Inspection on 07/07/05 for Braemar House

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Braemar House 19/09/07

Braemar House 31/05/06

Braemar House 28/10/05

Braemar House 05/10/04

Braemar House 29/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Braemar House 38 Seaway Road Preston Paignton TQ3 2NZ Lead Inspector Michelle Finniear Unannounced 7th July 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Braemar House Address 38 Seaway Road, Preston, Paignton, Devon,TQ3 2NZ 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) 01803 666011 Miss Rian Marie Hill Miss Cara Hill, Mrs Anna Teresa Hill Miss Rian Marie Hill Learning disability (12), Learning disability over 65 years of age (12) Care Home Category(ies) of 12 registration, with number of places Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12/10/04 Brief Description of the Service: Braemar is a large detached property situated on the level, near the beach and all local facilities, whilst being within easy walking distance of the local Community Resource Centre. The home provides accommodation for up to 13 adults with learning difficulties who may also have some level of physical disability. The home is situated in a residential area of Preston and service users are encouraged and supported to be an integral part of the local community. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours on a late afternoon and evening in July 2005. The timing of this inspection was to allow for service users to be seen, the majority of whom go out to day opportunity placements throughout the day. To complete the inspection a tour was made of all areas of the home, all service users not away on holiday were met, and discussions were held with the owners and staff on duty. Some records about service users were seen, and the arrangements for medication were inspected, including storage facilities. What the service does well: Braemar provides a comfortable and informal living environment, close to local shops, facilities and the seafront of Paignton. The home has access to transport facilities, but is within easy walking distance of the local resource centre. Service users have personalised and individual accommodation in single rooms, many with ensuite facilities, and a choice of communal space. Many of the service users have lived at the home for a significant number of years as a group, and are well settled with strong relationships between them. This could be seen with one service user in particular who has deteriorated physically in the last two years, but is however included in all activity, even the recent group holiday. The home is family run, with owners who work at the home daily, and at the time of the inspection ‘live in’ at the premises. This means they know the service users very well, and are in close contact, so would be able to identify problems at an early stage. The home has good systems for consulting with service users, staff and relatives about how the home operates. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Discussions were held with the owners on ways in which to ensure contact whilst away on holiday. This is because the home closes when all service users go away together, and therefore relatives would have no way of contacting the owners in case of a problem they were having. The owners and service users were fully able to contact relatives at any time if there was a concern. As a result of the discussions the home agreed that a special mobile telephone would be taken with them on holiday on which they could be contacted, or messages could be left, which they would pick up regularly. The home is advised to discuss the potential use of thickeners with a dietician, which may help to assist a service user who was finding drinking difficult. No other areas were identified during the course of this inspection. Please contact the provider for advice of actions taken in response to this Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 Information is provided about the terms and conditions of the home, in a way that service users will be able to understand. EVIDENCE: Since the last inspection the home has provided a service user accessible contract. This is available in a symbol and picture format, with photographs of relevant people, activities and places. This contract is to be implemented for all service users. This is in addition to the social services contract which is in place. The contract details information for service users such as how and by whom the fees are to be paid, and what they are entitled to receive in respect of the payments made. This means that service users and their advocates know what the fees are and what to expect prior to admission, to help them in making a choice about whether the home is where they want to live. An application will need to be made for one service user who is now falling outside of the homes categories of registration, but is however having their needs well met. This is to ensure the categories of registration reflect the service users in the home. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 Braemar provides a caring environment where service users care and healthcare needs are assessed, recorded and met in a consistent fashion. Service users lifestyle choices and preferences are respected. EVIDENCE: Each service user at the home has an individual plan of care, related to an assessment, and regularly updated. Plans for two service users were selected at random and found to contain appropriate information in relation to the individual service user, copies of correspondence, and sufficient information to ensure consistent care is delivered. Plans contain information on the management of risks. Evidence was seen of specialist healthcare support being provided including mammography services, diabetic nurse specialists and optical care. This means that service users care needs are identified and met. Discussion with the registered owners and staff showed a clear understanding of the rights of individuals and their commitment to ensuring service users autonomy is maximised. Choices could be evidenced in changes to décor, mealtimes and activities. The home has regular service user meetings, but many issues are raised during mealtimes or more informal interactions during Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 11 the day, or whilst carrying out care tasks. This means service users are having a say about the way in which the home is run. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14 Service users at Braemar follow full and active lives. EVIDENCE: The evening meal on the day of this inspection was macaroni cheese. Service users had mostly been at day opportunities during the day to which they had taken packed lunches. Service users are encouraged to participate in the local community and follow a full and active life. Service users spoke of the recent holiday they had all been on as a group, which had involved flying to Scotland, and had clearly been greatly enjoyed. Service user bedrooms demonstrated evidence of hobbies and interests, including achievement certificates and college attendance certificates. One service user demonstrated a vase they had made, and others showed photographs of their family and friends. Another had an achievement portfolio and evidence of college work they had completed. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 13 Service users attend a local community resource centre, and other special needs facilities such as the gateway club and Rafters nightclub. Service users enjoy take-aways and trips out to pubs, shops, theatres, bowling and the cinema. This means service users maintain contacts with the local community, as well as have fun. The home has many photographs of outings and holidays which are displayed throughout the home. The home is situated in a residential area, close to local shops and the seafront. This means service users can use local facilities without having to use transport. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Medication at the home is stored and administered safely. EVIDENCE: The home uses a blister packed system, which means that medication is prepackaged by the local pharmacy. Medication is stored safely in a locked cupboard and all medication is checked into the home. Staff at the home are administering insulin to one service user through a pen system. The staff have received training in the use of this system and an overview of diabetes. Staff monitor blood glucose levels regularly, and the service user is under the care of a specialist diabetes nurse. This means their care and health is regularly kept under review. Evidence of other healthcare specialists were seen, such as dental, GP’s optical and well person clinics. No service users deal with their own medication. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a complaints procedure which ensures service user views are listened to and acted upon. EVIDENCE: The home has a complaints procedure, accessible to service users. Other strategies for ensuring service users are able to voice any concerns or issues include regular surveys and daily open discussions with service users where they are encouraged to voice opinions. No formal complaints have been received. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,30 Braemar provides a comfortable, homely, clean and safe environment in an accessible location for people wishing to enjoy an active life. EVIDENCE: On this unannounced visit to Braemar, all areas of the home seen were clean, warm and comfortable. The hallways had been redecorated the week before and a new wheelchair accessible shower had been fitted to the ground floor bathroom. In addition a new laundry, office and visitor room had been provided. This means the environment is looking more attractive to live in. Service user bedrooms are individual and attractive, showing evidence of their personal interests and tastes in colours and styles of furnishing. There are ten single bedrooms, mainly with ensuite facilities, and one room for shared occupation which is currently used as a single room. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 17 Plans are in hand for further redecoration and renovation. Service users have been consulted throughout the decision making on décor, and the owners arranged for much of the work to be carried out whilst the service users were all away on holiday so as to minimise disruption to service users. The home has purchased a new specialist washing machine, capable of achieving a full sluicing cycle, which means that it is capable of ensuring total infection control of any contaminated linen or clothing. There is a large open plan lounge/diner, and since the last inspection the home has provided a visitors room/computer room for service users. This means service users have somewhere they could take relatives rather than have to sit in the communal lounge or their rooms. Appropriate arrangements are in place to dispose of clinical waste. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 The staffing arrangements at the home seen on this inspection are satisfactory to meet the needs of service users. EVIDENCE: On the day of this unannounced inspection the staffing arrangements comprised the two owners, and two other staff members on duty, one of whom was another family member. This included staff involved in catering for the evening meal. In addition during the course of the inspection a visiting instructor was taking an exercise class. This demonstrates the home provides activities of their choice for service users. Staff were well known to service users and clearly had a close working relationship. Discussions were held on the staffing arrangements at the home, including recruitment and selection issues. Discussion on staff training programs will be held at the next inspection, however no areas of concern were identified on this occasion. Staffing levels fluctuate throughout the day in accordance with meeting times of maximum service user need. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 19 Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Braemar has developed excellent systems for consultation with service users, relatives and staff which ensure the home is run in the best interests of service users. EVIDENCE: Discussion was held on strategies for enabling staff and service users to voice their opinions about the way in which the home operates. The home has instituted a comprehensive quality assurance system, utilises questionnaires for relatives, service users, staff and other stakeholders, and holds regular service user meetings. Questionnaires, and development reports were examined for this inspection. This means service users have opportunities to be formally consulted about the operation of the home. However in addition to this the owners confirmed they meet with service users regularly very informally over mealtimes or during the course of activities, and are therefore very accessible and approachable if there are any issues of concern. The home has an annual development plan. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 21 Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Braemar House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 23 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 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. 1. Refer to Standard 19 Good Practice Recommendations The home is recommended to consult with a dietician in relation to the use of the thickening agents and swallowing difficulties. Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Braemar House D54-D07 S58135 Braemar House V215937 070705 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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