Inspection on 08/06/05 for 15 Bramble Close

This inspection was carried out on 8th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

15 Bramble Close 17/01/07

15 Bramble Close 14/12/05

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 15 Bramble Close Chigwell Essex IG7 6DR Lead Inspector Sharon Thomas Unannounced 8th June 2005 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. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 15 Bramble Close Address 15 Bramble Close, Chigwell, Essex, IG7 6DR 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) 0208 502 7678 Essex County Council Peter Leslie Burrows Care Home 4 Category(ies) of Physical disability 4 Both registration, with number of places 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65, who require care by reason of a physical disability (not to exceed 4 persons) Date of last inspection N/A Brief Description of the Service: Bramble Close is a new purpose built habilitation unit located in Chigwell. It provides accomodation 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 rsidents 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 I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 8th June 2005, and took place over 5.5 hours. Fifteen of the thirty-eight National Minimum Standards were inspected: thirteen were met, and two were nearly 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, one member of staff, and two residents. The tour of the premises included observation of two bedrooms, the bathroom, the communal area, the kitchen, the laundry and the gardens. There was an opportunity to spend a considerable 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 was clean and tidy and offers a comfortable environment. It provides a calming and caring environment for the residents to live in. The residents spoke 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 staff in the home are enthusiastic and committed to providing good quality care. The staff are friendly and approachable. The residents living in Bramble Close benefit from an established and knowledgeable staff group who give sensitive, and professional care. The staff had 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. 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 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 6 to enable residents to become independent with a view to living permanently in the community. The routines in the home are flexible and resident led, and they are changed to the meet the varying needs of the residents. Relatives and visitors are welcomed into the home and residents felt that the home encouraged their relationships. What has improved since the last inspection? What they could do better: 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 I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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) 2 The home has a thorough pre-admission system in operation that ensures that the needs of prospective residents are fully assessed and can be met. EVIDENCE: Two resident’s care plans were sampled and both of these contained the information required for an appropriate and effective admission into the home. Comprehensive social services and/or hospital discharge assessments were found on the files along with the home’s own pre-admission document. The home’s pre-admission assessment document included all aspects of the resident’s care needs. Two of the residents who had recently moved into the home commented that they were fully involved in the pre-admission planning process, and stated that the staff had been very “kind and supportive” since they had moved into Bramble Close. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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, & 9. Residents health and personal care needs are well met; overall the individual care plans detailed the care and support required. The residents are enabled to make informed choices regarding their care. Residents are supported to take risks both in the home and outside the home. EVIDENCE: Resident files contained a clear and detailed care plan, which gave precise information for care staff on how to meet the residents’ personal, social and psychological needs, ensuring consistent and structured support. Some gaps in information were found and not all the information contained in the professional assessments was transferred over to the care plans. The files provided evidence of the resident’s 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. The two residents spoken with stated that the staff were able to “help me with everything I need” and that “all of staff know all about me”. Both residents confirmed that they been enabled to make the choices regarding all aspects of their life in the home. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 10 From discussion with the residents, the manager and the examination of records it was clear that, it is the residents that make the choices regarding the care that they receive. One resident stated that “it was scary after having had other people make decisions for me, to now make decisions for myself”. The care plans detailed the residents’ choices and preferences but did not detail how these choices had been made. The residents confirmed that they receive support with developing their skills for daily living including: finances, domestic tasks, social development and education. The residents spoken with confirmed that they were provided with information regarding risk when they were drawing up their care plans. Pre-admission risk assessments and general risk assessments were found on individual care plans. One resident is able to leave the home unescorted and a comprehensive risk assessment was found on the file regarding this issue. The home’s aim and objective is to promote independence, and risk taking is central to the service. This aspect of care is well planned and hazards are identified and addressed. One resident confirmed that “since I have been here I have done things that I have always wanted to do but was not allowed to do”. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 11 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 Residents have opportunities for personal development. They take part in activities that are appropriate to their needs. Residents’ rights are upheld and responsibilities are recognised in their daily lives. EVIDENCE: The care plans and weekly resident rota reflected that residents are involved in a number of activities. Residents spoken with on the day confirmed that they attend church, go to the local sport centre, the pub, and go shopping. One resident has attended a funeral and been on a trip to Hastings, these trips were organised by the resident with the support of staff. One resident has taken up gardening and stated that “I love gardening it is a great hobby”. The manager confirmed that staff are encouraging the residents to undertake more leisure pursuits. The home provides a service that focuses on residents achieving greater independence and will ultimately lead to residents living in their own home. The care plans sampled contained evidence that staff support residents to integrate into the community. Information and advice was available regarding local events and activities. Residents have access to an Essex County Council 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 12 minibus and use the local taxi service to access the local area. The staff are available to the residents during the evening and at weekends to support leisure pursuits. The residents spoken with confirmed that the staff had supported them to leave the home. This was observed on the day with one resident leaving the home to do their shopping. From discussion with residents, the manager and information found in the care plans it was clear that the home promotes independence. Staff and visitors have to request permission to enter both bedrooms and communal areas. Keys have been offered to residents and all of them have refused. Residents’ mail is not opened by staff. Staff were observed interacting with residents and it was clear that residents are central to the care service that is provided. The care plans contained comprehensive details of residents’ responsibilities regarding domestic tasks which aim to enhance independence. One resident was observed hoovering the carpet outside their room. The resident stated “that these are the things I am going to have to do in my own home”. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 13 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 Residents receive personal support in the way they prefer and require. EVIDENCE: From discussion with residents, the manager and the information contained in care plans it was clear that the staff provide sensitive and flexible support. The routines in the home are flexible and residents control all aspects of their daily lives. One resident stated that “ I have to have support with washing and dressing but the staff take direction from me”. All personal care is provided to residents in their own en-suite bathrooms. The home has state of the art equipment including electronic overhead hoists, and kitchen has electronic appliances that lower to the height of wheelchair users. The home works closely with the Occupational Therapy team, physiotherapists, speech therapists who regularly assess and review the needs of the resident’s and make changes when required. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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 standard(s) 22 & 23. The home has a clear and concise system for dealing with complaints. The home operates appropriate practices and procedures to protect vulnerable adults. The manager and staff actively promote awareness of adult protection issues. EVIDENCE: Bramble Close has a clear and informative Complaint Procedure that was on display in the home. The home had a complaint log ready for use. Residents reported that they were aware of a Complaint procedure and that they were clear that they could report a concern or complaint to a member of staff or the manager. The residents reported that they felt that complaints would be taken seriously and that they would feel comfortable making a complaint. One resident stated that when they would “not hesitate to complain if I needed to”. The home has a comprehensive and clear set of protection of vulnerable adult abuse policies and procedures. The home has clear guidelines for staff to follow should an allegation of abuse be made. Copies of the relevant national guidelines are available to staff. One resident stated that they “felt very safe in the home” and “trusted the staff to look after us”. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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 standard(s) 24 & 30. Residents live in a homely, comfortable and safe environment. The home is clean and hygienic. EVIDENCE: On touring the home all areas were found to be clean, tidy and free from odour. The furnishings and decoration were of a high standard and gave the home a warm and welcoming feeling. The bedroom sizes are over and above the requirement set out in the National Minimum Standards. Bedrooms are highly personalised and contained many items of the resident’s personal furniture and possessions. The home’s communal and private areas are naturally ventilated. All bedrooms are centrally heated and radiators are guarded to ensure the safety of residents. The residents spoken with reported that the “home was always clean and tidy” and that “I have responsibility for cleaning my room and doing my washing, as you can see I have not done it yet”. The home’s laundry facilities are located away from communal areas and individual bedrooms reducing the risk of cross infection. The equipment in the laundry is suitable for the needs of the residents. The home did not have a 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 16 sluice, however the washing machines in operation had sluicing facilities. Residents confirmed that they were supported by staff to do their own washing and stated that “I am going to have to do my own washing when I have my own home” and “although I cannot load the machine myself, I am responsible for directing the staff on how to do my washing”. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 33. The home provides the residents with a well trained and knowledgable staff group. Staff were provided with training appropriate to the needs of the current resident group. Staffing numbers were sufficient to meet the needs of the residents. EVIDENCE: The staffing levels on the day of the inspection had been calculated using the Department of Health guidelines. Discussion with the residents, and examination of the staffing rota, confirmed that staffing levels were well maintained, and were appropriate to the needs of residents. Any staff shortages due to sickness or annual leave, were covered by care staff working extra shifts; this enabled good continuity of care within the home. The home works within a multi-disciplinary framework and residents benefit from the support of the Essex County Council Enablement Team, the Occupational Therapists, Physiotherapists, Speech Therapists and any other professional agency identified within the individual care plan. The home provided the staff with a full and comprehensive programme of training. The programme included: first aid, fire safety, moving & handling, 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 18 food hygiene, infection control, disability awareness, risk assessments, and the protection of vulnerable adults. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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 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) 42 Overall the home ensures the health, safety and welfare of the residents. EVIDENCE: The home provided staff with appropriate Health and Safety training. Risk assessments of the premises were undertaken and regular Health and Safety checks of facilities and equipment are undertaken. The manager was aware of relevant Health and Safety legislation and was committed to the welfare of both the residents and staff group. Hot water, fire alarm and equipment checks were not accurate, nor up to date and the CSCI had not received Regulation 26 notices from the responsible person. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 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 3 3 x x x 3 x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 15 Bramble Close Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 21 NO 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 YA 6 Regulation 15 (1) Requirement The registered person must ensure that care plans are fully completed and include all aspects of identified need and care provision. The registered person must ensure that care plans are reveiewed on a monthly basis and provide evidence that residents are involved in the care planning process. The regsistered person must ensure that the daily records reflect the actual care provided. The registered person must ensure that the Regulation 26 notices are sent to the CSCI on a monthly basis. The registered person must ensure that records relating to hot water temperatures and fire alarm checks are up to date, accurate and well maintained. Timescale for action 31.08.05 2. YA 6 15 (2) (b) 31.08.05 3. 4. YA 6 YA 42 12 (1) 26 (2) (3) (4) 13 (4) (a) (c) 31.08.05 31.07.05 5. YA 42 31.07.05 6. 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 22 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. Refer to Standard Good Practice Recommendations 15 Bramble Close I56-I05 s61937 15 Bramble Close v221847 080605 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Fairfax House Causton Road Colchester 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. 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