they could live at Brookvale and be happy. Discussion was also held with some parents who were dropping people off for day care. Each of the parents felt happy and ‘have peace of mind and trust them’. Other comments included; ‘it’s absolute heaven’, ‘very relaxed’, ‘staff are helpful and approachable’, ‘facilities are brilliant’, ‘always kept informed’, ‘the residents are nice and look after each other’ and ‘residents are given opportunities’. When asked what improvements could be made one relative said’ I think they have got it all wrapped up’ Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: When reviewing the homes statement of purpose the manager needs to ensure that information is included about supporting individuals between the age of 16 and 18 years. Minor improvements have been identified with regards to residents’ medication. This will ensure that information is accurate and medication is administered safely. The home was also asked to provide written confirmation about the arrangements in relation to resident’s bank accounts. When recruiting new staff the home must make sure they continue to carry out both vulnerable adults and children’s checks due to the home supporting young people between the age of 16 and 18, ensuring any new staff have been properly vetted before starting work. A copy of the staff training matrix is to be sent to us showing that staff have received continuous training relevant to needs of residents living at the home. Consideration is given to the development of an annual development plan based on information gathered from people involved with the service as well as evidencing continuous self-monitoring and development based on the current and changing needs of the service. Copies of such a plan should be shared with residents and other interested parties including us. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 7 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. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 8 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 Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 9 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): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Needs are assessed before anyone is admitted to the home, written information about what the home offers is provided so that all concerned can decide whether the home will be suitable. EVIDENCE: As part of the inspection process discussion was held with the registered manager so that the current registration certificate could be reviewed and updated where necessary. Where previously the home also had the provision of a children’s service, Beit Yehudit, this is no longer provided. However the home continues to provide respite and day care support for people who are aged between 16 to 18 years. This is to be identified on the certificate for Brookvale. The managers are asked to ensure that the standards and regulations relevant to this group continue to be addressed to ensure needs are fully met and individuals are protected. This information should also be identified within the homes Statement of Purposes, clearly identifying who the home caters for and the arrangements in place to ensure their safety. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 10 With regards to assessment information, no new admissions have been made since the last visit to the home. The managers are aware of their responsibility in ensuring that adequate information is provided about a prospective resident prior to them being admitted. However at times this has been difficult to obtain or information provided by social workers has been out dated, particularly when the home has accepted emergency placements. It was noted during a random visit made to the home in March 2007 that information held about residents had improved. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about residents assessed and changing needs as well as areas of risk are included within their care plan detailing how each individual chooses to live their life. EVIDENCE: Information is held at the home for each of the residents. Care plans and risk assessments are held within the day centre office along with daily reports whilst health care information is held securely within primary care. For those individuals who only access day support a communication diary is completed so that information can be shared between the staff at the home and their main carers. No new placements have been made at the home since the last visit therefore information was reviewed in relation to previous action identified. Care plans, assessments and specific agreements had been dated and signed to evidence that information had been reviewed and updated where necessary. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 12 Issues identified during previous visits in relation to risk assessments for those individuals with additional support needs had been addressed. The home has sought the help of someone suitably qualified to assist them in this area. Training was provided for 8 staff, managers and senior care staff with regards to the completion of the risk assessment documentation. Documents have now been completed based on the level of support required and perceived risk. Further assessments are to be carried out on other residents where there is some level of risk identified. Information seen was comprehensive and included clear instruction for staff with regards to what support was required when supporting with various tasks, the number of staff needed and equipment to be used where necessary. Discussion was held with managers about the recent changing needs and behaviours of some residents. Action had been taken to address concerns. Where necessary contact had been made with social workers and health care professionals so that care could be reviewed and additional support explored. Where serious issues had occurred the home had contacted us providing details of such issues. Arrangements are made to ensure that each resident has a meeting at least on an annual basis. The home has an admissions and reviewing officer who will spend time with residents gathering feedback about individuals routines, if there is anything else they would like or would change etc. Minutes of such reviews are taken and copies were seen on file. Review notes were also seen by the funding authority. All relevant parties involved with the resident are invited, parents, family members, social workers, other professionals and staff from the home. Relatives were spoken with during the visit to ask what their views were about the care being offered to their family member. Each of them were very happy with care provided, one parent expressed that they would like additional day care. Other comments included: ‘it’s absolute heaven’, ‘very relaxed’, ‘staff are helpful and approachable’, ‘facilities are brilliant’, ‘always kept informed’, ‘the residents are nice and look after each other’ and ‘residents are given opportunities’. When asked improvements could be made one relative said’ I think they have got it all wrapped up’. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social and leisure opportunities are made available to residents enabling them to lead a full and active lifestyle as possible. Dietary needs of residents continue to be closely monitored ensuring their health and nutrition is maintained. EVIDENCE: The Expert by Experience looked at this area. Time was spent throughout the morning with residents and speaking with staff, looking at what they do during the day and how they were involved in making decisions about what they wanted to do. This is the report provided by the expert by experience; ‘When we walked into the office we were met by one of the managers, who I thought was a cool guy and I liked the way he introduced himself to us. I felt the manager was warm and he made me feel relaxed and good about things. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 14 I felt good about going around Brookvale and could live there myself, marks out of 10, I would give Brookvale 9 and a half! I met lots of lovely people at Brookvale. The resident I spent time with was warm, had lots of confidence and loved living at Brookvale. This resident showed me round the home and told me how the staff help her to make decisions and choice about her life. She also told me that if she has any problems how the respite manager had helped her to think her problem through before making a decision. The resident also said that they see their family every two weeks, but sometimes if she is busy then she may have to cancel or change there visiting dates. She also said that she loves swimming, going to the gym, music and yoga, has lots of friends and gets to do the things she likes to do. She loves the staff that work at Brookvale and told me that they are very helpful. Brookvale has a swimming pool and gym and a mini cinema, crazy golf course and cycling track, music room where they can also do yoga in, they have lovely gardens to walk around. People who live at Brookvale get to do lots of interesting things they have a 3 day sports programme, which is organised by a staff member for them during the summer months. This includes things like wellington throwing or bean bag throwing, egg and spoon races, crazy golf or bike riding and swimming. The staff member was described as being a warm person with lots of ideas and knows what people want to do. I found out that people who live at Brookvale must go swimming at least once a week. This is to make sure that they are exercising and getting to stretch their body muscles. There is a hairdresser who comes into Brook vale twice a week to cut their hair and give people advice on beauty treatment. They also have a sensory room at Brookvale, which is very relaxing and is soon to be up dated with new equipment. I met a lady who had worked at Brookvale for over 30 years. She said she loves her job and all the people who live at Brookvale. Her role is to look after all the residents when they come into Brookvale and make sure they are happy and if not she finds out why. She was thought a lot of by residents who said that they tell her when they would like to have a meeting with her to talk about things. I spoke with her and she told me that they go out when the weather is nice to do different things like walking and theatre trips. She also told me that they go to Blackpool 3 times a year twice for a holiday and once to see the lights and they also get fish and chips. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 15 I feel that Brookvale is a lovely place to live and the people who live there are happy, the people who work there were warm and friendly. There is so much to do there that I may of forget to mention, but myself I could live at Brookvale and be happy’. The inspectors also spent time speaking with relatives visiting the home. The parents of one person who received day care support were also actively involved in the home providing an activity group on afternoon each week as well as teaching Hebrew and choir another day. Each of the parents spoke highly about the support offered by Brookvale. One relative expressed that if possible she would like to increase the number of days currently accessed. As already identified above, residents have the opportunity to take holidays, this includes the holiday home owned by Brookvale, which is in Lytham St Anne’s. A theatre trip had also been organised following the inspection visit to see ‘Kiss me Kate’. One resident had also been supported by 2 members of staff so that they were able to attend their sisters wedding day, which was thoroughly enjoyed. The home has also now become more involved with advocacy groups and is still exploring opportunities for residents to develop their skills away from the home. Arrangements in relation to meals, continues to be prepared by designated kitchen staff with some residents helping with small tasks including preparing food, setting tables and clearing the dining room. A choice of meals are offered. Meals are kosher and observance is maintained over Shabbat. Mealtimes are relaxed and unhurried. There are two large dining rooms providng space for residents, particularly those who require support from staff. Where issues have been idnetified in relation to dietary needs the home has accessed advice and support from the GP and dietician. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are consistently offered the health and personal support they prefer and need, and are helped to achieve good physical and emotional health. Medication is generally well managed however minor improvements are required to ensure safety. EVIDENCE: The home continues to maintain records and information about the health and well-being of residents. The home regularly accesses the support of a number of health care professionals to assist in meeting health care needs of residents. Support and advice is provided from the local GP who visits the home on a weekly basis. Other support has been provided from the dieticians, district nurses, podiatrist, community nurses and OT’s. Whilst domiciliary visits are made to the home a number of residents will visit the local surgeries. Support is provided where necessary. The home supports people with varying support needs, whilst some are able to address their own personal care needs with prompts and encouragement others are not, requiring physical assistance. The home has been adapted to meet the physical needs of residents. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 17 Specialist equipment has available throughout the home allowing for the appropriate level of care to be provided in a safe and dignified manner. Equipment includes assisted toilets and bathing facilities, ceiling tracking hoists and grab rails. A large number of bedrooms are situated on the ground floor and are therefore more easily accessible to those residents who have physical support needs. Training has also been undertaken by some staff that are responsible for the management of residents health care. This has included a MUST nutritional assessment courses, advanced medication and risk assessments specific to moving and handling and the use of specialist equipment. Information and guidance is then passed on to the team along with training specific to their role and responsibilities. The medication system was looked at with staff from ‘primary care’. Medication is generally ordered and booked in by one member of staff. Records are maintained for items brought into the home and returned to the supplying pharmacist. A recent audit was carried out by the supplying pharmacist on the 17 September 2007 and no issues identified. On examination of the records, hand written entries had still not been double signed to ensure that the information written corresponded with the prescription. A bottle of promazine was also found, which did not have a label on the bottle or box in which stored. Medication should be properly labelled to ensure it is safely administered, any items without a label should be returned to the supplying pharmacist. Only one resident is currently prescribed a controlled drug. Records are being made on the MAR sheet. It was suggested that due to the limited space available that one member of staff signs the MAR to acknowledge the medication has been given and that a controlled drug register is then used so that detailed records can be held and clearly audited. Discussion was also held about the need for a controlled drug cabinet to be fixed within the medication cabinet should items require separate storage. At present no items were being stored within the fridge other than flu jabs which have been prescribed for residents. Arrangements are currently being made between the GP and district nurse with regards to these being given. Additional items and old records are stored in a small room next to primary care. It was suggested that a smoke detector is fitted due to the mix of items and materials kept in the room. Further records are also with primary care with regards to health appointments and assessments, district nurse files and weight records. Residents are generally weighed approximately every 8 weeks however additional records had been made for those individuals where there had been concerns about weight loss. The dieticians had also been involved to offer additional support. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place in relation to the protection of residents as well as responding to their concerns. EVIDENCE: As previously identified the home holds policies and procedures in relation to the safety and protection of service users. A copy of the home’s complaints procedure is displayed within the home so that it is easily accessible to residents and visitors. Further information is also provided in the information provided by the home. This tells people how their concerns/complaints will be dealt with as well as having contact details for CSCI. No concerns, complaints or allegations have been identified within the AQAA, nor have any issues been raised with us. The home has recently received a copy of the Local Authority Inter Agency Procedure on Safeguarding Adults. Whilst staff have previously undertaken training in this area, discussion was held with managers about training being made available to Providers through the Bury Adult Care Partnership Training Group. This will include management training in relation to reporting and responding to any allegations made in line with the new Procedure. In relation to residents’ finances, Brookvale acts as corporate appointee for some residents. Computer records were seen with regards to individual accounts and any transactions. Receipts are also held so that information can be clearly audited. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 19 The home was asked to provide written confirmation of the account in which residents money is held and that they receive any interest accrued. A separate record is held for those residents who receive and manage their own personal allowances. Records had been signed by the resident to evidence what they had received. Lockable storage is available in each residents bedroom for the safekeeping of money and belongings should this be required. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 20 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, 25, 26, 27, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The environment and facilities provided within the home are of an extremely high standard providing a safe, comfortable environment for people to live. EVIDENCE: Brookvale comprises of North View and West View, which are situated in the main building. South View is a group of 4 cottages at the side of Brookvale, each providing accommodation for 3 residents, the Atrium is a relatively new building providing accommodation for up to 14 residents and finally Heywood Road, which is a detached property approximately a mile from Brookvale which can accommodate up to 4 residents. Brookvale provides an extremely high standard of accommodation for residents living at the home as well as those who access the day care provision. During the last visit in March 2007 further work had taken place to enhance the home. This involved the computer room being converted into a cinema area where residents can watch videos and DVD’s. The day centre area had Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 21 been refurbished and redecorated as well as having an extension providing include a further dining room, which accommodates up to 30 residents requiring additional support with meals. Other redecoration has also been carried out in the building previously used for the children’s service. This is now used by younger residents living at the home on both a permanent and short-term basis. Bedrooms vary in size with larger being made available to those people with more physical needs. Accommodation is spacious, well equipped, nicely decorated and furnished to a high standard. Each of the buildings have ground floor level access and are easily accessible to residents in wheelchairs. Sufficient aids and adaptations are provided throughout allowing residents ease of movement around the home. The home also has a high number of communal and en-suite bathing facilities and toilets. These include a range of equipment, such as assisted bathing and showering and ceiling tracking hoists, to assist residents in having their personal care needs met safely. The home has a large laundry facility and team of staff who take responsibility for all general and personal items. There are also designated domestic staff that are employed to ensure that the home is kept clean and tidy. It was clearly apparent that the domestic staff continue to maintain the home to a high standard of cleanliness and hygiene. Adequate provisions are available with regards to protective clothing and suitable hand washing facilities to prevent any cross infection. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 22 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a consistent staff team that is trained and developed so they are competent to do their work. EVIDENCE: Staffing at the home has remained stable for sometime now with no changes to the team. Rotas clearly identify the number of staff on duty and the area in which they provide support. Sufficient numbers were noted with 13 support staff available each day between 6am and 12 mid-night plus night staff. Rotas are flexible and accommodate the needs and wishes of residents. Additional support is provided from the management team. The home is also supported by a number of ancillary staff that takes responsibility for the housekeeping, catering, maintenance and gardens. Current recruitment is taking place for further support staff to work in the day centre. The hours being weekdays whilst residents and day care people are accessing the facilities and group work. Recruitment files were not looked at for existing staff on this occasion due to there being no changes and no outstanding action however it was discussed Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 23 with the managers that relevant checks under POVA and POCA would still be required due to support being provided to some people aged between 16 and 18 years of age. In relation to NVQ training the home has been proactive in supporting staff to do the training. Of the 44 care staff employed at the home, 31 have completed the course, a further 8 are currently doing the training and the remaining 5 will commence next year. This exceeds the standard required. The training manager also said that an NVQ course in Infection Control was being explored for some of the ancillary and care staff. Since the last visit training has been completed as well as further course planned. These have included, infection control, health and safety, fire safety, advanced medication, moving and handling and hoisting and nutrition. A further course is planned for 36 staff called ‘Building relationships between residential care staff and relatives of service users’. The training manager was asked to produce a staff training matrix showing what training staff have received along with future courses and dates of attendance and send us a copy. Discussion was held with regards Bury Adult Care Partnership Training. This may be a resource that the home wishes to explore. Providers are asked to attend monthly meetings and will be offered training opportunities for their staff in line with Skills for Care. The Partnership is currently offering training in Safeguarding Adults in line with Bury’s new Safeguarding procedure. This includes an awareness day for staff and reporting and responding training for managers. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 24 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall management and conduct of the home remains consistent and reliable ensuring it is ran in the best interests of residents. EVIDENCE: No changes have taken place with regards to the management of the home. The registered manager is supported by department managers who take responsibility for staffing, training, respite care, primary care, day services and assessment and reviewing. Clear systems and records are in place to evidence that the registered manager is fully aware and involved in the day-to-day running of the home. Regular meetings are held between the management so that information is shared and everyone is fully informed. One member of staff felt that the management of the home was more flexible allowing individuals to take responsibility for their own area, whilst being fully supported by the registered manager. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 25 The manager is supported in her role by the Board of Trustees who she meets with on a monthly basis to discuss the business and running of the home. As already stated the manager was asked to complete and submitted the AQAA prior to the inspection taking place. This provided quite a lot of information about what the home was doing, areas of improvement and some of their future plans. Information about the National Minimum Data Set for Skills for Care had also been received but has yet to be completed. With regard to quality assurance, monthly monitoring visits are carried out by on behalf of the Provider and each month copies of the reports are forwarded to us. Other feedback continues to be sought during the health care reviews of residents, which the admission and reviewing officer will arrange on an annual basis. Residents, family members and social workers etc, are invited to these meetings. The admissions officer also holds regular meeting with residents where further discussion is held. Feedback is also sought from the staff during the periodic team meetings and supervisions. In line with Standard 39 of the National Minimum Standards (NMS), the manager may wish to consider the development of an annual development plan based on information gathered from people involved with the service. This should also include evidence of continuous self-monitoring and development based on the current and changing needs of the service. Copies of such a plan should be shared with residents and other interested parties including us. Health and safety continues to be addressed. The home has its own maintenance worker who ensures that generally repairs and checks are carried out including water temperature and fire safety. Additional records are held in relation to annual servicing for the gas, electric, fire appliances and alarm, emergency lighting, hoist, small appliances and bath hoist. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 26 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 3 28 3 29 4 30 4 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 6 Timescale for action Arrangements should be made to 30/12/07 review the homes Statement of Purpose to include details of support provided for those individuals between the age of 16 and 18 years of age. Requirement 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. Refer to Standard YA20 Good Practice Recommendations Any mediation, which is not appropriately labelled, should be returned to the supplying pharmacist ensuring the administration of medication is safe. Handwritten entries to MAR sheets should be signed and dated by 2 members of staff ensuring that the information recorded is correct. A copy of the staff training matrix should be forwarded to the CSCI. 2. YA20 3. YA35 Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 28 4. YA39 That consider is given to the development of an annual development plan based on information gathered from people involved with the service evidencing continuous self-monitoring and development based on the current and changing needs of the service. Copies of such plan should be shared with residents and other interested parties including us. Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Brookvale DS0000008451.V348104.R02.S.doc Version 5.2 Page 30 - 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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