Inspection on 22/04/08 for Bramble Lodge Care Home

This inspection was carried out on 22nd April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bramble Lodge Care Home 07/07/09

Bramble Lodge Care Home 17/04/07

Bramble Lodge Care Home 24/04/06

Bramble Lodge Care Home 23/08/05

Bramble Lodge Care Home 26/04/05

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Bramble Lodge Care Home Delemere Road Park End Middlesbrough TS3 7EB Lead Inspector Jackie Herring Key Unannounced Inspection 22nd April 2008 09:00 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 Care Home DS0000061455.V363407.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 Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bramble Lodge Care Home Address Delemere Road Park End Middlesbrough TS3 7EB 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) 01642 322802 01642 322803 Grant Williamson Mr Kenneth Walton Care Home 41 Category(ies) of Dementia (23), Mental disorder, excluding registration, with number learning disability or dementia (18) of places Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, maximum number of places: 23 Mental disorder, excluding learning disability or dementia - Code MD, maximum number of places: 23 The maximum number of service users who can be accommodated is: 41 17th April 2007 2. Date of last inspection Brief Description of the Service: Bramble Lodge is a two storey purpose built 41 bedded care home with nursing which operates two separate units for different categories of care. One unit is for older people with a mental disorder and the other unit is for older people with dementia. All 41 bedrooms are single rooms with ensuite facilities containing a toilet and wash hand basin and the rooms meet the required size. There are a number of bathrooms and showers as well as a variety of lounge areas. The home is set in its own grounds, with car parking. Bramble Lodge is located close to shops, public houses and transport. The weekly fees for Bramble Lodge range from £511 to £549. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced Key Inspection of Bramble Lodge Care Home; as such all of the key standards related to older people were looked at. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use the services, and that it does what the Care Standards regulations say it must. The visit to the home was conducted in one inspection day by one inspector. During the visit to the home, a number of records were looked at, including records of people who use the service, along with medication records, staff records, training records and maintenance information. A number of surveys from people who live at the home and one from a relative were also received. Time was spent talking to people who use the service, relatives and staff. Time was also spent walking around the home, observing interactions and generally finding out what Bramble Lodge Care Home was like for the people who live there and staff. Discussion also took place with the care manager and there was also some discussion with the manager and proprietor. The manager has completed the Annual Quality Assurance Assessment (AQAA), the services self-assessment of how well they think they are meeting standards. This was received prior to the inspection and some of information has been reflected within the report to support the judgements made. Discussion took place with the Operations Manager and Manager who both acknowledged there was the need for some areas of improvement and further development at Bramble Lodge Care Home. It was however clear that the organisation were committed to making these improvements. What the service does well: People who live at Bramble Lodge have a warm, well-maintained, homely and comfortable place to live. It is a very relaxed home in which there is choice and flexibility of life. People who live there said, “I am quite satisfied, the staff are very helpful and I feel that they are meeting my needs and helping me get better”. Another person said, “Everyone is here to help and if I need to know anything there is always someone to ask”. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 6 Staff said of what was good about the home, “Everyone mucks in together, we have a good team and there is always someone there to support us. It is a well run home and the manager is approachable”. Another member of staff said, “People are well cared for and are happy. There are lovely relationships and a good bunch of staff who all work well together”. People who were spoken to were also positive about the meals, they said, “Fantastic meals, if I could eat like this everyday that would do me”. 53 of staff are trained to NVQ level 2 with a number of other staff underway with this. People who live at the home benefit from a good range of skill mix in the staff team. What has improved since the last inspection? What they could do better: Whilst it is acknowledged that progress has been made to the care records, this needs to continue further. Some staff also need some further Dementia Care training to more fully understand how this impacts upon people and to ensure that rights, independence and dignity are key to providing care. The way in which meals are managed in the upstairs unit also need to be reviewed to ensure that it is a much more positive experience for people living there. A number of staff need to attend for mandatory training to ensure that they are up to date. Some additional information is needed within the staff files. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Bramble Lodge Care Home DS0000061455.V363407.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 Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 3 & 6 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People have their needs assessed before being admitted to the home and they were assured those needs would be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA detailed the pre admission assessment process. It was stated, “We have a comprehensive pre admission assessment tool that is carried out by the home manager or a person who is trained in carrying out these assessments”. It also states that care management assessments are also obtained prior to admission into Bramble Lodge. Two sets of care records of people who use the service were looked at, one for a recent admission and one for a person who had lived at the home for six months. There was a pre admission assessment in place in one of the records looked at along with a care management assessment. However it was Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 10 confirmed that the manager had completed a full assessment in respect of the second person, ensuring their needs could be met by the home. These records were not available at the time of inspection, however the explanation was acceptable and the records would be back in the service in the near future. Bramble Lodge Care Home does not provide intermediate care. Bramble Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 7, 8, 9 & 10 were looked at during this inspection. People who use the service experience adequate quality outcomes in this area. People, who could say, are happy with the way in which care is delivered by staff. Some of the records detailing how health and personal care is to be delivered and associated risks need more detail and information and some further training is needed in regard to caring for people with dementia to ensure that respect and dignity are fully promoted. The system for managing medication is good and only staff who have received the appropriate training have any involvement with medication. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The same two sets of records were looked at in more detail. The actual format in terms of information flow was good, leading from assessment to care plans, related risk assessment and daily records. Since the last inspection, there had been improvement in the way the care records are written, which are now much more person centred. It was agreed with the manager that further Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 12 work was needed to develop these further and this had already been identified through a recent audit. There is the need to ensure that the assessment and care plans contain all of the information required, have associated risk assessments and the all information is being cross-referenced. Examples of this included a person whose primary mental health needs were not fully specified within the assessment and there was no corresponding care plan, this was the same with someone’s restless and wandersome behaviour, for which they needed additional medication. A number of additional examples were shared with the manager during the inspection. There is also the need to ensure that the first full care needs assessment is completed soon after admission as in one of the files looked at, this did not happen until one month after admission. A range of risk assessments are incorporated within the care records including for example moving and handling, nutritional screening, continence and level of dependency. In one of the files looked at these had not been fully completed. The new accident audit systems needs to be implemented within the home. It was also identified that the evaluation of care needed to be developed further as it does not contain information as to the effectiveness of the care interventions. Currently they contain information like, “presentation unchanged, care plan valid”. There are clear records that detail the involvement of other people such as GP’s, District Nurses, Optician and Continence Advisors. A GP was observed to be visiting on the day of inspection. One of the people who live in the home said, “I am quite satisfied, the staff are very helpful and I feel that they are meeting my needs and helping me get better”. The people who were spoken to and could give informed information about Bramble Lodge believed they were treated with respect. One person said, “I am treated pretty good by the staff, they don’t talk to you like you are not important”. From observation during the inspection, it was identified that some of the care delivered to people at Bramble Lodge was not as personcentred as it could be and staff needed further training particularly in regard to Dementia Care. A member of staff when asked what life was like for the people who live at Bramble Lodge said, “They are content, you can see it in their eyes”. The medication system was looked at on the ground floor unit. The system was good in terms of ordering, storage and administration, with appropriate checks and supporting records in place. The records looked at contained appropriate information. It was confirmed that only qualified nursing staff were involvement in the administration of medication and that there is some Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 13 ongoing competency assessments. Medication audits are in place. It was recommended that the temperature of the downstairs medication room be monitored, as additional ventilation may be needed. One person’s medication administration record needed some additional information following agreements made by a multidisciplinary meeting. Bramble Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 12, 13, 14 and 15 were looked at during this inspection. People who use the service experience adequate quality outcomes in this area. People who use the service have some opportunity to take part in activities, although this could be developed further. They are supported to live in a flexible environment where there is choice of routines and independence. Improvement is needed to make the mealtime experience for some of the people more positive. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There are two activity co-ordinators in post within Bramble Lodge, both of who have been recently appointed. They are in the process of getting to know more about the people who live at the home and their interests, as such, there is no activities programme as such but it was confirmed that one would be developed in the near future to meet the collective and individual social and recreational needs of people. Relatives can freely visit the home and people spoken to said their friends or family did visit. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 15 The menu had been reviewed and updated since the last inspection and there was now clearly two choices available to people. The menu showed a good variety and selection of meals and is in the process of being looked at by a dietician to ensure that the meals are nutritional. People who live at Bramble Lodge said, “Fantastic meals, if I could eat like this everyday that would do me”. At the last inspection it was identified that the mealtime experience for people who lived within the first floor unit could be improved. The inspector spent time observing lunch and it was again identified that a number of improvements could be made. The mealtime came across more as a task for the staff to do rather than a positive experience for people who live at the home. People who needed to be supported with their meals did not get the appropriate level of support and another person who was requesting some attention did not get this and the inspector had to intervene. Tables were not appropriately set and people who were well able to use condiments had to request them and wait for them to be brought up from the kitchen. There were a number of areas of concern from this mealtime, which impacted upon dignity and respect of some of the people living at the home. These concerns were fully shared with the manager and operations manager, who agreed that this was not acceptable and agreed to look into these experiences. Staff said that choice and decision making was encouraged and this was also confirmed by people who live at the home. Life was described as relaxed and flexible and people who were able to could decide how they spent their days and lived their daily lives. A number of people were observed to be spending time in their rooms, whilst other were in the lounge areas. There was discussion with the manager about perhaps looking at different opportunities for different people in the home as there are now some younger people living there. Bramble Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 16 & 18 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People who live at the home are generally confident their complaints would be listened to, taken seriously and acted upon, although the actual procedure needs updating. People who live at the home are protected from abuse by the home’s policies and procedures. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA detailed that no complaints had been received in the past 12 months. A complaint had been made to CSCI, which was passed back to the provider to investigate and respond to, which they did. Information about this was available within the complaints records at the home. The complaint procedure was not on display in the home, the manager took immediate action to address this and confirmed that it had previously been available. It was confirmed that people received a service users guide and that the complaints procedure was contained within it. A service users guide was looked at and the complaints procedure was clearly available. It was however in need of updating and again the manager said this would be addressed quickly. People who were spoken to said they knew what to do and who to speak to if they had any concerns. One person said, “Ken the manager is very approachable”. Staff who were spoken to said they were aware of the topic of abuse and protection of vulnerable adults and knew what action to take if this was Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 17 necessary. The training records showed that staff had received this training, however further update training was needed and was in the process of being arranged. Bramble Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 19 and 26 were looked at during this inspection. People who use the service experience good quality outcomes in this area. The home provides an environment that is appropriate to the specific needs of the people who live there. People are able to personalise their bedrooms and the home is warm, clean and comfortable. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Bramble Lodge Care Home provides care for older people with dementia and mental health needs across two units. It is a spacious home with a good amount of communal rooms, suitably located throughout the home. It is a very clean, warm and comfortable for people to live. Since the last inspection, there has been an extension constructed, which provides an additional six bedrooms to the home and some additional lounge space. The front garden is accessible to people who want to use it and is a safe environment. Furnishings Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 19 are of a good standard and there are homely touches such as pictures and ornaments throughout the home. A member of housekeeping staff was spoken to. They said, “Yes there is sufficient equipment to do the job and sufficient staff who are on duty across the seven days”. There was evidence of personalisation of people’s own rooms, with people having family photographs, TV’s, DVS’s and other personal belongings. People who were spoken to said they were very satisfied with their rooms. All bedrooms are single rooms with ensuite facilities. There is the choice of bathrooms and showers for people to choose from. All are pleasantly decorated and well appointed throughout the home. Audits and checks are in place to ensure that Bramble Lodge is a safe place for people to live; this includes the monitoring of water temperatures. When asked about any improvements to the service a member of staff said, “It would be useful to have a small kitchen upstairs to make tea for example”. Bramble Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 27, 28, 29 & 30 were looked at during this inspection. People who use the service experience good quality outcomes in this area. People who live at the home have their needs were met by the numbers and skill mix of staff who were trained and competent to care for people who live at the home, although some staff need some further updating. People are protected by the home’s recruitment procedures. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Bramble Lodge is a care home providing nursing care for older people with dementia and older people with mental health needs. The qualifications and skill mix of staff is appropriate to meet the category of care and needs of people living there. During the day there is always two qualified staff on duty, one of each of the units and is usually a combination of a Registered Mental Nurse and a Registered General Nurse, which works very well. The qualified staff are supported by a number of care staff, which are thought to be sufficient in number to meet people’s needs. One member of staff said, “Yes there is sufficient staff, we have time to spend with the residents and to sit and chat with them”. Surveys from people who live at Bramble Lodge contained the following comments, “The staff are very kind to everyone”, “The staff are helpful”. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 21 Three sets of staff files were looked at and they generally contained the information needed to show that good recruitment procedures are in place, such as application form, CRB checks and reference. Care is however needed to ensure that the full range of information is kept on individual staff members files, such as passport and birth certificate. The manager agreed to action this straight away. A training programme and matrix was looked at, which had been improved upon since the last inspection. It was however noted that a number of staff were not up to date with the required mandatory training, steps are already underway to address this as it had recently been identified through an in-depth audit of the service by the provider organisation. Staff confirmed that there was a regular rolling programme for training and that they had completed both mandatory training as well as dementia care training. It was thought that it would be beneficial if there were some additional client specific training, which included other mental health needs. 53 of staff are trained to NVQ level 2 and a number of other staff are in the process of completing this qualification. It was confirmed that staff who are not qualified to NVQ Level 2 in care complete the Skills for Care common foundation standards. Bramble Lodge Care Home DS0000061455.V363407.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards: 31, 33, 35 & 38 were looked at during this inspection. People who use the service experience good quality outcomes in this area. The home is well managed and generally run in the best interests of the people who use the service. The health, safety and welfare of people who live at the home and staff was promoted and protected, however some additional staff training will enhance this further. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A Registered Mental Nurse, who has the relevant experience, knowledge and skill to manager the home, manages Bramble Lodge Care Home. He has been in post for a number of years. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 23 People who were spoken to said they were happy and settled in Bramble Lodge. One person said, “Everyone is here to help and if I need to know anything there is always someone to ask”. Staff said of what was good about the home, “Everyone mucks in together, we have a good team and there is always someone there to support us. It is a well run home and the manager is approachable”. Another member of staff said, “People are well cared for and are happy. There are lovely relationships and a good bunch of staff who all work well together”. The AQAA detailed the personal allowance system and this had been looked at during previous inspections of the service. Quality assurance was discussed with the manager who said that a range of audits take place within home to ensure that the home was operating at a good level and areas for improvement could be identified. This included audit of care plans, the medication system and the environment. In terms of quality assurance, surveys had been sent to relatives with some limited response. No actual summary report had been produced from this as yet; it was something that was still in the process of being developed. The manager also said that staff supervision was not taking place quite as regularly as it should however, they were aware of it and were addressing this. A sample of service and maintenance records was looked at. Regular servicing of equipment is taking place. Care is needed with the weekly fire checks, as there have been occasions when these have not been completed. Not all staff are up to date with their mandatory training despite the organisation having a rolling programme. The manager is currently addressing this. Bramble Lodge Care Home DS0000061455.V363407.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X 2 X 2 Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 14 • Requirement Individual assessments must continue to be developed to ensure that all needs are assessed and appropriate care plans are in place. These must be completed in a timely way. The evaluation of care must be improved, which shows whether the care interventions are being effective or not and the plan of care changed if necessary. There must be evidence of service user/ representative’s involvement. Timescale for action 31/07/08 • • • These improvements would enhance the care records further and further promote more detailed and person centred care. 2. OP8 13/14 Health care risk assessments 31/07/08 must be completed shortly after admission and be regularly updated. The new accident audit DS0000061455.V363407.R01.S.doc Version 5.2 Page 26 Bramble Lodge Care Home needs to be implemented. These will help to ensure that people’s health care are being monitored and appropriate care provided. Further training must be carried out to ensure that the respect shown to people and their dignity is fully promoted. The management of meal-times must be reviewed further to enhance the dining experience for some of the people living at the home and to ensure that appropriate support is in place needed to ensure independence and dignity is in place at appropriate times. Mechanisms must be in place to ensure that all staff receives mandatory training ensuring that people continue to be safe within the home. 4. OP10 12 (4) a 31/07/08 5. OP15 12 (4) a 31/07/08 6. OP38 18 31/08/08 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. 4. Refer to Standard OP9 OP16 OP29 OP30 Good Practice Recommendations The temperature of the ground floor medication room should continue to be monitored and if it is too hot may to have additional ventilation. The complaints procedure should be updated and any records containing a copy of the complaints procedure should also be updated. The manager should keep copies of all documentation as specified within Schedule 2 Care Home Regulations 2001. Further dementia care training should be arranged and consideration should be given to developing and DS0000061455.V363407.R01.S.doc Version 5.2 Page 27 Bramble Lodge Care Home 5. OP33 6. 7. 8. OP36 OP38 OP12 implemented additional client specific training such as topics on mental health. The quality assurance systems should continue to be further developed to include additional customer satisfaction questionnaires and to make the results of any questionnaires available to relatives and residents. The planned programme for staff to receive formal supervision six times per year should continue to take place for all staff. A system should be in place for the fire alarms to be checked weekly in the absence of the maintenance person. The recreation/social activities programme should be developed in accordance with detailed social and lifestyle assessments of all individual residents. Bramble Lodge Care Home DS0000061455.V363407.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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