Care Home: Little Brocklesby House

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What the care home does well The home is in nine acres of grounds some distance from a main road and provides a quiet and peaceful wooded setting for people. A visitor commented that it had a good reputation in the area. People are cared for in a clean and comfortable environment. All people spoken with made positive comments about the care they received; one said it was a lovely spacious place to live in and another said that he enjoyed sitting on the decking area at the rear of the building in sunny weather. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager has worked hard since her appointment to establish good communication with staff and residents, enabling a good knowledge of the needs of people. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. What has improved since the last inspection? Several bedrooms have been refurbished, communal areas have been decorated and carpets renewed. Residents and staff are now more involved in decision making. An administrative assistant has been appointed to give extra support. The system of having a key worker [a named member of staff for each resident] has been re-introduced to give people better access to help. What the care home could do better: Some documents need updating with the new contact details of the Commission. Advice should be sought from a pharmacist regarding the storing and administration of medicines to ensure that people are given medication safely. The week`s activities should be displayed for people to see and choose whether they wish to take part. Two bathrooms are in a poor condition and are not homely places for people to take baths in. Key inspection report Care homes for older people Name: Address: Little Brocklesby House High Street Great Limber Lincolnshire DN37 8JL     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: Julie Western     Date: 1 6 0 9 2 0 0 9 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 24 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Little Brocklesby House High Street Great Limber Lincolnshire DN37 8JL 01469561353 F/P01469561353 littlebrocklesby@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Little Brocklesby House Ltd. Name of registered manager (if applicable) Mrs Samantha Wilkinson Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home is registered to provide for service users of both sexes whose primaary needs fall within the following categories:- Old Age not falling into any other category OP (31) Dementia - Over 65 years of age - DE(E) - 5 The maximum number of service users to be accommodated is 36. Date of last inspection Brief description of the care home Little Brocklesby House is a two storey care home located in the village of Great Limber, which has a pub and a post office/general store. It is situated ten miles from Grimsby and five from Immingham. The home is located down a private driveway, away from the main road and is set in nine acres of parkland on the edge of the Lincolnshire Wolds. It was built during the mid Victorian period and has retained many original period features internally which help make it homely. Bedrooms are located on Care Homes for Older People Page 4 of 24 Over 65 0 31 5 0 Brief description of the care home both floors; the upper floor is accessed by a sweeping staircase or passenger lift. The home provides care for residents over the age of 65 years and can accommodate up to 5 residents who have dementia. Weekly fees range from £360-£459 and information about these and the other facilities offered by the service can be obtained from the manager, who is also the proprietor. Care Homes for Older People Page 5 of 24 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: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission (CQC). The visit lasted approximately four hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 24 out surveys to people before we visited the service. The main method of collecting information during this visit is called case tracking, which includes following the care of a sample of four people through their records and assessing their care. We spoke to two people who use the service and saw rooms of those people who said we could and to one staff member. The manager was present throughout the visit and the general outcomes of the visit were discussed with her. Care Homes for Older People Page 7 of 24 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 24 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 24 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. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. Evidence: We saw the statement of purpose which was very comprehensive and contained terms and conditions and contracts. The service user guide we saw contained useful information for people. It was in large print. There was also a brochure, which a resident said looked very nice. The manager said that she or a senior member of staff always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission records that were clear and gave staff all the information they needed to meet the needs of people. Two people we spoke with described how they had visited for the day before they were sure they wanted to move in permanently. Care Homes for Older People Page 10 of 24 Evidence: A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 24 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. Care plans are in enough detail to ensure that the health care needs of people can be met. The are no regular visits by a pharmacist and this puts people at risk from not having professional advice on storing and giving medication. Evidence: Care plans we saw contained information about the health and personal care needs of people. They were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that was clear and comprehensive. There were no records of a pharmacist visiting regularly to ensure staff are storing and giving medicines appropriately. The manager said this would be addressed immediately. People received regular visits from district nurses, Macmillan nurses and other agencies involved with their care. We saw staff carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs. A visiting District Nurse said that she found the standard of care to be good, the staff were knowledgeable and quick to refer to her and the home was always clean and Care Homes for Older People Page 12 of 24 Evidence: fresh smelling. People we spoke with said their health was looked after . Care Homes for Older People Page 13 of 24 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. Social activities are regular and are tailored to suit the individual needs of residents. People have a choice of meals from a balanced and varied menu. Evidence: We found that the home has an activities coordinator working 15 hours weekly, who provides a variety of activities for residents including entertainers, indoor games such as board and card games and trips to local pubs and shops. The activities programme is not displayed for people to keep informed of events. On the day of our visit people were sitting in the quiet lounge. People we spoke with all said they had a choice of whether or not to take part in any activities and some described a cream tea afternoon held in the summer. Two said they preferred to sit in a quiet lounge instead. Clergy visit the home on a monthly basis and offer services of leading denominations to those who wish to attend. We saw the mid day meal being prepared and eaten. People we spoke with all said they enjoyed the meals served; one said he had never refused to eat anything in four years of living at the home and another that the food was terrific. The menu for the week was displayed in the dining room and offered alternative choices of meals. People we spoke with all said they had a choice of whether or not to take part. People we spoke with all said they enjoyed the meals served; one said Its good food, Care Homes for Older People Page 14 of 24 Evidence: home-made and very tasty. The menu for the day was displayed in the dining room and offered alternative choices of meals. The cook said that if people did not like any of these choices, she would make them an alternative within reason. The cook was knowledgeable about the nutritional needs of service users and described cooking for diabetics and people with gluten-free diets. The environmental health officer had visited and awarded the home five stars, an excellent rating in their award scheme for kitchen hygiene. Care Homes for Older People Page 15 of 24 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. The procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People spoken with said they did not wish to complain but knew how to make a complaint. One comment was that the manager would see to any complaints she had to make. The home had an up to date copy of the Local Authority adult protection procedures and staff members said they had read it. The training programme showed that there was a rolling training course for staff on safeguarding adults. Staff members spoken with knew what to do in the event of a serious concern. Since the last inspection there had been no complaints. Staff spoken with confirmed that they had received training in safeguarding adults. Care Homes for Older People Page 16 of 24 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. Bathrooms are in a poor condition but elsewhere people live in a comfortable and pleasant environment that is suitable for their needs. Evidence: Overall, the standard of decoration internal was good and afforded residents a comfortable place to live. Two bathrooms we looked at which were not homely, being institutional in appearance, with gloss paint and no curtains or decorations. The manager acknowledged this. The business plan for improvements to the building showed that these were on the list to be upgraded. The gardens and grounds were extensive and well maintained and offered many pleasant places for people to sit out in good weather, including a decking area outside the main lounge. Recent improvements had included complete refurbishment of some rooms, new carpets to the communal areas and upgrading of outside lighting. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. Staff we spoke with were aware of hygiene regulations and all had access to gloves and aprons. The most recent visit from the Environmental Health Officer found no issues of concern and the service had been awarded a good standard. The building smelled clean and fresh throughout. Care Homes for Older People Page 17 of 24 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. Staff members are in enough numbers and are suitably trained, qualified and competent to meet the needs of people. Evidence: The staff rota we saw showed that currently there is one senior carer and four staff members on duty for 24 people. In addition the manager works Monday to Friday, the activities coordinator works three days and there is an administrator on one day a week. There is a cook and kitchen assistant, two cleaners and a gardener/handyman. People we spoke with all said there were enough staff to meet their needs and staff confirmed this. We saw training records for staff and these showed that 12 members of staff have achieved the National Vocational Qualification [a nationally recognised qualification] at Level 2 with 3 working towards it and 6 staff members had achieved Level 3, with 2 working towards it. We spoke with staff members who described how they had an interview, gave three references and underwent CRB/POVA checks and had induction before starting work. Staff records we saw confirmed this. We saw a training matrix on the wall, which showed that most of the training required by law has been undertaken, with the Mental Capacity Act, using hoists, moving and handling, health and safety and food hygiene planned. We saw that staff members all receive regular supervision. There were also minutes of Care Homes for Older People Page 18 of 24 Evidence: staff meetings. We spoke with people who all had much praise for the staff. One said that they were very patient and willing to help, even in little ways. Care Homes for Older People Page 19 of 24 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 home is well managed and the health, safety and welfare of people are promoted. The views of people are listened to and they are involved in decisions affecting them. Evidence: The manager has been in post since December 2008 and has worked at Little Brocklesby for 12 years, two of these being at a managerial level. She has the NVQ at levels 2 and 3 and is starting her Managers Award shortly. People we spoke with all made positive comments about the way the manager ran the home, finding her approachable and supportive. There is a clearly written quality assurance procedure, with separate questionnaires sent to people, their relatives/visitors and staff. The findings are discussed with the provider, who visits regularly, and acted upon. We saw minutes of the last residents meeting and these showed that residents felt free to express opinions about the running of the home, which management listened to and acted upon. Health and safety policies were well documented and showed a clear commitment to ensuring the wellbeing of people. . The manager manages finances, which are audited Care Homes for Older People Page 20 of 24 Evidence: on a weekly basis by the administrator and regularly by the provider. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire evidenced that fire alarm, fire drills and emergency lighting checks have been undertaken. Policies and procedures are well maintained and have been systematically updated since the manager commenced in post. Care Homes for Older People Page 21 of 24 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 22 of 24 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 1 21 23 The two bathrooms identified 13/12/2009 must be in a good condition and homely in appearance. To ensure that people bathe in well maintained and homely surroundings. 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 9 12 Assistance should be sought from a pharmacist to give advice on storage and administration of medicines. An activities programme should be displayed around the building to ensure that people know what is on offer and can choose which activities they would like to attend. Care Homes for Older People Page 23 of 24 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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