This inspection was carried out on 6th December 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
CARE HOMES FOR OLDER PEOPLE
Bramber Nursing Home 1 Bramber Avenue Peacehaven East Sussex BN10 8LR Lead Inspector
Melanie Freeman Unannounced Inspection 6th December 2005 10:00 X10015.doc Version 1.40 Page 1 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 Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 2 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 Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bramber Nursing Home Address 1 Bramber Avenue Peacehaven East Sussex BN10 8LR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01273-584594 01273-584594 The Bramber Nursing Home Limited Mr Peter John Stapleton Care Home 21 Category(ies) of Dementia (21) registration, with number of places Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. That service users are aged sixty (60) years or over on admission. That service users with a dementia type illness will be accommodated. That the number of service users accommodated must not exceed twenty one (21). 24th June 2005 Date of last inspection 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 Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 report should be read in conjunction with the report of the inspection that took place on 24 June 2005 for an overview of the core standards inspected over the year. This was an unannounced inspection carried out on a weekday in December 2005. Although the home manager was not on duty on the day of the inspection he made himself available and contributed to the inspection process and received the inspector’s feedback. The inspection focussed on meeting and talking to residents and visitors to the home and in accessing the homes progress in meeting the requirements made at the last inspection. The inspector was able to speak to the home manager and a registered nurse who works in the home. Other staff were spoken to informally and observed while working the care documentation of 3 residents were reviewed. Other areas and documentation inspected included: the home’s Statement of Purpose and Service Users’ Guide, The homes complaints and adult protection procedures. An inspection of the premises also took place. What the service does well:
During the inspection the inspector observed that a good standard of care was provided to residents visitors spoken to, who confirmed a very high satisfaction with the home, supported this view. The home focuses on providing a home like, caring environment where residents can make choices about how they spend their day. The homes management and staff also provide a support network for the visitors, who are always warmly welcomed to the home and given time to discuss any issues they wish to. 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 Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 the following standard(s): 1 and 3 Bramber Nursing Home has the required documentation to provide 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: Although 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. During the inspection these documents were not readily available and the registered nurse in charge at the home was not familiar with them or their location. The home has a clear admission procedure that ensures residents are fully assessed by appropriately qualified people and that they can be cared for appropriately and safely in the home.
Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 9 Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 the following standard(s): 7,8, 9 and 10 The home was found to be meeting resident’s health and general needs with accessed additional community support when needed. The home has established procedures for the safe administration of medicines within the home. The inspector judged that resident’s privacy and dignity rights were upheld and respected. EVIDENCE: Three 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. Visitors were very complimentary about the care, staff and management of the home. It was again evident to the inspector from talking to visitors residents and staff that the home is run to promote the well being of both residents and their relatives with support and help provided whenever necessary.
Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 11 Bramber has good systems for the safe administration of medicines, which are administered by a registered nurse following the homes own policies and procedures. Staff were seen to be respectful and considerate to all residents and visitors. Each of the residents are addressed by their preferred term and have all personal care needs carried out in the privacy of their own rooms or bathrooms. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 the following standard(s): 14 Resident’s choices and wishes are respected within safety parameters. EVIDENCE: During the inspection it was noted that choices are given to residents all the time and that these are responded to with resident’s wishes being respected. Residents are encouraged to be independent whenever possible with appropriate supervision being provided. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 Procedures in the home ensure that complaints and any allegation or suspicion of abuse made are managed appropriately. EVIDENCE: A full complaints procedure is available in the statement of purpose/service users guide. The complaints procedure has been updated since the last inspection to include a complaints form. 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 Adult Protection policy and procedure has been updated since the last inspection to provide clear guidance to staff on action to be taken in response to an allegation or suspicion of abuse. Discussion with staff identified that they were not clear on the procedure to be followed following a complaint or allegation/suspicion of abuse. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 The home provides residents with a comfortable and safe environment that has a home like feel where their needs can be met. EVIDENCE: Bramber is a converted property that has been adapted to its present use and has retained a home-like environment. The home is decorated to a good standard and ongoing redecoration was noted along with some furniture replacement. The home was found to be clean and hygienic throughout. The hand washing facilities in communal areas have been improved since the last inspection. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Staffing numbers and skills are appropriate and enabled the needs of the residents living in the home to be fully met. The recruitment practice was full however some records required are not being retained. EVIDENCE: At the time of this inspection 21 residents were living in the home. Staffing levels seen confirmed that they are good and appropriate to meet the specialist care and social needs of residents. Records confirmed that these levels are maintained and that staff turnover is low, and that agency staff are never required. Visitors spoken to confirmed a high satisfaction with all the staff in the home and it was noted that staff spent time with visitors and residents getting to know them as individuals. During the inspection 2 care staff recruitment files were examined in depth. Although recruitment practice was found to be good it was noted that although identity documents were seen copies of these and photographs were not retained by the home. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 16 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35 and 37 Resident’s views on how the home is run are taken into account and reviewed in order to develop and change the provision to meet their needs and best interests. Systems are in place to safeguard resident’s finances. EVIDENCE: The home has systems in place to monitor the quality of care in the home, which includes resident/visitors questionnaires and contacting visiting professionals for their comments. The feedback provided via these is mostly very positive and any comments are responded to on an individual basis, there is however no audit or report generated that could be included in the service users guide and provided to the CSCI. The inspector was advised that the home do not have any involvement in resident’s monies.
Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 17 During the inspection it was noted that an up to date photograph of each resident is not available in the home. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X 2 X Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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 OP1 4 and 5 Regulation Requirement That a Statement of purpose/service users guide is available in the home and that staff are familiar with its contents. That staff are fully aware of the homes policies and procedures and follow them. That the required documents/records are retained in the home in respect of employees. That the feedback contained in the resident/visitors questionnaires is audited and reported on. That a photograph of each resident is retained in the home. Timescale for action 01/02/06 2. 3. OP18OP16 22 and 13(6) OP29 19 01/02/06 01/02/06 4. OP33 24(2)(3) 01/04/06 01/02/06 5 OP37 17 (2) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 20 1. 2 3 4 OP1 OP28 OP29 OP35 That residents views are included in the service users guide. That 50 of care staff have an NVQ level 2 in care by 2005. That the previous employer of any prospective employee is approached for a reference. That a procedure for the safe keeping of resident’s monies/valuables is provided. Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Bramber Nursing Home DS0000013967.V269998.R01.S.doc Version 5.0 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
