CARE HOMES FOR OLDER PEOPLE
Bramble Lodge 82 High Lane West West Hallam Derbyshire DE7 6HQ Lead Inspector
Gail Meads Unannounced Inspection 17th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bramble Lodge Address 82 High Lane West West Hallam Derbyshire DE7 6HQ 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) (0115) 9444545 (0115) 9326566 Bucintoro Limited Mrs Susan Kim Cumberland Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Plus Four (4) Day Care Places Date of last inspection 22nd August 2005 Brief Description of the Service: Bramble Lodge is a predominantly new purpose built Care Home providing 34 single and 3 double bedrooms for Older People. The Home is set in its own extensive landscaped gardens that have been designed to enable wheelchair users and other residents easy access.The Home is situated on the edge of a rural area and the village offers only a few shopping facilities. However, the Home is only a short drive from the town of Ilkeston and the city of Derby both of which offer good shopping facilities and amenities.The services offered are 24 hour staffed care, 3 meals per day, personal laundry, heating and lighting, transport a range of leisure activities and social events. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place at the home over a four and a half hour period additional time was spent in preparation for the visit, looking at previous reports and other documents. During the inspection process a number of documents were examined, including, staff files and records, time was spent looking around the building and speaking to a number of residents, and to the manager and staff. The inspector spent a specific amount of the inspection concentrating on the Standards not assessed during the last inspection dated 22/08/05. What the service does well: What has improved since the last inspection?
The manager/provider and staff strive to provide a good quality of care for all the residents in the Home. This is demonstrated by their willingness to develop and change the services provided if resident care can be improved. There were no requirements made in the last inspection dated 22 /08/05 and there are no areas of concern in this report.
Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 6 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 Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1.4. The manager/provider and staff continue to provide a good administrative structure and information is detailed and easily accessed. Residents are Informed about the services and enabled to make informed choices. EVIDENCE: The homes Statement of Purpose was assessed and found to meet requirements. A full and informative information guide is given to each resident on admission. Residents are given the information that they need to enable them to make an informed choice about moving into the home. Intermediate care is not provided at this home. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 9 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): 11. The arrangements made for the care of residents when dying is appropriate and sensitive. EVIDENCE: There is a policy for the care of residents who are dying in place. The manager/provider stated that If the resident states that they wish to die at the home they would do everything they could to meet the wishes of the resident. The manager/provider stated that the resident’s general practitioner would be consulted and any nursing needs identified would be provided. Relatives/friends can visit at any time and the resident would not be left alone. The appropriate spiritual needs of the resident would be sought. Funeral arrangements would be made according to the residents/relatives identified wishes. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 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 the following standard(s): 14.15. Residents are supported and encouraged to maintain control over their own lives when appropriate. The food provided to residents is very good. EVIDENCE: The manager/provider stated that at the time of the inspection there were no residents dealing with their own finances or self-medicating.. The home has information made available to all residents/relatives about the advocacy services provided by Age Concern and Care Aware. The residents bedrooms assessed demonstrated that residents are able to bring their personal items and furniture with them One resident bought her cat with her into the home. There is a statement made in the residents’ Information Guide informing residents/relatives of their right of access to all information held by the home concerning themselves. Time was spent with residents during their lunch period the food was well presented hot and in amounts appropriate to the residents identified needs. Alternatives are always provided one resident said “you can have pretty much what you want and its always very good” another resident said “you could not complain about the food its excellent”
Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 11 Time was spent with the cook after the meal and she talked of a recent course she had attended that was dealing with the provision of soft food diets, she was delighted to share how it had changed her way of providing food for this group of residents. The provider had supplied a number of food moulds to enable the cook to provide soft foods that looked like a proper meal. The cook felt that the meals provided for this group of residents had now become a more valuing experience for them. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 12 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): 17. Residents are given information about how to gain legal advice/information should they need it. EVIDENCE: If residents need legal advice and their relatives are not in a position to help them the manager would ensure that an Age Concern/Care Aware advocate was requested to assist them. Solicitors would be also sought if required. All the residents are encouraged to use their voting right. There are regular residents meetings held to enable them to be more involved in the provision of services and the day to day running of the home. Minutes from the residents meetings were examined. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 13 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): These Standards were not assessed during this inspection as they were inspected 22/08/05 and found to meet the requirements. EVIDENCE: Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 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 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): These Standards were not assessed during this inspection as they were inspected 22/08/05 and found to meet the requirements. EVIDENCE: Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33.34.35.36.37. The home has a Quality Assurance system in place. Staff are given induction and regular supervision as required. A record of residents’ financial transaction is maintained. Health and safety issues are carried out and recorded as required. EVIDENCE: Residents/relatives are given a questionnaire to complete twice yearly a number of areas of care provided is audited e.g. accidents complaints and staff training the information is collated and feedback is given to residents/relative through the residents meeting and the provision of a newsletter. The information is used to promote the development of appropriate services to residents. The home can make the homes accounts available for inspection if needed. The record maintained for residents financial transactions was examined and found to be satisfactory.
Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 16 Two staff files were assessed during this inspection the appropriate information as identified in Schedule 2 was in place. There were completed induction and supervision minutes completed. The induction process takes place over a six week period it is very detailed and appropriate to the learning needs of staff members. Training programmes are maintained for all staff. Staff receive supervision on a six weekly basis and a staff appraisal is also completed yearly. All staff information is audited frequently to assess that the information held is always updated. A number of records were assed during this inspection including accidents, complaints, staff files, staffing rotas and the Statement of Purpose all were maintained as required. The service records of fire equipment, gas, electric, hoists and shaft lift were examined and found to up to date. The environmental health and fire officer inspection had taken place, no recommendation had been made. Water tests had been carried out for the prevention of Legionella as required. Health and safety posters were displayed throughout the home. The home has a current insurance certificate displayed in the front entrance. Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x 3 N/A x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 3 3 3 3 Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 18 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. Refer to Standard Good Practice Recommendations Bramble Lodge DS0000019944.V264268.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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