Inspection on 02/08/05 for Bracknell Nursing Home

This inspection was carried out on 2nd August 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

Bracknell Nursing Home 27/06/08

Bracknell Nursing Home 04/06/07

Bracknell Nursing Home 27/07/06

Bracknell Nursing Home 07/04/05

Bracknell Nursing Home 13/07/04

Bracknell Nursing Home 10/06/04

Bracknell Nursing Home 24/04/04

Bracknell Nursing Home 01/04/04

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

CARE HOMES FOR OLDER PEOPLE BRACKNELL NURSING HOME Crowthorne Road Bracknell Berkshire RG12 7DN Lead Inspector Julie Willis Unannounced 2 August 2005 @ 10:30 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 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 NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bracknell Nursing Home Address Crowthorne Road Bracknell Berkshire RG12 7DN 01344 484584 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Tamaris Healthcare (England) Limited Mrs Lydia Dipuo Makuyama Care Home 30 Category(ies) of Older Person OP registration, with number Physical Disability over the age of 65 years of places PD(E) Physical Disability PD BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Only people over the age of 60 years to be admitted. Date of last inspection 07/04/05 Brief Description of the Service: Bracknell Nursing Home is situated close to the local shopping precinct in Easthampstead. Bracknell Town Centre is approximately one mile away and is accessible via local public transport.The home provides accommodation for up to thirty service users with nursing needs in a variety of single and dual occupancy bedrooms. The service users accommodation is on two levels with passenger lift available between floors.There is a small garden to the rear of the property and parking to the front. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on weekday morning and early afternoon over a period of four hours. A tour of the home was undertaken during which service users accommodation and communal areas were visited. A number of care and health & safety records were examined. The inspector had the opportunity to speak to 10 of the 27 users, 2 relatives, 4 staff and to observe care practice. The inspector spoke with the Homes Manager at the beginning and end of the inspection when brief feedback about the inspector’s findings was provided. There were 2 requirements made at the previous inspection on the 7th April 2005. Both requirements have been met. What the service does well: What has improved since the last inspection? Since the last inspection all users have been provided with a key worker who takes a special interest in their welfare. All staff are being offered regular oneto-one meetings with management to provide them with additional support and advice to enable them to provide the best possible care to users. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 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. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 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 standard(s) 3 All service users are fully assessed by the home prior to admission and a care plan is formulated to meet the users specific need. EVIDENCE: There was evidence that users are visited by the homes management prior to admission to ensure the home will be able to effectively meet their needs. A comprehensive and holistic assessment is undertaken. Information is gathered from a variety of sources and is used to formulate a care plan. Service users confirmed that this assessment visit was very useful as it provided an opportunity to ask questions about the home and to meet some of the staff. One user told the inspector that it was meeting the manager and hearing about the home that made them decide to live their as they thought the manager was “open, honest and kind”. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 There is a clear comprehensive care plan system in place, which provides staff with the information they need to meet service user need. Health needs of the users were well met with evidence of effective multidisciplinary working. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure the safety of users. EVIDENCE: An examination of five care plans indicated that service users health and personal care needs were well met. Records were clear, concise, up-to-date and accurately reflected the needs of users. The use of clinical tools to identify and reduce risk to users was well developed and effective risk management strategies were in place. The care of wounds, dressings and tissue viability issues were well documented. The use of photographs to evidence resolution of wounds and BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 10 pressure sores should be considered as an adjunct to written records, wound measurements, body maps and line drawings. There was evidence in the daily records that users were referred to other health and social care professionals when the need arose and that the home was pro-active in seeking sources of professional advice and support when necessary. Observation of the drug round at lunchtime indicated that the nurses were mindful of the need to follow professional guidance and were accurate in their drug administration and record keeping. The inspector had the opportunity to talk at length to 10 users and 2 relatives. Service users were satisfied with the care they were receiving and highly complimentary about the caring qualities and kindly attitudes of the staff. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 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 standard(s) 15 The meals in this home are good offering both choice and variety and catering for users special dietary needs. EVIDENCE: Examination of the menu indicated that the home is providing users with a varied and nutritious diet, which effectively meets their dietary needs. On the day of inspection the meal provided for lunch was roast chicken, cabbage carrots and roast and boiled potatoes or sweet & sour chicken with rice. Dessert was spotted dick & custard. Tea was soup and mixed sandwiches or fish cakes & chips followed by crème caramel or ice cream. There are always cakes, biscuits and other snack foods available as well as a large range of drinks. Commendably all water jugs are changed at least twice a day. Accurate records are kept by the chef of what users have eaten each day. One user is refusing solid foods and is being provided with nourishing food supplements each day as an alternative. The user has been referred to a dietician for specialist advice and support. Service users confirmed that the food was well cooked and pleasantly presented and appropriate choices were available at each mealtime. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16 The home has a satisfactory complaints system with evidence that service users views are listened to and acted upon. EVIDENCE: Examination of the complaint records indicated that there has been one complaint since January 2005. The complaint is well documented and has been resolved to the satisfaction of the complainant. Service users confirmed that they knew how to raise concerns or make a complaint although none of those spoken with had ever had to make a complaint. Users said that management were approachable and regularly conferred with them about the quality of services provided by the home. They felt that they could make requests or raise issues on a daily basis that would be dealt with without the need to escalate the issue to complaint status. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19, 26 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: A tour of the home evidenced that standards of décor were good, furnishings were in satisfactory condition and the carpets were clean and free from odour. Service users spend most of their day in communal areas, which are bright and cheerful. Meals are provided in the dining area which can accommodate all of the users in one sitting and which is set with bright tablemats and vases of flowers. All bedrooms are personalised by the user to reflect their particular choice and interests. One user told the inspector that they felt the home was “modern clean and comfortable”. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The home has a full compliment of caring and committed staff that can effectively meet the needs of users. EVIDENCE: At the time of inspection the home had a full complement of permanent staff. Agency workers have not been needed at the home in past months, instead staff prefer to work overtime to cover gaps in the roster. Staff were observed to provide care in a discreet and sensitive manner, which maintained the users right to dignity, privacy and independence. The staff have a good understanding of users support needs. This is evident from the positive relationships, which have been formed between staff and residents. Service users confirmed that staff were “caring, kind and helpful”. Discussion with relatives confirmed that staff are responsive and professional in their attitudes and work well together as a team. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 There were some minor shortfalls in relation to health & safety, which could pose a risk to users. EVIDENCE: The temperature of hot water accessible to users in one of the bathrooms (identified during inspection) exceeded a safe temperature of 43c and could pose a risk of scalding to users. Engineers were visiting at the time of inspection and were asked to remedy the problem by the homes manager. This bathroom was also very congested with hoists and other equipment obstructing users access and posing a trip hazard. There is a need to ensure that users are provided with safe access to all bathrooms and toilets throughout the home at all times. BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 2 BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 17 no Are there any outstanding requirements from the last inspection? 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 38 Regulation 13 (4) a Requirement Ensure that all bathroms and toilets are accessible to users at all times and are free from risks to users safety. Timescale for action Immediate By 3.8.05 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 Good Practice Recommendations BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA 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 BRACKNELL NURSING HOME H51-H01 S10977 Bracknell N H V234583 020805 Stage 4.doc Version 1.30 Page 19 - 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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