Inspection on 01/03/06 for Bracebridge Court

This inspection was carried out on 1st March 2006.

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

Bracebridge Court 13/03/09

Bracebridge Court 13/11/07

Bracebridge Court 15/11/06

Bracebridge Court 15/08/05

Bracebridge Court 10/12/04

Bracebridge Court 24/06/04

Bracebridge Court 04/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Bracebridge Court Friary Road Atherstone Warwickshire CV9 3AL Lead Inspector Yvette Delaney Unannounced Inspection 1st March 2006 11:30 X10015.doc Version 1.40 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 Bracebridge Court DS0000035064.V285528.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 Older People. 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. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bracebridge Court Address Friary Road Atherstone Warwickshire CV9 3AL 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) 01827 712895 01827 713754 Warwickshire County Council, Social Services Department Gordon Fraser Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2005 Brief Description of the Service: Bracebridge Court is a Local Authority home for older people. It provides permanent care, short stays and day care. The home is situated on a housing estate less than one mile from the town centre of Atherstone. There are local shops, including a hairdresser, an off licence and a newsagent within fifty yards, and a bus stop outside the home. There are car parking spaces to the front and rear of the building. Bracebridge Court provides accommodation on three floors. Fourteen people have bedrooms and communal lounges on each of the two upper floors. On the ground floor there is a large restaurant, a conservatory, used mainly by day care and short stay residents, and a bar. The home has a hairdressing salon and a shop. Short stay service users have their bedrooms and lounge on the ground floor. All bedrooms have en-suite lavatory and wash hand basin. On each floor there are bathrooms and lavatories suitable for people with physical disabilities. The kitchen, laundry and staff offices are on the ground floor. As well as front and rear staircases, there is a shaft lift to the upper floors. The home is staffed over 24 hours. It has a management team of a manager, an assistant manager and three care officers. There is also a full time clerical officer and a full time activities organiser. In addition there are 32 people who provide care or domestic services. The home does not provide nursing care. Service users who require nursing attention at a level, which can be provided, by community nurses receive this as they would in their own homes. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on a weekday between the hours of 11.00 am and 5.00 pm. This was the second visit for this inspection year. The Deputy Manager was present at this inspection. Staff in the home co-operated fully with the inspection. Managers and staff were proactive in their response to the inspection and were keen to improve practices and the environment to ensure the service users needs are met. The inspection process involved talking to residents, discussions with the manager, examining care profiles, case tracking and discussions with staff. Records related to residents, staff, the environment and operations in the home were examined. These include care profiles, accident records and policies and procedures. What the service does well: What has improved since the last inspection? What they could do better: The areas where improvement is needed include the • Accurate completion of care plan documentation. Care plans must clearly identify the care needs of individual residents and the action to be taken by staff to meet individual residents needs. Updating training for all staff in topics related to the care of residents accommodated in the home and ensuring that all staff attend mandatory DS0000035064.V285528.R01.S.doc Version 5.1 Page 6 • Bracebridge Court training this includes fire, which should be provided twice per year, moving and handling, health & safety and food hygiene, moving and handling and infection control. 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. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 The contracts/statement of terms and conditions available informs residents of their rights prior to signing the documents and moving into the home. The pre-admission assessment ensures that the staff working at the home can meet residents’ personal, health and social care needs. EVIDENCE: The home provides residents’ with a statement of terms and conditions. A contract of residency is available for all residents, which details the terms and conditions for living in the home. Details of the fees payable and by whom (service user, local or health authority, relative or another) are included in a separate document. Bracebridge Court is a Local Authority owned care home and pre-admission documentation examined demonstrates that all residents have their initial care needs assessed by social services. This assessment is then followed with an assessment carried out by the manager of the home to ensure that the home has the resources to meet the needs of the potential resident. Records viewed and discussion with staff confirmed that staff had undertaken mandatory and Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 9 specialist training, which would support them to meet the needs of residents admitted to the home. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9 Residents’ health, personal and social care needs are not consistently described in care plans, which could result in the oversight of care and possible harm to residents. The administration of medication is generally well managed. EVIDENCE: Care profiles are based on the activities of daily living, which requires the person carrying out the assessment to identify a residents strengths, needs/problems and causes of problems. The information, which identifies a residents health, personal and social care needs is available but is not clearly identified. Care plans examined do not clearly identify the action to be taken by staff to meet individual residents needs. Care plans forms are not completed consistently to correspond with headings on care plan formats. Writing of daily statements have improved, staff are not consistent in dating, timing and signing entries with a full signature to provide an effective audit trail. When referred to read ‘Key Health’ events no information has been recorded to cross reference the outcome of a health intervention. This could be related to a visit from the GP or District Nurse. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 11 Some gaps were found on the Medicine Administration Record (MAR chart) and it could not always be demonstrated whether residents had received the medicine and the MAR chart had not been signed or they had not been administered and reasons for non-administration not recorded. Controlled Drugs are appropriately stored and a Controlled Drug register is maintained. Records indicate the medication administered and a second member of staff witnesses all entries. A balance of Temazepam available in the home once administered to residents for whom they are prescribed is maintained, which is good practice. The practice in the home is to dispense the medicine through another carer, the senior carer then signs to state that the medicine has been administered although they will not have seen the resident take the medicine. Medicines stored on the separate floors for administration by night staff are poorly stored decanted into different containers, eye drops/ointments not dated. The registered manager was proactive in her response to the medication issues and was keen to improve practice further to meet the needs of the residents. Information received following the inspection demonstrates that these practices have been reviewed. Two staff check the medication and the carer that gives the resident the medicine signs the MAR chart to confirm that the medication has been taken. All medicines are now stored in one trolley on the ground floor, which is stored in a secure area. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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 assessed as met at the first inspection of this year and have not been re-assessed at this inspection. EVIDENCE: Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The service ensures that resident’s are protected and have systems in place to protect them from the risk of abuse, increasing their feeling of safety and their quality of life in the home. EVIDENCE: A procedure for responding to allegations of abuse is available with clear guidance for staff to follow. Training records showed that only 8 of 22 care staff had attended recent adult protection training sessions. Discussions with two care staff on duty demonstrated that they have a good knowledge base and understanding of issues related to preventing and handling concerns related to the protection of adults. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 and 22 Residents have sufficient and suitable toilet and washing facilities available to meet their individual needs. The home is suitably adapted and specialist equipment is available to support residents in maximising their independence. EVIDENCE: Suitable accessible communal bathrooms and toilets are situated close to the lounge and dining areas. Equipment and aids provided for the use of residents include toilet seat raisers, assisted baths and hoist. Each bedroom has en suite facilities, which are of a good size and meet resident’s needs. The home has been suitably adapted providing easy access for residents to move around the home. Residents were able to use the lift independently, mobilised with the aid of various walking aids, which include walking sticks and Zimmer frames. Grab rails have been suitably placed to support those residents able to walk around the home. Some residents required the use of wheelchairs, which had been maintained to ensure they are safe to use. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 30 The skill mix of staff on duty on the day of inspection meets residents’ needs, ongoing training is needed to ensure that this level is maintained at all times. Staff were observed to be competent to do their job but training is not up to date, which could result in inappropriate care being given and deterioration in the quality of life for individual residents. EVIDENCE: There are currently 14 of 22 (62 ) care staff with NVQ level 2 qualifications or above. Evidence was available to confirm attendance at training sessions related to care topics. Training was not recent but would help to support staff to meet the needs of residents accommodated in the home. These include diabetes and management of incontinence. Training records examined show that statutory training is not up to date for a number of staff; this includes fire, which should be provided twice per year, moving and handling, health & safety and food hygiene, moving and handling, medication and infection control. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35 and 37 The home has a quality system, which looks at the quality of care and informs improvements in the home for residents. Accounting and financial procedures maintained in the home are suitably managed thereby safeguarding the residents’ stay in the home. Procedures are in place to manage residents’ monies and valuables so that their interests are safeguarded. Records are organised, accessible and securely stored, which should safeguard residents’ rights and best interests. EVIDENCE: The home has some quality monitoring in place, which involves surveying residents and relatives on the quality of care and services provided. Monthly reports detailing the outcome of visits made by the responsible individual Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 17 nominated by the Local Authority provide information on the quality of services provided in the home. Accounting and financial procedures in the home are managed appropriately with the support of the administrator. A valid and current insurance liability certificate is displayed in the home. The administrator manages small amounts of resident’s personal monies. Records were examined which demonstrated that information related to all transactions is available, and receipts are kept to indicate money spent. All monies are maintained individually and kept in a suitable locked facility. Individual residents records and other personal confidential information related to staff and residents are secured in locked cabinets, in the manager’s office. Computers in the home are password protected. Records examined include maintenance, contracts and servicing documentation for electrical equipment, clinical waste and all other services supplied to the home. Residents’ aids and equipment have also been serviced, this includes hoists and baths and maintenance work is up to date. Fire records and electrical tests are maintained. Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X 3 3 X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 X 3 X Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 19 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. 21 Standard OP7 Regulation 15 Requirement Residents care plans must set out in detail changes in their needs with documentation of action taken to meet and address any change in circumstances. Care plans must set out in detail, the action needed to be carried out by care staff to ensure all aspects of the health; personal and social care needs of the service user are met. Daily health related statements, must be completed consistently to demonstrate care prescribed and care given. The Registered Manager must ensure that all staff receive training related to the protection of vulnerable adults. The Registered Manager must ensure that all staff are up to date with Statutory training requirements and attend training related to the care of residents living in the home. Timescale for action 31/05/06 2 OP7 15 31/05/06 3 OP7 15 31/05/06 4 OP18 18 31/05/06 5 OP30 18(1)(c) 31/05/06 Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 20 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 Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Bracebridge Court DS0000035064.V285528.R01.S.doc Version 5.1 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!