Inspection on 21/09/05 for Brambles

This inspection was carried out on 21st September 2005.

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 15/02/06

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 Announced Inspection 21st September 2005 09:20 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.V251142.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. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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.V251142.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th November 2004 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.V251142.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 7 hours and comprised discussions with the owner/manager, assistant manager and other staff, the majority of the residents, a leisurely shared lunch with the residents, a tour of the building and the examination of records. Prior to the inspection, 12 residents completed a comment card and all comments received were favourable. Some of these will be quoted in the report. The manager provided the inspector with information in a pre-inspection questionnaire. Information thus received informed the inspection process. This was a positive inspection with input from the residents, the manager and all staff. What the service does well: What has improved since the last inspection? The Statement of Purpose, Service User Guide and medication policy have been reviewed and updated. Comments made in the previous report in respect of food and food choices have been acted upon and the menus have been reviewed. Lounges and some bedrooms have been decorated and new lounge furniture supplied. Brambles DS0000023328.V251142.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. Brambles DS0000023328.V251142.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 Brambles DS0000023328.V251142.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, 2, 3, 5 1 The Statement of Purpose and Service User Guide are excellent and provide residents with the information they need to make a decision about moving into the home. 2 3 Each resident is provided with a written contract. Residents would only be admitted following a full assessment of need. 5 Prospective residents have an opportunity to visit the home and assess whether they would like to live there. EVIDENCE: 1 The Statement of Purpose and Service User Guide were seen on display. These have recently been updated and the inspector was provided with copies. Both documents have been completed in accordance with the standards. Information therein would provide the resident with all information needed to make an informed choice about the home and the services it provides. Residents said that they have access to the most recent inspection report. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 9 2 All residents are provided with a copy of the service agreement, which incorporates very detailed information including the complaints procedure. 3 and 5 Records of assessments undertaken prior to admission were seen. A resident said that she moved in for a trial period to see if she liked living in the home. Following this period, she stayed. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 7 Residents’ personal, health and social care are recorded on an individual plan of care. 8 Residents’ health care needs are fully met. 9 Residents are protected by the home’s policies and procedures for dealing with medicines 10 Residents are treated with respect and due regard for their privacy and dignity. EVIDENCE: 7 A sample of care plans was perused and this was well maintained and reviewed every month by the care supervisor. The home uses three types of care plan. One relates to the activities of daily living, one relates to cognitive needs and one to behavioural needs. 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 Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 11 needs, including assessment and 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. 9 Medication charts are well maintained and the medication policy has recently been updated. 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. 10 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, “You can feel they really care”. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 12 Residents find that the home offers opportunities to meet their social and religious needs and to continue with their preferred lifestyle and recreational interests. 15 Residents are provided with a choice of healthy balanced meals. EVIDENCE: 12 Residents are provided with a wide range of activities and entertainment. A staff member has responsibility for organising activities and outings. Residents said they liked “making things” and recently created artwork was seen on display. Residents said they were looking forward to an outing the following day to Folkestone for a drive and cream tea. Several residents are keen gardeners and the home provides opportunities for looking after plants, growing tomatoes in the greenhouse and planting bulbs. Trips to the local garden centre are organised. A resident said he liked walking in the garden. Residents are part of the community and get invited to organised events in the village hall. At Christmas time residents attend pantomimes at the Marlowe theatre in Canterbury. Residents said that staff respect their wish not to take part in activities. Residents are enabled to go to church and attend a communion service. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 13 15 Residents said they liked the home cooking. Residents are provided with a choice of meals. The dining room provides a pleasant and relaxed environment. The kitchen was visited and looked clean and well organised. The cook said that, in addition to the main meals, residents are provided with cakes and scones at teatime. Records are maintained of alternatives to the main menu. Fruit and fruit juices are provided. A bowl of fruit was available in the lounge. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents know that staff will listen to their complaints and concerns and will act upon them. 18 Residents are protected from abuse. EVIDENCE: 16 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. 18 Staff are trained in adult protection issues. There are policies for the reporting of adult protection and whistle blowing and the manager is aware of the revised Kent and Medway Adult Protection protocol. Staff spoken to demonstrated a good awareness of such issues. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 26 Residents live in a clean, safe and well-maintained home with adequate lavatories and washing/bathing facilities. EVIDENCE: 19 The home provides a homely, clean and well-maintained environment for its service users and all space is used creatively. Several bedrooms and the lounges have recently been painted and new furniture provided. 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 and clinical room. Rooms visited were comfortable, personalised and homely. A resident said, “ It is very nice and comfortable.” 21 There a number of communal bathrooms. A resident said that he would like a shower. 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. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 16 26 The home was clean and fresh. The home has 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 a multi purpose facility. Plans for a sluice room are incorporated in the home’s extension plans. There is a dedicated laundry room. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 27 Residents are cared for by competent well-trained staff in numbers deemed appropriate. 29 Residents are protected by the home’s recruitment policy and practices. 30 Staff are trained and competent to do their jobs but night staff attendance to training may need to be monitored. EVIDENCE: 27 and 28 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. Every resident has a key worker. Residents said they know who their key worker is and what that role entailed. In addition to the care staff, the home employs domestic and catering staff. 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 and enjoyed all training provided. A newly appointed care worker said she was enjoying her induction training. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 18 29 In order to confirm that the home’s recruitment practices are sound, a staff file was examined. This was comprehensively maintained and included all checks, refences and a detailed application form. 30 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. Training records are maintained. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 38 31 and 32 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. 33 and 36 There are good systems in place ensuring that residents’ views on the service provided are sought. Staff are well supervised and supported. 38 Residents’ health, safety and welfare is promoted and protected. EVIDENCE: 31 and 32 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. All staff praised the manager for being “good to work for” and “a good boss.” Mrs Sheila Butcher, the assistant Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 20 manager, is also a qualified nurse with many years of experience of managing care homes. She has nearly 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. 33 Effective quality assurance measures are in place in respect of residents’ satisfaction, staff supervision and the review of care documentation, policies and procedures. 36 Staff receive formal supervision every 2 months and a yearly appraisal. Staff spoken to said that these sessions are useful and informative. The assistant manager said that supervision provides an excellent opportunity to introduce new or reviewed policies, as was recently the case in respect of the medication policy. The inspector met with the well-trained 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. 38 The home provides a safe environment for its residents and staff and risk assessments are undertaken. 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. The assistant manager demonstrated her awareness of the need to ensure that night staff are included in all statutory training. Accident records are well maintained. The manager informs the CSCI of all reportable events under that regulation. Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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 3 3 x 3 3 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 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 x x 3 x 3 Brambles DS0000023328.V251142.R01.S.doc Version 5.0 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. 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 Brambles DS0000023328.V251142.R01.S.doc Version 5.0 Page 23 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.V251142.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!