CARE HOMES FOR OLDER PEOPLE
Bramble Down Nursing Home Woodland Road Denbury Newton Abbot Devon TQ12 6DY Lead Inspector
Clare Medlock Unannounced Inspection 11th September 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 Down Nursing Home DS0000058730.V304038.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 Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Bramble Down Nursing Home Address Woodland Road Denbury Newton Abbot Devon TQ12 6DY 01803 812844 F/P 01803 812844 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) www.peninsularcarehomes.co.uk Peninsula Care Homes Ltd Sandra Thorp Care Home 39 Category(ies) of Physical disability (39), Physical disability over registration, with number 65 years of age (39) of places Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Maximum number of service users to be accommodated is 39. The categories are PD 39, TI 39, PD(E) 39 and TI(E) 39. 30th November 2005 Date of last inspection Brief Description of the Service: Brambledown is a care home which provides personal and nursing care to a maximum of 39 Residents. The home is a purpose built care home which has two floors. The home has a passenger lift and variety of equipment, adaptions, grab rails and ramps to ensure Residents are able to maintain independence. The home have mostly single rooms and 8 double rooms. All rooms have ensuite, telephone point, radio and television and residents have an option to bring in items from home to personalise their room. There is a registered nurse on duty at all times and the home have a call bell system. There are two communal lounge areas, a conservatory and newly appointed separate dining room. There are four bathrooms which are fitted with hoists. Residents have their clothes laundered in the on site laundry. There is an activities programme which Residents are able to access if they choose. Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on Monday 11th September at 11am. It consisted of speaking with residents, relatives, staff and the manager. Care plans, staff files and other records were inspected. Prior to the inspection, the Manager submitted an in depth pre inspection questionnaire. Resident and relative surveys were also returned and used for this inspection. What the service does well: What has improved since the last inspection?
There have been many changes and improvements made at the home since the last inspection in November 2005. The Manager has become registered with the Commission for Social Care Commission which shows she has
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 6 demonstrated the skills and knowledge to manage a care home. The Manager has then made many improvements which improve the life and safety for the residents and staff at the home. Residents now enjoy an improved environment. The two adapted bathrooms have now been completed and have been decorated to a very high standard. Both bathrooms have top of the range baths which allow residents to enjoy a bath whilst enabling them to be moved safely by staff. The decoration programme continues at the home with the ongoing redecoration programme. Some rooms have new carpets and new curtains had been hung in communal areas. In the dining room the conservatory doors had been removed to ‘open up’ the room and increase heating in the colder months. Outside the home the gardens had been well maintained and had been decorated with colourful bedding plants. Care at the home has also improved. Nursing staff at the home have worked very hard to introduce an improved care plan system which clearly demonstrates what care is needed and how this is to be achieved. Records are now concise, up to date and show individual needs. The management of dietary needs and nutrition has improved at the home. All resident have their weight recorded and a nutritional assessment performed on a regular basis. Any risks are then identified and acted upon. The chef at the home has also introduced food moulds for residents who require a soft or pureed diet. Foods can be pureed but then moulded back into the shape of that food stuff which helps protect privacy and dignity of residents. The chef ensures residents have access to fresh fruit on a daily basis and serves this chopped and arranged attractively to increase appetite. The safety of residents has been improved by the introduction of two new hoists to ensure more are available for staff use. Light switches in cupboard have been replaced with timer switches to reduce wastage and prevent fires. Staff files are now complete which demonstrates staff have been thoroughly checked. The Manager now ensures two signatures are recorded when money is placed or removed from resident ‘pocket money’ folders. This protects residents from financial abuse and protects staff at the home. Records have also been improved at the home. The use of bed rails continues but now only done following full assessment and consent from the resident or relative. Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 7 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 Down Nursing Home DS0000058730.V304038.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 Down Nursing Home DS0000058730.V304038.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service Residents and their families are given enough information to decide whether Brambledown is the right place for them to be. The home also thoroughly assess prospective residents to ensure staff at the home are able to meet their needs. EVIDENCE: A Statement of Purpose and Service User Guide were produced for this inspection. Both documents included necessary up to date information. This enables Residents to decide whether the home is the right place for them to be. All Residents are issued with a contract. A sample of these contracts was seen and contained the correct information. Residents spoken to say their relatives made the final decision to come to the home as admission was from hospital and a trial visit was not appropriate. One
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 10 resident said his son had looked at many homes and decided Brambledown was the right place for them. Residents spoken to said the Manager visited them before they were admitted which was lovely and meant they had a familiar face when they came to the home. Care Plans confirmed that the Manager performs a thorough check on residents to make sure staff at the home can meet their needs and know where to access specific help and advice. Staff spoken to in the home confirmed they did not have any resident with cultural differences but confirmed that if this were the case they would find out as much information prior to the admission. Staff spoken to said some staff were from overseas which had been difficult at first but worked well now. Bramble Down Nursing Home DS0000058730.V304038.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 good. This judgement has been made using available evidence including a visit to the service The improved clear and consistent care planning system means that the health and social needs of Residents are fully planned. Staff communicate well with the multi disciplinary team, which safeguards Residents. There is an ethos within the home that promotes the privacy and dignity of Residents at all times. EVIDENCE: All residents seen on the day of inspection appeared well cared for. Residents being cared for in bed appeared warm, pain free and had call bells within reach. Residents were seen to have clean eyes, teeth, and were dressed in their own clothes. Residents who wore glasses had them on and footwear appeared appropriate. Residents stated that they felt very well cared for. One resident said ‘you could not ask for better staff and even when they are short staffed they are kind and caring’. One relative questionnaire stated that: If staff levels are low whatever the reason, the standard is only slightly below par to normal, which is high.’
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 12 Thank you cards seen in the home said ‘Thank you so much for the care and attention’ and ‘Thank you for the great hospitality. It was nice to see him in such a lovely home’. Four Care Plans were inspected on this occasion which clearly demonstrated that Residents have all their needs met and make sure staff are aware of all aspects of the care. This system of Care Plans has been changed since the last inspection. The newly changed care plans were inspected and were written to a high standard that was easy to read and follow. All care plans were up to date, well written and complete. A separate system of care planning at night was present which reflected in detail specific care needs, routines and likes of the residents. Risk assessments for skin care, continence, risk of falls and use of bed rails were seen in all care plans and had been regularly reviewed. The improvements in the care planning are to be commended at the home. Care Plans showed that staff access a range of health care services for the residents. These services included out patient appointments, visits by the GP, District nurse, speech and language therapist, physiotherapist. Continence nurse specialists and other nurse practitioners are also consulted when needed. During the inspection, one resident was returning from an appointment with her own dentist. Discussion with relatives stated that regular dental appointments are not performed due to a lack of dentists in the area but the home would arrange an appointment if necessary. All residents spoken to said staff were very kind and caring. All residents said they wear their own clothes, staff knock before entering their room and residents receive their post unopened. During the inspection, the administrator was delivering post to residents. Some residents chose to have a telephone in their room. Rooms where residents share have screening, which was used by staff. Residents said staff had been able to move their room upon request and where a spare room became available. During the inspection, a resident was overheard thanking the manager again for the room change. The homes medication administration system is a pre packed blister pack system that the local pharmacy delivers with some additional boxed or liquid medicines. The storage area of the medicines were, clean, tidy and secure and the systems for the collection and disposal of medicines were well managed. The recording of medication was on the whole well completed, however there were repeated gaps in the MAR (Medication Administration Record) where staff had not signed to say they had given the drug or may have omitted to give the medicine. This needs to be reviewed as a matter of importance. Sharps bins throughout the home were not labelled in the correct manner.
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 13 Four Resident questionnaires were received regarding this service. All stated that residents feel they always receive the care and medical support they need. Three relative questionnaires said that they are always kept up to date with changes in care and consulted about plans of care. Bramble Down Nursing Home DS0000058730.V304038.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 good. This judgement has been made using available evidence including a visit to the service Social activities are creative, well managed and varied. Residents have choice and control over their lives whilst living at the home and enjoy the meals that are provided. EVIDENCE: Observation of the visitor’s book confirmed that friends and family have access to the home at any reasonable time. Discussion with relatives confirmed relatives are able to join their families for lunch with minimal notice to the home. A tour of the home confirmed that Residents rooms are personalised by bringing in personal possessions with them to the home. Residents spoken to said they are able to go out for lunch with family and friends. Residents spoken to say they always receive post unopened and are able to make and receive telephone calls in private. Discussion with the Manager and observation confirmed that the home have a new activity co coordinator who has recommenced the activities programme. She works three days a week. Residents spoken to said they were able to join
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 15 in with these activities if they chose. Staff said these activities are varied and at least one day is spent by the coordinator going around to see individual residents. Residents, staff and posters confirmed that activities include bingo, 1:1’s reminiscence sessions, musicians, tranquil moments, knitting, 1:1 reading sessions, quizzes and charity fund raising. Discussion with the Manager and residents confirmed that Brambledown had hosted a fete on a wet afternoon recently and had raised over £400 for Devon Air Ambulance. Care Plans contained some information on residents but not all forms were completed. All residents and relatives spoken to said the food was excellent. Residents said there was enough and ‘seconds’ was always offered. A rota of menus was produced pre inspection but this may vary depending on seasonal produce. During the inspection the chef turned down a batch of cooking apples as the home has it’s own apple tree, which is used in addition to a Damson tree. On the day of inspection residents were served chicken and bacon casserole and bakewell tart. Fresh fruit was available and observation showed that the chef cuts up a variety of fresh fruit and arranges it attractively on an individual plate to tempt residents. For those residents who need soft and pureed diets, the chef has introduced moulds that pureed food is put into so the food resembles the piece of food. Moulds seen included; peas, broccoli, carrots and swede. This should be commended as it can often increase the appetite of residents. Staff have also introduced a nutritional screening tool, which identifies those residents of being at risk of loosing or gaining weight. A Quality Assurance Survey showed there had been an improvement in meals since the last inspection. This effort by the staff at the home should be commended Bramble Down Nursing Home DS0000058730.V304038.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 adequate. This judgement has been made using available evidence including a visit to the service The recent training in adult protection awareness is beginning to protect Residents and will continue as it is introduced. Residents feel able to complain knowing the manager will act on them appropriately. EVIDENCE: The existing requirement that the Manager must implement adult Protection training is being implemented but has passed the timescale set. The Manager explained this has been delayed due to being unable to find a suitable training provider. The Manager stated that an external trainer has been used for the adult protection awareness training and this programme will continue. Some staff spoken to said they had received training and others said they had not yet had it. Residents spoken to said they felt safe at the home and that staff were kind and gentle. Staff at the home have introduced a bed rail assessment and consent form which is now used to ensure residents give consent for the use of bedrails and to make sure they are only used appropriately. The Manager produced the complaints register. The home have only received one formal complaint in 2006. Records confirmed that this is being dealt with
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 17 appropriately. The Commission for Social Care Commission have not received any complaints about Brambledown since the last inspection. All resident and relative questionnaires stated that no complaints have needed to be made but they knew how to complain. One relative said she has not needed to complain because things get sorted out before they become problems. Residents spoken to said the Manager comes around the home often and if there are any problems they just tell the nurses. Staff at the home spoken to said they have never had to complain but go to the Manager with small issues, which get sorted out immediately. Bramble Down Nursing Home DS0000058730.V304038.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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service Brambledown is a purpose built and provides a safe comfortable home in which Residents are able to stay as independent as possible. The home has a good standard of décor, furnishings and fittings, which provide a comfortable pleasing environment for residents to live in. EVIDENCE: Brambledown is a two-story purpose built Care Home, which has adaptations and equipment to ensure Residents needs, are fully met. There is a choice of bathing facilities, both assisted and unassisted, showers and baths and there are a number of toilets strategically placed around the home. There are also well placed storage cupboards throughout the home. A tour of the building confirmed that the home employ a maintenance man who was observed to carry out routine and ad hoc repairs.
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 19 On the day of inspection there was a lot of activity within the home. Building work was being carried out to provide the last of three extra single ensuite bedrooms. All work was being done behind doors to ensure the safety of the residents. Residents spoken to said the noise is limited and that some other residents have moved rooms because of the noise. A tour of the building confirmed that the Provider continues to fund improvements to the home. The two bathrooms have been completed to a very high standard and include high tech adjustable baths which make residents feel safe and provide safe moving and handling for staff. Residents were seen to be enjoying the two finished bedrooms and the third was inspected and is close to completion. Conservatory doors by the dining room have been removed to open up the room and provide extra heat and space. Some rooms have been re decorated and carpeted and the process of replacing curtains has now been completed. Timers have been installed on light switches to save electricity and reduce the risk of fire in cupboards. Outside the home the gardens have been well maintained and decorated with colourful flowers. Infection control measures are present within the home. Hand cleansing gel was available throughout the home, and further hand dispensers and towels are available. Tabards are used at mealtimes and some staff have received infection control training. All Residents spoken to said the home is always clean, warm, well lit and comfortable. Bramble Down Nursing Home DS0000058730.V304038.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 judgement has been made using available evidence including a visit to the service The improved recruitment procedure and staff induction ensure residents are cared for by a suitably selected team. EVIDENCE: All residents were very positive about the staff. Comments included ‘caring’ ‘wonderful’ and ‘always kind and polite’. Discussion with the Manager confirmed that staffing levels have been low over the last few weeks because of sickness and holidays. The Manager, staff and residents all stated that agency staff have been employed and that staff pull together. Staff also stated that the Manager has come in to work to ensure residents were safe. Off duty records confirm generally the aim is to provide two trained staff plus the manager in the morning with 8 carers. Then in the afternoon this is two trained nurses and 4-5 carers between 6 and 8.30 and then 1RGN and 2 carers overnight. One relative questionnaire stated that: If staff levels are low whatever the reason, the standard is only slightly below par to normal, which is high.’ Five staff files were inspected on this visit. All files contained all information required to show that all staff have had the necessary checks performed. The
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 21 Manager confirmed that all staff are issued with a contract and copy of the General Social Care Council Code of Practice. Written induction records are made, however these were not present in some staff files inspected as they were with the staff members who were not on duty. Off Duty records confirmed that more than 50 of the staff have NVQ 2 or equivalent. Training files were inspected but evidence was not clear. This is scored and reported in the next section. Bramble Down Nursing Home DS0000058730.V304038.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 adequate. This judgement has been made using available evidence including a visit to the service The manager is supported well by staff within the home with all staff demonstrating an awareness of their roles and responsibilities. The home is generally well managed and provides a safe place to live. Training at the home is inadequate and could potentially place residents, staff and the Provider at risk. EVIDENCE: The atmosphere at the home appeared bright. The first thing heard by the inspector was laughter amongst staff. Some residents were observed to enjoy a friendly ‘banter’ with staff and affection was shared between the Manager and residents. The Manager has become registered with the Commission for Social Care Commission since the last inspection. The Manager is a Registered Nurse with
Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 23 experience of running care homes. She also has completed the Registered Managers Award and updates her knowledge on a regular basis. Communication between the Commission for Social Care Commission and Manager is good. The Manager has also worked hard to try and achieve the Requirements and Recommendations set at the previous inspection. Residents, Staff and Relatives all spoke highly of the Manager and said she was approachable and tried her best to sort out things before they became problems. Staff said she had worked hard recently to maintain staffing levels during the recent shortages and has even come in to work as a carer to make numbers up. Records and discussion with staff confirmed that staff receive regular supervision and have daily report sessions each day. Staff also stated that they also receive daily supervision as part of the Management process. Staff said they sometimes see the Provider and Area Manager and have out of hours contact details for all managers. Staff meetings have been held on a regular basis. Minutes demonstrated that the Managers at the home enable staff to voice their opinions and concerns. Resident meetings are held within the home and are advertised through posters, although the Manager said next time she will send ‘fliers’ to encourage more residents and relatives to attend. Since the last inspection the Manager has worked very hard to perform a quality assurance survey. This information has been collated and compared to last year’s results to show where improvements have been made and are needed. The improvement in meals was obvious from the data and this supported the findings and feedback from residents at this inspection. The Home is managed very well. The Manager employs an administrator who is involved in the day-to-day running of the home. Together they have improved the way ‘pocket monies’ are recorded ensuring two signatures are obtained which protects both resident and the home. Discussion with Residents and Relatives confirmed that the home do not manage the financial affairs of the Residents and that this is done by the Residents, their families or a solicitor. Up to Date Service Records were seen in respect of the prevention of legionella, fire safety, lift, bath and hoist maintenance, gas and electricity checks, and waste management. Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 24 First Aid boxes were present at the home and Accident books were correctly completed. Generally the records seen within the home were well maintained. Accident books allow for the reporting of dangerous incidents to RIDDOR and allow follow up and action. All records seen were secure and stored in a safe manner. The Main area of concern within this inspection was the poor organisation of the training programme. Feedback from staff was that some staff had received some mandatory training but not all staff had received all mandatory training. A Previous Requirement for adult Protection training was unmet due to the Manager having difficulty obtaining a training provider. Some recent training was cancelled due to staff shortages. This had been rearranged. Other training within the home was inconsistent with minimal evidence being produced. The Manager was aware of this and would be making this her next priority. Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 1 Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13(2) Requirement The Manager must ensure staff correctly record the administration of medicines correctly Existing Requirement: The Manager must ensure that the adult protection training is complete The Manager must ensure all staff have revieved all mandatory training and have evidence to show this has been done Timescale for action 01/03/07 2. OP18 13(6) 01/01/07 3. OP38 18(ci) 01/07/07 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. Refer to Standard OP9 OP12 OP24 Good Practice Recommendations Staff at the home should label sharps bins correctly Staff at the home should ensure the social care plan is completed for all residents The Manager should replace all worn bed linen.
DS0000058730.V304038.R01.S.doc Version 5.2 Page 27 Bramble Down Nursing Home Bramble Down Nursing Home DS0000058730.V304038.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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