Inspection on 15/02/06 for Brambles

This inspection was carried out on 15th February 2006.

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

Brambles 08/07/09

Brambles 04/05/07

Brambles 21/09/05

Brambles 25/11/04

Brambles 22/06/04

Brambles 12/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Brambles Brambles Bramble Lane Wye Ashford Kent TN25 5EW Lead Inspector Lisbeth Scoones Unannounced Inspection 15th February 2006 10:10 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 Brambles DS0000023328.V281227.R01.S.doc Version 5.1 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. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brambles Address Brambles Bramble Lane Wye Ashford Kent TN25 5EW 01233 813217 01233 813217 pkr.carehome@tesco.net 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) Mr Arnold Hartnoll Parker Mr Kevin Arnold Parker, Mrs Jean May Parker Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: Brambles provides homely accommodation for a maximum of 18 residents aged 65 and over. There are two lounges: one for TV viewing, the other for music and relaxation. (The lounge has a fish tank and two budgies). The dining area backs onto a large heated conservatory allowing all year use. All rooms provide single accommodation. There are en-suite facilities in some rooms as well as communal assisted bath and adequate toilet facilities. In summer, the large, well-maintained garden is accessed for eating out, parties and fetes. A greenhouse is provided for those residents who like gardening. Brambles is situated just outside the centre of Wye village; the bus stop and railway station are nearby. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over just under 4 hours and comprised discussions with the owner/manager, assistant manager, other staff, some of the residents, a partial tour of the building and the examination of records. This was a positive inspection with input from the residents, the manager and some of the staff. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected but standards 1, 2, 3 and 5 were inspected and met at the previous inspection. The Statement of Purpose and Service User Guide have recently been updated. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Residents’ personal, health and social care are recorded on an individual plan of care. Residents’ health care needs are fully met. Residents are protected by the home’s policies and procedures for dealing with medicines Residents are treated with respect and due regard for their privacy and dignity. EVIDENCE: A sample of care plans examined was well maintained and reviewed every month by the care supervisor. Some aspects of a resident’s care plan needed an update following a recent change in condition. The assistant manager said that the team involved with provididing specialist care (Rapid Response), would provide their own notes, which would then feed into the home’s care plan. Care plans provide the staff with comprehensive information needed to deliver the care. Risk assessments are undertaken and the outcome recorded. The residents sign their care plans and a copy is kept in their rooms. Staff maintain daily records. Residents’ nursing needs, including assessment and Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 9 the provision of pressure relieving and moving and handling equipment are met by district nurses who keep their own notes, which are available to staff in the home. Residents have access to other health care specialists as e.g. chiropodist, dentist, optician, continence advisors and community psychiatric nurses. At the time of the inspection, a resident had been referred to and was awaiting assessment by the psycho-geriatrician. As already mentioned, a resident, recently returned from hospital was receiving additional support from the Rapid Response team. The team was praised for their assistance both in respect of services (physiotherapy and occupational therapy) and the provision of equipment. Medication charts are well maintained and the medication policy has recently been updated. The assistant manager audits the medication charts daily. Safe storage of medication is provided but currently there is no dedicated medication room or medication trolley. Plans for a dedicated room are incorporated in the home’s plans for an extension. It was observed that staff treat the residents with humour, dignity, patience and respect. Residents said that they liked the staff and one resident said, “They all are very good”. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 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): 12, 13, 14, 15 Residents find that the home offers opportunities to meet their social and religious needs and to continue with their preferred lifestyle and recreational interests. They maintain contact with family and friends and the local community. Residents are assisted to exercise choice and control over their lives and are provided with a choice of healthy balanced meals. EVIDENCE: Residents are provided with a wide range of activities and entertainment. A staff member has responsibility for organising activities and outings. A resident said, “Nothing is too much for her.” Residents said they liked “making things” and recently created artwork includes home made cards and placemats. Two residents said they were looking forward to the monthly meeting at the Wye Gardener Society that evening. Several residents are keen gardeners and the home provides opportunities for looking after plants, growing tomatoes in the greenhouse and planting bulbs. The garden is full of wildlife and on the day of the inspection, pheasants, a rabbit and robins were spotted. A resident said, “It is like living in a wood”. Trips to the local garden centre are organised. Residents are part of the community and get invited to organised events in the village hall. Residents said that staff respect their wish not to take part in activities. Residents are Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 11 enabled to go to church and attend a communion service. Contact with families and friends is encouraged. Residents said they liked the home cooking and are provided with a choice of meals. Lunch was steak and kidney pie/ broccoli/carrots/potatoes /rice pudding/apple or blackcurrant juice. The dining room overlooks the garden and provides a pleasant and relaxed environment. The kitchen was visited and looked clean and well organised. Fruit and fruit juices are provided. A resident praised the cook’s pastry making skills. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 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): 16, 18 Residents know that staff will listen to their complaints and concerns and will act upon them. Residents are protected from abuse. EVIDENCE: Complaints are recorded and logged. There is a complaints procedure for residents to follow. Residents said that staff are receptive to their needs and act upon any concern expressed. In addition to adult protection training, staff are presented with a questionnaire to check their understanding of the issues. There are policies for the reporting of adult protection and whistle blowing. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 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): 19, 26 Residents live in a homely, clean, safe and well-maintained home. EVIDENCE: The home provides a homely, clean and well-maintained environment for its residents and all space is used creatively. As already referred to, plans for an 11-bedded extension are underway. In addition to 11 additional bedrooms, the extension would provide more communal space, a sluice room, hairdressing room, clinical room and a new (nurse) call system. The provision of a shower is included in the extension plans. The manager said that the shower might be installed before the home is extended. Rooms visited were comfortable, personalised and homely. A resident said, “ The whole place is nice.” The home was clean and fresh. There are policies for and staff are trained in infection control. Appropriate systems are in place for hand washing in respect of paper towels, liquid soap and foot operated bins. Currently there is no sluice room and the utility room acts as a multi purpose facility. Plans for a Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 14 sluice room are incorporated in the home’s extension plans. There is a dedicated laundry room. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 15 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, 30 Residents are cared for by competent well-trained staff in numbers deemed appropriate. Residents are protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: Staffing levels are stable and currently the home is fully staffed. In addition to the manager and assistant manager who work in a supernumerary capacity, two care workers cover every shift. At night there is a sleeping and waking member of staff. Other staff on duty were the cook, cleaner and a recently employed care worker in a supernumerary capacity. The hairdresser was also in the home. Every resident has a key worker. Residents said they know who their key worker is and what that role entailed. At the time of the inspection, the dependency levels were higher than usual due to two residents’ changing needs. Staffing implications were discussed. As already referred to in standard 8, the Rapid Response team was assisting the home. The assistant manager said, “I regularly work hands on.” She also said that some senior care staff would be available for additional flexi hours if needed. NVQ training is encouraged and many members of staff have a level 2 or 3 qualification. A staff member said that she had NVQ 2 ands 3 qualifications Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 16 and enjoyed all training provided. A newly appointed care worker, who worked in a supernumerary capacity, said she was enjoying her induction training. The manager and assistant manager organise staff training and a training matrix is available. Staff are well trained both in respect of induction, level 2 and 3 (and 4) NVQ, statutory and other training as e.g. adult protection, dementia awareness and medication training. In respect of statutory training, see also standard 38. Every member of staff has an individual training file. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 17 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, 35, 36, 38 Residents benefit from a well run home. The manager is supported well by senior staff in providing clear leadership throughout the home with all the staff demonstrating an awareness of their roles and responsibilities. There are good systems in place ensuring that residents’ views on the service provided are sought. Staff are well supervised and supported. Residents‘ financial interests are safeguarded. Residents’ health, safety and welfare is promoted and protected. EVIDENCE: The home is owned and managed by Kevin Parker, a qualified nurse with 20 years experience of the care industry. He is the chairman of the Kent Care Homes Association. The home has a management structure with clearly defined roles and responsibilities. Mrs Sheila Butcher, the assistant manager, Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 18 is also a qualified nurse with many years of experience of managing care homes. She has completed her NVQ 4 in management and is responsible for training, staff supervision, staff rotas, medication and quality assurance. Staff meetings are organised three times a year. A recent staff meeting for senior care staff took place in early February. Job descriptions have recently been reviewed. Effective quality assurance measures are in place in respect of residents’ satisfaction (questionnaires), staff supervision and the review of care documentation, policies and procedures. Residents said that residents meetings take place regularly usually after lunch. A resident said, “Kevin comes round each day.” Residents are encouraged to control their own monies. Some residents’ relatives have requested that the home manages their relatives’ personal monies. Excellent records were maintained for the financial transactions, including receipts, a running total and regular recorded audit. Whilst no individual wallets are maintained, residents’ financial interests are safeguarded thereby meeting the standard. All staff receive formal supervision every 2 months and a yearly appraisal as was evidenced on the supervision matrix. A record of a recent supervision session undertaken with a senior member of night staff was seen. The assistant manager said that supervision provides an excellent opportunity to introduce new or reviewed policies, as was recently the case in respect of new job descriptions. The inspector did not meet with the care supervisor who is training to become an NVQ assessor and is planning to do a mentorship course. Staff said they were happy with the training and that they feel well supported by senior staff and management. The home provides a safe environment for its residents and staff and risk assessments are undertaken. In respect of safety, two issues were discussed. Two residents said, “The exit via the front door can be a bit tricky” and requested a grab or safety rail outside the front door. The home currently does not have a user-friendly path for walkers or wheel chair users. Mr Parker said than the latter was incorporated in the home’s development plans. The issue of grab rails would be considered but it was pointed out that the home has other safe ways of entering and leaving the home. It was recommended that that the issue would be risk assessed. A senior carer is the home’s health and safety coordinator. Staff are provided with statutory training, which include moving and handling, first aid, infection control, food hygiene and fire safety awareness. Regular fire drills are organised. Accident records are well maintained. The manager informs the CSCI of all reportable events under that regulation. Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 19 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 x 3 3 x 2 Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/A 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. 1 Refer to Standard OP38 Good Practice Recommendations That the safety of entering and leaving via the front door be risk assessed Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brambles DS0000023328.V281227.R01.S.doc Version 5.1 Page 22 - 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. 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