Inspection on 16/07/07 for Brackens The

This inspection was carried out on 16th July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brackens The 03/03/09

Brackens The 27/06/06

Brackens The 18/10/05

Brackens The 05/10/04

Brackens The 21/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor Lodge

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

CARE HOMES FOR OLDER PEOPLE Brackens The The Brackens 5 Elm Road Beckenham Kent BR3 4JB Lead Inspector Ann Wiseman Unannounced Inspection 16th July 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brackens The DS0000006913.V340038.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. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackens The Address The Brackens 5 Elm Road Beckenham Kent BR3 4JB 020 8658 6343 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) Mr Serge Jhurry Mrs Prunjodee Jhurry Mr Serge Jhurry Care Home 9 Category(ies) of Dementia - over 65 years of age (1), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (7) Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th April 2007 Brief Description of the Service: This is a registered care home for 7 people in the category of old age, one mental disorder and one dementia/learning disability. The current Registered Provider is also the Registered Manager. The home was first registered 29th August 1997 to the current owner. The Brackens provides care and accommodation in a family like setting. The home is an adapted building located in a residential area of Beckenham, close to local shops and Beckenham Town centre. The accommodation is located on three floors accessed by stairs only. This makes it difficult for service users with mobility problems. Staff are available throughout the 24-hour period. Mr Jhurry, the Registered Provider / Registered Manager, is on site five days a week working as part of the care team. In addition, he provides the on call cover when he is not on duty. Health provision is provided through the local Primary Care Trust. The GP is in the same street and the visiting district nursing service is provided through the surgery. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Key Inspection and took place over six hours. The Manager was present and facilitated the Inspection. The Inspector spoke to several of the Residents two of the care staff on duty and the people living in the home and some of their relatives have completed surveys sent to them by the Commission. In comparison this is a small home with only seven Residents, most of who have lived there for many years. It is owned and managed by the same person and over time the Manager has built up a close relationship with the people living in the home. He knows and understands their needs and tries to build the right package of care around each individual. All of the Residents feel that they are well looked after and are comfortable and happy living in the home. The atmosphere is relaxed and the home is comfortably furnished but could do with a higher level of maintenance and some of the old furniture being replaced. What the service does well: What has improved since the last inspection? What they could do better: The home is comfortable and the residents have what they need, but some redecoration and refurbishment would be an improvement. The furniture in communal areas is of a reasonable standard but once the Residents are all in the lounge it has an appearance of being over crowded and worn. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 6 An induction program has been developed and the staff receives some training, mainly in house. It would desirable if the Manager could access some external training for the staff. 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. Brackens The DS0000006913.V340038.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 Brackens The DS0000006913.V340038.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): All these standards were assessed on this occasion. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Perspective Residents are given enough information to enable them to make an informed choice about the home, Contracts are given along with statement of purpose and the terms and conditions. Visits to the home are arranged for the Resident and their families. EVIDENCE: The home has a Statement of Purpose and Terms and Conditions that are given to Residents and files examined contained contracts. The Manager will visit people in their own home or at hospital to carry out an assessment before they move into the house and the manager will talk to everyone involved to make sure he gets a full picture of their needs before he decides whether the home would be suitable for them. People wanting to move in are encouraged to come and visit the home before they do to meet the other Residents and have a look around. They will be Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 9 invited to stay for a meal. No one moves in until all parties are happy that the home will be able to meet their needs. There is evidence in records of review meetings and that peopled visited the home before moving in. The home will offer intermediate care if they have a vacancy and will endeavour to support the person in a way that will enable him to retain his independence and return home. Brackens The DS0000006913.V340038.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): All of this area was examined during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Plans are written and reviewed, Health needs are addressed and medication is managed appropriately. Residents feel they are treated with respect and can be assured that at the time of their death staff will treat them and their families with care, sensitivity and respect. EVIDENCE: Detailed Care plans are developed from the information gathered during the assessment and are reviewed monthly, additional information is added once the Residents become better known to the home. One contained information about how the confused Resident did not like to be rushed in the mornings and how she would react if she was, there were guidelines for giving her medication and what to do if she refused. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 11 Heath needs are recorded in the care plans and the files examined contained evidence that Residents receive medical attention as needed. There were records of hearing, dental and ophthalmic appointments. The home is next to the GP’s practise and the home has developed a good working relationship with him. He visits the Residents at home and regularly reviews medication. Appointments and their outcomes are recorded. Medication is stored appropriately and recorded as required. There is a copy of staff signatures and the medication is checked when it is delivered. All of the staff receive training and are monitored and assessed before they are able to dispense medication. All of the Residents returned the Commissions survey and said that they believed that they were respected, that they were supported to make their own choices and that their right to privacy was upheld. The Residents have been asked how they wish to be treated during illness and at the end of their life. One Muslim Resident’s file gives detailed information about how he wants his body cared for in the event of his death. The homes Death and Dying Policy is clear in its instructions about how to care for people and their relatives in a respectful way during illness and at their death. It details who to contact and when to sent people to hospital. Brackens The DS0000006913.V340038.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): All of this area was assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home offers a lifestyle that is relaxed and unrushed, cultural and religious needs are addressed and contact with families is maintained and visits are encouraged. Residents believe that they are in control of their lives and are happy with the food offered them. EVIDENCE: The home is very small and the Manager is able to make sure that every Resident experiences the lifestyle of their choice. The lounge, although big enough for all of the Residents to be comfortable, is too small to allow entertainers and formal activities are not arranged but the Manager and staff spend a lot of time with the people living in the home; the Manager will read the paper with the residents and will instigate discussions amongst the group. These discussions are recorded and the topics are wide ranging. It is also usual for the group to do a crossword puzzle from the paper after dinner, the Inspector observed that most of the Residents joined in and managed to complete it. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 13 Resident meetings are regularly held and notes are taken. When asked none of the Residents felt that they wanted activities or entertainment arranged, One person attends a day centre and the Manager said that if anyone requested to attend an activity he would make it possible if he could. Visitors are welcomed into the house and relatives take an active interest in it. Those who responded to the survey felt that the home reached their expectations and offered a good standard of care to their relative. A local Vicar visits some of the people in the home. Other religious needs are set out in care plans and are met. Residents confirmed that they were able to exercise choice and control over their lives. Supervision and staff meeting notes show that Residents rights and treating them with respect is a common topic. The dinning room is in the conservatory and there is just room for everyone if they chose to eat in it, but most of the Residents prefer to eat in the lounge or their own room. The food was well presented and everyone said it was well cooked and that they enjoyed it. Menus are prepared in advance with consultation with the Residents; it is varied and well balanced. Brackens The DS0000006913.V340038.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): All of this area was judged during this Inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that complaints will be taken seriously and acted on. Legal rights are protected and people living in the home are protected from abuse. EVIDENCE: The Commission has not received any complaints about this home and on examination the complaints log did not show any recorded either. The recording system is as required and it would be possible track a complaint from start to finish including timescales. The home has a folder full of letters and cards expressing satisfaction of the service given and giving thanks for the good care given to relatives. People asked said they had not needed to make formal complaints as they were able to discuss any concerns with the Manager and he would always sort out the problem or offer reassurance. Residents are all registered to vote and are supported if they wish to exercise this right. The home does not manage anyone’s finances and will ask a relative to see to their affairs or refer them to an advocacy service if a Resident becomes unable to manage their own monies. The home will keep a small amount of money, topped up by a relative to cover day-to-day expenses. Two purses were examined and found to be in order. Records were kept of expenditure and receipts are kept. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 15 Staff are trained to recognise abuse and how to react if they suspect it. The Homes recruitment policy included obtaining references and a Criminal Records Bureau check before allowing staff to start work. Records show of an investigation instigated by the manager when a Resident was found to have an unexplained bruise on her arm. The Doctor was asked to examined her. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 16 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): All of these standards were judged on this occasion. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Residents live in a safe and reasonably well maintained environment, they have access to comfortable communal facilities and have bedrooms that suit their needs with their own possessions around them. The home is clean and hygienic. EVIDENCE: Health and safety checks are carried out in the home and outcomes are recorded. A sample of safety certificates were examined and found to be in order. The Home is generally of an adequate standard of decoration and well carpeted. Bedrooms meet the needs of the Residents who have their own possessions about them. Although they did not complain the furniture in the bedrooms is old and miss matched which gives the rooms a neglected air and gives a Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 17 negative impression. Consideration should be given to developing a schedule for replacing the bedroom furniture. Recommendation 1 The kitchen is clean and tidy and a previous requirement to repair units has been completed. The old cupboards still remain but were passed as fix for purpose when the Food Standards Agency visited the home to assess their facilities. The Manager has undertaken training by this agency and has joined its “Safer food, better business for caterers” scheme and have obtained the food safety management pack produced by the Agency. The Manager is encouraging staff to use the pack and has passed on his knowledge to them. Repairs required from a previous Inspection have been carried out and the garden pond has been made safe. The garden is secluded and is a pleasant environment. There are still some maintenance issues that need to be addressed but they do not put the Residents in danger and the Manager is aware of them and has applied for a grant to carry out the work. A sink has not been provided in the laundry, there are hand-washing facilities close by but the Requirement to provide hand-washing facilities in the laundry still remains and will be restated. Please see Requirement 1 The flat at the top of the building is no longer occupied by a family with children to there are no longer any concerns that the Residents would be disturbed by their presence in the home. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 18 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): All of these standards were evaluated during this Inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents can be confident that they are in safe hands with sufficient numbers of staff on duty that are supervised, qualified and trained. EVIDENCE: Rotas show that there is sufficient staff on duty to safeguard the Residents and to manage their care needs. Staff receive in house training and a limited amount of external training. Staff files contained certificates for the mandatory training needs, including Moving and Handling, First Aid, Health and Safety and Food Hygiene. The Manager takes the need to train staff seriously and gives extensive induction training, however it is the Inspectors impression that the staff and Residents would benefit if staff were to participate in more formal training sessions in some specialist areas. It will be a Requirement that the Manager carries out an assessment of the training needs of the staff and investigates ways to enable the them to undertake the required number of training sessions a year so that they are equipped to meet the assessed needs of the Residents. Please see Requirement 2 The number of staff who have attained an NVQ in care or an equivalent qualification has met the target percentage of 50 of all staff being qualified. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 19 The Inspector talked to two staff members who were on duty and found that they appeared to have a good understanding of the needs of the Residents and showed a clear understanding of the importance of protecting the Residents from abuse and how to recognise it and what to do if the saw any form of abuse within the home. They confirmed that they received induction and supervision. They also said that their recruitment included references being taken up and CRB checks undertaken. Their files also showed evidence that the recruitment policy was followed as required. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 20 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): All of these standards were assessed during this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is well managed by a person who is committed to offering a good quality of care to the Residents. EVIDENCE: The Manager/owner of this establishment is a Registered nurse who has kept his qualification current. He has managed this home for many years and the residents have expressed satisfaction in the way it is run and how he manages the service. Financial procedures are in place that protects the Residents financial interests; the home does not manage their money and only keeps a small amount for their every day expenses, records of any transactions are made and receipts are kept. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 21 Staff are supervised and house meeting are held when Residents will voice opinions on the running of the home and requests for change will be noted and actioned if possible. The home has obtained a fax machine and although it still does not have a computer the Manager has expressed his preference to handwrite all his work. He has access to a computer if it is needed. Policies and procedures are in place and are reviewed regularly. He is in the process of developing a staff member to assist him in managing the home and to be able take responsibility when he is absent from it. The Manager is in close contact with the Residents and is constantly seeking their opinion of the running of the home and the standard of care offered but he still needs to develop a formal Quality Assurance system and the outcomes must be analysed. Please see Requirement 3 Brackens The DS0000006913.V340038.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 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 2 3 2 3 2 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 3 3 Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP26 Regulation 13 & 23 Requirement The Registered Person must ensure that there is appropriate hand washing facilities located in the Laundry. This is a restated Requirement with a previous time scale of 01/03/07 Timescale for action 20/12/07 16. OP27 18 3 OP33 24 The Registered Person must 20/11/07 ensure that staff have the appropriate knowledge and understanding of the residents identified needs. This must include training in relation to mental health and dementia. This is a restated Requirement with a previous time scale of 01/03/07 The Manager is in close contact 20/11/07 with the Residents and is constantly seeking their opinion of the running of the home and the standard of care offered but he still needs to develop a formal Quality Assurance system and the outcomes must be analysed. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP24 Good Practice Recommendations The furniture in the bedrooms is old and miss matched which gives the rooms a neglected air and gives a negative impression. Consideration should be given to developing a schedule for replacing the bedroom furniture. Brackens The DS0000006913.V340038.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Brackens The DS0000006913.V340038.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!