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Inspection on 12/12/06 for Bramble Cottage Retirement Home

Also see our care home review for Bramble Cottage Retirement Home for more information

This inspection was carried out on 12th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

Bramble Cottage provides a clean, well maintained and well decorated home which includes a very attractive rear garden. Residents said that this is made full use of in the summer, `I spend a lot of time out there it is so lovely` and `Beautiful garden and we have barbeques out there`. All rooms have a full ensuite bathroom and residents are encouraged to personalise their rooms. One resident uses his room as a workshop, in which he works on various projects, he has built a waterwheel in the garden which uses the waterfall to turn and this is called `The Bramble Eye`, he said `I don`t know of any other place which would allow me to make such a mess of my room, the staff come in and clean around whatever project I am working on, and they are very helpful and cheerful about it too`. Activities provided for residents take place throughout the week and at weekends and residents participate fully in a very varied programme which includes poetry reading, discussion groups, quizzes and painting. There are outings to places of interest. Residents decide what activities they wish to be provided. Residents have been encouraged to participate in a `Nutritional project` set up by the deputy manager. This involves meetings with residents where the menus are discussed, residents choosing all parts of the menu, with special emphasis being put on the health implications. Residents are encouraged to be specific about which vegetables they would like to see served in the home as well as the main parts of the menus. Residents are informed of the nutritional and calorific values of food and the catering staff are fully involved in this project. The home has the `Clean Food Award`. Alcoholic beverages, including wine and gin and tonic, are offered to all residents before lunch and in the evenings. The manager stated that she tries to run the home `on the lines of a nice hotel`. Care plans address all the care needed by the individual residents and were seen to be well written and detailed. Daily records were informative about the care given to residents, and it was seen that the staff discuss the residents care plan with them on a monthly basis. The majority of staff have undertaken medication training and the procedure involving medication administration and recording was generally good. All medications being correctly stored and residents encouraged to take responsibility for administering their own medication if able. There was evidence of thorough risk assessments in these cases. The home is committed to staff training in the care of the older person, and 70% of the staff now have their National Vocational Qualification level 2 in care, with staff attending other training relevant to the care needs of the residents.

What has improved since the last inspection?

All of the requirements made at the last inspection have been complied with. The standard of administration and storage of medication has improved and now meets all regulatory and most good practice requirements. A new shaft lift has recently been installed, the manager said that this is now much easier for residents to use. Some redecoration has taken place in the home and two new showers installed.

What the care home could do better:

There is little that needs improving within this home. Recording of controlled drugs, or those drugs used as controlled drugs, must have the name of the recipient written in full. When medications are obtained for residents that administer these themselves, the amount of medication received by the home must be written on the chart and the member of staff who gives these to the residents should ensure that they sign the chart as handed to resident. This was discussed with the manager, and recommendations made.

CARE HOMES FOR OLDER PEOPLE Bramble Cottage Retirement Home 18 Carden Avenue Brighton East Sussex BN1 8NA Lead Inspector Elizabeth Dudley Key Unannounced Inspection 13th December 2006 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 Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 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. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bramble Cottage Retirement Home Address 18 Carden Avenue Brighton East Sussex BN1 8NA 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 565821 Bramble Care Homes Limited Mrs Diana Shaw Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-eight (28). Service users will be older people aged sixty-five (65) years or over on admission. 3rd January 2006 Date of last inspection Brief Description of the Service: Bramble Cottage is registered to provide accommodation and personal care for up to 28 older people. The registered provider is Bramble Care Homes Ltd. The responsible individual is Mr M. Newman. The registered manager is Diana Shaw. The home is located in Brighton with access to local amenities. It is set out over three storeys and has a passenger lift to all floors. There are 26 bedrooms, all of which have full en-suite facilities. There is a good range of communal space, including a main lounge, dining room and large rear garden. Fee information received on the 24th September 2006 are that fees range between £520-£720 per week with extra services such as hairdressing and chiropody being charged separately. A list of these is available at the home. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 13th December 2006 over a period of six hours. During the visit to the home a tour of the home took place and records, which included care plans, medication records, health and safety and catering documentation, personnel files and training records were examined. Sixteen residents were spoken with, in depth conversation took place with six of these and the views of seven staff were obtained. There were no visitors seen on this occasion. Prior to the inspection the CSCI sent out questionnaires to residents and relatives of visitors, a total of thirty four were returned which included nine from visitors to the home, and one from a health care professional. The majority of comments on these questionnaires were positive, ‘Bramble Cottage is run to a very high standard at all times, and is clean throughout. It is a home that takes a lot of beating for care provision’, ‘The home provides a good quality of both care and life for my mother’, ‘All staff extremely helpful, kind, cheerful and efficient’, ‘The food is good but can be bland and unseasoned’, ‘The standard of meals is very good and the food is well cooked and nicely presented’, ‘I very much appreciate how Bramble has regular reports and responds to any requests made, the meals for example could not be more to my liking and suitability’, ‘The manager makes it very clear, let her know of any complaints and she will sort it out directly’, ‘Everything is dealt with very efficiently; this is a super home in all respects’, ‘The coffee is not good, but I enjoy the meals which are superb’ and ‘Many activities take place and we are encouraged to carry on doing what we enjoy’. What the service does well: Bramble Cottage provides a clean, well maintained and well decorated home which includes a very attractive rear garden. Residents said that this is made full use of in the summer, ‘I spend a lot of time out there it is so lovely’ and ‘Beautiful garden and we have barbeques out there’. All rooms have a full ensuite bathroom and residents are encouraged to personalise their rooms. One resident uses his room as a workshop, in which he works on various projects, he has built a waterwheel in the garden which uses the waterfall to turn and this is called ‘The Bramble Eye’, he said ‘I don’t know of any other place which would allow me to make such a mess of my room, the staff come in and clean around whatever project I am working on, and they are very helpful and cheerful about it too’. Activities provided for residents take place throughout the week and at weekends and residents participate fully in a very varied programme which Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 6 includes poetry reading, discussion groups, quizzes and painting. There are outings to places of interest. Residents decide what activities they wish to be provided. Residents have been encouraged to participate in a ‘Nutritional project’ set up by the deputy manager. This involves meetings with residents where the menus are discussed, residents choosing all parts of the menu, with special emphasis being put on the health implications. Residents are encouraged to be specific about which vegetables they would like to see served in the home as well as the main parts of the menus. Residents are informed of the nutritional and calorific values of food and the catering staff are fully involved in this project. The home has the ‘Clean Food Award’. Alcoholic beverages, including wine and gin and tonic, are offered to all residents before lunch and in the evenings. The manager stated that she tries to run the home ‘on the lines of a nice hotel’. Care plans address all the care needed by the individual residents and were seen to be well written and detailed. Daily records were informative about the care given to residents, and it was seen that the staff discuss the residents care plan with them on a monthly basis. The majority of staff have undertaken medication training and the procedure involving medication administration and recording was generally good. All medications being correctly stored and residents encouraged to take responsibility for administering their own medication if able. There was evidence of thorough risk assessments in these cases. The home is committed to staff training in the care of the older person, and 70 of the staff now have their National Vocational Qualification level 2 in care, with staff attending other training relevant to the care needs of the residents. What has improved since the last inspection? Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 7 All of the requirements made at the last inspection have been complied with. The standard of administration and storage of medication has improved and now meets all regulatory and most good practice requirements. A new shaft lift has recently been installed, the manager said that this is now much easier for residents to use. Some redecoration has taken place in the home and two new showers installed. 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. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 8 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 Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5 and 6 Quality in this outcome area is excellent, this is based on the available evidence including a visit to this service. Residents receive sufficient information to advise them of the suitability of their choice of home and whether it can meet their needs. Staff receive appropriate training to enable them to care for the residents admitted to the home. EVIDENCE: There is a statement of purpose and service user guide which meets the National Minimum Standards and the regulations. All residents spoken with confirmed they have a copy of the service user guide. The statement of terms and conditions meets the standards and regulations and all residents have received this, evidence was seen of this. Requirements made at the last inspection relating to the terms and conditions of residence have been complied with. Residents said ‘I have a contract, this was given to me when I came in , I was also given information about the home’. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 10 The majority of residents are assessed prior to their admission to the home, this may take place in the home when a resident comes to look around or at their current place of residence. All residents are admitted on a month’s trial period. Staff receive sufficient training to enable them to care for the residents admitted into the home, over 70 of the staff have their National Vocational Qualification level 2 in care. The home does not admit residents for intermediate care. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 and 11 Quality in this outcome area is excellent, this is based on the available evidence including a visit to this service. Care plans reflect the assessed and current needs of the resident, staff using these to ensure the care given reflects that which is required. The standard of medication administration safeguards residents in the home. Residents are able to administer their own medication if able, therefore maintaining their independence. EVIDENCE: Each resident has a care plan, which addresses his or her physical, psychological and social needs. There was evidence of monthly review in conjunction with the resident and in depth daily records, which detail the care given to the resident on a daily basis, are in place. There was evidence care plans reflect current care needs and any change in the residents condition. There is a key worker system in operation, with each carer being responsible for a resident or group of residents. Residents said ‘We talk about our care with the staff every month and they also ask us if there is anything we want changing’ and ‘(member of staff Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 12 name) takes care of me, she comes in about every three to four weeks and discusses how I am looked after and any changes or problems that I want sorted out’. Staff should try to ensure that residents care plans are completed within 5 days of their admission. District nurses provide any nursing care, and other health care professionals visit the home. Residents are able to retain their own GPs if in the area. Staff have received training in matters relating to the care of the older person, and advice is sought from continence specialists and dietician. The deputy manager has commenced a nutrition programme with the residents which involves regular weighing of residents and dietary needs planned in consultation with individual residents. All residents receive health and personal care within the privacy of their own rooms and can be escorted on hospital if necessary. Residents have their own telephone and there was evidence that staff treat residents with courtesy. The preferred form of address and times of rising and retiring are recorded in the care plans. Policies and procedures relevant to the administration, receipt and disposal of medications are in place, and senior staff have undertaken medication training. All medications and creams had been signed for following administration and the recording and storage of controlled drugs were in order. Residents names should be written on the record each time a controlled drug is given to that resident. Residents who self medicate do so under the auspices of regular risk assessment and are provided with a lockable cupboard or drawer for storage. It is recommended that when medications are given to the resident for selfmedication, that the staff signs the medication charts to indicate this. There is no specific drug fridge and medications requiring refrigeration are kept in a secure box in the domestic fridge. The staff have received some training in palliative care and residents who are terminally ill can remain in the home where appropriate, with care being given under the direction of the district nurses and other health care professionals. Advocates and bereavement counsellors can be accessed. The manager said that they are commencing study for the implementation of the ‘Liverpool Care Pathway’, which is a method of ensuring complete care for the terminally ill resident. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 13 Comments from relatives of residents included ‘she is very well cared for, she has never looked better’ and ‘this home looks after their residents very well’. Residents stated ‘The care is good, they always make sure that I see a doctor if I need to’, ‘they were so good when I wasn’t very well’, ‘I’m not well at present, the staff are exemplary, they keep coming in to make sure I’m comfortable and bringing fruit and drinks, and try to make sure that I am still eating properly with food I can manage. They have made sure I get to the hospital and bring the doctor in’. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 14 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): 12,13,14 and 15 Quality in this outcome area is excellent, this is based on the available evidence including a visit to this service. Residents are offered a good quality of life with activities tailored to reflect their ongoing interests. There is a good standard of catering with residents being able to participate in the choice of menus and benefit from the nutritional project which is taking place in the home. EVIDENCE: There is a varied range of activities provided, which includes painting, arts and crafts, quizzes, poetry and discussion groups. Residents stated that they are able to choose their times of rising and retiring and encouraged to maintain their interests and lead an active and independent life as possible. There is an activities programme and this includes outings to places of interest. All residents spoken with were aware of forthcoming events and activities. Residents spoken with stated ‘The activities are good – I am about to go to a poetry reading’, ‘I have made a gaming table and the home has allowed me to have a workshop in my room, not many homes would do that. The Bramble Eye is still going, I’m now working on a perpetual motion machine, it’s a Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 15 simple thing, the Romans could have made it’, ‘We have plenty of activities and there is always something of interest going on’, ‘There are parties arranged and the activities provided here are very good, and one has the choice over whether to participate or not’ and ‘I prefer my own company and don’t join in activities’. Parties are held at Christmas and other times throughout the year, with relatives being invited. Visitors are welcomed at any time. Residents can go out to church services and there is a service held within the home on a regular basis ‘They always welcome visitors and they are invited to functions here’. The menu is varied and allows choices at mealtimes - residents said that ‘The food is really good, we have two or three choices and sometimes six or seven at suppertime, we can have a cup of tea at any time we wish’, ‘The food has improved, it couldn’t be better’, ‘We have a good choice of food and its very good food, with homemade cakes at teatime’, ‘The food is all right on the whole – they do lovely buffets and party food’, ‘Buffet lunches, barbeques, all excellently arranged’. The deputy manager has commenced a nutritional programme, and meetings with residents and staff are held to determine what they would like on the menu, and giving information on the nutritional values and calorific value in food. Residents can also determine which vegetables they would like to be included in the meals that are served. A nutritional audit is undertaken monthly. Catering staff are involved in these meetings. There was evidence of fresh fruit in the dining room, and fresh vegetables are used in food preparation. All residents are offered morning sherry, gin and tonic or wine. The standard of catering is good, with all tables being attractively laid out and the food is well presented. Cooked breakfasts are available and residents can either have their meals in the dining room or in their rooms. The environmental health authority recently inspected the kitchen and commended the food served as excellent; the home has the Clean Food Award. All records as required by the Environmental health authority were in place and catering staff have the appropriate training. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 16 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): 16,17 and 18 Quality in this outcome area is excellent, this is based on the available evidence including a visit to this service. Residents are protected by the homes complaints procedure and the way in which concerns are dealt with by the provider and manager. Staff are aware of their responsibilities in the safeguarding of the residents in their care. EVIDENCE: There is a complaints policy displayed in the home, which meets the National Minimum Standards and the regulations. It is also included in the service user guide. All residents spoken with were aware of the complaints procedure, and stated that if they had a complaint they would speak with the manager who ‘would sort it out’. Those residents who had previously voiced a minor concern to the manager stated that these had been dealt with promptly and in a transparent manner. There have been no complaints and only two minor concerns in the past year relating to a particular meal and the ironing. Residents are able to take part in the civic process by either postal votes or by visiting the polling station. The manager will help residents to access financial or legal advisers and can arrange advocates if required. All staff have undertaken training in the safeguarding of the vulnerable adult and those spoken with showed that they were aware of their responsibility Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 17 towards those in their care. A new member of staff was sent to the social services training session on safeguarding adults. There have been no adult protection issues in the home. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 18 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): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is excellent, this is based on the available evidence including a visit to this service. The home is well maintained and decorated, and provides a clean, pleasant environment for residents. Residents are able to bring in their own furniture therefore providing a homely feel to their rooms, an attractive landscaped garden is accessible to all residents. EVIDENCE: The home is well maintained and decorated to a high standard with well landscaped gardens to the front and rear. The gardens are accessible to all residents. The home has an attractive lounge and a separate dining room and there are comfortable seats and a sitting area in the entrance area. A new shaft lift has recently being fitted, residents said that this has made a difference as the previous lift doors were heavy. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 19 There are no communal bathrooms in the home, but all rooms have an ensuite with bath or shower and assisted bathing aids are provided. All parts of the home meet the size requirements of the amended National Minimum Standards. There are twenty-four single rooms and two double rooms, all have a lockable door facility and residents are offered keys within the auspices of a risk assessment. Evidence of this is seen in the care plans. Residents bring their own furniture into their rooms; a lockable drawer or cupboard is provided for those residents who self medicate. All rooms are attractively decorated and curtains, linen and carpets are fit for purpose. All rooms have a call bell, window restrictors and radiator guards. The hot water from residents outlets is tested on regular basis and records kept, they were seen to be within recommended parameters. The home has been assessed by a qualified person and has sufficient aids, including moving and handling aids and grabrails to meet the needs of the residents in the home. There are policies and procedures relating to infection control and staff have received basic training in this. All staff have their ‘Food Hygiene Certificate’. Residents stated that the standard of laundry and cleanliness within the home was ‘Very good’, ‘my room is cleaned very well and the rest of the home is always beautifully clean’ and ‘The laundry is always fresh and clean but the standard of ironing could be improved’. All areas of the home were very clean on the day of the visit, with no odours apparent. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 20 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): 27,28,29 and 30 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Sufficient staff with appropriate skills are employed to meet the assessed needs of the residents. Monitoring of recruitment systems is essential for safeguarding the residents. EVIDENCE: Seven members of staff were spoken with during the inspection, all stated that there were sufficient staff on duty over a twenty four hour period to meet the assessed needs of the residents and that they did not feel rushed or too busy to give time to the residents. Residents said that ‘the bell is answered promptly’ and ‘staff have time to talk with us and are quick to do things when we ask them to’. Care staff are supported by sufficient domestic and catering staff, with agency staff rarely being used. Staff attend training relevant to the care of the residents in the home. Training has included attending a Deaf/Blind awareness session, ‘Death and Loss’, ‘Bereavement’, ‘Developing good relationships within the work place’, and ‘Safeguarding Adults’. All staff have attended health and safety mandatory training and food hygiene training. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 21 70 of the care staff have their National Vocational Qualification level 2 in care. The home is considering training to take part in the ‘Liverpool Care Pathway’, a palliative care tool for those residents who may become terminally ill. All staff undertake an induction course which meets the National Training Organisation Guidelines, with ancillary staff also partaking in this induction alongside training relevant to their role. A total of six personnel files were examined, there is evidence that all documentation as required by the regulations is obtained prior to the individual commencing employment at the home. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 22 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): 31,32,33,34,35,36,37 and 38 Quality in this outcome area is excellent, this is based on the available evidence including a visit to this service. Management systems within the home protect residents, staff and visitors. Residents views about the service offered by the home are sought, and responses gained influence the service provided. Efforts are made to improve all aspects of the home and to provide a service in line with the expectations d i h f th id t EVIDENCE: The manager, Mrs Shaw, has been in post for a number of years, she has the National Vocational Qualification level 4 in care and the Registered Managers Award and is registered with the CSCI. Residents stated that the ethos within the home was ‘Friendly and homely’ and that staff ‘Are very polite and kind’ and ‘The staff will do anything you ask and Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 23 the manager comes around every day to make sure we are alright and is very approachable’. Staff turnover is very low, many staff having worked at the home for a number of years, staff said that the working atmosphere was ‘Very good’ and ‘A lovely place to work’. There is a quality monitoring system in place, which includes questionnaires given to residents on an annual basis. Some quality monitoring takes place on the monthly care reviews. Residents meet three monthly to give their opinions about the menus and food, and auditing of the service offered by the home takes place. The manager uses results of the questionnaires to inform the service the home offers. There are yearly residents meetings, and residents and staff are made aware of the CSCI inspection reports. It is recommended that the manager approaches health and social care professionals for their views on the home. Annual staff meetings take place and minutes of these were seen. The manager does not act as appointee for any resident, and the home has no money or valuables in keeping for residents. The provider undertakes regulation 26 visits on a monthly basis, these were seen in the home and address all the issues that are required by the regulations. All staff receive formal supervision on a two monthly basis, with the manager receiving supervision from the provider. All records relating to staff and residents and other aspects of the service were seen to be accurate and secure. The pre-inspection questionnaire identified that all certificates relating to the servicing of equipment and utilities were in place, and in date and this was evidenced. The gas certificate was seen and it was noted that the lift is still under post commissioning warranty. The inspector was assured that the IEE certificate is kept at the main office. All staff have undertaken mandatory training and twenty-one members of staff hold a current yearly first aid certificate. Fire drills take place, with residents and staff being aware of the actions they should take in the event of fire. Both the fire risk assessment and general risk assessments for the building are in place. Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 24 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 4 4 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 3 18 4 4 4 4 3 3 4 3 4 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 x 3 4 3 4 Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations That the medications brought into the home for those residents who self medicate have the number of medicines received and a signature of the member of staff on supplying the medication to the resident recorded. That the residents name is written into the controlled drug record on each occasion that the medication is administered. That the views of health and social care professionals visiting the home are sought as part of the quality monitoring procedure, and views obtained are included in the home’s improvement plan if necessary. 2 OP33 Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 26 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 Bramble Cottage Retirement Home DS0000014180.V311672.R01.S.doc Version 5.2 Page 27 - 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. 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