Inspection on 07/09/07 for Brackenlea Care Home

This inspection was carried out on 7th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Brackenlea Care Home 09/01/07

Brackenlea Care Home 16/01/06

Brackenlea Care Home 23/08/05

Brackenlea Care Home 01/02/05

Brackenlea Care Home 27/07/04

Brackenlea Care Home 02/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Brackenlea Care Home Pearson Lane Shawford Winchester Hampshire SO21 2AA Lead Inspector Nick Morrison Unannounced Inspection 7th September 2007 10:00 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 Brackenlea Care Home DS0000057455.V344306.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. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackenlea Care Home Address Pearson Lane Shawford Winchester Hampshire SO21 2AA 01962 713242 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) Shawford Healthcare Ltd Mrs Jacqueline Deborah Coles Care Home 25 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (25) of places Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: Brackenlea is a care home providing personal care and accommodation for 25 older people including those who have dementia. The home is located in the village of Shawford three miles south of Winchester and is within walking distance of a mainline station, bus route and post office. All bedrooms are single; twelve of these have en-suite facilities. There is a lounge, a dining room and a conservatory. The home has an established garden and seating accessible to service users. The fees as given in the pre inspection questionnaire are between £440.00 and £485.00 per week. Items not covered by the fee include hairdressing, chiropody, toiletries, newspapers and magazines. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 7th September 2007 and lasted five hours. During this time the Inspector toured the premises, looked six service users’ files and met with people living in the home. The Inspector also met with the Deputy Manager and a Director of the company and spoke with two members of staff. The Inspector also had conversations with three relatives of people living in te home. All records and relevant documentation referred to in the report were seen on the day of inspection. Observation throughout the day showed that all service users appeared to be happy with the service they were receiving. What the service does well: What has improved since the last inspection? What they could do better: The Provider has acknowledged that the system for the safekeeping of people’s money needs to be reviewed. The Provider also acknowledged that more information could be gathered in the assessment process to determine the Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 6 individual interests of people so that activities could be organised in response to them. 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. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 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 Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. EVIDENCE: Examination of service users files showed that each person living in the home had had an assessment of their needs prior to admission. Assessments were comprehensive and contained input from service users, their families and relevant health professionals. Families of service users and health professionals confirmed that they had been consulted during the assessment process. Families also confirmed that the home provided useful information prior to their relative moving into the home. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 9 The Manager actively manages admissions to ensure that the home can clearly meet the needs of prospective residents and to ensure, as far as possible, compatibility with people already living in the home. Relatives spoken with confirmed that there was a probationary period to ensure that people newly admitted were able to settle into the home. The home does not provide intermediate care. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs identified in a care plan and from having their healthcare needs met. They are protected by the home’s medication policies and procedures and are treated with dignity and respect. EVIDENCE: There had been a recommendation from the previous inspection that the registered manager completes an assessment of staff before they are permitted to give out medication unsupervised, to assess their competency. A written record of this supervision should be kept. Staff files seen during this inspection demonstrated that this recommendation had been addressed. Examination of files showed that there were care plans in place for each service user. The plans had clearly been written in response to those needs identified in the pre-admission assessment, as well as to those needs identified as staff in the home got to know service users better. Staff spoken with said Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 11 that the plans were accessible at all times and that they understood the care plans for each person living in the home. The plans were all reviewed on a monthly basis and changes made where necessary. Copies of previous care plans were kept in order to demonstrate progress. Changes were also made to the plans in-between the monthly reviews if it was clear that needs had changed. Family members spoken with said they were consulted about care arrangements and were kept fully informed of any changes. The healthcare needs of service users were monitored daily and formally monitored on a monthly basis. Records were kept to demonstrate any changes in the person’s health and staff in the home liaised with other healthcare professionals whenever necessary. Family members spoken with confirmed that staff in the home were attentive to the health needs of people living there and responded to any concerns and that they involved external healthcare professionals when necessary. There was also information for staff in the home on specific health issues different service users had. There were risk assessments in place where a potential risk had been identified and these assessments were regularly reviewed and updated as necessary. Evidence from service users’ files showed that risk assessments were discussed and shared with service users and their relatives. Medication in the home was well managed. There was a clear medication policy and staff spoken with understood it fully. Staff involved in administering medication had all received training. All medication was stored safely and securely in the home and good records were kept of all medication administered. Records were also kept of all medication coming into and going out of the home. Observation throughout the inspection visit showed that staff understood how to respect the privacy and dignity of service users. Staff were courteous at all times to all service users and this was confirmed by family members spoken with. All service users seen and spoken with on the day of inspection were well-presented and, where necessary, had support from staff to maintain their appearance. The induction training for staff provided them with guidance on the rights of service users and on ways to actively demonstrate respect and maintain peoples dignity. Care plans emphasised the need to support people to retain their independence as far as possible. The approach of staff seen on the day of the inspection visit emphasised this and relatives spoken with said they felt this was positive. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from being able to exercise choice and control and have stimulating activities. They also benefit from good support in maintaining contact with friends and families and a good, balanced diet. EVIDENCE: Staff had received training in communicating with people who have dementia and were skilled in communicating with people living at the home. Service users’ methods of communication were recorded and there was close liaison with families over the needs, choices and wishes of each service user. Families spoken with confirmed that all the staff in the home were very good at communicating effectively with their relatives and that they were respectful of the choices they made. Observation of staff on the day of the inspection visit showed that they gave time and consideration to all service users and Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 13 attempted to respond to their wishes at all times. They spent time listening to people and engaging them in conversations. The home provides some planned activities and staff were mindful throughout the day of the need to ensure that service users were receiving sufficient stimulation. Some service users and some relatives said they would like to see more activities in the home. There was an Activities Coordinator in the home but she has left. The home is about to appoint a replacement for her. Activities that had taken place included card games and puzzles, crafts, quizzes, bingo, sing-alongs and physical exercises. There were also Carols at Christmas and a Garden Party in the summer. One relative said that he was pleased the home had organised transport and support for his relative to attend Holy Communion on a regular basis. Visitors were encouraged to come to the home at any time and family members confirmed that they felt able to visit whenever they wanted to. Relatives spoken with said they were always made to feel very welcome in the home and that staff made it easy for them to visit and spend time with their relative. They said it was a very friendly and homely atmosphere and that they always felt welcome. They also said that staff in the home were very courteous. Information was available within the reception area for visitors and this included the Statement of Purpose, Service User Guide, a copy of the last report from the Commission for Social Care Inspection and a copy of the most recent summary of consultation with service users and their families. The home also had a positive attitude to addressing the nutritional needs of service users. On admission each service user had an assessment of their nutritional needs and individual nutritional care plans and risk assessments were devised in response to any issues highlighted in the assessment. Food was always served in the best way for each service user to consume it and staff were available to provide support for people who needed it. Fresh fruit was available for people. The meal seen on the day of the inspection visit corresponded with the menu for the day and people spoken with said they enjoyed the food in the home. Feedback from family members described the food as good. There was only one choice on the menu for people, but each person was consulted each day and if they did not want what was on the menu they were able to specify an alternative. Service users and their relatives confirmed that choices were always offered. The lunchtime observed on the day of the inspection visit was a relaxed and sociable occasion. Service users spoken with were aware of what was to be served for lunch and the information was also recorded on a menu board. There was consultation with service users about ideas for the menus and they were changed periodically during the year to reflect the change in seasons. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from a clear and effective complaints procedure and are protected by the home’s adult protection procedures and practices. EVIDENCE: There had been a requirement from the previous inspection that all staff who are responsible at any time for the management of the home must have training in working with the adult protection procedures. This is to ensure they have sufficient knowledge about the action they are required to take if an allegation of abuse is reported to them. Since that time all staff had received training in adult protection procedures and those spoken with were clear about their responsibilities within this. This requirement has been met. The home has a clear and effective complaints policy in place. The policy is made available to service users and their families on admission and a copy is also available in the front entrance of the building. Families of service users spoken with were aware of the complaints policy and how to use it, but those spoken with said they had never had to make a complaint. There had been no complaints since the previous inspection. The home has a system in place for recording and responding to any complaints that may be made. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 15 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): 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from living in clean, safe, well-maintained environment. EVIDENCE: All parts of the building were kept very clean and the home retained a homely and comfortable appearance. Relatives and service users spoken with said a lot of thought was put into ensuring the environment was comfortable and homely and that attention was paid to detail, including fresh flowers around the building. They said that there appeared to be an ongoing programme of redecoration in the home. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 16 A new call alarm system had been added and both service users and their relatives found this reassuring. Service users spoken with said staff responded quickly if they ever had to use the call alarm. There was also a programme of routine maintenance and records were kept to demonstrate that maintenance issues were responded to swiftly. The home employs adequate numbers of domestic staff to maintain the appearance of the building. There were comprehensive cleaning rotas in place and these were checked regularly by the Manager to ensure that all cleaning was undertaken to the necessary standard. Infection control policies were in place and were posted in places throughout the building to ensure that staff were able to refer to them throughout their work. The home had a very positive approach to infection control. Relatives said the building was always maintained to a high standard. The lounge area had recently been redecorated and was also well-furnished with comfortable chairs. A large screen television had recently been added. Adjacent to the lounge was a conservatory area that appeared to be well used. The garden was well-kept and provided different areas where people could sit. On the day of the inspection visit there were people in the garden throughout the day. Relatives spoken with were aware that people were encouraged to make use of the garden when the weather was good. The Provider has plans to improve the garden area. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by adequate numbers of sufficiently trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: There had been a requirement from the previous inspection that the registered manager must ensure that a full employment history is obtained from applicants and any gaps in it are explored to make sure they are fit to work with service users. Examination of the recruitment procedures showed they had been changed to ensure that asking for a full employment history was now a part of the process. The staff records examined showed that employment histories had been recorded. This requirement has been met. There was also a requirement from the previous inspection that the registered manager is further required to ensure any employees from overseas can demonstrate they have permission to work in this country. Staff records showed that appropriate documentation was in place and this requirement has been met. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 18 The home employs sufficient numbers of staff to meet the needs of service users. Rotas showed that, in addition to this there were domestic staff including cleaners and a cook. The numbers of staff on duty meant that service users were able to have their care needs met and were also supported to be involved in leisure activities and were stimulated throughout the day. All staff had very comprehensive induction training when they first began working in the home and clear records were kept of this. Ongoing training for staff was also provided. Staff spoken with said they had good access to all the training they wanted and were encouraged and supported to undertake as much training as possible. Families of service users said all the staff appeared to be very well trained and were competent in their roles. All staff in the home had, or were undertaking, NVQ level two or equivalent. Good training records were in place to demonstrate the training staff had received. The home had recently converted the attic of the home to provide office space, kitchen facilities and a training room. There were three care staff each morning, two each afternoon and two at night. The home tries to use agency staff as little as possible. Existing members of staff picked up shifts that needed covering. Observation during the inspection visit showed that staff worked very well as a team and were supportive of each other. All staff received regular support and supervision sessions with a member of the management team. Records were kept of all sessions and issues were followed through from one session to the next. All staff spoken with said that they were well supported by the Manager and owners of the home. Examination of recruitment records showed that the home ensured that all necessary pre-employment checks were in place for all staff before they began working in the home. All staff were interviewed before being offered a job and clear records were kept of all interviews. Family members spoken with said members of staff were always very helpful, courteous, reassuring and supportive and were always able to answer any questions or concerns they had. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s financial procedures and by the management of health and safety issues. They benefit from living in a service that is well managed and focussed on their best interests. EVIDENCE: The Manager is registered and has the skills, knowledge, qualifications and experience to manage the service. Service users in the home have their finances managed by family members or by other representatives outside the home. The home does look after small Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 20 amounts of spending money for some service users and has a policy and procedures in place to govern this. Access to the money is limited to the Manager and the Deputy Manager and it is kept locked in a box inside a locked room. Clear and accurate records were kept of all transactions, along with receipts. The records were regularly checked and monitored. On the day of the inspection visit it was noted that some small amounts of change being looked after for people had fallen out of their individual wallets into the box. The Deputy Manager and Director acknowledged that they needed to implement different arrangements to prevent this from happening. Health and safety was well managed in the home. Comprehensive workplace risk assessments were in place and these were monitored and reviewed on a regular basis. Procedures for safe working practices were posted around the building and were covered in staff induction training. Staff spoken with were clear about the need for ensuring the health and safety of themselves, their colleagues and service users in all the work they undertook. Any incidents or accidents were recorded clearly and these records were regularly reviewed to ensure that practices were changed where necessary. All staff received regular training and updates in health and safety issues. All fire records within the home were up-to-date. The quality assurance system in place in the home was comprehensive and focussed on outcomes for service users. There were regular questionnaires for service users and family members about the service provided and the results of these were considered and acted upon where necessary. Questionnaires were available in the reception area. The format of the questionnaires had been improved over time to ensure that the home was getting the information it needed about the quality of the service provided. Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 21 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 22 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. 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 Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Brackenlea Care Home DS0000057455.V344306.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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