Inspection on 04/05/05 for Brambles

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 08/01/10

Brambles 31/10/06

Brambles 20/10/05

Brambles 18/10/04

Brambles 10/05/04

Brambles 23/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Brambles Birchfield Road Redditch Worcestershire B97 4LX Lead Inspector Annie OMara Unannounced 4 May 2005 08:00 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 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 E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brambles Address Birchfield Road Redditch Worcestershire B97 4LX 01527 555800 01527 548888 brambles@heartofengland co.uk Heart of England Housing and Care Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Lorraine Joy Gibbons Care Home 60 Category(ies) of DE(E) Dementia (over 65) - 60 registration, with number OP Old Age - 60 of places PD(E) Physical Disabilities (over 65) - 60 Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may accommodate one person under 65 years of age who has a physical disability and a mental disorder. 2. The Home may also accommodate one person over 65 years of age with a learning disability. Date of last inspection 18 October 2004 Brief Description of the Service: Brambles is a purpose built home for older people who may have a physical disability and/or mental health needs asociated with old age. Additionally the home has registration for one older person with a learning disability and registraton for one person under 65 who has a physical disability and mental disorder. The home is set in a residential area of Redditch which is about half a mile from local amenities. A local bus service stops at the top of the drive. The home is on three floors and there is a passenger lift to all levels. All bedrooms are single and all have ensuite facilities. Adapted toilets and bathrooms are available on all floors. There is also a garden area which can be accessed by residents. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a six-hour period from early morning to the afternoon. The visit was carried out as part of the inspection program for the year. A partial tour of the building took place and staff records and care records were inspected. Two care assistants, one visitor and six residents were spoken to in detail during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Staff provided personal care to residents in an unhurried manner during the morning of the visit. However, the morning routine could be looked at to make sure the residents do not have to wait a long time for their breakfast or their medication. Changes in residents needs when they are ill could be recorded more quickly. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 6 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 E52 S28579 Brambles V225917 040505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 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 standard(s) 1, 2, 3, 4 The home provides good, accessible information for prospective residents, which details the services provided in order for them to make a decision about moving to the home. EVIDENCE: The statement of purpose and service users’ guide were in place and residents who were asked were able to say that they had seen copies of them and were aware of their purpose. They contained the information needed to help people form an opinion about the home and detailed the services provided. Two residents were able to confirm that they had been able to visit the home prior to moving in and have a trial stay before making a decision to be a permanent resident. One resident said she had made a “positive choice” to be at the home. Residents were assessed before moving to the home and documentation indicated that assessments were thorough and covered all areas of residents needs. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, 11. Care plans setting out the personal and health care needs of residents were generally kept to a good standard. Some minor additions were needed to ensure that residents’ health care needs were being consistently met. EVIDENCE: Care plans were in place for all residents and indicated that their personal and health care needs had been thoroughly assessed and agreed with them. There was evidence that they were regularly reviewed and residents who were spoken to about them were able to confirm this fact. Residents said that they were happy with the care they received and one resident continued to access her General Practitioner as she wished. Records were kept of visits by the primary healthcare team. Specialist mental health practitioners had also been involved appropriately ensuring that residents had support with their specialist care needs. A visitor to the home said she was very happy with the care her mother received. Residents were all complimentary about the staff and how they protected their privacy and dignity. Whilst observing care practices a member of staff was seen to engage with a resident with dementia in such a way that promoted her dignity and her independence. One resident named several members of staff who were very good and another said that she “admired them” and that they were “patient and respectful” Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 10 Choices were given to female residents with regard to receiving care from a male care assistant. Observations made during the inspection indicated that the morning medication round was one hour late. There was no protocol in place for staff to follow for a resident receiving medication for anxious behaviours which meant that there may not be consistency for the resident as to when she received it. Medication was kept in a locked trolley and the senior had received training in the administration of medication. She was seen to follow the homes’ procedures for safe administration. Medication received for one resident had not been signed in to show it had been checked. Residents were able to manage their own medication if they wished. Three requirements have been made in respect of medication practices. A care plan for a resident who had been terminally ill was seen. The home operates a system of “acute short term” care plans if a resident becomes ill to deal quickly with changes in needs. Daily records indicated that this had been delayed in starting although the resident had become quite ill. There was also a delay in writing an up date on a skin care risk assessment when a sore was noted and also the moving and handling risk assessment had not been up dated. Daily records kept did indicate that the resident received medical treatment, pressure care and frequent attention whilst unwell. The family were involved in their care and with sitting with the resident. Two requirements were made in respect of care records. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 11 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 standard(s) 12, 13, 14, 15. The management endeavours to provide suitable activities to keep residents active and interested. The residents are actively encouraged to exercise choices to maintain their independence within the home. EVIDENCE: There were differing opinions from residents about the activities on offer in the home. Half of the six residents spoken to felt the activities provided were adequate although five said they would like more outings. It was said the main problem with the outings it was said was lack of appropriate transport. The registered manager stated that on the day of the inspection, links had been made with a local community group, which provided transport. An activities organiser was employed by the home and residents spoke very positively about her. It was noted that the activities list was in very small print which made it difficult to read. One resident who stayed in her room did not know what activities were on offer, as she never saw the list. A visitor to the home said she was always made welcome and said she visited at different times during the day. The two mealtimes observed were relaxed and unhurried, with residents requiring help to eat being able to go at their own pace with assistance. At breakfast time there was a delay whilst residents were waiting for their cooked breakfast to come up from the kitchen but they did not become impatient as Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 12 the time was spent sociably with staff and residents. There were differing opinions about the quality of the food served, and the vegetables served on the day of the inspection were seen to be unappetising. The cabbage was watery and the potatoes had been sent up as boiled potatoes, which the staff said the residents did not like. Residents spoken to were going to discuss their concerns about the food with the registered manager in the residents meeting arranged to take place later in the day. It was commendable that residents were empowered to be open about issues that concerned them, promoting independence and autonomy. Other residents said the food was “good and plentiful”. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 13 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 standard(s) 16, 17, 18 There was an effective complaints procedure in place and evidence that it was used to the residents benefit. Measures were being taken to protect residents from the risk of abuse. EVIDENCE: There was a procedure in place which all residents spoken to were aware of, and they knew whom they should approach with any concerns. One resident was able to give an example of how the process had worked when she had made a complaint. She said she had been happy with the outcome. Residents spoken to were able to confirm that they had been enrolled on the electoral roll. Policies and procedures were available to guide staff in the protection of vulnerable people. There had been two incidents of concern raised with the management which were being dealt with by them. Money held in safekeeping and managed by the home for the residents was lodged in one ‘Residents Property Account’. Interest to each person’s balance was added pro rata. Money was said to be readily available whenever one of the managers was on duty. At other times a limited amount of money was available through the senior on duty at the time. Meticulous records were maintained of all Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 14 transactions and residents were able to see an account of their financial records when they wished. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 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 standard(s) 19 The home provides a safe and comfortable environment for the residents. EVIDENCE: The home was well maintained and clean on the day of the inspection. There were some walls in the corridor areas, which were in need of cleaning or repainting as they were scuffed. Good hygiene practices were observed and infection control measures in place. Staff wore gloves and aprons, which they changed as appropriate to the jobs they were undertaking. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staff received training to enable them to care for the residents in the home. Recruitment practices were thorough and provided protection for the residents. EVIDENCE: Half of the residents spoken to felt that there were not enough staff on duty and that they did not have time to spend with them although all praised the staff. Two staff also thought that more staff were needed, especially at busy times Staff were seen to be patient, efficient and having warm and affectionate relationships with the residents. The manager said that the home had vacancies for three care assistants to work during the day and a vacancy would soon arise for a care services manager. These posts had been advertised and recruitment was in progress in the mean time other staff were covering the vacant shifts. Two staff files were inspected. They indicated that an acceptable recruitment policy and procedure had been pursued. A duty roster was observed to be in use. Staffing levels were higher during the busier times of the day and the manager said that she had authority to increase levels when the needs of residents warranted it. A team of ancillary staff were employed and were under the supervision of the hotel services manager. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 17 There was a total care staff team of 35 people of whom six people had achieve qualifications in NVQ to level 2 or above and a further eleven people were currently on courses. The registered provider employed NVQ assessors and training was undertaken both in house and through the local college. The records showed that newly appointed staff undertook a structured induction programme and good records of progress and achievement were maintained. The manager said that the registered provider was developing a similar structured foundation programme. In the meantime the training matrix demonstrated that training in other relevant care subjects supported induction training. Two staff were interviewed, one being relatively new to the home. Both people demonstrated a knowledge and respect for the residents in the home. One person needed more training relating to the content of the complaints procedure and location of the home’s risk assessment documents. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 to 37 The home was well organised and managed by a competent team. Staff were well supported and guided in their duties enabling them to meet the needs of the residents. Residents were consulted regarding the management of the home and their interests were safe guarded. EVIDENCE: Residents were all aware of who the registered manager was and the majority spoke well of her. There was plenty of evidence that residents were included in the general management of the home and were consulted frequently. Staff also confirmed that all the managers were approachable and supportive. The registered manager was an experienced and well-qualified person who was about to conclude her training to successfully achieve the Register Managers Award. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 19 For the first time for a considerable period the home had a complete senior team and the registered manager said that the benefits of this could be felt through the home. Good structures were in place to enable communication and planning to be regularly undertaken. The quality assurance system was based on questionnaires completed by residents, visitors and staff. These had been analysed and actioned. In addition the annual development and training plan for the home was monitored and adjusted as the dictates of the home demanded and monthly visits undertaken by the responsible individual resulted in an informed and detailed report. Policies and procedures were readily available and the manuals were easy to navigate. The general file had been reviewed and work was in progress on other manuals. Some of the documents seen had not been reviewed since they were drawn up in 2002. One requirement had been made following the last inspection and this had been met. Financial and accounting procedures were described and the documents indicated that procedures were being followed. Since the senior team had been complete a full supervision programme had commenced and records of these meetings were being kept. Staff confirmed that they had received supervision. The manager confirmed that with the exception of inventories of personal furniture all records required by regulation were being kept. Standard 38 was not fully inspected. An accident book was kept on each floor. A sample was inspected and entries had been correctly completed. The programme of fire safety checks were being correctly undertaken and a fire risk assessment had been carried on the home. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x x 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 2 x Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 21 no Are there any outstanding requirements from the last inspection? 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. 2. 3. 4. Standard 7 8 9 9 Regulation 15 13(4) 13(2) 13(2) Timescale for action Care plans must be up-dated 30th June quickly when service users needs 2005 change. Risk assessments must be 30th June changed as service users needs 2005 change. Medication rounds must be 30th June carried out at the correct times. 2005 A written protocol must be in 30th June place for service users who are 2005 given medication for anxious and frustrated behaviours. All medications received into the 30th June home must be checked and 2005 recorded. A record of furniture brought into 30th June the home by service users must 2005 be kept. Requirement 5. 6. 9 37 13(2) 17 Schedule 4 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 12 19 Good Practice Recommendations The activity list should be in larger type. The corridors around the home which are scuffed should be re-painted. E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 22 Brambles 3. 37 Policies and procedures should be regularly reviewed. Brambles E52 S28579 Brambles V225917 040505.doc Version 1.30 Page 23 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Droitwich Road Worcester WR3 7NW 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. 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