Inspection on 18/10/05 for Brackens The

This inspection was carried out on 18th October 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brackens The 03/03/09

Brackens The 16/07/07

Brackens The 27/06/06

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 Wendy Owen Unannounced Inspection 18th October 2005 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 Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 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.V256179.R01.S.doc Version 5.0 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.V256179.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2005 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 29 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, various hours. In addition, he provides the on call cover when he is not on duty.All 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.V256179.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one morning with two inspectors undertaking the inspection. This inspection included a tour of the premises; discussions with residents, member of staff and manager and viewing of records. The inspectors also monitored the progress of the implementation of the requirements and recommendations raised at the previous inspection. There were eight residents in the home with one vacancy at present. What the service does well: What has improved since the last inspection? The home has progressed and continues to progress with areas of core training for staff. There has also been progress in the number of people with and registered to undertake the NVQ qualification. The last report also detailed to the need undertake remedial repairs on the fixed electrical wiring to ensure the wiring within the home was safe. This has been completed. Care plans which record the residents’ needs and how they are to be met, have also improved, with the records reflecting the care required. The testing of the hot water temperatures showed them to be running within the required temperatures, in most cases and all radiators have now been covered ensuring the protection of service users from injury. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 6 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. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 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.V256179.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: There have been no new residents admitted since the last inspection. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 The health and personal care needs of service users are being met and staff are aware of the needs of residents as identified in the care plan. EVIDENCE: Two care plans were viewed and found to be adequate in the content and in the main, reflected residents’ identified needs. However some suggestions for improvement were advised. Particularly, in relation to communication needs. The last report also identified the need to improve the risk assessments in relation to pressure care. This requirement has now been implemented and the pressure care assessment details the care and actions required by staff to minimise the risks. There was a medication policy available and a brief statement in respect of medication errors. The medication policy, in respect of medication errors, advised staff to try and remove the tablets, advise the GP and, if necessary, contact emergency services. More information could be incorporated into this section of the policy to include notification of next of kin and include, as necessary, a review of records, storage and administration procedures, to prevent further errors occurring. (See recommendation 1) Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 10 The home has the mediform system in place. The medication charts for this system are quite condensed and space for some information is limited particularly receipt of medications. The medications are hand written on the administration sheets and on the front of the sheet there is a short sentence stating two persons have checked the medications. On some occasions this statement had only one signature in place. Mr Jhurry advised the inspector that two people administer all medications. There were no gaps in the records seen and allergies were recorded. Clear photographs were in place. Those medications returned to pharmacy are documented on the front of the medication charts. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 & 15 The home offers some stimulation to residents, which meets their needs. Whilst meals offered are nutritious, healthy and balanced, there are no records to determine what residents actually receive to ensure their dietary needs are being met. EVIDENCE: As the inspectors arrived the residents were having tea in the lounge. Six residents were in the lounge and two in their bedrooms. Tea was served in mugs with biscuits and one gentleman had fruit, which was cut up. The inspector spoke to the group of six residents. Discussion focused on their stay, type of accommodation, meals including choices and snacks, and staff attitudes. Almost everyone in the group participated in this discussion and favourable responses received. One area which was not clearly responded to by some of the residents, was the menu alternatives and what was available should the resident not want the meal offered. Alternatives were stated a sandwiches although not other hot choice was referred to. The staff should maintain a record of the food eaten by Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 12 each resident, not as is the current case a record of the food provided generally. (See requirement 1) In respect of quantities of food one lady remarked that she never needed them. Biscuits and fruit were said always to be available. In relation to the activities, residents referred to the TV, radio and crosswords. One resident stated that he goes out to the local shops. Another resident stated that there was a visiting priest and hairdresser. One resident said he was “ sick of playing cards”. Most residents seem to receive visits from family and friends. The two residents in their own bedroom gave little feedback to the inspector and one seemed quite annoyed by the inspector’s presence. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 EVIDENCE: This standard was inspected at the last inspection and found to be satisfactory. There have been no complaints since this time. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24 & 26 Some improvements in the décor have been made providing a warm and comfortable environment for residents. There have also been improvements in the covering of radiators and fitting of thermostatic valves which provide a safer environment for service users. EVIDENCE: The physical environment is adequate but homely. The bathrooms, WCs some of the private areas and corridors have, since the last inspection, been redecorated. This has been completed to a basic standard with all areas decorated in the same colour scheme. A group of service users spoken to were all satisfied with the accommodation provided. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 15 Hot water valves have been fitted in most areas the hot water temperature in the first floor bathroom was still running at 55 degrees although the Manager states this bathroom is no longer used. Radiators are covered in all areas. There is a need to ensure the cover, in one bedroom area, is fixed. (See requirement 2) The home was of a reasonable standard of cleanliness with no offensive odours. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 The procedure for the recruitment of staff are not robust enough and do not provided adequate protection. Staff training has improved providing competent staff to provide the care and support required by residents. EVIDENCE: The recruitment procedures require some improvement to ensure residents are protected from unsuitable staff. Shortfalls include incomplete application forms and lack of exploration of gaps. Criminal Records Bureau Checks were absent on one of the three files viewed and the references provided were, in the main personal, with lack of references in relation to the last employer. (See requirement 3) Discussions with service users showed that they felt there are enough staff on duty and staff are competent in their roles. A staff member was seen feeding residents in a very patient, gentle manner even though this was very time consuming. She confirmed that she had received training in medication, infection control, three- day first aid, fire training and basic food hygiene. Staff received praise with comments such as “ always there if you need them”`. The records viewed showed evidence of training that has been undertaken and is currently taking place. These are relevant to the requirements of the home and cover core areas. The last report identified the need for all staff to be Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 17 trained in food hygiene, as they are all involved in food preparation. This training is currently taking place through distance learning. Infection control and moving, medication and moving and handling training have all been undertaken over the last year. The training records could be organised in a more user- friendly way, which would also ensure that updates are regularly undertaken such as in fire instruction and adult protection, ensuring all information is up to date and residents remain protected. There has been some improvement in the number of staff trained to NVQ 2 or above with two members of staff have NVQ 3 with three currently registered to undertake NVQ 2. When this complement have achieved the qualification the 50 target will almost be met. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34,35 & 38 The home is being managed adequately but there are areas for improvements to ensure the quality of care is reviewed regularly to meet residents’ needs. EVIDENCE: The last report identified the need for remedial work to be undertaken on the fixed wiring. This has now been addressed and a satisfactory report provided. Health and safety training procedures include training such as infection control, moving and handling, food hygiene and safe handling of medication. This is good practice promoting their health, safety and welfare. All accidents are now fully recorded. Since the last inspection last inspection the home has once again achieved a Clean Food Award and the inspection report showed a satisfactory outcome. Two residents finances were randomly selected and checked .The residents have monies stored in tins with a small book in which records relating to Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 19 income and expenditure are noted. There were very few receipts available in the two books. There was evidence that there next of kin / appointee confirms any expenditure by signing the book. (See requirement 4) The insurance required for the home expired on the day of the inspection. The Manager could not supply the Commission with evidence that the home would be insured after this date. This must be sent to the Commission without delay. (See requirement 6) There are no quality assurances systems in place with the manager relying on his regular contact and informal discussions with residents and relatives. This may not always provide individuals with the opportunity, in confidence, to provide honest feedback. Nor are there are any systems in place for monitoring the systems and procedures used within the home. (See requirement 5) Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 20 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X 2 3 3 x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 2 2 X X 3 Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 21 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. 1 Standard OP15 Regulation 17 Requirement The Registered Person must ensure accurate records are made of the food provided and taken by each individual in the home. The Registered Person must ensure that the radiator cover located in one bedroom is adequately fixed. The Registered person must ensure that the appropriate checks are made on all new employees prior to the commencement of employment. The Registered Person must ensure receipts are maintained, whenever possible, where the home has spent money on a service users’ behalf. The Registered Person must ensure that a review of the quality of care provided must be undertaken regularly. This must include consultation with service users. The Registered Person must ensure there is adequate insurance in place. Timescale for action 01/11/05 2 OP19 23 01/11/05 3 OP29 18 01/11/05 4 OP35 17 01/11/05 5 OP33 24 01/04/05 6 OP34 25 01/11/05 Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 22 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 2 Refer to Standard OP9 OP33 Good Practice Recommendations The medication procedures should be further elaborated to include notification of next of kin and a review of records, storage and administration procedures. The Registered Person should investigate the implementation of a quality assurance system which would provide monitoring and auditing within the home. Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brackens The DS0000006913.V256179.R01.S.doc Version 5.0 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. 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. 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