Inspection on 29/08/07 for Bracknell House Residential Care Home

This inspection was carried out on 29th August 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 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... 18/07/08

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

CARE HOMES FOR OLDER PEOPLE Bracknell House Residential Care Home 34 Helena Road Capel-le-Ferne Folkestone Kent CT18 7LQ Lead Inspector Sandra Crosby Key Unannounced Inspection 09:00 29th August 2007 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.V346508.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.V346508.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.V346508.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user in the category LD may continue to be accommodated in the home. 14th May 2007 Date of last inspection 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. The Home is presently registered to accommodate 20 older persons. 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, one shared room being used currently for single occupation. Ten single bedrooms are en-suite. 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 for service users. The garden is accessible to residents, and is used in good weather for sitting out; the garden is securely fenced and backs onto a bridle path and surrounding farmland. There is limited parking to the front of the property, but free parking is available in the nearby streets and roads. The Registered Providers stated that the current fees range from between £312.00 and £360.00 per week. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Registered Providers purchased and took over the home in March 2007, so this was the first key unannounced inspection visit. A random inspection visit was undertaken on the 14th May 2007 following allegations made anonymously. It was indicated at that time that the allegations were unfounded and no requirements were made. The Registered Providers acknowledge that the early months have been difficult mainly in relation to the retention of staff, however currently the home is fully staffed and the Registered Providers are aiming to spend time in updating and reviewing the documentation systems in the home. The key inspection visit was unannounced and carried out on Wednesday 29 August 2007 between 09.00 and 15.30. During the inspection the Inspector spoke mainly with one of the Registered Providers, Service Users, one relative and several members of staff. Some records were seen together with some areas of the home. The atmosphere of the home was welcoming, calm and relaxed, and the home was clean and orderly at the time of the inspection visit. A good rapport between Service Users and staff was seen. The Annual Quality Assurance Assessment (AQAA) documentation completed by the Registered Providers, together with surveys received from Service Users and Relatives and information gained in discussion with the Registered Providers, Service Users and staff has been used in this report. Inspector received the completed AQAA documentation on the Monday before the inspection on the Thursday. It is evident that a great deal of work has been put into the completion of this documentation and good comprehensive information has been provided. This information together with information provided by Service Users, management and staff at the time of the inspection, has been used in this report. Information collected in relation to surveys provided comments for example ‘I am happy here looked after very well the staff are very kind to me‘, ‘any minor problem has always been addressed and resolved promptly’ and ‘I believe the registered providers try to set a high standard and their staff to do the same’. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? This was the first key unannounced inspection since the Registered Providers took over in March 2007. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 7 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.V346508.R01.S.doc Version 5.2 Page 8 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.V346508.R01.S.doc Version 5.2 Page 9 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): Standards 1,2,3 and 6 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose and Service User Guide provide Service Users and prospective Service Users with the information they need to make a decision about moving into the home. The assessment process makes sure that the needs of the person can be met at the home. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 10 EVIDENCE: The Statement of Purpose for the home was seen, and the Statement of Purpose dated January 2007 and the Service User Guide documentation was considered satisfactory at the time of registration in March this year. It was seen that the home obtains completed assessment documentation from Social Services as appropriate, and the Registered Providers confirmed that they carried out their own pre-assessment visits to meet prospective Service Users and assess their needs. The AQAA documentation also states that assessment was undertaken by the Registered Providers of a Service User prior to their admission to the home, and continues to say that close relatives and friends of Service Users have visited the home prior to an arranged admission. New Service Users can therefore be assured that the home is right for them at the start of their stay. One of the Service Users that the Inspector chatted with confirmed how happy and settled they were since they moved into this home. The Registered Providers have provided new Service Users contracts/terms and conditions residence, and a completed contract was seen that had been signed by both parties and dated. One Service User confirmed that they had been residing at the home for short -term care, whilst recovering from being in hospital, and having adaptations made to their own home. The person spoke highly of the care that they had received whilst staying at the home. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 11 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): Standards 7,8,9 and 10 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system is not clear, and does not provide staff with all the information they need to meet Service Users needs. Service Users health care needs are well met, but may not always be documented. The systems for medication administration are mainly good, however issues were discussed in relation to poor recording practice. Personal care is offered in a way to protect Service Users’ privacy and dignity. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 12 EVIDENCE: Two Service User plans were seen, and although all components as required by regulation were contained within the folder, the care plan was not informative as to how care staff provide assistance to meet the needs of the Service User. Regular reviews were seen as part of the care planning system and these again were unclear in places. On the whole risk assessments are in place, however it was found that for one Service User that was prescribed ‘Warfarin’ medication, the medication risk assessment did not address any risks that are known for people taking this medication. The Registered Providers agreed that the documentation needs improvement and discussed that a new care planning system is to be introduced in the coming months. The AQAA documentation states that currently Service Users are registered with four different GP practices, and that District Nurses visit regularly. The Service Users are enabled to access routine health care appointments. The medication records were seen, and on the whole were well recorded and up to date. Some of the information recorded was unclear, and it was also found that a medication had been administered and not signed for. An error in recording was seen in the Controlled Drugs Book, together with a possible error in relation to a controlled drug medication that had been taken on a home visit. The Registered Providers agreed with the findings, and said that the issues of concern would be addressed. The medication storage was also seen, and it was indicated that only sufficient supplies of medication was stored to meet the needs of the current group of Service Users. The Registered Providers said that a medication trolley is on order and should be delivered in the near future. They also confirmed that staff had undertaken medication training, consisting of a one-day course provided by South Kent College. It was seen that staff spend time with Service Users, talking to them and offering discreet assistance that respects dignity. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 13 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): Standards 12,13,14 and 15 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users spoken with confirmed they were happy with the lifestyle they had living at the home. Service Users are encouraged to maintain contact with family and friends. The meals in the home are good offering both choice and variety and catering for special diets. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 14 EVIDENCE: Several Service Users were chatted to during the course of the inspection visit. All had positive things to say about the home, for example the staff were kind and caring, the meals were good and alternatives are always available. Service Users called Registered Providers and staff by their first names and said that this is a very friendly place. The home has a volunteer who provides support during group activities. The Registered Providers talked about the extra efforts made to celebrate individual Service Users birthdays, to make these occasions special. The AQAA documentation states that daily social activities are organised by the cook, housekeeper and care staff. A number of Service Users are able to take visits out with family and friends and one of the Service Users relatives spoken with confirmed this and spoke very positively about the care their Mother has received since admission to the home. The record of the meals provided need to be more comprehensive in order to provide the evidence to show that a varied and nutritious diet is available, and also provide a record of the alternatives offered. The Registered Providers agreed to address this issue, and to review the weekly menus. Through discussion with a number of Service Users, it is indicated that the food provided at the home is good, varied and nutritious with alternatives available. The Registered providers talked the positive comments they had received in relation to the provision of a fresh fruit salad being provided regularly containing a number of different fruits. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 were inspection at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system that indicates that Service Users feel that their views are listened to and acted on. Policies and procedures are in place to safeguard Service Users from abuse. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 16 EVIDENCE: The Registered Providers confirmed that there have been no verbal or written complaints from Service Users or their representatives, since they took over the home in March 2007. There have been anonymous allegations made about the home since the Registered Providers took over in March 2007. A random inspection visit was carried out on the 14 May 2007, following allegations made and no evidence was found to substantiate the issues raised. No requirements were made at that inspection visit, however two recommendations were made in relation to good practice. This key unannounced inspection visit also looked at issues raised from further allegations, and it is indicated that the home at the time of the visit on the whole is meeting the required standards, and that Service Users and their families are happy with the care provided at the home. The AQAA documentation states that procedures for responding to suspicious or evidence of abuse or neglect are in place together with whistle blowing policies and procedures. The Registered providers confirmed that some staff need to attend training in relation to Adult Protection, but also indicated that this is covered at Induction, and also is included in NVQ training. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 17 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): Standards 19,20,21,22,23,24,25 and 26 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a home where the routine maintenance, decoration, and renewal of the fabric of the premises are exemplary. The addition of the conservatory enhances the homeliness and comfort of the communal facilities provided for Service Users, offering extra choice. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 18 EVIDENCE: The premises are presented to a good domestic standard. On the outside the fabric of the property looks to be in good order. On the inside most areas are well decorated, comfortably furnished and clean. The rear garden is laid to lawn with flowerbeds and contains garden furniture for Service Users to use weather permitting. The dining room on the day of the inspection was well presented with co-ordinating tableware. An accompanied tour of some areas of the premises was made and Service Users spoken with confirmed that their bedrooms were comfortable and suitable to meet their needs. It was seen that the bedrooms are well appointed and all contained personal possessions of the Service Users. Re-decoration within the home is ongoing. A number of adaptations were seen during the tour of the premises for example special mattresses, chairs, raised toilet seats and a special lamp to aid a partially sighted person. The AQAA documentation states that referral for special aids and equipment for moving and handling of Service Users is to be made to the appropriate local authorities and the NHS. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 19 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): Standards 27,28,29 and 30 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users needs are mainly met at all times by the numbers and skill range of the staff. Service Users are protected by the home’s thorough recruitment procedures, and staff training is ongoing. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Registered Providers confirmed as stated in the AQAA documentation that there are three carers on duty during the day, and two carers at night. The care staff are supported by the Registered Providers as necessary together with ancillary support of a cook and housekeeper. This staffing level was evidenced at the time of the inspection visit. Following discussion with the Registered Providers and staff it was found that the housekeeper works four days a week, the cook works five days a week, and the care staff are responsible for laundry duties. It is therefore indicated that there may not always be sufficient staff on duty at all times to meet the needs of the Service Users. The Registered Providers said that other family members also work at the home and cover some of the duties discussed. The Registered Providers were requested to maintain a full and accurate staffing rota in order to provide evidence that the home meets the required staffing level at all times. The Registered Providers agreed to do this. The Registered Providers acknowledged that staffing has been a difficulty over the early months when they first took over, and this has meant that they have put in many hours working as part of the team, however they confirmed that the home is now fully staffed and they now had the opportunity to update and improve the documentation systems within the home. Two staff files were checked, and were seen to contain all the required information. This indicates that a thorough recruitment procedure is in operation at the home. The Registered Providers confirmed that sufficient staff were trained to NVQ Level 2 to meet the requirements of regulation and that three carers are to commence NVQ at the local college in the near future. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 21 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): Standards 31,33,35,36 and 38 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users benefit from a well run home, and on the whole the health, safety and welfare of service users and staff are promoted and protected. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Registered Providers are experienced in working in the care profession, and aim to achieve an open, positive and inclusive atmosphere. The Registered Provider/Manager is to commence NVQ Level 4 in Management in the near future. It was confirmed by the Registered providers that they do not handle any personal allowance monies for Service Users at the home. Regular supervision is undertaken with written records kept. Staff have recently undertaken training in relation to Fire Safety. The home does not as yet have a fully implemented Quality Assurance system, however there have been staff meetings, and also relative and Service User meetings, these being held to keep people fully involved of development within the home. The Registered Providers confirmed that they will be developing surveys in order to obtain the views of Service Users and their families in the coming months. Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 23 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 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 3 2 3 3 3 3 STAFFING Standard No Score 27 2 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 3 X 3 Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 Timescale for action A service user plan of care 31/12/07 generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered The registered person ensures 31/08/07 that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines Requirement 2. OP9 13(2) 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 OP27 Good Practice Recommendations To ensure that the staff rota clearly identifies lines of accountability and the role of staff and includes all hours worked by staff and management Bracknell House Residential Care Home DS0000069647.V346508.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local 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.V346508.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. 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