Inspection on 18/07/08 for Bracknell House Residential Care Home

This inspection was carried out on 18th July 2008.

CSCI found this care home to be providing an Good service.

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

Bracknell House Residential Care... 29/08/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Bracknell House Residential Care Home 34 Helena Road Capel-le-Ferne Folkestone Kent CT18 7LQ Lead Inspector Christine Lawrence Unannounced Inspection 18 July 2008 11:00 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 Bracknell House Residential Care Home DS0000069647.V367359.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. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bracknell House Residential Care Home Address 34 Helena Road Capel-le-Ferne Folkestone Kent CT18 7LQ 01303 254496 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 Bidianund Jaunky Mrs Vindoo Jaunky Mrs Vindoo Jaunky Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29 August 2007 Brief Description of the Service: Bracknell House is a large detached property, located in a quiet residential street of Capel-le-Ferne, near Dover. Whilst retaining some of its original features, the home has benefited from considerable upgrading and modernisation whilst still maintaining an appearance in keeping with surrounding properties. Communal areas and some bedrooms are located on the ground floor with the remaining bedrooms and bathrooms on the first floor, which may be accessed by either one of two staircases, one of which also has a stair lift installed. The home currently has 14 single rooms and three shared rooms. Ten of the single bedrooms have en suite facilities. The home has several small lounges, and a well-used and popular conservatory to the front of the property; a second and larger conservatory has now been installed to the rear of the home overlooking the garden, with a ramped access into the garden. There is limited parking at the front of the property but unrestricted parking is available in the road. The current fees range from between £318.00 and £370.00 per week. Further information about Bracknell House can be provided by the manager on request. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection visit was unannounced and started at 11.00 and finished at 15.40. We, that is the commission for social care inspection (CSCI) looked at various records in the home and also used information sent to us by the manager through her completion of the Annual Quality Assurance Assessment (AQAA). We received surveys from people who live in the home, as well as staff, and information from these surveys is included in this report. Information from the previous inspection was also referred to. A tour of parts of the building was undertaken in the company of one of the owners. We observed staff interacting with residents and we spoke to staff on duty as well as the manager. We chatted to some residents, both in a group and individually. What the service does well: What has improved since the last inspection? Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 6 Improvements have been made to the care plans although there is still some work to do. The medication procedures and storage have been improved. 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. Bracknell House Residential Care Home DS0000069647.V367359.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 Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable to this home) People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs because it assesses their needs before they move in. EVIDENCE: We looked at four individual records for this inspection. They showed that information is gathered before admission about what someone’s needs are. This assessment is carried out by the manager/owner. The assessment covers a range of aspects of daily living and care needs. There was an example of information being provided by the placing authority, including one ‘joint assessment’ involving health care professionals also. The information is used to compile a care plan. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: Four care plans were looked at for this inspection. Three of them were in the revised format that the home is now using and one was in the older format. This one had no risk assessments but Mr Jaunky explained that it would be updated to the new format in the near future and would then contain all the relevant information. Care plans generally contained guidance to staff about care needs and contained information about a range of things such as personal care and physical well-being; diet and weight including dietary preferences; sleeping routines; oral health; mobility and dexterity; foot care; continence; medication usage; physical/mental state and cognition; personal safety and risk; social interests, hobbies and activities and carer and family involvement Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 10 and other social contact/relationships. Risk assessments were also seen and they included falls, taking medications, mobility and diabetes. There is a format for reviewing the care plan on a monthly basis. One example was noted of a care plan not being updated after a resident returned from a stay in hospital, when some care needs had changed. This was discussed with Mr Jaunky and he stated that this would be noted for future similar situations. The care plan contains goals and objectives, based on assessed needs, and actions to be taken. Three people who completed surveys said ‘always’ in response to the question about receiving the care and support you need. Staff who completed surveys were also positive about this and comments included “…staff are informed very well about any changes, either at report or by managers…”. Residents do get involved in discussions about their care and how staff support them and this was confirmed in our discussions with some of the residents. The manager has however identified (within the AQAA) that she would like to encourage more family involvement where this is appropriate. It would be useful if the home noted more formally about how residents are involved in compiling their care plans. The care plan contains information relating to individual’s health care needs and records the involvement of health care professionals such as GPs, consultant’s appointments, chiropody, optical tests and dental appointments. There is a section within the record which is used to keep all correspondence relating to health together. An assessment tool is used when there are concerns about skin integrity and residents weight is monitored monthly. There is a chair exercise session each week. Medication storage (including for controlled medicines) is appropriate and staff who give out medication are suitably trained; they have Certificate of Safe Handling of medication or they are qualified nurses. A form is available for completion in the event of an error. One resident said staff were “…very good at making sure I get all my medication…”. We observed residents being spoken to with respect but also with a degree of banter when initiated by the resident. A member of staff when asking about preferences for lunch and having to speak loudly to some residents, was still able to demonstrate respect for their dignity by keeping the voice level as low as possible and not displaying anything other than patience. Residents told us that staff were kind and patient and didn’t rush them. One said, “…they have been especially kind to me…”. We saw staff knock on doors before entering rooms. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be identified and responded to and that they will be enabled to maintain contact with friends and family. Residents will be enabled to make choices and they will benefit from healthy, well-presented food at a time and place to suit them. EVIDENCE: The daily records and care plans seen show that residents make choices about daily routines such as what time to get up and whether or not to join in activities. A local church provides a monthly service in house which many residents enjoy. People who live at Bracknell House pursue their own interests such as reading (books and newspapers etc), watching television, listening to the radio or music tapes and they also choose to be on their own at times or join others in the communal areas. A notice on display had the following as planned activities within the home:- doing puzzles, board games, book reading, bingo, colouring/art and chair exercises. The care plan contains information about individuals’ social interests, hobbies and family/friends involvement. One person was out at the time of the inspection with a local over 60s club and another person was out with a relative. One person Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 12 continues to attend a day centre used before moving into the home. Residents and staff confirmed that there are no restrictions on visiting. There are lots of pictures on display of past social occasions such as birthday celebrations or Christmas/Easter parties etc. Residents said they can invite their relatives and friends to such occasions. On the day of the inspection the cook was not able to work at short notice. A member of staff stepped in to provide the lunch. She went round to all the residents explaining the situation and talking about what would be for lunch. The residents I spoke to during this visit, and responses made through the surveys completed by people who live at Bracknell House were positive about the food provided (one person commented that they would prefer the food served o warm plates). Mr Jaunky confirmed that special diets can be catered for and residents’ likes and dislikes are known. Residents can choose to have their meals in their rooms or in the dining room. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. EVIDENCE: Mr Jaunky confirmed that there is a complaints procedure in place but there had been no complaints since they had taken over the home. The residents who completed surveys were positive in their responses to the questions about knowing how to make a complaint and being clear about who to talk to if they were concerned about anything. One person specified that they would “…talk to Vin, the manager…” (Mrs Jaunky). All of the staff who completed surveys ticked ‘yes’ when asked if they knew what to do if a resident or relative had concerns. Staff spoken to were aware of their responsibilities with regard to protecting the people who live in the home and they were aware of the policies in place such as disclosure of bad practice and abuse (whistle blowing) and safeguarding adults, as well as those relating to residents’ money and valuables. Some adult protection training has had to be rescheduled due to the training provider cancelling at the last minute. Staff receive guidance about this during induction training and nine members of staff have national vocational training at level 2 or above which also covers this subject. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, well-maintained home which is homely, clean, comfortable, pleasant and hygienic. EVIDENCE: We toured the building with Mr Jaunky. The house is well maintained and decorated and the furnishings are domestic in style although in the AQAA Mrs Jaunky has noted that that there are plans to continue to improve the décor. The garden is attractive and welcoming, providing space and furniture for residents to enjoy sunshine and fresh air. The bedrooms seen during this inspection were personalised and residents spoken to confirmed they were satisfied with their surroundings. The home was clean and fresh at the time of this inspection and residents spoken to and who completed surveys confirmed that this was usual. The Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 15 laundry is satisfactory and many of the staff have received training in infection control and food safety although some still need to undertake this. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: The staff team are a mixture of backgrounds and experience. There were no comments either in the surveys or during the inspection to indicate that there were not sufficient staff on duty. One person said, “…there are times when we might get a bit short of staff but members of staff are always happy to cover plus management helps a lot to…”. Another person said this did not happen very often and “…staff here are very nice and work so well as a team…”. We looked at two staff records for this inspection. Both have NVQ level 2 and one is planning on undertaking level 3 and one has commenced this. The AQAA stated that nine people have NVQ level 2 and two people are currently undertaking this. The records showed that the home has a robust procedure for recruiting staff which includes an application form, a record of the interview, terms and conditions of employment, references and in one case, relevant document relating to permission to work in the UK. There is an induction checklist which covers things relevant to working at Bracknell House but does not reflect the Skills for Care common induction standards. This was discussed with Mr Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 17 Jaunky who agreed to discuss with Mrs Jaunky. In the completed surveys staff were positive about their induction, indicating ‘very well’ or ‘mostly’ about what it covered. They were also mostly positive about the training provided although two people answered ‘no’ in respect of understanding individuals’ needs in relation to diversity. There is a programme of training and Mr and Mrs Jaunky are encouraging staff who have completed their NVQ level 2 to go for NVQ level 3. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: Mrs Jaunky is the registered manager. Mr Jaunky informed me that she has now completed her registered manager’s award although the certificate has not yet been issued. Mrs Jaunky is a registered nurse. The home has an Investors in People award and the quality assurance system in the home now includes sending out questionnaires to residents and their Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 19 representatives. The AQAA was completed when requested but was rather brief and there was not information relating to each of the core standards. The home does not manage any aspect of residents’ finances. We looked at some of the maintenance and service contracts including fire fighting equipment, gas safety, electrical installation and hoists, and these were all satisfactory. There are policies and procedures in place relating to various aspects of health and safety and staff have either received relevant training or it is planned. Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Bracknell House Residential Care Home DS0000069647.V367359.R01.S.doc Version 5.2 Page 23 - 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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