Inspection on 17/07/06 for Brackenthwaite

This inspection was carried out on 17th July 2006.

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

Brackenthwaite 19/01/06

Brackenthwaite 24/05/05

Brackenthwaite 22/09/04

Brackenthwaite 04/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Brackenthwaite Senhouse Street Whitehaven Cumbria CA28 7ES Lead Inspector D Jinks Unannounced Inspection 17th July 2006 10:30 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 Brackenthwaite DS0000036544.V294363.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. Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackenthwaite Address Senhouse Street Whitehaven Cumbria CA28 7ES 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) 01946 852561 www.cumbriacare.org.uk Cumbria Care Ms Susan Meyers Care Home 30 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (30) of places Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. A maximum of thirty older people (30 OP) including three people over the age of 65 with dementia (3 DE(E)). The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults . When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 19th January 2006 Date of last inspection Brief Description of the Service: Brackenthwaite provides accommodation and care for up to 30 older people, 3 of whom may have dementia. The Home is situated in the centre of Whitehaven, close to all the towns services and amenities. Brackenthwaite is operated by Cumbria Care, an internal business unit of Cumbria County Council. The accommodation is provided on three floors and there is a passenger lift for ease of access. The Home is divided into three separate living areas. On the ground floor there is a lounge/dining room with small kitchen, plus a further quiet lounge with bedrooms, toilets and an assisted bathroom nearby. Also on the ground floor is another lounge/dining room, and the bedrooms and bathroom for the people who use this lounge are on the third floor. There is a lounge that can by used by those people who wish to smoke, and a spacious entrance hall with seating. On the second floor there is a lounge/dining room with small kitchen area, with bedrooms, toilets and assisted bathroom nearby. There is a garden area to the rear of the home with raised flowerbeds, a greenhouse and seating. There is parking to the side of the home. The home produces a guide to the services and facilities provided by the home and this is available on request from the manager. The scale of charges range from £317.00 - £422.00 per week (April 2006), subject to the assessment. Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of this service included a visit to the home, a meeting with the senior person in charge of the home on the day and the manager of the home. The views of some of the people living in the home were obtained through discussions and the completion of questionnaires. Comments from relatives and visitors to the home were also received via questionnaires. The manager of the home completed a detailed questionnaire about the home and the services that it can provide. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to ensure that all the work that has been carried out so far regarding the activities at the home is continued and built upon. This will help to ensure that people living at the home are given sufficient opportunities for stimulation through leisure and recreational activities both within and outside of the home. Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 6 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. Brackenthwaite DS0000036544.V294363.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 Brackenthwaite DS0000036544.V294363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 (Standard 6 is not applicable to this home). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives are provided with sufficient information about the home in order for them to make an informed choice. The manager ensures that care needs assessments are carried out prior to admission to the home. This helps to ensure that the home is appropriate and able to meet the needs of service users. EVIDENCE: Service users and their relatives are provided with information about the services the home provides, prior to their admission to the home. They are also given a copy of their contract and the terms and conditions of residence. The home offers a trial period, initially of 6 weeks. At the end of this time a review takes place to ensure that the needs of the person can be met by the home and that the service user is happy with their choice of home. A copy of the home’s service user guide is available on each floor of the home for reference. Service users have their needs assessed prior to admission to the home. This helps to ensure that the home will be able to meet the person’s requirements Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 9 and expectations. Copies of assessments, including assessments carried out by health and/or social care workers are obtained prior to admission to the home. Brackenthwaite DS0000036544.V294363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users health and personal care needs are clearly set out in an individual plan of care and help demonstrate that people are treated with respect and dignity. EVIDENCE: Each person living at the home has a very detailed and informative plan of care. The plans contain information from the care needs assessment and are reviewed and updated to reflect the changing needs of the resident. Detailed actions for staff to follow and the goals and outcomes for service users are clearly recorded in the plans, which have been agreed and signed by the service user and/or their relative where appropriate. Care records indicate that people living at the home have access to health care services and the doctor and district nurse visited the home on the day of the inspection. Appropriate measures are taken for people who have been identified as being at risk of pressure sores. Specialist mattresses and equipment are in place and professional advice is sought when necessary from Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 11 the community nursing staff. Nutritional screening and assessments have been undertaken for each resident and are reviewed at regular intervals. The home has medication policies and procedures in place to help ensure that medicines are administered and handled safely. Staff are made aware of the medication procedures at the home and almost half of the staff employed at the home have undertaken an accredited course in the safe handling of medicines. The medication records looked at during the inspection have been maintained properly and include the dates medication was received, the name, strength and amount of the medication received. Administration records are signed for appropriately. The home has a policy of using two members of staff when administering medication; the second person is there to check the medication administered, again to help ensure that medicines are administered correctly and safely. People living at the home are able to manage their own medication if they wish. This is subject to an assessment, which covers all aspects of the administration of medicines, including safe storage. A secure storage space is provided in the service users own room. At the time of the inspection there were no service users responsible for administering their own medication (with the exception of inhalers). Service users were treated with respect and dignity. An incident occurred during the inspection where a service user slipped off their chair. Staff dealt with this quickly and sensitively ensuring that the person was not injured. Consideration was also given to the other residents who were close by and staff were seen reassuring them. Medical treatments are carried out in the privacy of the resident’s own room. The people living at the home are able to choose where they see their visitors. This can be in one of the communal areas or their own room for more privacy. Brackenthwaite DS0000036544.V294363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not always meet the social and leisure expectations and preferences of people living at the home. This potentially places limitations on the independence, autonomy and choice for the people living at the home. EVIDENCE: People living at the home indicate that there are not enough social and leisure activities available at the home. They feel that at times there are not enough staff to help provide such activities. The manager is trying to address this and a member of staff has recently been allocated some extra hours to arrange and organise activities for people living at the home. She is very enthusiastic and has consulted service users about their interests and wishes as well as using her own ideas. She has started to keep records of activities that individuals have taken part in and hopes to build on this. Activities tried so far include, board games, trips out into the local town, visits to the library and arts and craftwork. At present only a few people have benefited from these activities as most of them are done on a one to one basis. The work needs to continue and staff allocated more time for such activities in order for all people living at the home to have the opportunity and encouragement to take part if they wish. Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 13 Once a week young people come to the home as part of an organised voluntary group to talk to residents and play board games with the people living in the home. A list of the activities available at the home is posted on the lounge/dining area doors. Residents meetings take place at the home and relatives are also able to attend these meetings. The minutes kept from recent residents meetings indicate that the people attending the meetings are happy with the activities on offer. Minutes of one of the meetings indicate that a long debate took place regarding meals/mealtimes and choices. Fillings for sandwiches and jacket potatoes were also debated. The cook was involved and kept notes of likes, dislikes and discussions with service users about the meals. The menus have been reviewed following the meetings and discussions. People living at the home are able to receive visitors at any time. They are made most welcome and are offered refreshments if they wish. People living at the home generally thought that the food was very good. The cook and the manager have discussed the menu choices with service users as a group and also as individuals. The cook keeps records of her menus, and frequently discusses the food choices with residents. The cook keeps records of these discussions. Nutritional monitoring records are kept where service users continued health and well-being might be at risk. Specialist advice has been sought where required and nutritional supplements obtained. Three full meals are provided each day with a range of snacks and drinks available throughout the day. Where sandwiches or jacket potatoes are on the menu a daily list of the choices of fillings is available for service users to choose. This list should be extended to the choices at breakfast to ensure that all service users are aware of what is available. Where communication difficulties have been experienced, the manager has sought advice and obtained pictures of foods in order to help service users choose their meals. There is a small kitchen area in each lounge and service users are able to make themselves drinks and snacks. This is subject to a risk assessment to ensure the safety of the service user when carrying out such tasks. Brackenthwaite DS0000036544.V294363.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 inspected at least once during a 12 month period. 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 are confident that their comments or concerns will be listened to and acted upon appropriately. This openness helps to ensure that people living at the home are protected. EVIDENCE: The home has a clear and accessible complaints process. A copy of the complaint process is available in each service users room and a copy is also contained in the service user guide. The manager has not received any complaints recently. The people participating in the inspection were aware of whom to direct any complaints to and indicated that they had not had to make a complaint. People living at the home would tell the manager if they have a problem and are confident that staff will listen to them. Staff at the home are made aware of the policies and procedures during their induction training and refresher training is given at various intervals or when policies have been updated. Staff also receive training in adult protection or the mistreatment of adults and the home has policies and procedure for dealing with allegations of adult abuse should this ever occur. Brackenthwaite DS0000036544.V294363.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 at least once during a 12 month period. 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 live in a home that is clean, hygienic and maintained to a high standard whilst maintaining a homely atmosphere. This helps to ensure their safety and comfort. EVIDENCE: A domestic is employed at the home and this helps to ensure that it is maintained to a clean and hygienic standard. Residents and visitors commented on the high standard of cleanliness at the home. The domestic has received training in various subjects including infection control. Several areas in the home have recently been redecorated. This includes eight bedrooms, a small conservatory and the staff toilet and changing area in the kitchen. There is a small lounge available for service users who wish to smoke and this is kept clean and fresh. All the communal bathrooms and toilets are equipped with soap dispensers, paper towels, disposable gloves and aprons to help maintain infection control. Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 16 The communal lounges, dining areas and service users own rooms are decorated and furnished to a high standard. Service users are able to personalise their own rooms with small items of furniture, ornaments and pictures. Throughout the home there are hand rails to aid mobility. Bathrooms, showers and toilets are equipped with grab rails, bath chairs and emergency call bells. There are hoists available on each floor of the home for use by staff if necessary. The laundry was found to be suitably equipped and maintained in a clean and tidy condition. There is a pleasant garden area at the home and some new garden seating has recently been provided so that service users can sit outside if they wish. On the day of this visit to the home two communal bathrooms were used as storage areas, they were not locked. This was discussed with the manager because of the potential risks to people living at the home. Brackenthwaite DS0000036544.V294363.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home follows robust recruitment procedures. Staff participate in regular and relevant training courses. This helps to ensure that appropriate and competent staff care for the people living at the home. EVIDENCE: The home has not recruited any staff since the last inspection. The way in which the home recruits staff was looked at during the last inspection. The home was found to be following a robust process including carrying out all the checks necessary to help ensure that suitable people are appointed and service users are protected. The staff work rota indicated that sufficient numbers of staff were on duty at the time of this inspection. Staffing included the cook, kitchen domestic and a supervisor. People living at the home indicated that staff are usually available when they need them and that they generally receive the support necessary to meet their care needs. However, comments were also received to indicate that there is not always enough staff available to ensure the social and recreational needs of residents are met. Staff training and development plans showed that staff had participated in relevant training in order to help them meet the needs of the people living at the home. The training includes specialist training in dementia care and over half of the staff employed at the home have gained a National Vocational Qualification (NVQ) in care. Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 18 One of the staff records indicated that they had participated in various training courses and the manager was advised to obtain verification of this training. Brackenthwaite DS0000036544.V294363.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 at least once during a 12 month period. 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. The home is run by a competent and knowledgeable manager who ensures that the home is run in the best interests of the service users. EVIDENCE: The manager has many years experience of working in care. She has recently completed the Registered Managers Award. Several discussions took place during this inspection and the manager demonstrated that she keeps her knowledge and skills up to date. She has obtained advice from various resources to ensure that she is aware of up to date guidance, legislation and good practice. There are clear lines of accountability within the home and the manager is supported in carrying out her role by a number of experienced care supervisors. An action plan was produced by the manager to ensure that any requirements from the last Brackenthwaite DS0000036544.V294363.R01.S.doc Version 5.2 Page 20 inspection were met in order to raise the standards of care and safety at the home. There is a quality assurance system at the home. This involves regular monitoring of the policies and procedures and the manager ensures that staff familiarise themselves with these documents at frequent intervals. Service users, relatives and staff are requested to complete quality questionnaires and this information helps to produce the home’s annual improvement and development plan. Where the home takes care of service user’s money, written records are kept. The records are individual and arrangements are in place to ensure that money belonging to service users is kept in respect of each individual and in a secure place. Staff training records indicate that they participate in health and safety training including, first aid awareness, infection control, moving and handling, fire procedures and food hygiene. Risk assessments have been carried out and are reviewed in order to keep them up to date. A visit to the kitchen was made during this inspection. The food storage areas and the kitchen were found to be in a clean, tidy and hygienic condition. Food stored in fridges and freezers had been resealed properly, labelled and dated. The food storage areas are kept in a very organised manner. Records relating to maintenance, health and safety and fire fighting/detection systems were kept up to date. Accident records were maintained and the manager ensures that any incident that affects the well-being of a service user or the safety of the home is reported to the Commission. Brackenthwaite DS0000036544.V294363.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Brackenthwaite DS0000036544.V294363.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. 1. Standard OP12 Regulation 16(2)(m) Requirement The home must provide suitable facilities and a programme of suitable activities to ensure that service users social, cultural, religious and recreational interests and needs are met. The manager must ensure that rooms used for storage are kept locked at all times. Timescale for action 30/09/06 2. OP19 13(4)(a) 23(2)(l) 31/08/06 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 OP15 Good Practice Recommendations Where sandwiches or jacket potatoes are on the menu a daily list of the choices of fillings is available for service users to choose. It is recommended that this type of list be extended to the choices at breakfast to ensure that all service users are aware of what is available. Where staff claim to have received relevant training and qualifications, the manager is recommended to obtain documentary evidence to verify the claim. DS0000036544.V294363.R01.S.doc Version 5.2 Page 23 2. OP30 Brackenthwaite Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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