Inspection on 18/01/06 for 10 Brampton Court

This inspection was carried out on 18th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

10 Brampton Court 30/06/08

10 Brampton Court 15/08/06

10 Brampton Court 14/09/05

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 Announced Inspection 18th January 2006 09:30 Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 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 Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 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. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brampton Court (10) Address 10 Brampton Court Melksham Wiltshire SN12 6TH 01225 707233 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) Ordinary Life Project Association Mrs Teresa Trott Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2005 Brief Description of the Service: 10 Brampton Court is run by the Ordinary Life Project Association (OLPA). The home is a domestic style, detached property and located 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 garden at the rear of the home. The service users receive support and personal care from a permanent staff team that is managed by Teresa Trott. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged at short notice, at a time when the manager could be present. It started at 9.30 am and lasted for four hours. There were three service users living at the home. Two service users were met with, although conversation was very limited and they are not able to comment directly on the support that they receive. Both service users spent time in the lounge before going out for lunch and an afternoon activity. There were individual meetings with two staff members. Records, including care, health, medication, staff training and recruitment were looked at. This inspection focussed on a number of key standards that were not looked at during the last inspection of the home. What the service does well: What has improved since the last inspection? What they could do better: Individual contracts have not yet been agreed with the service users’ placing authority. Staff members participate in a range of courses that cover statutory areas of training well. It would be beneficial to look at developing the programme to Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 6 include more learning disability related subjects. This would particularly be of benefit to staff who are new working in a learning disability service. It would also be worthwhile to look at how managers can develop their skills, for example by being involved in the interviews for new staff. Systems for quality assurance are not well established and this is an area that OLPA could usefully develop. 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) DS0000028375.V279559.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 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 the following standard(s): Standard 2 did not apply at this time. The three service users have lived together for several years. No service users have moved into the home during the last year. (Standard 5 was inspected and almost met at the last inspection). EVIDENCE: The Commission has been informed of discussions about contracts that are continuing between OLPA and Wiltshire County Council. It is of concern that individual contracts for the service users have not yet been agreed between OLPA and the funding authority. The Commission has also raised this with Wiltshire County Council. OLPA has produced ‘license’ agreements for service users. Recommendations were made at the last inspection in connection with these. These have not been actioned. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed on this occasion. (Standards 6, 7 and 9 were inspected and met at the last inspection). EVIDENCE: The manager confirmed that action that has been taken concerning a recommendation from the previous inspection that: ‘Changes in the service users care plans are dated and recorded using a review section on the care plan forms’. An example of a service user’s care plan was looked at. An amendment to the plan had been made and the date of this change was clearly identified. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 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 the following standard(s): 11, 13 and 15 Service users have activities in the community that they enjoy. They are supported with their relationships, which are of an individual nature. The implementation of ‘Shared Action Planning’ is improving. There is a better focus on providing consistent support for service users with individual activities. (Standards 11, 12, 16 and 17 were inspected at the last inspection. Standards 12, 16 and 17 were met and standard 11 was almost met ). EVIDENCE: Service users are helped to make decisions through a system of ‘Shared Action Planning’. This was looked at the last inspection and recommendations were made about the completion of the documentation and the monitoring of progress with meeting personal goals. This was discussed again with the manager, who felt that some further work was needed in order ensure that all stages of the system are consistently completed. An example of the current documentation was looked at and this showed that some relevant sections had been updated since the last inspection. Staff members receive training in Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 11 Shared Action Planning while employed with OLPA. It may be useful for staff to have some refresher training about the system and their roles within it. Service users have activities during the week, which include attendance at some local day and resource centres. Staff members said that some additional activities had been arranged. 10 Brampton Court is located within a well established residential area and with support from staff the service users are able to access a range of community facilities. There are limited facilities locally and one of the nearby towns is used for most shopping trips and for accessing public amenities. Service users have spent much of their lives in institutional settings, which may have been without the involvement of close family. The manager and staff spoke about the support that one service user has received with seeing his sister on a regular basis. This appears to be very worthwhile. It was also reported that service users tend not to establish close friendships, but they enjoy the company of people they see when attending activities outside the home. Staff said that for one service user in particular this is the highlight of his day. Another recommendation was made at the last inspection about maintaining the frequency of one-to-one activities at the planned level. The manager said that the frequency was now at the expected level. This was shown in the examples of activity records that were seen. Sometimes the activity has consisted of a service user being offered a choice of what they would like for lunch. It is very worthwhile to encourage decision making in this way, although it is recommended that it this is seen as being more of a daily routine, rather than a one-to-one activity. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 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 the following standard(s): 19 and 20 Service users benefit from the support that they receive with their health care and medication. Some changes in the record keeping would be beneficial. A staff member has made a very positive contribution to increasing awareness of service users’ health issues. (Standard 18 was inspected and almost met at the last inspection). EVIDENCE: The manager said that there were no concerns about the service users’ health at the present time. Action has been taken in the recent past to follow up one service user’s long-standing health condition. Tests and investigations have been carried out in connection with this. An occupational therapist and physiotherapist have been assisting one service user. The home is waiting to receive a new aid in connection with this. The home’s medical file included individual forms for the recording of health care matters. This gave a good overview of recent appointments with dentists and other health care professionals. Chiropody visits were not recorded and the manager said that these would be reported elsewhere. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 13 One staff member, as part of a training project, has produced a ‘men’s health’ resource file. This highlights the importance of health promotion and particular health issues and checks that are relevant to male service users. This is relevant within the home and appears to be a very useful resource for the organisation as a whole. Information about the service users’ medication was included in the medical file. Staff members administer medication to service users. The home seeks to obtain the written consent of service users although it is recorded that the service users do not have the capacity to sign the consent forms that are on file. One service user’s medication had recently been reviewed with their GP. A stock record is kept of drugs received in the home. The medication administration records were up to date. Separate forms have been produced for the recording of P.R.N. medication. These had also been used for the recording of short courses of medication to be given daily and it was agreed with the manager that this be recorded on the standard forms, with start and finishing dates identified. There is an OLPA procedure for the administration of medication and all staff members receive training in drugs as part of the in-house OLPA programme. Some external training from a specialist source is also recommended. It was recommended at the last inspection 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. The organisation has produced a statement that focuses on the need for anti-discriminatory practice. Although this is important, other factors are also relevant and may justify limiting, on the basis of gender, the involvement that staff have in intimate personal care. The manager has produced a statement on the provision of support, which refers to the need to look at the service user’s previous history and for staff to receive training in abuse awareness. It is also stated that the views of the care manager and family will be sought. It is recommended that OLPA continue to look at developing a more comprehensive organisational policy that will reflect good practice and the range of factors that need to be taken into account. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 23 There is guidance and training for staff members that helps to protect service users. (Standard 22 was inspected and met at the last inspection). EVIDENCE: The OLPA policies and procedures file includes a brief statement about the protection of vulnerable adults from abuse. This refers staff to the Department of Health ‘No Secrets’ guidance and to the policy and procedure for the protection of vulnerable adults in Swindon and Wiltshire. OLPA provides ‘in-house’ training for staff in ‘Abuse Awareness’. Both staff members met with said that they had received this training. This was recorded on their individual training records. The staff members were also familiar with the ‘No Secrets’ booklet. This is kept in the home and one staff member said that she had been given her own copy. The manager said that no referrals have been made under the vulnerable adults procedure during the last year. The manager has not attended a training course for managers. Staff members may also find that external training in adult protection, for example involving a local vulnerable adults unit, would be useful in addition to the in-house arrangements. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 15 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 the following standard(s): These standards were not looked at on this occasion. (Standards 24 and 30 were inspected and met at the last inspection) EVIDENCE: Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Service users benefit from staff they know well. Staff training is provided through in-house activities. The benefits for service users are reduced by the lack of an accredited programme of induction for new staff. The staff team is close to achieving the level of qualification that is expected. The recruitment arrangements help to protect service users from unsuitable staff. (Standard 33 was inspected and met at the last inspection). EVIDENCE: Member of the staff team have several years’ experience of supporting the service users. Relationships between service users and staff members during the inspection appeared friendly and informal. There is a low use of agency carers and the main relief member of staff used to be on the permanent staff team. A new permanent staff member has been appointed since the last inspection. The recruitment records showed that appropriate checks, including written references, C.R.B. and P.O.V.A. list had been undertaken prior to the staff member starting in the home. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 17 Two staff members are undertaking N.V.Q. at level 2 and one at level three. The manager who is the internal assessor said that they were expecting to finish in February 2006. The staff training records show that staff members participate in a range of courses as part of the OLPA programme of training. This covers statutory areas of training well although it would be beneficial to look developing the programme to include more learning disability related subjects. The new staff member had completed an OLPA induction and foundation programme. Learning Disability Award Framework accredited training is not being provided. This is recommended for staff who are new to working in a learning disability service and can be used to provide the underpinning knowledge for progress towards achieving NVQs. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 The home benefits from an experienced manager who is gaining relevant qualifications. Systems of quality assurance are not well established although the manager has made a positive development. (Standards 41 and 42 were inspected and almost met at the last inspection) EVIDENCE: Teresa Trott has several years’ experience of managing the home. She has completed the registered managers award and is now undertaking NVQ in care at level 4. The staff members spoken with said that they felt valued and will supported in their employment. Teresa Trott said that she had not been involved in the formal interview stage for the recruitment of the new staff member. The involvement of the registered manager would be consistent with their legal responsibilities and line management role. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 19 OLPA has produced a policy on quality assurance. This refers to a number of internal and external devices by which the service is monitored. However these are not presented as an approach to quality assurance that is in line with National Minimum Standards. The policy does not refer to how these devices will contribute to a cycle of planning-action-review, involving timescales and the production of improvement / action plan. However the manager has produced an annual development plan, dated September 2005, which includes four objectives for the home. Shortcomings in respect of standards 41 and 42 were identified at the last inspection. These have since received attention. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 20 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 X 2 N/A 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 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 3 X 2 X X X X Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 21 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 YA39 Regulation 24 Requirement The Commission is supplied with a report of the most recent review that has been carried out in accordance with Regulation 24 of the Care Homes Regulations 2001. Timescale for action 31/03/06 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. 5. Refer to Standard YA5 YA5 YA11 YA19 YA18 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 work continues to ensure that the system of shared action planning is consistently and fully implemented. Refresher training for staff is recommended. That chiropody appointments and their outcome are recorded in the service users’ individual health care forms. That OLPA continue to look at developing a more comprehensive organisational policy on gender and DS0000028375.V279559.R01.S.doc Version 5.1 Page 22 Brampton Court (10) 6. 7. YA35 YA37 personal care, which will reflect good practice and the range of factors that need to be taken into account. That the staff training programme is developed to include more learning disability related subjects. That the registered manager is involved in the formal interviews for new members of staff. Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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. Extracts may not be used or reproduced without the express permission of CSCI Brampton Court (10) DS0000028375.V279559.R01.S.doc Version 5.1 Page 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. 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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