Inspection on 24/06/05 for Bramber Nursing Home

This inspection was carried out on 24th June 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 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

Bramber Nursing Home 30/01/09

Bramber Nursing Home 11/01/07

Bramber Nursing Home 06/12/05

Bramber Nursing Home 28/01/05

Bramber Nursing Home 23/01/04

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

CARE HOMES FOR OLDER PEOPLE Bramber 1 Bramber Avenue Peacehaven East Sussex BN10 8LR Lead Inspector Melanie Freeman Announced 24 June 05 10:00 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. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Bramber Address 1 Bramber Avenue Peacehaven East Sussex BN10 8LR 01273 584594 01273 584594 None The Bramber Nursing Home Limited (Organisation) Mr Peter John Stapleton Care Home with Nursing 21 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) Category(ies) of Dementia (DE), 21. registration, with number of places Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That service users are aged sixty (60) years or over on admission. 2. That service users with a dementia type illness will be accommodated. 3. That the number of service users accommodated must not exceed twenty one (21). Date of last inspection 28 January 2005 Brief Description of the Service: Bramber Nursing Home is privately owned and can accommodate up to 21 service users with dementia. The home is registered for service users aged 60 years and over. Nursing care is provided at this establishment. The home is a converted home and now provides 21 single rooms on two floors and has a shaft lift available to ensure all service users have access to all areas of the home. The home is located in Peacehaven near the sea front and is a short walk to local amenities.The home sends out newsletters to relatives of service users to keep them informed of what is happening within the home. This is done 3 to 4 times a year. Bramber Nursing Home was first registered on the 1st January 1993. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Bramber Nursing Home will be referred to as ‘residents’. This was an announced inspection carried out over one full day in June 2005. Although comment cards were made available to residents, visitors and health care professionals feedback was not received via this route. This inspection focussed on the experience for residents living in the home and on visiting relative’s views. The inspector spent most of her time with residents and their relatives in the communal areas of the home and in individual rooms. Six visiting relatives were spoken to in private where they were able to share their thoughts on the home. One relative contacted the inspector following the inspection to confirm her satisfaction with the home The inspector also observed staff working and spoke informally to 3 staff members receiving general feedback. The care documentation pertaining to 2 residents were reviewed in depth. The inspector toured the home and was able to review the facilities. The inspector also ate a meal with the residents in the dining room. What the service does well: During the inspection residents were seen to be well cared for and all relatives spoken to confirmed a very high satisfaction with the standard of care provided and made the following comments which included ‘everything is wonderful, top class nothing could be done to improve things’ ‘home is superbly run’ The home is out of this world the dedication and care is wonderful’. The homes management and staff also provide a support network for the visitors, who are always warmly welcomed to the home and involved in the homes entertainment. Bramber Nursing Home is a converted premise that provides a home like environment that is pleasant. All residents are assessed prior to admission and individual plans of care are well documented and clearly record the care needs of residents and how these needs are to be met. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? 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. Bramber H59-H10 S13967 Bramber V224501 240605 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 Bramber H59-H10 S13967 Bramber V224501 240605 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) 1,2,3,4,5 and 6 Bramber Nursing Home provides appropriate information about the home and the services it offers. The home ensures they can meet residents needs prior to them being admitted, residents and relatives are fully involved with the decision to move into Bramber Nursing Home. EVIDENCE: Bramber Nursing Home has developed a satisfactory statement of purpose that outlines the layout of the premises, the homes philosophy of care, and the nature of services offered to residents. The home has a clear admission process and this includes providing prospective and all new admissions with a copy of the statement of purpose/service users guide which contains the homes terms and conditions of residency. All prospective residents are fully assessed by the home manager/owner who takes into account the prospective residents needs, the other residents in the home, and the skills of the staff before agreeing to a new admission. The inspector reviewed the assessments completed on the 2 most recently admitted residents and these were found to be full and informative. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 9 All relatives spoken to confirmed that they had made a positive decision to use Bramber Nursing Home based on recommendations, previous experience and visiting the home. Intermediate or rehabilitative care is not provided at Bramber Nursing Home. Bramber H59-H10 S13967 Bramber V224501 240605 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) 7,8 and 10 The home was found to be meeting the health and social care needs of the residents with the support and advice of local General Practitioners as necessary. The inspector judged that resident’s privacy and dignity rights were upheld and respected. EVIDENCE: Two individual plans of care were inspected and were found to contain full assessments and risk assessments that are used to inform the plans of care which were individual and provided clear guidance for staff on how to care for residents. Care documentation was found to be up to date and reflect regular contact with visiting health care professionals. All relatives spoken to indicated that they were very happy with the way the needs of residents are being met, feeling that they were respected as individuals, and also confirmed that the home also care for and support relatives. Staff were seen to be respectful and considerate to all residents and visitors. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 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) 12,13,14 and 15 Resident’s opportunities for stimulation through leisure and recreational activities are good and meet individual needs. The provision of meals is well managed and this ensures that the quality of food is good, and that choice and variation is available. EVIDENCE: The provision of meaningful activities and entertainment is central to the care provided at Bramber and a leisure activities co-ordinator works 2 hours every weekday to promote this. Activities include bingo, skittles, musical sessions, exercises, walks, shopping trips, indoor games, artwork, reminiscence, one-toone chats, craftwork and visits to the pub. Occasions like birthdays and seasonal events are always celebrated and visitors are always included. Two relatives said how much they enjoyed these events and said they were looking forward to the BBQs held by the manager/owner in the summer. On the day of this inspection it was a residents 60th wedding anniversary, staff were fully aware and helped her and her husband celebrate the day. It was clear from conversations with visitors that they were made to feel very welcome at Bramber and that their input is much valued. Many of the relatives visit daily and they know and support each other, this relationship is promoted by the home. Resident’s wishes are respected and during the inspection it was noted that residents were encouraged to make choices whenever possible and to be independent with supervision being provided. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 12 The meal eaten by the inspector was found to be well presented and to have a very good taste with an emphasis on home cooking and fresh ingredients. Residents are encouraged to eat communally, however choice is respected. Residents were seen to enjoy the meal and staff were encouraging residents to eat a good amount, as independently as possible. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 13 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 and 18 Procedures and practices in the home ensure that complaints made are managed appropriately. Clear guidance on the protection of vulnerable adults is lacking and this does not effectively demonstrate the well being of residents is fully protected. EVIDENCE: A full complaints procedure is available in the statement of purpose/service users guide. The home owner/manager is in the home much of the time and relatives confirmed that he listens and responds to any suggestions or concerns. The homes adult protection procedure needs to be updated to provide clear guidance to staff following an allegation or suspicion of abuse in accordance with local multi agency guidelines and DOH guidance. Staff training records confirmed that staff receive training on recognising and identifying all forms of abuse. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 14 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) 19,20,23,25 and 26 The home provides residents with a comfortable and safe environment that has a home like feel where resident’s needs can be met. EVIDENCE: Bramber is a converted property that has been adapted to its present use and has retained a homely looking environment. The home is decorated to a satisfactory standard and ongoing redecoration was noted and this should continue along with furniture replacement. It was noted that some beds are old and need replacing. There is garden area that has been recently paved to enable more regular use for those resident wanting to walk outside in a safe area. A pleasant communal lounge/dining room is found on the ground floor and a small seating area is found on the first floor. All communal areas are well used and can be used in a flexible manner. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 15 Resident’s rooms are personalised and individualised. Five of these rooms measure under 10 square meters and all are for single use. During the inspection the home was found to be very clean. The inspector did however note that not all communal toilet areas were provided with appropriate hand washing facilities. Bramber H59-H10 S13967 Bramber V224501 240605 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) 27,28 and 30 Staffing numbers and skills were satisfactory to meet the needs of the residents living in the home. EVIDENCE: At the time of this inspection 21 residents were living in the home. There was 4 carers on duty in addition to a registered nurse and the home manager/owner, appropriate kitchen and domestic staff were also provided. Relatives confirmed that they believed that there was enough staff working in the home throughout the day and night to meet the needs of residents. On the day of inspection it was clear from observing the staff that there was a sufficient number and that they had the skills to care for the residents in the home. Relatives praised the staff highly saying ‘staff are very kind and understanding’ ‘the staff are perfect well trained all of them are like my extended family’ ‘staff are wonderful and dedicated’. Staff training is well developed with records confirming regular training and a high percentage of carers completing NVQ level 2 in care. Bramber H59-H10 S13967 Bramber V224501 240605 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) 31,32,36 and 38 The home is well managed by the home manager/owner who has the skills and commitment to run this care home in an open and positive way that promotes an inclusive atmosphere. Staff are able to share their views with senior staff in the home. Health and safety procedures are good and ensure staff and resident’s safety. EVIDENCE: The registered manager/homeowner and his wife are very involved in running the home and are in the home most days. Relatives were very complimentary about the manager/owner and his wife saying ‘they worked extremely hard’ and ‘manage the home superbly’. People spoken to said that the manager/owner was readily available and always made time for anyone wanting to talk to him. Relatives also confirmed that he kept them informed of any changing health care needs and always involved the GP. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 18 Staff are given regular supervision and records relating to this were seen during the inspection. A clear procedure and guidelines to underpin this process needs to be developed and made available to all staff. All records relating to health and safety matters were found to be full and thorough, although an up to date thorough examination certificate for the passenger lift was not available at the time of this inspection. Bramber H59-H10 S13967 Bramber V224501 240605 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 3 3 3 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 x 3 2 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 4 4 x x x 3 x 2 Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 20 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 18 Regulation 13(6) Requirement Timescale for action 1.8.05 2. 3. 4. 24 26 38 16 (1)(2)c) 13(4) 13(3) 13(5) That an adult protection procudure providing clear guidiance to staff on what to do following an allegation or suspicion of abuse is provided. That all beds are risk assessed to 1.8.05 ensure they are safe and suitable for use with specific residents. That appropriate hand washing 1.8.05 facilities are provided in all communal toilet areas. That a copy of the up to date 1.8.05 certificate demonstrating the thorough examination of the passenger lift is provided to the CSCI. 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. 2. 3. Bramber Refer to Standard 1 16 28 Good Practice Recommendations That residents views are included in the service users guide. That any complaints made are recorded on a dedicated complaints form That 50 of care staff have an NVQ level 2 in care by H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 21 4. 36 2005. That a clear procedure and guidiance for staff supervision is provided and shared with all staff. Bramber H59-H10 S13967 Bramber V224501 240605 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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