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Inspection on 22/08/05 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 22nd August 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.

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

Residents said that they consider that the providers give excellent care and services. They like the physical surroundings, the staff and the manager. A visitor described the home as "absolutely perfect". Staff are experienced and enthusiastic. One described the home as "really friendly". The home is maintained to a very high standard and records, policies and procedures are well kept.

What has improved since the last inspection?

Since the last inspection the home has met both requirements. The manager has reviewed its adult protection policy, and ensures that fire doors are no longer propped open. An automatic door closure has been installed on a bedroom door.

What the care home could do better:

Where residents self medicate, the home must ensure that drugs are held securely. It is recommended that care staff receive formal supervision at least six times a year. The manager`s job description needs minor review.

CARE HOMES FOR OLDER PEOPLE Bramble Cottage Retirement Home 18 Carden Avenue Brighton East Sussex BN1 8NA Lead Inspector James Houston Unannounced 22 August 2005 09:00 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. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bramble Cottage Address 18 Carden Avenue Brighton East Sussex BN1 8NA 01273 565821 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) Bramble Care Homes Ltd Mrs Diana Shaw Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (OP), 28 of places Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is twenty-eight (28.) 2. Service users will be older people aged sixty-five (65) years or over on admission. Date of last inspection 4 February 2005 Brief Description of the Service: Bramble Cottage is registered to provide accomodation 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. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon of the twenty second of August 2005. Before the inspection papers held by Commission for Social Care Inspection were read, and those standards to be inspected prepared. The inspection in the home took 5.6 hours. A tour was made of most of the premises. A variety of records including three care plans were read. The inspector met nine residents, a visitor, three staff and the home’s manager. Twenty-six residents were being accommodated on the day of the inspection. What the service does well: 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. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 6 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 Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 7 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) 3,4,5 and 6. The home fully assesses prospective new residents. The home meets the needs of the current resident group. Residents are encouraged to visit the home before admission to assist them in the decision about to whether or not to enter the home. EVIDENCE: Records inspected showed the home carries out its own full needs assessment on prospective residents, and obtains a copy of Care Management assessment papers where these are to hand. Discussion with residents, staff, a visitor, and the manager and the reading of a range of records showed that staff individually and collectively have the skills and experience to meet the needs of residents. Residents said that they had visited the home prior to admission. The manager said that she or a colleague visit residents in their own setting where this is needed. Emergency admissions are made only rarely. Intermediate care is not offered in the home. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 8 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) 7,9 and 10. Care plans are well kept. Medication administration systems are thorough, but medication held by residents who self medicate must be held securely. Residents are treated with respect. EVIDENCE: Three care plans were read in detail. They set out in detail action to be taken by care staff. Care plans are reviewed monthly. Risk assessments are drawn up and reviewed regularly. Daily recording is made for residents and these entries were found to be to be up to date and well written. Staff said they had received guidance in writing in such documents. The home has a key worker system. Medication administration records were inspected and were fully kept. Residents said that the home deals with their medication well. The home has suitable medication administration policies and procedures. Staff said that they have received suitable training, and records inspected confirmed this. A local pharmacist regularly visits the home to check its systems. Medication held by residents who self medicate must be held securely. Residents said that they are treated with dignity by staff and that their privacy is respected. Residents said that staff knock before entering their rooms, and call them by the name they prefer. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 9 Staff said that they respect the privacy and dignity of residents whilst giving personal care and residents confirmed this. Most residents have their own phone in their own rooms, and they receive their mail unopened. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 10 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 and 13. Social activities are well managed and provide interest and provide interest and variation for people living in the home. Visitors are made welcome. EVIDENCE: Residents said that they exercise choice about the routines of daily living such as times of getting up and where they eat. Residents have the opportunity to exercise their choice in relation to religious observance. Residents said they have the opportunity to participate or not in the wide range of activities arranged in the home. Residents spoke of enjoying, amongst others, the quizzes and the arts and crafts. There are regular outings which residents said that they enjoy. The home displays prominently information about forthcoming events. The manager shops regularly for residents, and plans to bring a mobile shop into the home shortly for the benefit of residents. Residents said that their visitors are made welcome and offered hospitality. Staff said that they see this as important. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 11 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. The home has suitable arrangements to deal with complaints made to it. The home’s procedures and processes are designed to protect residents in the event of any allegations of abuse. EVIDENCE: The home has a suitable complaints policy, which is made available to residents. Residents said that they are aware of it. The log where complaints made are kept was inspected and was found to be well kept. There have been no complaints made to the Commission for Social Care Inspection about the home in the last year. Since the last inspection the manager has reviewed and redrafted its adult protection and related guidance. Staff are aware of the adult protection procedures, and have had recent training on this area and on challenging behaviour. Adult protection procedures have not been invoked in respect of anyone living at the home. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 12 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) 19,20,24,25 and 26. The home provides accommodation to high standard. Communal and bedrooms are well presented. Residents live in safe comfortable surroundings. The home’s laundry service is suitable. EVIDENCE: Bramble Cottage is a large detached building in its own grounds. The home is on three floors all served by a passenger lift. The garden area is accessible to residents and they said that they enjoy using it. One said that it is like “ a small park”. The whole building is well maintained and equipped. Staff described how matters needing attention are addressed, and the home’s maintenance staff member was in the home during the inspection. The home received a report from the Fire Officer in March 2005, detailing fire safety matters requiring attention. Evidence was produced that these have been attended to. A recent Environmental Health Officer report identified no issues needing attention and the home has just been awarded the Clean Food Award of Brighton and Hove City Council. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 13 The home has a range of communal areas: a quiet reception lounge to the front, a larger south-facing lounge to the rear, a large dining room and a small inner dining room, and a lobby with a pay phone. These are all well furnished and decorated, and lighting is domestic in character. Residents’ bedrooms are spacious and all have en-suite facilities. Almost all ground floor rooms have French windows onto the gardens, and several first floor rooms have balconies. Residents said that they like their rooms and that they have been able to bring in their own possessions. Records inspected showed that an inventory is kept of these. Residents said that, if they wish, they can have a key to their rooms. Rooms are centrally heated, with the heat controllable in the residents’ own rooms. Radiators are guarded. Lighting is domestic in character. The home checks regularly to prevent risks from Legionella. The home’s laundry is suitably sited away from food preparation areas. The manager said that the home is planning to re-equip the laundry shortly. Staff said that they have had suitable training in infection control and records inspected confirmed this. The home was clean and tidy throughout. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 14 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. A competent staff team meets residents’ needs. EVIDENCE: A staff rota was available for inspection. This showed that three carers are on duty during the day, and two carers are on waking duty at night. There are in addition catering, cleaning, administrative, gardening and maintenance personnel. The manager is on the rota and works in the home on a full time basis. She said that she and representatives of the owners are on call to staff, and staff confirmed this. Residents and staff confirmed that they consider that there are sufficient staff on duty to meet the needs of residents. Residents said that on those occasions when they have had to use the alarm call system the response was very rapid and helpful. Residents said that staff turnover is very low, and staff said that agency staff are very rarely used. The manager said that no staff aged under 21 are left in charge of the home. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 15 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) 31,34,35,36 and 38. The registered manager is able to discharge fully her responsibilities. The home has suitable financial procedures. Residents’ financial interests are safeguarded. Supervision of staff needs some attention. The health and safety of residents is promoted. EVIDENCE: The home’s manager has managed Bramble Cottage since 1993. Staff said that she is approachable and a resident described her as an “amazing lady”. She has attended relevant training and has recently completed the registered managers award. Her job description needs minor amendment. Staff said that lines of communication in the home are clear. The home employs an administrator, who said that she is responsible for many of the home’s day-to-day financial procedures such as invoices. A suitable insurance certificate was on display. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 16 The administrator and manager said that the home does not currently hold any monies or valuables for residents, but confirmed that the facility to do exists, should the need arise. Staff confirmed that they receive regular formal recorded supervision. Records inspected did not show the recommended level of at least six times a year being attained in all cases. At this inspection no fire doors were found to be propped open. A bedroom door has been fitted with an automatic door closure. Staff said that they have had recent training in fire safety, first aid, moving and handling, and food hygiene, and records inspected confirmed this. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x 3 3 2 x 3 Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 18 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 9 Regulation 13(2) Requirement Ensure that when residents self medicate drugs are held securely. Timescale for action 31 August 2005. 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. Refer to Standard 31 36 Good Practice Recommendations Review managers job description. Supervise all care staff at least six times a year. Bramble Cottage Retirement Home H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex 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 H59-H10 S14180 Bramble Cottage V238864 220805 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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