Inspection on 12/09/07 for Bracken House

This inspection was carried out on 12th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Bracken House 19/09/06

Bracken House 02/11/05

Bracken House 25/05/05

Bracken House 14/12/04

Bracken House 09/06/04

Bracken House 21/01/04

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 Bracken House Bracken Close Burntwood Nr Walsall WS7 9BD Lead Inspector Mrs Wendy Grainger Key Unannounced Inspection 12th September 2007 09:00 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 Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 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. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bracken House Address Bracken Close Burntwood Nr Walsall WS7 9BD 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) 01543 686850 01543 670326 jakki.hamer@staffordshire.gov.uk Staffordshire County Council, Social Care and Health Directorate Jacayln Ann Hamer Care Home 36 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (36), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (20), Old age, not falling within any other category (20), Physical disability over 65 years of age (10) Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 Dementia (DE) - Minimum age 50 years on admission Date of last inspection 19th September 2006 Brief Description of the Service: Bracken House was built in 1968 to provide care and accommodation to older people. Located on an estate the home is not in a conspicuous position, overlooking a school and near to the centre of the village of Burntwood. The City of Lichfield is approximately four miles away. Standing in its own grounds the home continues to be upgraded internally and externally. Occupancy at Bracken House is for thirty-six older people. The home provides care for long term stay older people with dementia or related conditions of old age. The two-storey building has bathing and toilet facilities throughout the home. The first floor can be accessed via the stairs or shaft lift. Within the home there has been created three lounge/diners, Roseview remains a self-contained dining room/lounge with a small kitchen area. The laundry and main kitchen are located on the ground floor away from any service users bedrooms. The home has a separate hairdressing room, treatment room and staff room on the ground floor. The home has recently undergone a major refurbishment throughout with each area being refurbished and decorated. From the information received the current fees were £452. Additional costs would include hairdressing, private chiropody, personal toiletries and periodicals. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 12 September 2007 it was undertaken by W D Grainger Inspector. The Head of Home, a number of the people who use the service and the staff and relatives in the home, contributed to the information gathered during the day. The inspector was provided with documents, reports, records, menus, and contractual details for servicing equipment, the medication routine was be observed. The Head of Home had forwarded the annual quality assurance assessment to the Commission; information will be included in the report. Four “have your say about the home” had been sent to the inspector, these with a tour of the home, observations of the staff and conversations with the people who use the service and staff will be part of the report. What the service does well: At the time of this inspection Staffordshire County Council Social Care and Health Directorate are considering the future of this service. This service is registered for thirty-six people and at the time of the inspection there were twenty-three service users resident. Service users felt that they were receiving a lot more attention because the numbers had reduced. The home is well furnished and maintained to a high standard. The service users, where able, can choose their daily life style and routines. During the inspection a minimum of five residents came to the office to pass the time of day with the inspector and Head of Home to offer their opinion about the home and the care they receive. Each one was very satisfied and complimentary about the staff and Head of Home. The comments received included: “ I am well looked after” “ the “girls” are so good to me” “ I like it when we have music” “its my home and I would not be anywhere else”. Some service users also expressed their concerns about their futures: Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 6 “Who is going to look after us when Jacki (Head of Home) leaves.” The “have your say” comments received were positive about the service: “the staff are all good and very nice if ever I need help there is always someone to help me” “I know I can go to the office if I need help” “ the food is very good I always choose what I want from the menu” “the home is always clean and tidy its cleaned every day” “ I am very happy here and would not like to move” “ the staff always get the doctor if I need him”, “ we have lots of activities and I like to join in with them.” Visitors offered their comments about the home and care it provides: “ My mum is very happy here, she eats well; I cannot fault the staff for their dedication, the care is exceptional from all who are at the home” “ my relative has had care kindness and respect during her short time at the home” “ my mum could not be better cared for anywhere else” A tour of the home confirmed the comments made by the people who use the service, that the home was clean tidy and of a high standard of hygiene. The staff were committed and dedicated to the care of the people who use the service, they were observed during the day to demonstrate sound practices of care, and they were knowledgeable and met the daily needs of individuals in a sensitive gentle manner. People who use the service responded during the day to the care and approach of the staff in a relaxed manner. The catering staff had recently been inspected by the Lichfield Council Environmental Health Officer he had awarded them a “FIVE” star rating for the overall conditions of the kitchen its hygiene and storage of foods. What has improved since the last inspection? The Head of Home had recently received a new policy for the safeguarding of the people who use the service. This will be cascaded down to the staff in supervision and in staff meetings. The annual quality assurance assessment refers to menus being adjusted to incorporate new ideas from the residents. To promote personalisation and dignity, new individualised door plaques have been fitted to bedroom doors. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 8 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 Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Standards 3, 5 were reviewed. Admissions are not made until a qualified member of the staff has undertaken a full assessment. The skill mix of the staff, ability and qualifications are taken in to account to meet the individuals’ needs. Prospective residents to the home are given the opportunity to spend time in the home prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the information in the annual quality assurance assessment there had been one new admission recently. The home had taken this person from Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 10 another home to enable her to be with her friends. The family and person had been involved in all the stages of the move. This was evidenced in the assessment document provided. The resident confirmed that she had come to be with friends and that she was extremely happy at Bracken House where the staffs meet her needs. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Standards 7,8,9,10 were reviewed. People who use the service are consulted about their life style. The Statement of Purpose identifies the qualifications of the staff group; who were competent, relaxed and enabled residents in their daily routine Meals served are well balanced and nutritious, catering for varied diets of the people who use the service. Residents individual plan of care clearly records the needs and details of how care is to be delivered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this inspection there were twenty three people at Bracken House. A sample of three care plans were evidenced, individuals were spoken Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 12 with. The plans of care were detailed identifying any needs that may be required. The staff had full access to the plans, which were maintained in the office. The last person to be admitted to the home confirmed that the transfer had been with her knowledge; her family were involved and visited often. The plan identified that this person had received a review of her medication since admission. The staff had recognised three risks and had endeavoured to minimise them via the comprehensive risk assessment. Where applicable staff monitored and recorded another resident’s blood sugars, which were then checked by the visiting district nurse. One person chooses to continue to smoke, the resident was aware that there was a room or garden, where smoking was possible, this plan had a full risk assessment. Care plans in general were reviewed monthly, changes identified and recorded. This was clearly evidenced in the “contact” records and monthly record. Residents were observed during the day to be well presented; a number of the residents would require the assistance of the staff to achieve this. All the staff remain pro active in the prevention of pressure sores, recently the staff had gathered information guidance and training for the care of a stoma. All the management have completed accredited training in the administration of medicines. The homes policy for medication is located in the dispensing office where the medication was stored appropriately. The medication routine for administration was observed and gave the inspector no concerns as to the awareness and knowledge of the person responsible. Records were current, senior staff prior to administration checked all the medication received into the home. During the inspection the inspector observed the staff address the needs of individuals; administer medicines, serve the meal, staff informed residents about the meal and asked their preference. Each procedure was comfortable and relaxed. Staff had the training and skills to support and encourage people who use the service to be involved in a daily routine of their choice. The home operates a key worker system. People who use the service spoken with were able to inform the inspector about their particular key worker. “ My key worker is great she helps me when I need it” “ I would not be able to cope if she did not assist me” “ If my key worker is not on duty I know some one else would help me” one visitor commented that “this staff go the extra mile for all of these residents I know my mum is happy here, which gives me comfort” Where necessary support is given during meal times staff were observed to assist with a sensitive approach. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent Standards 12, 13,14,15 were reviewed. The homes objective was to promote independence and choice while respecting the rights of the people who use the service. Contact was maintained with the community, family and friends. The meals are well balanced offering a nutritional menu based on the needs and choice of the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The promotion of a social life at Bracken House continued, there has been limited external outings due to the frailty and choice of the a number of the people who use the service. One person continues to place a bet on the horses, he gives the staff a list of the horses he chooses. One person attends a church of her faith each weekend. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 14 Internal entertainment was provided on a regular basis. The home has an activity co-ordinator who attends the home four days each week. She had the ability to promote the skills of individuals; some one is always knitting, during the inspection a game of Bingo was welcomed by a number of residents. A relative commented, “my mum would not miss the Bingo”. Some residents had been involved in planting bulbs, the progressive exercises were popular with the people who use the service. The less able people who use the service are stimulated by the external music and entertainment. Simple games for the less able were promoted by the activity person who encouraged easy co-ordination tasks as part of the weekly programme for the home. Spiritual needs were recognised and respected in the home for the people who are unable to go to their church. Staff were observed greeting visitors, from the comments made each one was made to feel welcome. Visitors noted that they are anxious about the possible closure of the home and commented that they were unsure that they could find another “home like this in the area” Recently the homes catering staff received “five stars” from Lichfield County Council for the very high standards in the kitchen, the food storage and the records maintained. People who use the service were offered three alternatives each day at lunchtime, this always included a vegetarian choice, at the time of this inspection there were no vegetarians at the home but on any one day someone may like the option. Home cooking and baking is the commitment made by the catering staff. “my mum eats well and enjoys her meals” The menus were well balanced, no special diets either for medical or cultural needs were served at this time. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Standards 16 18 were reviewed. The home has a clearly written complaints procedure displayed, and made available to relatives and people who use the service. Training of the staff in the area of protection is a priority and made regularly available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the discussions with the staff and people who use the service who were case tracked confirmed that each one was aware of the process or who to speak to in the event they had a problem. The “have your say” forms confirmed that each person was aware of the complaints process and who to refer to. The residents spoken with were sure that their concerns would be taken seriously and addressed. Staff training for the safe guarding of people who use the service has recently been updated with the new safe guarding policy. The management were cascading the training during supervision and staff meetings. Access for the staff to the new policy was available in the office. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 16 Bracken House management or the Commission had received no complaints for any part of the service provided. There were a number of “thank you” cards from grateful relatives for the excellent care provided to their relative. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent Standards 19 20 23 24 25 were reviewed. A tour of the home, provided evidence that the home was comfortable, clean and tidy with no malodours. Adaptations had been made to suit personal and collective needs of the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Located on a small estate, Bracken House people who use the service had access to some shops a distance away from the home. Following the major refurbishment there had been no structural changes made to the home. New personalised name plaques had been fitted to bedroom doors. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 18 At the time of this inspection and due to decreased numbers of people who use the service, one of the lounges had been closed off; it remained tidy and comfortable and accessible for families to use. The home was maintained to a high standard throughout. The housekeeping staff consistently maintained this high standard based on previous inspections. Each of the lounges when decorated had involved the people who use the service for the colours they preferred. The lounges were comfortable and allowed sufficient room for people who use the service to use the dining room/lounges. The main dining room is attractive in its decoration. In the entrance hallway there is a quiet area where people who use the service can relax, watch the staff and talk to friends. From comments from the people who use the service it was felt by them that Bracken is their home; they had been encouraged to bring in personal possessions for their bedrooms. This was confirmed during the tour of the home. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good standards 27,28,29,30 were reviewed There is consistently sufficient staff on duty to support and meet the needs of the people who use the service. Staff training is undertaken beyond the basic mandatory training requirements. The service has a robust recruitment process when employing new staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas identified that there were sufficient staff on duty at all times to meet the daily routine of the people who use the service. With the decrease in resident numbers the staff find they have more time to devote to individuals needs. Staff training and knowledge is promoted by each person undertaking the mandatory training and other external training i.e stoma care, religion belief in the workplace, staff have been nominated for the mental capacity act training. From the records provided approximately 98 of the staff had completed Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 20 Moving & Handling this year, the rest are not due until 2008; the care shift leader has almost completed her management course. The home employs twenty-one care staff, from these numbers and information in the annual quality assurance assessment, two staff remained without an NVQ qualification. The entire staff had completed risk assessment training; this training was then transposed into the care plans and around the home ensuring the safety of the people who use the service. Recruitment is robust to ensure that the people who use the service are protected at all times. The Head of Home has policies and procedures to refer to if necessary. She was aware that no person could be employed prior to the required checks and references being received. Records identified police checks, induction, contracts, and references with the application form, any previous qualifications, a recent photograph and interview record. The people who use the service at Bracken have a variety of experience and ages within the staff group. Despite the uncertain future of the home the staff remain committed to the care of the people in the home. This was demonstrated during the inspection by the staff approach, attitude and sensitivity towards the people who use the service. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good Standards 31,33,35,38 were reviewed. The manager has the required qualifications and knowledge to run the home effectively and for the best interest of the people who use the service. Clear leadership and a competent staff group promote the health and safety of the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Head of Home has the required qualification to operate the home effectively; this coupled with a relaxed style of management ensured that the Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 22 entire staff team have the interests of the people who use the service as their priority. Comments evidenced from relatives’ cards, people spoken with and the staff “ I could not receive better care” “ thank you for the care and kindness during my respite stay” “ my relative has excellent care from dedicated staff”. The home has a suggestion box for relatives, people who use the service to make comments regarding the service provided. Resident and relative meetings are arranged regularly, in light of the possible closure of Bracken House. Financial records and checks on the monies held on behalf of people who use the service were accurate and well managed. Records in respect of fire, water, lift and equipment were current and accurate. In the event of a fire or other emergency the home had contingency plans in place and the staff confirmed that they had received training in the event of a fire occurring; the records provided confirmed this. Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 23 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 X 3 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 X 3 4 4 4 X STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action 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 Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Birmingham Local Office 1st Floor, Ladywood House 45-46 Stephenson Street BIRMINGHAM National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Bracken House DS0000028915.V348397.R01.S.doc Version 5.2 Page 26 - 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. 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