Inspection on 04/05/07 for Brambles

This inspection was carried out on 4th May 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

Brambles 08/07/09

Brambles 15/02/06

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 Wendy Jones Key Unannounced Inspection 4 May 2007 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.V327316.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. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brambles Address Brambles Bramble Lane Wye Ashford Kent TN25 5EW 01233 813217 01233 813217 info@bramblescare.co.uk 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 Mr Arnold Hartnoll Parker Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: Brambles is a family run home just outside the centre of the village of Wye near Ashford. There are local shops, a bus stop and railway station nearby. Brambles provides comfortable, homely accommodation for a maximum of 18 older people. All rooms are single. Eight have en suite facilities, three of which are en suite bathrooms. There are also two bathrooms and adequate toilet facilities around the home. The statement of purpose gives information about the services the home provides. A copy of this and the most recent inspection report can be obtained from the home. Currently the fees are between £317 and £425 per week. The hairdresser, chiropodist, personal toiletries, newspapers and magazines are at an extra cost. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out over a period of time and concluded with a site visit to the home between 10:10am and 3:15pm on 4 May 2007. A range of evidence has been used to inform this report and judgements have been made based on this evidence. Evidence used includes information from a questionnaire about the home and the services it provides completed by the manager; concerns, complaints, allegations and other information received; reports of incidents and deaths that have occurred in the home since the last inspection; a tour of the home; inspection of some residents’ care plans and other records and discussion with the residents, manager and staff. What the service does well: What has improved since the last inspection? What they could do better: Residents’ risk assessments are general and need to be more comprehensive and individual to them. They need to show specific risks that have been Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 6 identified for them, what needs to happen to reduce or remove the risks and the outcome that is expected from putting this action in place. In addition to the regular, planned reviews, residents’ care plans should be reviewed after any incidents or accidents occur that affect their safety and welfare. This will help care staff be able to keep up to date with residents’ needs and how to help them achieve them. 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. Brambles DS0000023328.V327316.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 Brambles DS0000023328.V327316.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, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ needs are assessed before they move into the home so that they can make sure these will be met. EVIDENCE: A copy of the home’s statement of purpose and service user guide is displayed in the entrance hall. Residents have their own personal copy. One resident said that they moved into the home recently. They had visited a couple of times, spoken with the manager and looked around the home before they moved in. They had decided to move in because the home could provide what they were looking for. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 9 Care plans contain a full assessment of residents’ needs. These assessments are carried out when they move into the home and show how to meet the resident’s needs and goals. Brambles does not provide intermediate care. Brambles DS0000023328.V327316.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 – 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ general health and personal care needs are well met and their privacy is respected. The procedures followed in the home make sure they are protected. EVIDENCE: Residents’ care plans are clear, comprehensive and well presented. They show the residents’ needs and goals and how staff are to help them to achieve these. Residents sign to show they agree them and have copies in their rooms. Daily notes are clear and give a detailed picture of each resident’s day. They include information about when residents have seen their doctor, district nurse, hospital consultants and of optician, dentist etc appointments. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 11 Records show that residents’ care plans are reviewed regularly. However, accident records and daily notes show that some residents have had a number of falls and other incidents have happened since their last reviews. Details of the action taken in response to these e.g. arrangement to see GP or physiotherapist are clearly documented in the daily notes and show that prompt action was taken. Their care plans do not reflect any changes to their needs or risk assessments as a result of these incidents. All assessments should be reviewed as necessary when incidents happen that affect the safety and welfare of the residents so that care staff are kept up to date with their needs and how to help them achieve them. Risk assessments are general and need to be more comprehensive and individual to each resident. They need to show specific risks that have been identified for them, what needs to happen to reduce or remove the risks and the outcome that is expected from putting this action in place. The manager will now make sure that residents’ care plans are updated promptly when incidents happen that affect them. He will also make sure that more comprehensive risk assessments are carried out to identify specific risks for residents and the action to be taken to reduce or remove the risks. When residents want to deal with their own medication this is recorded in their care plans and they are assessed to be sure it is safe for them to do so. Medication is now stored in a medication trolley that is fixed to the wall. Medication administration records are kept accurate and are up-to-date. An extension that is planned for the home will provide a dedicated medication room. Training records show that staff have received appropriate training and are competent to deal with residents’ medication. Staff spoken with said they feel confident that they have the knowledge and skills they need to deal with the medication residents take safely. Staff are helpful, patient and caring and get on well with the residents. Residents said the staff are “very kind and helpful” and “they treat me well and are always polite and helpful”. Brambles DS0000023328.V327316.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 - 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A wide range of activities and outings are provided that meet the residents’ needs. Residents are able to have close contact with their family and friends and to be involved in the local community. EVIDENCE: A member of the care staff has responsibility for arranging activities and outings for the residents. Residents said this person works hard to give them the activities they want. One resident said they enjoy joining in with the quiz and exercise class each week. Another enjoys the art and craft sessions. Items residents have made in these sessions are displayed in their rooms and around the home. Residents spoke of going to clubs in the village, going to church and receiving communion. They said that their relatives and friends visit them regularly. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 13 There is a greenhouse in the garden for residents to use. One resident said they are growing vegetables in the greenhouse and have planted up pots in the garden. Another said “staff will always get me anything I want when they go into the village”. There is a TV lounge and a separate music lounge. Residents said they enjoy listening to music in the music lounge. The activities co-ordinator keeps a record of the various activities and outings that are organised. It shows which residents take part and what they thought about them. In addition to quizzes, bingo, armchair exercises and arts and crafts sessions there is a visiting dancer, clothing services, garden parties and regular outings. Copies of menus are kept in the dining room. These show a choice of nutritious and appealing dishes each day. There is room in the dining room to seat all the residents comfortably. Residents said that they have their breakfast in their rooms but eat lunch and tea in the dining room. There will be a new, larger dining room in the new extension. A copy of the plans is displayed on the wall of the dining room for residents to look at and see what is planned. Residents said the food is “very good”, “is always hot and nicely laid out”. They said they have “lots of choice” and “plenty to eat”. Brambles DS0000023328.V327316.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. Residents’ complaints are taken seriously and investigated. They are protected from abuse. EVIDENCE: Information received before the site visit stated that there had been two complaints received since the last inspection. These had been fully investigated within the 28-day timescale and feedback had been given to the person who had complained. Residents said they are able to discuss any concerns they have with the manager and are confident that he will look into them and sort them out. The complaints procedure is included in the home’s statement of purpose. It gives details of how to complain, timescales for investigating any complaint and how to contact the Commission. There is a copy in every resident’s room. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 15 Training records showed that staff attend training in the protection of vulnerable adults. They are able to identify signs of abuse and know what to do if they suspect a resident is being abused in some way. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 16 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): 19 – 21 and 23 – 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a clean and comfortable home with private and communal rooms that meet their needs. EVIDENCE: All areas of the home are well maintained but in need of some refurbishment. The manager explained that some of the refurbishment work has been postponed until the extension has been built. The home was clean and comfortable and there were no unpleasant odours. There are attractive gardens mainly laid to lawn and bordered with shrubs and plants. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 17 Plans to build an 11-bedded extension have been agreed by the local authority and work is due to start later this year. The extension will include a large dining room, which will provide enough room for residents to eat there comfortably and also be used for entertainment. In addition to 11 extra en suite single rooms there will be a new kitchen and laundry. There will also be hairdressing and sluice rooms and a medication room. Residents’ rooms are individual to them and meet their needs and tastes. They have their own personal items including photos, pictures, televisions etc. Some have an en suite bathroom. There are two communal bathrooms and a number of communal toilets around the home. These are kept clean and staff follow infection control and toilet washing procedures to protect residents from the spread of infection. Both bathrooms are due to be refurbished and will be fitted with hydraulic bath hoists to make them more comfortable for the residents and more manageable for the staff. There are two lounges and a conservatory for residents and their visitors to use. The conservatory is to be replaced by a communal room that will lead from a corridor in the newer wing of the existing home. An enclosed garden will be created when the extension has been completed. The kitchen was clean and contained appropriate equipment for the cook to use. The laundry is large enough to deal with clean and dirty laundry separately. There are two domestic washing machines and driers. A new laundry is to be provided when the extension is complete. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 18 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 – 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected by the home’s recruitment procedure. They are supported by staff who have the skills and knowledge to meet their needs. EVIDENCE: There are 17 people living in the home. The manager, two care staff (including a senior carer), a cook and a housekeeper were on duty during the site visit. This was clearly enough staff to meet the needs of the residents living in the home at the time. Rotas showed that extra staff are on duty at busier times of day, for example at meal times. There is one waking and one sleeping member of care staff on duty every night. Files were seen for three members of staff. One had started in recent weeks. All the relevant checks and documentation including Criminal Records Bureau and Protection of Vulnerable Adults checks are obtained showing that the recruitment process protects the residents. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 19 All staff attend an induction when they first start. Records show when they have completed this. Information received by the Commission shows that staff have attended training in a number of subjects since the last inspection. These include manual handling, fire awareness, first aid, health and safety, medication, infection control and NVQ levels 2 and 3 in care. Staff files contain details of the training staff have attended, the dates and certificates. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 20 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 – 33, 35, 36 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents live in a safe and extremely well managed home that is run in their best interests and safeguards their rights. Their views are sought and taken into account about the services they receive. They are kept informed of planned improvements and changes to the home. Their health and safety and welfare are given the highest priority. EVIDENCE: Brambles is owned and managed by Kevin Parker, a qualified nurse with 20 years experience in the care industry. The assistant manager is also a Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 21 qualified nurse with many years experience of managing care homes and holds the NVQ 4 in management. The atmosphere in the home is welcoming, calm and unhurried. There is a good relationship between the management, staff and residents. Residents said the manager, deputy manager and staff are “very kind, helpful and caring” and are always willing to help them when they need it. The residents and staff are very aware of the plan to build a new extension and what this will mean to them. The plans are displayed in the dining room for everyone to look at. The manager is in discussion with prospective construction companies about the project and will pick the successful contractor shortly. The manager explained that he was very keen to make sure that the work is done with the least disruption for the residents. He is very clear that the successful company must put the residents’ safety and wellbeing first. As the conservatory will be demolished at the beginning of the work the new communal room will be built first. This will mean that residents will not be restricted on communal space. Quality assurance surveys are carried out every year. Survey forms completed by residents in October 2006 were seen. These have been analysed and used to improve the service provided to the residents. The manager explained that he intends to involve residents’ relatives when the next survey is done. Minutes of a relatives’ and residents’ forum held on 12 February 2007 were seen, which was well attended. The minutes detailed the action the manager has taken to deal with concerns and issues raised at the last meeting. The manager advised that it had been suggested that the home introduce a quarterly newsletter and this is to be piloted. The minutes noted that relatives had asked for “thanks to be given to the manager and staff for the excellent care given”. Feedback from staff meetings is also used to assess the quality of the service provided. Information received indicated that the home does not act as appointee for any of the residents. Small amounts of money are kept for some of the residents. Records are kept of how much is spent, on what and receipts. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 22 Supervision records were seen in staff files. These showed that regular, formal, staff supervision is taking place. Staff also receive feedback at shift handovers and are clear about their roles and responsibilities. Records show that water temperature checks are carried out every week. Fire alarms and the nurse call and emergency lighting systems are also tested weekly. Staff attend fire awareness training and regular fire drills are held. Records seen show which staff have taken part. Information received prior to the site visit shows that all other relevant maintenance and checks have been done and are up to date. Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 23 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 X 3 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 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 x 3 3 3 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 4 3 x 3 3 x 3 Brambles DS0000023328.V327316.R01.S.doc Version 5.2 Page 24 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.V327316.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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