Inspection on 14/12/05 for 15 Bramble Close

This inspection was carried out on 14th December 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

15 Bramble Close 17/01/07

15 Bramble Close 08/06/05

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

Bishop Herbert House

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

CARE HOME ADULTS 18-65 15 Bramble Close Chigwell Essex IG7 6DR Lead Inspector Sharon Thomas Unannounced Inspection 14th December 2005 09:30 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 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 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 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. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 15 Bramble Close Address Chigwell Essex IG7 6DR 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) 0208 502 7678 www.essexcc.gov.uk Essex County Council Peter Leslie Burrows Care Home 4 Category(ies) of Physical disability (4) registration, with number of places 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a physical disability (not to exceed 4 persons) 8th June 2005 Date of last inspection Brief Description of the Service: Bramble Close is a new purpose built habilitation unit located in Chigwell. It provides accommodation for 4 residents between 18 and 30, with varying degrees of physical disability. Bramble Close is a one-storey bungalow style building and accommodation is provided in single bedrooms, with ensuite facilities. The home is located on the outskirts of Chigwell, and it is accessible through the local bus service. It is able to address the needs of individuals with high dependency levels and provides the appropriate aids, adaptations and equipment to enhance the safety of the residents. The home aims to provide the residents with a range of activities and experiences in order to maximise their personal development and independence. The staff aim to provide a service that is driven by equal opportunities, and maintaining the rights of the resident. The home has strong links with the local primary health care team and it uses the support and advice of professional teams linked to the home. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 14th December 2005, and took place over 3.5 hours. Nine of the forty-three National Minimum Standards were inspected: five were met, three were nearly met and one was not met. For the purpose of this report the individuals living in the home spoken with on the day stated that they would prefer to be called residents or the ‘guys’. The inspection process included: discussions with the manager, and two members of staff. On the day of this inspection the residents were hosting an open day so the inspector took the decision to have minimal discussion with them. The tour of the premises included observation of two bedrooms, the bathroom, the communal area, the kitchen, and the laundry. There was an opportunity to spend a period of time observing the care being provided by the staff. The inspection included the examination of a sample of policies and records. The home is clean and tidy and offers a comfortable environment. It provides a calming and caring environment for the residents to live in. The residents continued to speak highly of the care that they receive in Bramble Close, and spoke highly of the efforts of the staff to give them the care that they need. Despite the newness of the building the homely atmosphere is already established. What the service does well: The home provides a warm and friendly atmosphere for residents. The furnishings and decoration are of a good standard. Although Bramble Close is a new home, it has already achieved a warm and welcoming atmosphere. The home is working well in providing a service that is based promoting independence and the care is centred around the client. The aim of the home is to enable residents to become independent with a view to living permanently in the community. The home enables residents to maintain social activities in and outside the home. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 6 Bramble Close supports residents to choose and plan their daily menus. The home promotes independence by supporting residents to shop for and prepare their own food. The resident’s living in Bramble Close benefit from an established and knowledgeable staff group who give sensitive, and professional care. The staff have a well-formed knowledge regarding the needs of the individual residents. This was seen in the positive relationships that had formed between the residents and staff. What has improved since the last inspection? What they could do better: The care plans used in the home are not satisfactory and do not provide staff with enough information to enable them to deliver appropriate, safe, care. The care plans used in the home did not have satisfactory comprehensive risk assessments available to staff. The care plans for residents did not contain a medication consent document. Bramble Close has not implemented a quality assurance programme to measure the effectiveness of the service. The home does not keep sufficient information in staff personnel files and the lack of information in the recruitment process may have the potential of placing residents at risk. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Overall the resident files contained a clear care plan, which gave information None of the above standards were inspected. EVIDENCE: 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 10 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): 6. Care plans examined indicated that the home’s care planning systems are insufficient. The residents care needs were not fully identified, planned for, and therefore not monitored in an appropriate manner. The shortfalls identified have the potential of placing resident at risk. EVIDENCE: Two residents files were examined on the day. Overall the resident files did contain a care plan, which gave some information for care staff on how to meet the residents’ needs. Some gaps in information were found and not all the information contained in the professional assessments was transferred over to the care plans. The care plans did not cover all aspects of the residents physical, mental and social needs, and were not reviewed on a monthly basis. Risk assessments were not completed with enough detail to enable staff to deliver care that is safe and appropriate. One risk assessment examined did not contain any information regarding the risks that the resident experienced. The manager reported that all risk assessments are planned to be completed by the end of January 2006. The files provided evidence of the resident’s 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 11 choices and preferences with regard to their personal support needs. The care plans contained a detailed daily programme of care that had been drawn up with the resident. These daily programmes were detailed and comprehensive but should not be used as the main document used to provide care. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 12 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): 13, 15, & 17. Residents have opportunities for personal development and they take part in activities that are appropriate to their needs. Residents are enabled to build and maintain relationships with both families and within the local community. The home enables residents to maintain a healthy diet. EVIDENCE: 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 13 The home aims to be part of the local community. It does not restrict residents to specified groups or activities. The home accesses many local facilities that included: garden centres, cinemas, shops, pubs and restaurants. The home has access to a minibus and this enabled external activities to be maintained. The staff spent time outside the home with their key residents, and additional staff cover was provided to account for this provision. The staff spoken with were aware of the social needs of the residents and worked hard to enable them to have a full range of social opportunities within the community. The staff spoken with confirmed that communal activity would only be undertaken at the request and planning of the resident. They were aware of the legislation regarding access to the community and were aware of local facilities and events that may benefit the residents. Care plans examined on the day indicated that staff support residents to maintain links with their families. One resident was enabled with the assistance of the staff to visit their family home. The manager and staff confirmed that relatives are welcomed into the home at any time. Families and friends are invited to events held in the home. The care plans indicated where a relationship had been built up outside the home and how this is maintained. The residents are able to meet people in the community through the choices that they make. Residents living in Bramble Close purchase their own food and prepare their own meals, snacks and drinks with the support of staff if and when required. The residents are encouraged to have a well-balanced meal and they write up a weekly menu based on their own choice and preference. The staff monitor the food intake of the resident to ensure that they have a well-balanced and nutritional diet. The fridges and freezers were well stocked and clean. The home also had stocks of fresh, frozen and processed foods to be used by the residents when required. Residents choose when and where they eat and details of this are recorded in the care plans. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 14 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): 20 Bramble Close has systems in place that ensures the safe administration of medication. EVIDENCE: Two of the resident’s medication records were examined. One resident is able to administer their own medication and signs their own medication sheet. The records were well maintained and up to date. Residents order their supplies of medication and arrange for them to be picked up. Medications are kept in individual bedrooms in lockable storage. The home promotes residents to order, store and administer their own medication where possible, to enhance their independence. Support is available from staff if residents should require it. The care plans did not contain a resident consent form agreeing that the individual would be provided with support should they need it. Staff spoken with confirmed that they had received appropriate training on the issue of the safe administration of medication, and evidence of this was found on their staff personnel files. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 15 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): None of the above standards were inspected – please see previous report. EVIDENCE: 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 16 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): None of the above standards were inspected – please see previous report. EVIDENCE: Although the environmental standards were not inspected the home maintains a warm, homely feeling and it is clean and well maintained. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 17 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): 34 & 35. Overall the recruitment procedure in the home was robust and provided the safeguards to ensure that appropriate staff were employed. The home provides residents with a well trained and knowledgeable staff team. EVIDENCE: The personnel files of two long-term members of staff were examined; these did not contain all of the information necessary to ensure the safety of residents through the recruitment process. The files did not contain the two required references, a Criminal Reference Bureau check or three copies of identification. On discussion with the manager it became clear that Essex County Council had reviewed the files, and the missing documents had been archived at County Hall. The manager was requested by the inspector to get copies of the CRB checks and keep them in the staff files until examined by the CSCI. From discussion with the staff and the manager it was evident that the staff are well trained and supported to do their jobs. The staff have a clear understanding of the issues and needs of the residents. The staff are aware of their responsibility of care that aims to provide choice and increase independence. The majority of care staff in the home has achieved the NVQ Level 2 and the home is set to reach this standard by the agreed date. The annual training and development programme was not available for inspection and the manager agreed to send a copy of this to the CSCI. The staff 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 18 personnel files contained evidence that staff are provided with a range of appropriate training. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 19 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 & 39. The home benefits from a skilled and well-trained manager. Bramble Close does not have systems in place to ensure that the quality of the service is measured. EVIDENCE: The manager has many years experience working with adults with physical disabilities and he is in the process of studying for the Registered Managers Award NVQ Level 4. The manager confirmed that he regularly undertakes training to update his knowledge and skills. The manager also confirmed that he is responsible for ensuring that the aims and objectives of the home are achieved, and that policies and procedures are implemented. From discussion with the staff it was clear that lines of accountability are evident within the home. The home has not implemented a quality assurance programme. This issue was discussed on the day and the manager agreed that a system would be implemented within a timescale agreed by the CSCI. 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 20 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 21 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 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 15 Bramble Close Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 1 X X X X DS0000061937.V273480.R01.S.doc Version 5.0 Page 22 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 YA6 Regulation 15 (1) Timescale for action The registered person must 31/01/06 ensure that care plans are fully completed and include all aspects of identified need and care provision. The care plans must contain a resident medication consent forms. This is a repeat requirement. The registered person must 31/01/06 ensure that care plans are reviewed on a monthly basis and provide evidence that residents are involved in the care planning process. This is a repeat requirement. The registered person must 31/01/06 ensure that the daily records reflect the actual care provided. Care plans must contain a detailed risk assessment that details the risks, the action and the outcome of care. This is a repeat requirement. The registered person must 31/01/06 ensure that all recruitment information is received prior to appointment. The staff files must have a copy of a current CRB available for inspection. DS0000061937.V273480.R01.S.doc Version 5.0 Page 23 Requirement 2. YA6 15 (2) (b) 3. YA6 12 (1) 4 YA34 7, 9, 19, Schedule 2 15 Bramble Close 5 YA39 24(1)(a)(b)12 The registered person must 31/01/06 ensure that Bramble Close (1)15 implements a quality assurance programme. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 15 Bramble Close DS0000061937.V273480.R01.S.doc Version 5.0 Page 25 - 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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