Inspection on 23/07/07 for Brambledene Rest Home

This inspection was carried out on 23rd July 2007.

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.

Other inspections for this house

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Brambledene Rest Home 20-22 Moorland Road Weston Super Mare North Somerset BS23 4HN Lead Inspector Alison Murray Key Unannounced Inspection 23rd July 2007 09:30 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 Brambledene Rest Home DS0000069528.V345698.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. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brambledene Rest Home Address 20-22 Moorland Road Weston Super Mare North Somerset BS23 4HN 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) 01934 633711 01934 419485 Alutarius Ltd Post Vacant Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate older persons (category OP) who require personal care only. May provide a service for up to 14 persons of either sex. Date of last inspection N/A Brief Description of the Service: Brambledene Residential Care Home is situated in a quiet residential road in Weston-Super-Mare and close to the seafront. The town centre is nearby with a range of shops and recreational activities. The home is registered to provide residential care for up to 14 older persons in two semi-detached Victorian houses. The accommodation is situated over two floors with a chair lift and stairs for accessing the upper floor. A lounge and dining area is situated at the front of the house and there is a separate sun lounge overlooking the rear garden. Since spring 2007, the home has been owned by Alutarius Ltd. Mr Neil Plummer is responsible individual for the company The current fee levels are between £359 and £360 per week. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a 7.5 hour period. Before the site visit, all information CSCI has received about Brambledene since Alutarius Ltd took over the running of the home was reviewed. Comment cards were sent to residents, relatives and health and social care professionals. Responses were received from 4 residents, 5 relatives and one health and social care professional. Their comments are included in the body of the report. Mrs Rosemary Munday, the deputy manager, was available throughout the inspection; Mr Plummer, the company responsible individual was present for part of the visit. All areas of the home were inspected. There were twelve people resident in Brambledene. Nine of these residents were consulted individually, whilst a further three people were observed in the communal areas of the home. Not all people were able to comment on the care they received, but time was spent observing interactions between staff and residents. Staff were observed as they went about their work. What the service does well: Residents and relatives praised the ‘homely atmosphere’ at Brambledene. One person commented ‘This is a home from home. The meals appear home cooked, and the environment looks clean and always smells fresh’ People think that the staff deserve particular praise. One person said ‘the staff are extremely kind and caring towards not just my relative, but to the whole of the residents’. Another added ‘ the staff at Brambledene enable residents to feel part of an extended family’. This person went on ‘They make visitors very welcome; nothing is too much trouble’. Residents receive an excellent standard of care and support. Staff work well with other healthcare professionals, to ensure that residents’ needs are met. They show a commendable commitment to promoting residents’ dignity and respect. A healthcare professional said ‘staff have helped turn my client’s life around. They have supported my client, but have been very careful not to try and control him’. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 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 Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents are given good information about Brambledene, but those with mobility needs should be made aware that there are steps to some rooms. New residents have their needs assessed, before they move in to the home. Staff make sure that they have the information and equipment they need to care for them. EVIDENCE: The statement of purpose and service user guide are displayed in the entrance hall of the home. They give generally good information about what it is like to live at Brambledene. There are steps to some of the rooms on the first floor. These are not a problem for the current residents, but should be reflected in the statement of purpose, so people who are looking to move to the home are aware. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 9 Not all the residents could remember being given a contract when they moved to Brambledene. Individual files kept in the home showed that a contract had been given to all residents, including those funded by the local authority. People who are purchasing their care privately should be provided with a contract, whilst those who are funded by the local authority should be given a copy of the terms and conditions of the home. During the inspection, a lady was admitted to the home. Her relatives said that they had been able to spend time arranging her room, and talking to staff about her care needs and preferences. Staff said that they had made sure that the equipment the lady needed was in place before she moved in. When the lady arrived, staff introduced themselves, and the other residents. By the end of the afternoon, the lady said ‘I feel at home already’. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 10 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): 7, 8, 9, 10 and 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who live at Brambledene receive excellent support from a knowledgeable and caring staff team. They treated with respect, and are encouraged to maintain control over their lives. EVIDENCE: Care records for 5 residents were reviewed. These were clearly written, and gave staff very good guidance to meet assessed needs. Individual risks were identified, and sensible management systems put in place. One of the residents has poor eyesight. He likes to go out for walks, but staff were concerned that he would get lost. They agreed that he would carry the address of the home in his pocket. He said ‘If I get lost, I can just get a taxi back home’. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 11 A health professional commented that staff had been ‘very careful not to control’ her client. She felt that the home have supported her client and helped him to ‘turn his life around’. One person has a wound on her leg. Care records showed that staff had worked closely with the district nurses to treat the wound. Staff said it had nearly healed. Several of the residents require high levels of personal care. Staff said that they kept this under review, and would have no hesitation consulting the GP or district nurses if they felt they could no meet these people’s needs. Another person has a terminal illness. Staff have supported him as he made decisions about his future treatment. His wishes have been documented, and all staff consulted were aware of these. He is visited regularly be the GP and staff from the local hospice. He said ‘the staff are excellent. They make sure that I am comfortable and let me do things how I want. I feel that I am in control’. Since the last inspection, a monitored dosage system for medications has been introduced. Staff said that this is working well. The drug storage facilities were well organised, and medication charts demonstrated good practice. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 12 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose how they spend their time. They are given the opportunity to take part in a range of activities, and encouraged to maintain contact with friends and family. The majority of people enjoy the meals provided. EVIDENCE: Residents’ previous experiences, likes and dislikes are recorded in a ‘life history’ when they are admitted to Brambledene. Staff use this information to ensure that the activities they offer meet the needs and expectations of the residents. One person has always got up early, and gone out to get the morning paper. Staff make sure that he is still able to do this. Another person said that he likes to go out for long walks. Staff always put his meal to one side, and heat it up for him, if he is late back. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 13 Residents are given the opportunity to take part in a range of ‘low key’ activities in the home. These include sing along with a visiting musician, board games, and video afternoons. They also enjoy chatting with staff and fellow residents. Some people are encouraged to keep up membership of local clubs; others go to a nearby care home, owned by the same provider, to join the residents there in arts and crafts sessions. Relatives feel able to visit at any time. One person commented ‘I am always made welcome. The staff are very friendly, and make me feel as if nothing is too much trouble’. One person commented that the meals were ‘the same week in, week out, with little variety’. This view was not held by majority of residents, who said that they liked the food provided at Brambledene. Staff have recently reviewed the menus. These now operate on a 4 week rotation, with a choice offered at each meal. The lunch served during the inspection looked and smelt appetising. Portion size was nicely judged, with fresh green vegetables. Staff were attentive, and offered second helpings to all who wished. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 14 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear and accessible complaints procedure. Residents and their relatives know how to make a complaint, and feel comfortable that this would be dealt with appropriately. Staff have a good knowledge of safeguarding issues. EVIDENCE: The home has a clear and accessible complaints procedure. All residents and relatives consulted knew who to approach if they needed to make a complaint if necessary. No complaints have been received by either CSCI or the home. Staff said that they would record any concerns in an exercise book. It was recommended that they devise a form, on which people can record any complaints, concerns or compliments. This would make it easier to meet data protection guidelines. All the staff consulted showed a good awareness of safeguarding issues. Most had attended recent training in these issues. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 15 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): 9. 20, 21, 22, 23, 24 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents like the homely atmosphere at Brambledene, but will benefit from the planned refurbishment programme. People who have mobility needs may have difficulty accessing all areas of the home. EVIDENCE: Brambledene is made up of two connecting Victorian houses. Accommodation is provided on two floors, with a chair lift up one of the staircases. There are steps to some of the rooms on the first floor. There are grab rails beside these steps, and staff said that current residents do not have difficulty with them. Some people said that they found it difficult to use two of the toilets on the ground floor. These are built under the stairs, and have a small, narrow door. People said it was difficult to get in and out of the toilet with a walking frame. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 16 There is a more accessible toilet on the ground floor, but this is further from the lounge. Many of the residents said that they like the homely atmosphere and appreciate having their personal belongings around them. Some areas of the home look dated and are in need of redecoration. A refurbishment programme has been produced, which includes redecoration, together with the replacement of furniture and carpets. Since Alutarius Ltd took over the ownership of Brambledene, all the windows have been replaced. Residents said this has been very effective in cutting out draughts and noise. All areas of the home were clean and tidy. Staff showed a good awareness of infection control procedures, with paper towels and pedal bins in all bathrooms. Gloves and aprons were readily available. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Night staffing arrangements do not meet the needs of current residents. Recruitment procedures and training programme help to ensure that staff have the skills and experience to provide appropriate care to the residents. EVIDENCE: Residents said that there were enough staff on duty during the day time to meet their needs. At night, there are no waking staff, but two people are on ‘sleep in’ duty. Two of the current residents require care at night. Staff said that they get up at set times overnight to care for these residents. Care records indicated that a number of residents are at risk of falling. Two people had fallen overnight. Neither person had sustained a significant injury, but they had been unable to reach a call bell to summon staff. Night time staffing arrangements need to be reviewed to ensure that they meet the needs of the current residents. The records of three members of staff were reviewed. Two of these contained all the required checks. The third only contained one written reference. Mr Plummer explained that this person also worked for another Alutarius Ltd care Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 18 service. He was able to arrange for the second reference to be faxed from this other care service. Training records confirmed that newly appointed staff had completed an induction programme. All staff had attended training relevant to the needs of the residents. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 35, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and staff benefit from the open and inclusive atmosphere at Brambledene. Their views about the running of the home are taken into account EVIDENCE: The registered manager of Brambledene has recently resigned. Mrs Munday, the deputy manager was acting as manager. Mrs Munday has NVQ level 4, and many years of experience in the care sector. She demonstrated a very good knowledge of the residents’ needs and management priorities for the home. Mrs Munday was able to provide all the information necessary for the inspection. Staff and residents spoke highly of her. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 20 The home has recently introduced a quality assurance system. Residents have been asked to give their views about the running of the home. It was clear that many of their ideas have already been implemented. Small amounts of residents’ ‘pocket money’ are kept in a safe. Clear records are kept of deposits and withdrawals. Health and safety checks were generally well maintained, but there were some gaps in the record of fire alarm tests. Mrs Munday has now agreed to do these every week. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 21 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 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP27 Regulation 18.1 Requirement Night time staffing arrangements need to be reviewed to ensure that they meet the needs of the current residents. A copy of each reference obtained in respect of a member of staff must be kept in the care home. The fire alarm must be tested every week. Timescale for action 23/08/07 2 OP29 17.2 schedule 4 23.4 23/08/07 3 OP38 23/07/07 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 Refer to Standard OP1 OP2 Good Practice Recommendations People who have mobility needs may have difficulty accessing all areas of the home. This should be reflected in the statement of purpose. People who are purchasing their care privately should be provided with a contract, whilst those who are funded by the local authority should be given a copy of the terms and conditions of the home. DS0000069528.V345698.R01.S.doc Version 5.2 Page 23 Brambledene Rest Home 3 4 5 6 OP16 OP19 OP21 OP22 A form should be devised, on which people can record any complaints, concerns or compliments about the service. The programme of refurbishment should continue as planned Accessible toilets should be provided close to the lounge. The registered provider should explore options to improve the accessibility of the home. Brambledene Rest Home DS0000069528.V345698.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI - 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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