Care Home: The Briars Residential Home

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What the care home does well The Briars is homely and comfortable. It has a big lounge downstairs and a conservatory. All the bedrooms are single and there is a quiet garden at the back of the house. At the inspection we sat in the lounge and talked to five people who live at the Briars. They told us lots of funny stories about things that had happened since they`d lived there. Everybody we spoke to at the home said they like living there. One person told us, `The home is great.` The people who live there have a say in how it is run. They tell the staff what sort of food they would like and where they want to go on holiday. Everyone who lives at the Briars is encouraged to live a healthy life. Good food and regular exercise, including walking, swimming, and dancing, help them keep fit. There is lots of choice at meal time. The people who live in the home all said they liked the food. One person told us, `The food`s nice. I like salad best.` The staff team is small and the people who live in the home get to know them well. Everyone we spoke to said the staff were good. One told us, `The staff are very nice.` Another said, `I like my key worker.` The Manager gets on well with everyone at the Briars. One of the people who lives there told us, `I like Anne and I trust her.` What has improved since the last inspection? The home has a `Comments Book` for visitors to write in. They can use it to say what they think about the home. Some parts of the home have been painted and improved and there is a new shower and toilet in one of the bedrooms. Staff have had lots of training. This will help them to look after the people who live in the home as best they can. What the care home could do better: Everybody who lives at the Briars should have Person Centred Plans (PCPs). Some medication needs to be kept more securely. Staff need to be sure that everyone who lives in the home can get safely across the gravel at the front of the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Briars Residential Home 29 Spa Lane Hinckley LE10 1JA     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Cowley     Date: 2 0 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: The Briars Residential Home 29 Spa Lane Hinckley LE10 1JA 01455613749 01455840616 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Roy William McCormick,Mrs Ann O`Neill care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: No further conditions of registration apply. Date of last inspection Brief description of the care home 7 The Briars is a care home providing personal care and accommodation for up to seven people with learning disabilities. The home is located on a busy road close to the centre of Hinckley. It is easily accessible by private or public transport. Local amenities include a post office, shops, a swimming pool, public houses, and cafes. A health centre, dentist and optician are nearby. On the ground floor there is a lounge, a conservatory, and a kitchen. All seven bedrooms are single and two of them are on the ground floor. Three bedrooms have en-suite facilities. The house is detached and has a secluded garden at the rear of the building. Fees are based on local authority rates and the needs of the person in question. They include personal care, accommodation and meals. Additional charges are made for chiropody, toiletries, magazines, holidays and some transport. Inspection reports are available at the home, or can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the Registered Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home Manager. Care Homes for Adults (18-65 years) Page 5 of 29 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, we (throughout the report the use of we indicates the Commission for Social Care Inspection) spent half a day reviewing information relating to the home. During the course of the inspection, which lasted six hours, we checked the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means we looked at the care provided to three of the people living at the home by meeting them; talking with the staff who Care Homes for Adults (18-65 years) Page 6 of 29 support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were examined. We also talked to three other people who live in the home, the Manager, and one care support worker. Five of the people who live in the home completed surveys prior to this inspection. All indicated (using tick boxes) they were satisfied will every aspect of the service. One staff survey was also returned. The respondent said they felt well-supported, and had had the training they needed to provide good care. 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 Care Homes for Adults (18-65 years) Page 8 of 29 following this report, you can contact them using the details set out 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 Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Quality in this outcome area is good. Peoples needs are fully assessed prior to admission to ensure the home is suitable for them. This judgment has been made using available evidence including a visit to this service. (Standard 2 was inspected.) Evidence: Most of the people who live at the Briars have been there for a long time, but some do move on so there are occasional new admissions. One person has moved into the home since the last inspection. We looked at records and saw theyd had a full assessment beforehand and their views and the views of their families/friends and others involved in their care have been taken into account. The Manager told us that people who are interested in moving into the Briars are always invited to visit first as many times as they like. They come for meals and take part in activities and social events. This gives them to opportunity to meet the people Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: who already live there. The Manager said the views of the people who already live in the home are taken into account before a decision is made to offer a place to someone new. This helps to ensure that everyone who lives at the Briars has a say in who they live with. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Quality in this outcome area is good. Detailed care plans help staff to identify and meet peoples needs. This judgement has been made using available evidence including a visit to this service. (Standards 6, 7 and 9 were inspected.) Evidence: All the people who live in the home have care plans. These help to ensure the care provided fits in with their lifestyle and meets their particular needs. The plans cover the health, personal and social needs of the person in question, their likes and dislikes, and preferred routines. Those we looked at contained examples of people improving since being at the home and gaining new skills. For example, with the support of staff, one person has achieved a lifetime ambition of flying abroad. Another has increased their independence skill to Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: the extent that they are now able to move to another home where they can be more self-caring. Person Centred Plans (PCPs) are being introduced for all the people who live in the home. These are in the form of photograph albums with accompanying text and contain information about the person in question, and their lives from birth to present day. They are an excellent resource as they are more user friendly than traditional care records. It is recommended that these are completed and the people who live in the home are encouraged to use and enjoy them. Everyone who lives in the home is encouraged to make decisions and take responsible risks. Staff only intervene if there are serious concerns about their well being. This helps the people who live in the home to increase their independence and decision making skills, while at the same time remaining safe. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. Daily living and social activities enable people to lead full lives and grow in independence. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 15, 16 and 17 were inspected.) Evidence: Everyone who lives in the home has their own programme of recreational, educational, and vocational activities, depending on their needs and what they want to achieve. Staff help them to discover what interests them and what their goals are. These are identified in care plans so staff can help them achieve their ambitions. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Some activities take place in the home. For example, every Monday evening the homes entertainment organiser runs a quiz, or a bingo or karaoke session in the lounge. Most of the people who live in the home attend local day centres and colleges while some do voluntary work. Records showed that frequent holidays, day trips, and meals out are popular and well attended. Good use is made of local community facilities including churches, leisure centres, and shops. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Quality in this outcome area is good. Peoples personal and health care needs are met in the way they want by staff in the home. This judgment has been made using available evidence including a visit to this service. (Standards 18, 19 and 20 were inspected.) Evidence: Most of the people who live in the home are able to tell staff how they would like to be cared for. Their preferences with regard to their personal care are set out in their care plans so everyone is clear about them. If a person is unable to indicate what sort of personal care they would like staff observe their body language to determine their likes and dislikes on the day in question. Both male and female staff are employed and male staff do not assist the women who live in the home with their personal care. Everyone who lives at the Briars is encouraged to live a healthy life. Wholesome food and regular exercise, including walking, swimming, and dancing, help the people who live in the home to keep fit. Annual health checks are carried out and records show that staff respond promptly to health changes. A range of health care professionals Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: provide services to people at the home including GPs, consultants, district nurses, dentists and opticians. Rather than just administering medication, staff help the people who live in the home to understand what medication they are taking and why. A contract pharmacist supplies most of the homes medication and a list of staff authorized to give out medication is displayed in the medication room. This helps to ensure that only staff who are appropriately trained and experienced give out medication. At present medication is kept in a locked cupboard in a locked room. However one of the people who live in the home takes a controlled drug and improved storage facilities are needed for this. The secure storage of controlled drugs is specified in the Misuse of Drugs (Safe Custody) Regulations 1973. In the 2007 Amendment the term nursing home was replaced by care home. The main impact is that every care home must store controlled drugs in a CD cupboard, including care homes registered for personal care. We understand that legal requirements for storage may appear to have little or no impact on the care given to people. What it does achieve is a greater deterrent against diversion and theft. And it should also serve as a constant reminder to care workers that these medicines are potent. In brief, the requirements for CD storage are: Metal cupboard of specified gauge Specified double locking mechanism Fixed to a solid wall or a wall that has a steel plate mounted behind it Fixed with either Rawl or Rag bolts Suppliers of CD cabinets can confirm that a cupboard meets the legal requirements. We suggest that care homes request formal confirmation when purchasing one. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Quality in this outcome area is good. Staff know how to safeguard the people who live in the houses and help them express any concerns they might have. This judgement has been made using available evidence including a visit to this service. (Standards 22 and 23 were inspected.) Evidence: All the people interviewed said they would tell staff or the Manager if they had any complaints. There is a complaints procedure, which has pictures to make it more userfriendly. People also have the opportunity to raise concerns at the homes house meetings. Everybody we spoke to said they would speak out if they had a concern. Their comments included If there was a problem Id tell Anne or a member of staff. If I was unhappy I d tell any of the staff. I feel safe with Anne and Roy. If I wasnt happy I would tell Anne. We havent received any complaints about the service since the last inspection. The Manager confirmed that no complaints have been received at the home. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Since the last inspection comments and suggestions book has been introduced to give relatives and friends the opportunity to comment on the home, make suggestions, or raise concerns. Staff have had training on the Mental Capacity Act and the Deprivation of Liberty Safeguards. This will help them to protect the interests of the people living in the home. Staff are trained in safeguarding during their induction, and when they study for National Vocational Qualifications. However they have not had any additional training. This should be provided so staff are aware of the latest protocols for safeguarding adults. Suitable courses should be arranged, for example the alerters and referrers training run by the local social services department. Care Homes for Adults (18-65 years) Page 20 of 29 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Quality in this outcome area is good. People live in an environment that is community-based, comfortable, and well maintained. This judgment has been made using available evidence including a visit to this service. (Standards 24 and 30 were inspected.) Evidence: The Briars provides homely, comfortable accommodation for the people who live there. The home is situated in a large detached house with a secluded garden at the back, and a small car park at the front. One the ground floor there is a kitchen diner, a large comfortable lounge, and a conservatory. This gives people a choice of areas to sit. All bedrooms are single and individual to the people they belong to. With the permission of their occupants, we looked at some of the bedrooms. They were all homely and personalized. One person told us, My bedroom is the best thing about this place. Another told us she had had some new shelves put up in her room which she was using to display ornaments. Since the last inspection the following improvements have been made to the home Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Ensuite shower and toilet fitted in Room 5 Grab rail fitted in downstairs shower room Room 4 refurbished and redecorated Front and back car park leveled and resurfaced Conservatory carpet removed to reveal original tiles One of the people who lives in the home told us she was finding it difficult to get her walker across the front access to the home because of the little stones put down when the area was resurfaced. We discussed this with the Manager who said that once the stones had settled there shouldnt be a problem. However she agreed to monitor the situation to ensure that the person in question didnt experience any long-term problems in getting to and from the front door. All areas of the home were clean and tidy at the time of inspection. Care staff are responsible for the cleaning, most of which is done while people are at day centres or colleges. The people who live in the home are also encouraged to help keep it clean and tidy. One person commented, I help with the hoovering. I do my bedroom. Care Homes for Adults (18-65 years) Page 22 of 29 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Quality in this outcome area is good. Friendly and professional staff meet peoples needs. This judgement has been made using available evidence including a visit to this service. (Standards 32, 34 and 35 were inspected.) Evidence: The staff team is small and established. This gives the people who live in the home stability and the opportunity to build up trusting relationships with those who care for the. All the people in the house who we spoke to praised the staff team. One told us, The staff are very nice. Another said, I like my key worker. The people who live in the home are involved when new staff are being recruited. They meet with potential staff and then use a pictorial score sheet to give them ratings. This gives them a say in who cares for them. The Manager confirmed that all staff, including ancillary staff, have CRB (Criminal Records Bureau) checks and two references before they start work in the home. This helps to safeguard residents. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Since the last inspection staff have had training in the following Deprivation of Liberty safeguards Mental Capacity Act Safe Administration of Medication Health and Safety In addition, four staff are doing NVQ (National Vocational Qualification) Level 2 in Care. The Manager is an accredited NVQ assessor and verifier. Overall the staff team are well trained and have the necessary skills and knowledge to care for the people who live in the home. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is excellent. People live in a home that is safe and well managed and are actively involved in the way it is run. This judgment has been made using available evidence including a visit to this service. (Standards 37, 39 and 42 were inspected.) Evidence: The home is well managed in an open and inclusive way with both staff and the people who live in the house being involved in decision making. The Manager is experienced and knowledgeable and highly regarded by everyone at the Briars. One of the people who lives in the home told us, I like Anne and I trust her. The views of the people who live in the home are central to how it is run. During the inspection they expressed firm views about their home and how they wanted it to be. It was evident that they were used to being asked for their opinions about all aspects of the service. House meetings are also held, the last one being during the week of the Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: inspection when the people who live in the home were asked to choose destinations for a series of trips out. They are also in the process of trialling a new quality assurance form designed for people with learning disabilities. If effective, this will be another way for them to provide feedback to the Providers. Records showed that there were no outstanding maintenance or health and safety issues. An Environmental Health inspection on 27.01.09 judged the kitchen to be satisfactory. Care is taken to keep the people who live in the home safe while at the same time maintaining a homely atmosphere. Care Homes for Adults (18-65 years) Page 26 of 29 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 Adults (18-65 years) Page 27 of 29 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 1 20 13 Controlled drugs must be stored securely in the home in accordance with To ensure medication is kept safely. 20/07/2009 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 6 Person Centred plans should be completed for all the people who live in the home. They are a valuable resource which can be used engage the people in dicussions about their lives and care needs. Further training in safeguarding should be provided. This will help to ensure that staff are aware of the latest protocols for safeguarding adults. 2 23 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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