Inspection on 02/02/07 for Brackenley

This inspection was carried out on 2nd February 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brackenley 17/01/06

Brackenley 19/04/05

Brackenley 09/11/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Brackenley 33 Forest Lane Head Harrogate North Yorkshire HG2 7TE Lead Inspector Mrs Maggie Coxon Key Unannounced Inspection 2nd February 2007 10:45 Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 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 Brackenley DS0000007818.V327875.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackenley Address 33 Forest Lane Head Harrogate North Yorkshire HG2 7TE 01423 862230 01423 861541 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) Applewalk Homes Limited Mrs Julie Ann Lunn Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 12 Service Users with Learning Disabilities some or all of whom may have Physical Disability Service Users with physical disability not to be accommodated on the second floor 17th January 2006 Date of last inspection Brief Description of the Service: Brackenley is a care home registered by Applewalk Homes Limited to provide personal care and accommodation to up to twelve adults with learning disabilities under the age of 65 years of age. The home consists of a large, late Victorian detached property. The home is situated between Harrogate and Knaresborough and has good access to all the facilities in both towns. All twelve bedrooms are for single accommodation and are sited on several floors. Whilst the home has neither a usable passenger lift nor stair lift, all areas are accessible to those residents currently living there. The home has level access. Current information about services provided at Brackenley in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Information provided by the manager on 27th October 2006 indicated that the current weekly fee for the home is £695. Additional costs include toiletries, hairdressing, holidays, leisure activities and clothes. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report: • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the visit, this is called a pre-inspection questionnaire. A visit to the home that they didn’t know was going to happen. This lasted for five hours and included talking to most of the twelve residents, three of the care staff, the registered manager and the deputy manager. Most areas of the home were seen and records that the home has to keep were checked. Residents’ medication was also checked to make sure that it was being properly looked after for them. Twelve comment cards were sent to residents eight of which were returned. No comment cards were sent to residents’ relatives because the information required in order to do so was not provided by the home although requested. Two relatives were talked to however during the visit. Comment cards were sent to two care management teams one of which was returned. • • • People living in the home have expressed a preference to be known as residents. What the service does well: Residents and staff get to know each other very well and staff are kind and friendly so residents can be confident that they will get good help. Residents can have lots of contact with friends and family and see them at any time. Staff also spend a lot of time talking to the residents. This means that they can have company whenever they like. Residents meet with the manager to talk about the help they need and to find out about the home before they move in. They can also visit the home to see if they like it. This means that residents can decide whether or not they move into the home. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 6 The home is well run and staffed so residents are well looked after. They have plenty of activities both inside and outside of the home and spend lots of time out and about in their local town as well as visiting places further away. Residents are helped to be as independent as possible and to make as many choices as they want to regardless of their age, gender or needs, they are all treated equally, they are also all treated respectfully by the staff. Residents see their GP, dentist, optician and chiropodist whenever they need to. This means that they can stay as healthy as possible. Residents have a good choice of food and drinks at mealtimes. This ensures that they have a varied diet of their choosing and can enjoy their meals. Residents are asked to say what they think about the service they get at Brackenley. This gives them the chance to ask for any changes and to have a say in planning services in the future. 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. The summary of this inspection report can be made available in other formats on request. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4. Quality in this outcome area is good. Information about the service provided is available to anyone who wants it. A detailed needs assessment process ensures that the diverse needs of residents are identified and planned for before they move into the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has produced a statement of purpose and service user guide, which set out the services provided to residents at Brackenley. A copy of the amended statement of purpose was provided during the visit. An assessment had been taken of each resident’s need before they moved into the home. Whilst no new admissions have been made in the last year the deputy manager explained that any such admissions are arranged via planned introductory programmes including visits to the home and trial placements prior to being made permanent. People currently living in the home are also asked for their views. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good. Residents make as many decisions and everyday choices as possible. They can be confident that staff can meet their needs and are keen to give them the chance to be as independent as possible. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Case tracking confirmed that residents’ individual personal plans are very comprehensive and well organized and are being regularly reviewed. They contain sufficient detail to ensure that staff know how best to meet the diverse needs of the individual resident in a way that promotes their independence wherever possible. Records made and comments made by residents when surveyed and during the visit and comments made by staff and observations made at the visit all Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 10 show that residents are able to make many choices and decisions in their daily lives including whether they want their own bedroom door key and choices about activities and meals. Residents can also take reasonable risks subject to negotiation and agreement with the manager and to a well-recorded personal risk assessment. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area is good. Residents enjoy lots of activities that they have chosen themselves. They are supported to develop and maintain relationships with family and friends. Meals are home made and nutritious so residents can enjoy good, healthy food. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Conversations with residents and staff, observations of staff interaction with residents during the visit and care records show that whilst each resident has timetabled activities and is encouraged to contribute to the running of the home on a planned and agreed basis they are also able to make choices and decisions in their daily lives and can take reasonable risks after a risk assessment has been undertaken and recorded. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 12 Residents also said they are supported to keep in touch with family and friends Relatives spoken with said that they are made welcome at the home at any time and are kept well informed about their relative should a need arise. All of the residents have at least one holiday each year and staff also support individuals to holiday with their families. They also go out on group trips that they have chosen. The home has open days twice every year when all relatives and friends are invited. The staff team also produces an annual newsletter, which is sent to all relatives. Staff cook all the meals using quality, fresh ingredients. Residents said that they choose each week what they want to eat. Records of meals eaten show that meals are varied and nutritious and provide residents with a healthy diet. Lunchtime was very relaxed and informal. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. Residents are able to stay as healthy as they can by being helped to attend regular health appointments and by being helped to take their medication. They are also well supported when having their personal care needs met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff were seen to provide all support, including that concerning personal care needs, in a way that promoted the residents’ privacy and dignity. Case tracking identified that each resident has a detailed health assessment and is registered with a GP. They attend regular appointments with various health care professionals, opticians, chiropodists and dentists. Residents’ health records are well kept. Two residents self medicate and are supported to do this. The other eight residents have their medication administered by staff mainly via a monitored Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 14 dosage system although a small amount is dispensed in boxed strips. All medication is securely stored. Administration is well recorded. Staff have had some medication training and a relatively new employee explained that staff are not allowed to administer medication until they have had this training. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Systems and procedures are in place for dealing with complaints and for safeguarding the residents from abuse and of staff are well trained so residents can feel safe and well listened to. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A comprehensive complaints procedure is followed and is made available to residents and their relatives. Residents also have regular meetings in which they are reminded about how to complain and are given the opportunity to express any dissatisfaction. There has been one complaint made to the home since the last inspection, this was fully investigated and appropriately dealt with. Staff spoken with were very clear that if they were to witness or suspect any abuse of a resident they would take appropriate action. The deputy manager explained that there is a policy of no restraint in the home. Residents’ monies are checked after every transaction by staff to make sure no mistakes have been made and every financial transaction is very well recorded providing a clear audit trail. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28 and 30. Quality in this outcome area is good. The standard of the environment is good and provides residents with a clean, comfortable and safe home in which to live. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Communal areas are well maintained and very pleasantly decorated and furnished. The kitchen has been redecorated and refurnished within the last year and residents had had a say in this. Many other rooms have also been redecorated. Several of the residents showed me their bedrooms, which again are well maintained, decorated and furnished. They said that these have been decorated and furnished to their personal taste and they are very happy with them. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 17 There are sufficient well-equipped bathrooms and toilets. These are situated on different floors throughout the premises. One resident said that they would like to be able to use the lift to go to her bedroom but the registered manager explained that because of the age of this equipment it is only suitable for transporting goods not people. The resident concerned said that she understood this and confirmed that she is able to use the stairs unassisted and therefore access her bedroom freely. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. Quality in this outcome area is good. The home is well staffed by individuals who are experienced and trained. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Sufficient staff were on duty at the time of the visit and staffing rosters indicate that the home is well staffed at all times. Staff confirmed this to be the case. Personnel records checked for the newest employee evidenced that whilst a CRB certificate was awaited the individual was acting in a supernumerary way and was not providing any personal care. The deputy manager agreed to undertake a POVA 1st check on this individual. New staff undertake the learning disability award framework induction and foundation training prior to enrolling on NVQ training. Fourteen of the twenty care staff have already completed either a nursing qualification or an NVQ and a further four are currently undertaking a NVQ to level 2 or 3. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 19 All staff have completed basic training which was has been regularly updated. Staff said that they are extremely well supported by the management team and have regular supervision from the deputy manager. They said that the registered manager holds regular staff meetings. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42 and 43. Quality in this outcome area is adequate. The home is well managed so residents can feel safe and be confident that the manager and staff are always looking for ways to improve the service and thus improve residents’ quality of life. Evidence that the home is financial secure however was unavailable and residents’ future security could be uncertain. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The registered manager is very experienced in the management of care services and has been the registered manager of Brackenley for a number of years. She explained that she has completed the Registered Managers Award and is awaiting certification of this. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 21 Staff say that the management team provides very good leadership, guidance and support in an open and inclusive style. Staff said they have regular supervision from the deputy manager and are encouraged to contribute fully to team meetings. Quality assurance and monitoring is undertaken on a continual basis. Residents have their own meetings on a monthly basis and close contact and open dialogue is actively encouraged with relatives. Every resident is surveyed by an external agency on an annual basis and an action plan is developed following resident and staff meetings. The responsible individual also undertakes monthly quality audits of the service. Current records pertaining to residents are well maintained and stored. Regular health and safety checks of the premises are undertaken and fire safety is well maintained including regular fire safety training for all staff. Other health and safety systems and records are well maintained including fridge and freezer temperatures that are recorded daily. The registered persons have been asked several times to provide current evidence of Applewalk Homes Ltd’s and Brackenley’s financial situation in light of recent concerns regarding unmet tax demands. This information has not yet been provided and the registered manager agreed to speak to the responsible person for the home and ask that this information be submitted to CSCI. Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 3 1 Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 23 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 YA43 Regulation 25(2) Requirement The registered persons must provide financial information concerning Applewalk Ltd and Brackenley as requested in letters to the responsible individual on 1st and 23rd November 2006. Timescale for action 31/03/07 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 Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Brackenley DS0000007818.V327875.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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