Inspection on 05/02/09 for Braeside Care Home

This inspection was carried out on 5th February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Braeside Care Home 07/02/07

Braeside Care Home 04/05/06

Braeside Care Home 10/01/06

Braeside Care Home 25/04/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Braeside Care Home 8 Royal Street Smallbridge Rochdale Lancashire OL16 2PU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Bernard Tracey     Date: 0 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Braeside Care Home 8 Royal Street Smallbridge Rochdale Lancashire OL16 2PU 01706526080 01706860923 matron.braeside@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): East & West Healthcare Limited Name of registered manager (if applicable) Christine Julie Baines Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 36 Date of last inspection Brief description of the care home Braeside is a privately owned care home providing personal and social care, nursing and care for those with dementia. The home was formerly a domestic property, which has over the years, been extended to accommodate 36 residents. It is located on the main Halifax Road, approximately 1 mile from Rochdale and a regular bus service between Littleborough and Rochdale stops close to the home. Care Homes for Older People Page 4 of 28 care home 36 Over 65 0 36 36 0 Brief description of the care home Accommodation is provided on three floors in both single and double bedrooms. There is level access to the front door and a small garden/patio area is provided to the front of the home. There is no designated parking area but cars may be parked on the minor road. A copy of the most recent Commission for Social Care Inspection report is available in the reception area of the home. The home makes the following charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody #10.00 Hairdressing #4.50 Men #6.00 - #19.00 Ladies Fees charged by the home provided in February 2009 are as follows: #352.82 per week to #463.00per week Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We (the Commission of Social Care Inspection) undertook a key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. The previous key Inspection took place on the 7th February 2007 and we completed an Annual Service Review on the 18th January 2008. Some weeks before our planned visit the manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. This helps us to determine if the management of the home see the service they provide the same way that we do. We felt this form was filled in honestly and that a lot of time and effort had been given to filling it in. Where appropriate, the comments have been Care Homes for Older People Page 6 of 28 included in the report. We spent five hours at the home over one day. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to six residents and two relatives who were there during our visit, as well as speaking to five staff, the manager and the owner. We have not received any complaints about the service since our last inspection but, in discussion with the manager and owner, issues of concern that have been raised with the manager have been recorded and details of how these matters had been resolved were examined. What the care home does well: What has improved since the last inspection? What they could do better: The writing down of medicines on the recording sheets should be signed by two members of staff to avoid a mistake being made. The provision of activities inside the home should be further developed and consideration given to the possibility of employing a member of staff with responsibility for this, so that the social needs of residents can be better met. Care Homes for Older People Page 8 of 28 There are not enough staff available to meet the residents needs during the breakfast period on the Dementia Unit. The manager must consider how staff are deployed in the home during this time to ensure that residents are properly cared for. The manager has a good understanding of the areas in which the home could further improve. Planning was in place and set out how these improvements are to be resourced and managed. These areas included refurbishment of further bedrooms and bathrooms. Signage could be improved to help residents identify toilets and bathrooms. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that it can meet the needs of the individual. Evidence: Before any resident was admitted to the home an assessment of their needs was undertaken, either by a senior member of the nursing staff from the home or from the professional i.e. Rapid Response Nurse requesting their admission. The assessment documents of four residents were looked at. The assessments were detailed and gave a clear indication of the residents needs and their capabilities. The assessments looked at the physical, mental and social care needs of the residents as well as the involvement if any, of their relatives. We spoke with the relatives of a resident who had recently been admitted, who stated that the manager had been out Care Homes for Older People Page 11 of 28 Evidence: to the residents home to undertake an assessment of her needs and also provided information that helped them to come to the decision that the home would be able to meet her needs. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care practices ensured that the residents health care needs were met, that they were treated with respect and their dignity was upheld. Evidence: Each resident had a detailed up to date and individual plan of care, covering all aspects of personal, health and social care needs. These are based on the pre admission assessment and other specialist assessments in place including Psychiatric Nurse and social work assessments. The care files of four residents were looked at. Each of these files contained a detailed and comprehensive care needs assessment that describes the help that the resident needs with everyday living including health, personal and social care needs. All of these documents had been reviewed at monthly intervals using a separate document that described any changes in the way that the resident needed to be looked after. Any areas of risk for the resident were highlighted along with the planned action to Care Homes for Older People Page 13 of 28 Evidence: reduce that risk. These included an up to date manual handling assessment and a nutritional assessment tool that is used at the time of the residents admission to the home and then afterwards as required. Nutritional well-being is also assessed by direct observation and by regular and up to date weight checks. Skin condition is also checked by direct observation with a pressure area care plan being implemented if required. Care plans demonstrated that residents personal choices and preferences had been taken into account by staff around care delivery, such as who liked a bath and who would prefer a shower. Personal care was provided privately in bedrooms or bathrooms, and door locks or engaged signs were used. One resident told us that the staff are very good indeed. Always there when needed. All staff very pleasant supportive and helpful Residents wore their own clothes and were dressed appropriately for the weather and their activity. Personal care had been attended to. Healthcare arrangements were also good. Residents had access to their local doctor and the district nursing service visited the home regularly. At the time of our visit a resident was being reviewed by the psychiatrist from the General Hospital. The management of medicines in the home was safe and served to protect residents from harm, and ensure they benefited from the medicines prescribed for them. Staff were knowledgeable about residents medicines and understood about monitoring for side effects and adverse reactions. Medicine records were good, although there was evidence that hand written medications had not been checked by two members of staff, in line with good practice recommendations. Staff who have responsibility for giving out medicines have been given the necessary training for this task, which was up-dated in 2008.The home has a satisfactory medicines policy and procedure that includes guidance for the self-administration of medicines. No residents were dealing with their own medicines at the time of this visit. Residents spoken with were all complimentary about how staff assisted them with personal care tasks and felt their privacy and dignity was respected at all times. This was also observed during the inspection. The care assistants interviewed were able to give good examples of how they promoted privacy and dignity in their daily care routines, for example knocking on bedroom doors before entering. The residents said that the staff had a kind and considerate manner and that the staff spoke to them in a Kind and courteous way. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of the need to provide opportunities for leisure and activity for people living at the home but do not always meet this need. Evidence: The residents involvement in social activities varies greatly according to their abilities and needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. Provision of activities in the home is limited. The owner is advertising for an activities organiser and this appointment may well lead to the provision of increased social activity, as well as activities to meet the individual needs of the residents. A discussion with the residents and care staff confirmed that the residents were able to receive visitors in private and that they were able to choose whom they see and do not see. Visitors can be seen in the privacy of the residents own bedroom, although many choose to sit in one of the communal areas. Care Homes for Older People Page 16 of 28 Evidence: Residents are encouraged to bring personal possessions into the home. Many of their bedrooms were highly personalised, with small pieces of their own furniture, pictures, photographs and ornaments, etc. We did not dine with the residents but observed lunch being served in the dining room. The meals served were of ample portion and looked appetising. The tables were nicely set with napkins, cruets and cold drinks. Staff discreetly assisted some residents to eat. There was always a choice of meal at lunchtime and evening. The menus were inspected and they looked varied and nutritious. Mid-morning and mid-afternoon drinks were served and milky drinks were provided at suppertime. A discussion with the residents showed that they were very happy with the choice and quality of the food provided. Comments made by residents included You could not have better and Excellent food. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear complaints procedure and residents and their families know action will be taken to resolve their concerns. Staff have a good knowledge and understanding of Adult Protection issues which safeguards residents from abuse. Evidence: There is a clear complaints procedure, which told people how and who to make any complaint to. The procedure was well advertised to relatives and visitors to the home. Records showed that any complaints made had been fully investigated and responded to appropriately. A staff member said, If a resident wanted to make a complaint, I would go to the manager and give her the information. There was also evidence that, where relevant, the manager made complaints on behalf of residents who received a poor service outside of the home. No complaints have been made directly to the Commission for Social Care Inspection. The majority of the staff have undertaken training in relation to the Protection of Vulnerable Adults. The home also has an abuse policy and whistle blowing procedure. The staff training record evidenced abuse awareness training for a number of staff and staff interviewed had an understanding of how to report an alleged incident. The home has a copy of the Rochdale Guide for the Protection of Vulnerable Adults. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in pleasant, safe, comfortable and well-maintained surroundings. Evidence: The home is purpose built and accommodation is provided on three levels. It is fully accessible to people who are physically disabled and is fitted with aids and adaptations to promote independence. The main entrance hall is spacious and there is ample information available regarding the home and the service it provides. A partial tour of the building was undertaken, two bathrooms, a shower room and six bedrooms were viewed. The bathrooms were clean and tidy and hot water temperatures are recorded each month to ensure the hot water is delivered to a safe temperature. One bath, not presently in use, was heavily marked and the manager was asked to ensure that this is remedied before residents are allowed to use it. Improved signage for toilets and bathrooms would help residents more easily identify these facilities. Bedrooms viewed had individual items and were homely. A resident said, I have everything I need, including some of my own furniture. Care Homes for Older People Page 20 of 28 Evidence: Bedrooms have door locks and storage space for valuable items. Bedrooms have a call system with a hand held buzzer to call for assistance. The home is equipped with comfortable furniture, fittings and electrical equipment, including television and CD. players. . There is a well equipped laundry and there was evidence of gloves and aprons for staff use. Infection control training is given to staff and infection control policies are available. Residents commented on the good laundry. There are sufficient domestic staff and on the day of this visit the home was clean, fresh and hygienic. Policies and procedures are in place to promote a high standard of cleanliness and hygiene. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriately trained and experienced care staff employed so that residents feel supported and that their needs are understood and met. The recruitment policy is generally robust to protect the residents. Evidence: The manager had provided details of the staffing arrangements in the home prior to the inspection, the details of which were checked during the visit. Staffing levels within the home were seen to meet the needs of residents but consideration should be made with regard to the deployment of care staff on the upper floor during breakfast time. It was felt that the staff were not able to provide sufficient time to fully support the residents. This was discussed with the manager and she assured us that she will look into this and provide a solution. Residents confirmed that staff were always respectful and met their needs competently. In the main, residents were satisfied with the support they were given and described staff as ok, nice people, alright, find time to listen and good. Sufficient ancillary staff were employed e.g. domestics, laundry and kitchen assistants, cook and handyman. Care Homes for Older People Page 22 of 28 Evidence: Staff were in the main knowledgeable about the needs of residents and demonstrated that they understood their own role. Staff files demonstrated that a robust recruitment process is in place, with all appropriate checks being undertaken prior to working in the home. These include criminal record bureau disclosures, application forms and references with one from the previous employer always obtained. New staff undertake a full induction programme that is followed by further in house training. Several staff are presently undertaking National Vocational Qualifications in care at Level Two. The home has an ongoing training programme that staff can apply for. Since the last inspection several staff have received training in abuse awareness and more are booked to attend in the future. Staff spoken with showed that their knowledge had increased since the training and that they were more aware and confident in reporting concerns. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the best interests of the residents. Evidence: Throughout the inspection the inspector was able to evidence the professional, capable and approachable manner in which the manager undertook her role when dealing with residents, staff and visitors. Staff and residents said she was easily accessible and welcomed her open door policy as well as providing structure and a sense of direction through more formal meetings. Residents said she made sure she spoke to them on her arrival at the home each day to check out how they were feeling. The manager operates a quality assurance programme made up of audits and satisfaction surveys to gain feedback on the quality of the service offered at the home. The responses to the latest survey had not been collated as yet but showed that Care Homes for Older People Page 24 of 28 Evidence: respondents were very happy with the care provided. A set of management audits was used to monitor the standard of care planning, medication records, upkeep of the building and provision of meals. The manager also sees every accident/incident report and is therefore able to implement any newly identified safety measures accordingly. The manager holds small amounts of spending money of behalf of some residents. Any spending was accounted for with receipts and the records were open to scrutiny by residents or their advocates. There is a sound system in place for promoting the health, safety and welfare of staff and residents. All services and equipment for the building were under contract for regular testing and repair and the appropriate documentation to support this was available for examination. There was information on, and staff had received training in, fire safety, safe moving and handling, and the safe use of chemicals, food hygiene and first aid. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 The assessment form completed before a resident is admitted should be signed and dated by the assessor to provide an audit trail. Hand transcribed medicines should be witnessed and signed by two staff to avoid errors occurring. To give residents interest and stimulation, they or their relatives should be asked about activities they would like to take part in. Once this consultation has been made, a planned programme of activities must be implemented. The manager should consider improving the signage to the bathrooms and toilets to assist residents in better identifying these facilities Sufficient care staff should be available in the Dementia Care Unit to support the residents during the early morning period. 2 3 9 12 4 19 5 27 Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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