Inspection on 14/09/05 for 10 Brampton Court

This inspection was carried out on 14th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

10 Brampton Court 30/06/08

10 Brampton Court 15/08/06

10 Brampton Court 18/01/06

10 Brampton Court 07/03/05

10 Brampton Court 08/06/04

10 Brampton Court 17/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Brampton Court (10) 10 Brampton Court Melksham Wiltshire SN12 6TH Lead Inspector Malcolm Kippax Unannounced 14 September 2005 th 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 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 Stationary 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. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brampton Court (10) Address 10 Brampton Court Melksham Wiltshire SN12 6TH 01225 707233 01985 847789 olpa@olpa.fsnet.co.uk Ordinary Life Project Association Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Theresa Trott Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number of places Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7th March 2005 Brief Description of the Service: The home is run by the Ordinary Life Project Association (OLPA). 10 Brampton Court is a domestic style, detached property situated in a residential area on the outskirts of Melksham. There are some local facilities although one of the nearby towns is used for most shopping trips and services. The home has its own vehicle for trips out. The accommodation is on two floors. Each service user has their own room, one of which is on the ground floor. There is one communal room, which is used as a lounge and a dining area. Patio doors lead on to a well maintained garden. The service users receive support and personal care from a permanent staff team that is managed by Theresa Trott. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place at 9.30am. Two service users were at home and there were two staff members working at the time. A third service user was at a resource centre in Trowbridge. The inspection lasted until 1.10pm, when the two service users and the staff members had arranged to go out. Time was spent with the service users in the lounge and the garden. Conversation was not possible with the service users and the staff members spoke about the care and domestic arrangements in the home. Bedrooms were seen with the service users and other areas of the home were looked at. A number of the home’s records were examined. What the service does well: What has improved since the last inspection? What they could do better: Changes in the service users’ care and support should be better shown within their personal records. This will help staff members to see how the service users’ needs have changed over time. The service users’ progress with completing their personal goals should be better monitored to ensure that these can be achieved without undue delay. More thought should be given to the best way in which information is provided for service users and their views acted. Risk assessments need to be regularly reviewed. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 6 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. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 Service users do not understand the terms and conditions that have been produced and should receive support with this from a third party EVIDENCE: License agreements produced by OLPA were kept on the service users’ files. The home’s manager had signed the agreements and it was stated that the terms and conditions had been explained to service users. The service users do not have the capacity to understand the contents of such an agreement and a person who is independent of OLPA has not been involved. Such a terms and conditions statement is useful, as there are on-going difficulties between OLPA and Wiltshire County Council, which have resulted in a lack of agreement about the terms of individual contracts. However the licence agreements should be agreed with a third party acting on the service user’s behalf and cover those items which are specified under Standard 5.2 of National Minimum Standards. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Service users benefit from the information that is available to the staff team about their individual needs. Staff members assist service users with making decisions in the home and there is a good system for supporting service users with their personal goals. EVIDENCE: The service users’ personal records were informative and included individual care plans and guidance for staff about daily routines. Two of the care plans were not dated and although review dates had been identified, it was not possible to see what had changed as a result of the review. A staff member said that the original care plan had been amended over time. A different method of recording would enable changes in the care pan to be more readily identified, whilst not altering the original care plan. ‘Shared Action Planning’ documentation was included in the service users’ files. This provides a means by which service users can receive support with their personal goals (see Standard 11). Some of the service users’ personal goals concerned being able to make choices in areas such as meals and being more involved in the domestic arrangements. This was evident during the inspection. Matters relating to the safety of service users, for example the risk of choking, were being addressed through risk assessments. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 16, and 17 Service users generally enjoy their activities and are encouraged by staff to participate in the home. The system of ‘Shared Action Planning’ promotes the service users’ personal development. However, service users would benefit from a more consistent approach being taken to implementing the system and to the provision of ‘one to one’ activities. Service users are encouraged to treat the home as their own. They enjoy the meals and staff members are aware of individual preferences. EVIDENCE: Staff members said that one service user, who was not present during the inspection, enjoyed attending a resource centre throughout the week. Two service users had a more varied week and spent more time relaxing in the home. Targets had been set for service users to receive support from staff with individual activities, although the records showed that the actual number of weekly activities taking place is less than expected. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 11 Some of the service users’ personal goals, as shown in the Shared Action Planning documentation, dated back to 2003. The personal goals looked relevant although sections of the Shared Action Planning records had not been completed and the records did not show the achievement and progress that service users had made with some goals. Tenants meetings are not being held, however, ‘Tenants’ meetings’ forms were being used to record a monthly statement about the service users’ needs and welfare. Service users are not able to be involved in the planning of menus. Staff members said that the choice of meals was decided on the day and took into account the service users’ preferences at the time and known likes and dislikes. A menu album is being developed to assist service users with selecting their preferred meal. Staff members are aware of the support that service users require when eating. This particularly concerns the risk of choking and guidance has been produced about this. A staff member sat with the service users during the lunch meal. Details of the meals prepared for service users were recorded on an individual basis. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Service users receive the support that they need, although there is a lack of clarity about a policy for the provision of personal care. EVIDENCE: Each service user has their own room where personal care can take place in private. The permanent staff team consists of male and female staff members, providing support to male and female service users. The male staff member on duty said that he did not provide personal care to the female service users, although there was no policy concerning gender and the provision of personal care. A policy would help ensure that service users receive consistent approach in line with the organisation’s views. Service users were up and about during the inspection and personal support was limited to verbal prompting with some domestic tasks and with what the service users were doing. The service users looked well supported with their personal care. Guidance on personal care needs was included in the service users’ records. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Service users do not have an accessible complaints procedure and are dependant on others to raise any formal concerns. Staff members are aware of how service users express themselves. EVIDENCE: OLPA have produced a complaints procedure although staff members said that this was not something that service users could understand. The home keeps a record of complaints and there was discussion about a complaint that had previously been dealt with and investigated. This had resulted in staff gaining knowledge about how service users communicate their feelings and can show when they are not happy with something. This would be useful information to include in guidance for staff about responding to complaints. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The accommodation is meeting the service users’ current needs. The service users benefit from a homely and domestic type environment. EVIDENCE: Service users were mostly spending time in the home’s lounge. This is comfortably furnished, with patio doors onto the back garden. The garden is well maintained with a nice sitting area. One service user was choosing to spend time in the garden and staff members said that service users generally like to use the communal rooms rather than their own rooms. During a tour of the home, the service users showed their rooms and looked to be at home in the accommodation. The bedrooms were uncluttered and personalised in different ways. Staff members said that the facilities in the home were being looked at, with a view to making changes should the service users’ mobility become more difficult. The home looked clean and tidy. The domestic arrangements looked well organised and staff members use a colour-coded system to help keep items separate. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 There is a settled staff team and service users benefit from staff who know their needs well EVIDENCE: The three service users have lived together at 10 Brampton Court since 1995. Both the staff members working at the time of the inspection had several years’ experience of working in the home. A written roster showed the planned deployment of staff members. Two staff members are working for most of the day until 7 pm. This includes all the mealtimes, when staff members said that it was important to have two staff available to support service users. The records showed that members of the permanent staff team cover shifts in the home. Staff members said that relief and agency staff were rarely used. Relationships between service users and staff members during the inspection appeared friendly and informal. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 and 42 Staff members keep regular records in connection with the service users. However the use of particular forms is not always clear. The health and safety of service users is promoted through risk assessments, although the benefits may be reduced by an inconsistent approach to reviews. EVIDENCE: Staff members use individual diaries for the reporting of daily events involving the service users. A short monthly overview is also written on a ‘Tenants Meetings’ form. Staff members explained that tenants meetings are not being held but they had nevertheless been asked to use this heading. ‘One-to-one’ forms are used for the recording of support that service users have received with individual activities. These are also used for the recording of occasions when a service user has been offered a choice, for example at lunch. Brampton Court (10) Version 1.40 Page 17 D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Assessments had been completed in respect of various hazards that may present a risk to service users. In several of the examples seen, a review date had not been identified, or the outcome of a review was not shown. There was no record of the fire risk assessment having been updated and reviewed since 2001. A requirement about this had been identified at the previous inspection. In other respects the home’s fire log book was up to date. Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 2 3 x x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brampton Court (10) Score 2 x x x Standard No 37 38 39 40 41 42 43 Score x x x x 2 2 x D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 19 YES Are there any outstanding requirements from the last inspection? 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 42 Regulation 13 Requirement The Registered Person must ensure that the home’s fire risk assessment is updated and includes service users’ level of participation during an evacuation (this is an outstanding requirement from the last inspection) Risk assessments must be kept under review and the outcome recorded Timescale for action BY 23/09/05 2. 42 13 FROM 15/09/05 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. 2. 3. 4. Refer to Standard 5 5 6 11 Good Practice Recommendations A third party, usually the service users care manager, should be involved with agreeing any terms and conditions That the licence agreements include all those items that are specified under Standard 5.2 of the National Minimum Standards That changes in the service users care plans are dated and recorded using a review section on the care plan forms That all stages of the Shared Action Planning documentation, including goal sheets, are consistently Version 1.40 Page 20 Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc 5. 6. 11 18 7. 8. 22 41 completed. Progress with meeting personal goals should be regularly monitored, with achieve by dates identified That the frequency of one-to-one activities is maintained at the planned level That a statement on personal care is produced to include the organisations policy on gender and personal care and to provide details of any limitations and restrictions that may apply in the provision of personal care That the information gained about the service users is incorporated into the homes complaints procedure That the use and purpose of recording forms is reviewed to to ensure that: - Feedback from service users about the home and the service they receive is clearly recorded - Progress with meeting personal goals is regularly recorded - An appropriate heading is used on the forms Brampton Court (10) D51_D01_S28375_BRAMPTONCOURT(10)_v247279_140905_Stage4.doc Version 1.40 Page 21 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB National Enquiry Line: 0845 015 0120 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. 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