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Inspection on 26/04/05 for Braemar Lodge Residential Home

Also see our care home review for Braemar Lodge Residential Home for more information

This inspection was carried out on 26th April 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a stable staff group, who are knowledgeable of service users` needs and continue to provide a high standard of care. Residents and a relative spoken with were unanimous in their praise for the staff. A visiting relative commented how their relative has improved since being in the home. The home provides comfortable, well furnished accommodation which generates a homely, relaxed atmosphere.

What has improved since the last inspection?

The Proprietor/Manager who took over the home in September 2004, has addressed all but one of the requirements identified at the previous inspection. The remaining requirement is being progressed. Staff training has continued to improve particularly with the promotion of NVQ Level two training.

What the care home could do better:

The home`s care planning system requires further development to clearly identify action to be taken by staff. Staff supervision and quality monitoring systems have recently been introduced but require further development to be fully effective.

CARE HOMES FOR OLDER PEOPLE Braemar Lodge 481 Victoria Avenue Southend on Sea Essex SS2 6NL Lead Inspector Ron Reeve Unannounced 26.04.05 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. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Braemar Address 481 Victoria Avenue Southend on Sea Essex SS2 6NL 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) 01702 339728 Mrs Saima Munir Raja Vacant CRH 12 Category(ies) of OP, DE(E) registration, with number of places Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate twelve persons of either sex who fall within the categories of old age and dementia. Date of last inspection 31st January 2005 Brief Description of the Service: Braemar Lodge is registered to provide care and accommodation for twelve persons over 65 years of whom some may have dementia. The home also offers day care for a maximum of two service users from Monday to Friday.The premises provide homely, comfortable and adequate space. There is a choice of communal areas including lounge, dining room and conservatory. There are six single and three shared rooms on the ground and first floor. Access to the first floor is via a passenger lift. The second floor is for staff use only.There is a pleasant and secure garden and off road parking. Braemar Lodge is in keeping with houses in the vicinity. It is situated in close proximity to the Priory Park and is close to local community facilities and services. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 26th April 2005, lasting eight hours. The inspection process included discussions with the Acting Manager/Proprietor, three staff, a visiting relative and three service users. A random sample of bedrooms were inspected, together with the bathrooms, toilets, kitchen, communal areas and the garden. What the service does well: What has improved since the last inspection? The Proprietor/Manager who took over the home in September 2004, has addressed all but one of the requirements identified at the previous inspection. The remaining requirement is being progressed. Staff training has continued to improve particularly with the promotion of NVQ Level two training. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 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 Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 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) 1,2,35 The home operates a thorough pre-admission process, through which the Manager ensures the home can meet the needs of prospective service users. . . EVIDENCE: The home’s Statement of Purpose and Service User’s Guide were examined at the previous inspection and found to be appropriate. The Manager visits and assesses all residents before agreeing admission to the home, including those residents sponsored by a local authority. However, there were no terms and conditions of residence completed for those service users sponsored by a local authority. The home benefits from a core group of experienced staff who are fully aware of the residents’ care needs. Residents and visiting relatives spoken with felt that the staff were committed and caring and provided the care they required. A visiting relative confirmed that they can visit anytime they wished and that she was always made welcome. The home does not offer intermediate care. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 9 Policies and procedures relating to death are dying were not inspected on this occasion. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-10 It was evident that residents’ personal and health care needs are being met by the home, although improvements are required to the care planning documentation. The home has a core group of stable and experienced staff who are fully aware of the residents’ care needs. EVIDENCE: Three care files were inspected. The format of the care plans did not fully evidence the residents’ care needs and how they are to be met by the staff. Constructive discussions took place with the Manager who agreed to review the format of the care plans to ensure care needs are clearly identified and instructions for staff to meet the identified needs are comprehensive. Daily recordings did not always reflect the welfare of the residents, how they spent their day and the progress of the care plan. Residents and a visiting relative spoken with were positive about the way personal and heath care needs were being met in a sensitive manner respecting their privacy and dignity. The home’s medication administration procedures were seen to be appropriate and medication stored appropriately. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 11 Policies and procedures relating to death and dying were not inspected on this occasion. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 The routine of daily living within the home was seen to be flexible to meet the service users’ needs. Residents are encouraged to maintain control over their lives where possible. Visiting arrangements are flexible and relatives encouraged to visit. The food provided was to a good standard. EVIDENCE: Residents spoken with confirmed that the daily routines are flexible and their individual choices and needs are met by the home. The home has a programme of activities and records were maintained. Residents spoken with said they enjoyed the activities arranged by staff. On the day of the inspection, three service users were provided with transport to attend a local church. Staff were seen to spend time with the service users in small groups and on a one-to-one basis, particularly with the residents who have dementia. The Manager said she was proposing to purchase a multiperson vehicle to enable residents greater access to the community. Residents meetings are held on a regular basis. The Manager informed that relatives are invited to attend if they wish. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 13 All service users spoken with were positive about the quality of the meals provided. One resident said the food was “excellent”. Menus received showed a wide range of meals. Residents can have their meals in the dining room or lounge. Mealtimes were observed to be relaxed and residents assisted where appropriate. Nutrition records require developing to ensure they fully reflect that service users have eaten. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Appropriate policies and practices to promote the protection of the residents from abuse and appropriate staff training were in place. EVIDENCE: The home has an appropriate complaints policy and procedure which is displayed in the home. One complaint has been received by the home regarding care provision which has been appropriately managed by the home. Many letters of compliment were seen displayed in the home. All service users are registered on the voters’ list and details of advocacy services displayed. The home has policies and procedures in respect of Adult Protection. A copy of the Essex Guidelines on the Protection of Vulnerable Adults (POVA) was available in the home. The home has accessed some places on a forthcoming POVA workshop for staff. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The home provides a safe, well maintained environment that is accessible to the residents, homely and meet residents’ needs. EVIDENCE: The home continues to provide a well furnished “homely” environment for the residents. No physical changes have been made to the accommodation . On the day of the inspection, the home was seen to be clean and tidy throughout. A random sample of bedrooms revealed they were well-furnished, personalised and decorated to individual residents’ tastes. Bathrooms and toilets were adequate to meet residents’ needs. The problem regarding the provision of window restrictors identified at the previous inspection had been addressed. The garden was well maintained and accessible to the residents. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 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 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) 1,2 The home benefits from a core group of experienced and knowledgeable staff. Staffing levels remain appropriate to meet residents’ needs. EVIDENCE: From staff working on the day of the inspection and from staff rotas examined, it was evident the home was meeting the agreed staffing levels (i.e. four staff in the morning, three staff in the afternoon, two staff in the evening and one awake and one asleep at night). Care staff also undertake catering and domestic tasks. One of the residents reported that “staff are great, you can’t fault them. They do find time to sit and talk to you”. The majority of residents in the home have low dependency needs. Two staff files examined contained evidence that all required checks had been made before they started work. The Manager reported that one member of staff has achieved NVQ Level 3. Two members of staff have achieved NVQ Level 2, whilst four staff are currently training at NVQ Level 2. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 17 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) 31,32,33,35,36 From comments made by Service users, staff and a visiting relative it was clear that the change of ownership went smoothly and the new Proprietor/Manager was very supportive to the staff and residents. EVIDENCE: The home was registered to the new Proprietor in September 2004. The Proprietor has recently assumed the post of Acting manager and has applied to be registered. She is at present undertaking the Registered Manager’s Award. Residents and staff spoken with expressed their confidence in the Manager and felt she was approachable and supportive. Staff reported that the transfer of the home to new owners had gone very smoothly. Regular staff and residents’ meetings are held. The Manager said she invites relatives to some of the residents’ meetings. Staff appraisals have been completed and supervision has commenced. Constructive discussions were held with the Manager regarding improvements to the staff supervision system. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 18 A random sample of money held by the home on behalf of residents was found to balance with the records. Safety certificates were available for services and equipment and regular safety checks are carried out. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 x 3 2 x 3 Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 20 YES 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 2 Regulation 5(1)(B) (C) 17(2) Schedule 4 Requirement All service users must be issued with a contract which includes the terms and conditions of residence. A record of food provided for service users in sufficient detail to enable any person to determine whether the diet is satisfactory in relation to nutrition and otherwise including special diets. The home must establish and maintain a system for reviewing and improving the quality of care at the home. The home must review its care planning system to ensure service user needs in respect of their health and welfare will be met Timescale for action 30/6/05 2. 15 30/6/05 3. 33 24 30/6/05 4. 7 15 30/6/05 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 36 Good Practice Recommendations Staff should receive formal supervision at least six times a I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 21 Braemar Lodge 2. 3. 28 31 year. 50 of care staff should achieve qualification at NVQ Level 2 or equivalent by 2005. The Registered Manager should have NVQ Level 4 in Management and Care or equivalent by 2005. Braemar Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend On Sea Essex SS2 6BG 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 Lodge I56 I06 S59881 Braemar V223113 260405 Stage 4.doc Version 1.20 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. 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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