Inspection on 26/04/07 for Brambles Care Home Limited

This inspection was carried out on 26th April 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brambles Care Home Limited 09/04/08

Brambles Care Home Limited 30/06/06

Brambles Care Home Limited 02/03/06

Brambles Care Home Limited 06/05/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Brambles Care Home Limited 22 Cliff Road Leigh On Sea Essex SS9 1HJ Lead Inspector Helen Laker Unannounced Inspection 26th April 2007 10:00 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 Care Home Limited DS0000063786.V337609.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 Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brambles Care Home Limited Address 22 Cliff Road Leigh On Sea Essex SS9 1HJ 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) 01702 472417 01702 472417 Brambles Care Home Ltd Manager post vacant Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2006 Brief Description of the Service: The Brambles provides care and accommodation for up to twenty two older people. Generally residents have low to medium dependency needs. The home does not provide nursing care and does not cater for people with a diagnosis of dementia. The Brambles is a large, extended and converted house situated in a residential area. Accommodation at present is provided on three floors in fourteen single and four double rooms. All rooms have en-suite facilities. The ground and first floor are accessed via a shaft lift and the lower ground floor rooms by stair lifts. The communal areas include an open plan lounge and dining area. There is also a conservatory and a raised decking area. The homes gardens are well maintained and include a new pond which is being installed. There is limited parking at the front of the building. The Brambles is close to a mainline station and bus route. The most recent inspection report was readily available in the entrance hall of the home. In July 2006 the fees were from £350 to £500. Residents paid additionally for hairdressing, chiropody, newspapers, toiletries and transport and any personal items, aids etc. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which covered all the core key National Minimum Standards. The site visit took place one day. During the visit there was a tour of the premises and a selection of records and documents were studied. Time was spent in the lounge and dining room, and with residents in their own rooms observing practice. Eight residents were spoken to about life at the Brambles. The inspection process also included discussions with the deputy manager, most staff on duty and four relatives. A pre-inspection questionnaire was sent to the home prior to the inspection with a timescale for its completion, however to date this has not been returned to the CSCI. The home has yet to provide contact details so that other interested parties can be provided with surveys and asked their views on the running of the home. The deputy manager, staff, and residents were most helpful and this was greatly appreciated. Discussion of the inspection findings took place with the deputy manager and nurse in charge during the inspection and guidance was given. What the service does well: What has improved since the last inspection? Nutritional screening is now in place albeit a little disorganised. Previously some residents missed meals without adequate consideration to their nutritional needs and weights were not recorded. Weight recording has been implemented. Previous care plans in the home had been poor and these had been removed but not replaced with new comprehensive working tools. It is acknowledged that this has now been done and some improvements have been made since the last inspection. Staff morale has improved Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Brambles Care Home Limited DS0000063786.V337609.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 Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 6 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Present and prospective service users and their supporters are not given adequate information about the home so that they can make informed choices. Each service user has a contract directly with the home if privately placed or a statement of terms and conditions if funded by social services. EVIDENCE: Residents spoken to said previously that they were not given the Service User Guide until they were signing the contract, not all service users could confirm they had a copy. Some said that the information they were given did not reflect a true picture of the home. A copy of the homes’ most recent inspection report was not displayed in the hallway, and residents spoken to did not realise it was there. The statement of purpose and service users guide were not on display and the inspector was informed they were at the printers. The acting manager previously said that she would discuss the residents and Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 9 relatives right to read the inspection report at the next residents’ meeting and ensure that all prospective residents have a copy of the Service User Guide. It is unclear whether this was done as the deputy on duty on the day of inspection could not confirm this. Contracts or statement of terms and conditions were in place for most residents apart from the most recent. The deputy manager reiterated that they were all still in the process of being reviewed. Pre-admission assessments are undertaken by the deputy manager and prospective residents are encouraged to visit before making a decision to move in. The home was reminded that following the assessment they must confirm in writing whether they are able to meet the prospective residents’ health and welfare needs. This is still not being done The Brambles does not provide respite care. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can know their assessed and changing needs, they can make decisions and participate in all aspects of the home. Each service user has an individual plan and service users are supported to take risks as part of an independent lifestyle via a process of assessment. These care plans are not specific enough and staff are not adequately trained in how to complete and use them. EVIDENCE: Care plans and some risk assessments were available for service users but were non specific in places and lacked any instructions for staff. The deputy manager said that information about residents is still shared at handover. Very limited written information about the residents was available and this was not shared with care staff. Residents’ personal and oral hygiene needs were still not recorded in some cases. Residents at risk of falls or pressure sores were identified but more detailed documentation would ensure clarity of needs. Support for maintaining continence is being addressed. Residents Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 11 psychological health was not known in all cases and management plans were incomplete with some physical needs requiring clarification and instruction for staff. Nutritional screening is now in place but dating was erratic and they were a little disorganised. Previously some residents missed meals without adequate consideration to their nutritional needs and weights were not recorded. Weight recording has been implemented. Previous care plans in the home had been poor and these had been removed but not replaced with new comprehensive working tools. It is acknowledged that this has now been done and improvements have been made since the last inspection. It is still of concern though that staff appear to require further training regarding the maintenance of current care plans and work without adequate information about the residents. Daily notes are written by senior staff and the member of staff undertaking a task for or with a resident records this in the daily notes themselves with the support of the manager or senior staff. It would definitely be preferable for the daily notes to be an integral part of the residents care plan. A lot more training and support will be required and the acting manager and senior staff will need to supervise and monitor the records on a daily basis. A member of night staff previously said that writing notes means there is less time to spend with the residents so duties at night need to be reviewed. The Medication Administration Record (MAR) sheets for the last and present month were studied and no gaps were noted and medication had been appropriately booked in. There were clear signs of improvement at the last inspection as there had been poor medication practice noted at the last two inspections. Medication must not be decanted and staff must observe residents taking their medication before signing the sheet. The deputy manager had a clear understanding of appropriate safe procedures and was able to suggest methods to rectify any shortfalls noted. Some residents were self medicating with risk assessments being undertaken or appropriate lockable facilities being provided. Staff were noted at the last inspection to be testing blood sugars although not all had been trained to do so and there were no protocols or care plans in place. Training for this has now taken place and only senior carers undertake this task. The administration for insulin was discussed with the senior carer and the deputy manager on duty with regard to one service user who had difficulty administering it themselves. Transcribed medication was noted for some service users and it is best practice to ensure two signatures record this process on the MAR chart. Residents spoken to on the subject said that staff treated them with respect and their privacy and dignity were maintained. Staff spoke of the residents with warmth and affection, some referred to them previously as ‘like family’. And never too busy to help. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 12 Overall the home is now endeavouring to record changes in the residents needs and residents wishes regarding their terminal care or arrangements for after their death are being addressed but are still not recorded for all residents. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A wider range of meaningful pastimes need to be developed to promote the residents mental and physical wellbeing. Links with families are good and contacts are maintained. Choice in the routine of the day can be adapted to ensure residents rights are maintained. The home provided good food in ample quantities and is served in a congenial setting. EVIDENCE: Previously residents and relatives complained of a lack of stimulation. During the inspection the television remained on the whole time even during the meal times and little other stimulation was provided. It was noted that all staff spend time talking to residents. Residents said that some care staff and domestic staff would sit and have a short chat. One member of staff spent part of his off duty time playing chess with a resident. The acting manager said that she has plans for a senior member of staff to take the lead with activities. This is in place but an ordered activity plan would facilitate residents having more choice. The home may wish to obtain advice on appropriate Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 14 activities for the elderly from the National Association for Providers of Activities for Older People on 02070789375 Fax 02077359633 Email: info@napaactivities.co.uk NAPA Bondway Commercial Centre 5th Floor unit5.12 71 Bondway London SW1 8SQ The home is advised that providing stimulation and meaningful pastimes is an integral part of good care of the elderly and is not an optional addition conducted by one or two members of staff. This was reiterated at this inspection. It was noted that music is now playing at all mealtimes and a service user had had a birthday tea the day before. The member of staff concerned said they had since attended a course and did keep a file record however that was at home. A diary of activities was started in Nov 2006 but had dwindled. Much of March and April were blank with no entry at all. Visitors to the home said that they are made welcome and offered drinks. No complaints were made on the day of inspection. The home is advised to introduce greater choice and autonomy for the residents. The practice of residents being woken in the morning or being prepared for bed early in the evening is still being addressed. Clear and positive leadership is required to make changes which will benefit the residents. The improved choices at meal times is one area of change which has been accepted by staff and appreciated by the residents. A period when changes were made to the ordering of food, to reduce the amount of bulk buying and over stocking, led to shortages which has now been addressed. The dining room is attractive and tables were nicely laid with condiments and tomato sauce. Meals observed looked and smelt appetising and residents were complimentary about the food. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy which informs complainants of their rights, in the event of any informal complaint documentation must be maintained appropriately or fully. Staff have received poor levels of relevant training relating to the protection of vulnerable adults and no updates have been planned. EVIDENCE: The home has a complaints policy and procedure which requires updating and people may raise concerns formally or discuss any issues in a more informal way with the homes manager. There is a comments book in the hallway where visitors are at liberty to record their concerns or compliments. It was reported by the homes deputy manager that there have been no complaints made since the previous inspection. It was noted that informal and verbal complaints are not logged in a manner which records the outcomes and the home would benefit from this to avoid recurring issues and highlight areas where services could be improved. The home has an Adult Abuse Policy and Whistle Blowing procedure. Most staff have now attended “Protection of Vulnerable Adults” training. The home must continue to ensure that all staff receive training in the protection of vulnerable adults and ensure through the home’s supervision procedures that all staff are fully aware of what is expected of them. On the day of inspection the deputy manager was going on a management of abuse course. Brambles Care Home Limited DS0000063786.V337609.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, 25, & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Brambles generally provides a safe comfortable environment for service users. Some safety issues in the home must be addressed to protect residents. EVIDENCE: At the homes last inspection it was noted that the Brambles had been extended and adapted and has many turning narrow corridors and rooms that can only be accessed by a chair lift. This makes it more suited to residents with moderate and low dependency needs. Most rooms are unsuitable for people with very limited mobility. The home is clean and well maintained and there were no offensive smells. The garden which had become over grown previously and has now been cleared and new garden furniture inset. One resident previously said she was Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 17 very pleased to hear this as she had been very disappointed by the garden as it had not looked like the picture in the brochure. It now does and a conservatory built, which reduced the size of the veranda slightly. The home also has a brand new kitchen and there are plans afoot to move the stores up into that area. There is a choice of communal areas where residents can sit. A number of rooms have free standing heaters and risk assessments are now in place. Some windows still do not have restrictors fitted in service user areas. The home has three bathrooms, one has an assisted bath and one has been upgraded with a bath hoist. Bedrooms are comfortable, well decorated and furnished. Residents had been encouraged to bring items with them and each room had been personalised. The laundry is in the basement and was clean and tidy. Staff said that residents’ clothes used to be returned to residents rooms as part of the daily routine but now with the more flexible approach it often gets left. This was discussed on the day of inspection Paper towels and liquid soap dispensers had been fitted in WCs and bathrooms which will reduce the risk of cross infection. Brambles Care Home Limited DS0000063786.V337609.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, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The current procedures for the recruitment and training of staff do not always have safeguards in place to offer protection to people living in the home. Staffing numbers, skills mix, level of induction and recruitment procedures put residents at risk. Staff training is taking place and there are plans for an improved induction. The home could have an effective and competent staff team. EVIDENCE: Adequate staffing levels have are not generally maintained. Previously the acting manager said that adequate staffing levels for the number of residents and the layout of the home would be: • • • • 1 senior and 3 care staff from 7 am to 9 pm 2 awake staff at night. Catering staff to provide all meals and domestic staff every day. The manager’s role to be supernumerary The rota was studied and confirms that there is now a designated cook and two domestics at the weekends and attempts were in place to try and ensure the above staffing level was maintained. Staff on duty on a pm shift are Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 19 responsible for preparing the evening meal. This should not detract from the care duties of staff and the proprietor should give consideration to employing adequate members of kitchen and domestic staff to cover all shifts. Also consideration should be given to whether enough night cover is maintained as staff spoken too expressed concern and the current levels do not allow provision for break cover, double handed lifting, or emergencies where one member of staff may have to accompany a service user to hospital etc. The acting manager previously made changes to the rota to increase the number of staff on duty in the early mornings and later into the evening. This is seen positively as a way to provide residents with more choice in the times they get up and go to bed. Staff training levels are still good and five of the care staff have NVQ 2 and three have NVQ 3. The inspector was informed that there is an ongoing review of training records and booking training and the proprietor is supportive. Three staff files were studied at random and this evidenced that the recruitment system was not robust. Previously a number of staff had left in a short space of time. To address this difficult situation the acting manager employed staff who were known to her without following the proper procedures. Criminal Records Bureau or POVA First checks were still not in place. References from their previous employer or when they have previously worked with vulnerable people were not adequate and missing in some cases. A full employment history was not available with written explanation for any gaps. Full permissions to work and legal checks were not checked thoroughly or obtained. The acting manager was asked previously to obtain a copy of the amended Care Homes Regulations to ensure that future recruitment practice meets statutory requirements and protects residents. This could not be confirmed at this inspection. The present induction programme used in the home needs to comply with, ‘Skills for Care‘ standard. Some staff have still not completed an adequate induction within the first six weeks of employment. All staff should be involved in the induction so that senior staff can support new and inexperienced staff. New members of staff are encouraged to read policies and procedures. Brambles Care Home Limited DS0000063786.V337609.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, 32, 33, 35, 36 & 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home does have procedures in place to ensure the health, safety and welfare of service users is promoted and protected. There is attention needed in some areas. EVIDENCE: The acting manager has been in post at the home since Oct and has made an application for registration. The inspector was informed she has yet to attain her NVQ level 4 qualification. The current acting manager was not present on the day of inspection. A pre-inspection questionnaire was sent and is yet to be returned to the CSCI as part of the inspection process. The home previously went through an unsettling period of change and since then the previous Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 21 manager has left and one member of staff stated that staff morale has improved greatly. The inspector was informed that the proprietor visits the home on Tuesdays only and is approachable and respected by staff, relatives and residents. The deputy manager feels the situation has improved and staff feel supported. A Quality Assurance system introduced by the previous manager has not been fully implemented and some questionnaires have been completed by staff, residents and relatives. The Proprietor is reminded of the need to carry out his monthly checks in accordance with Regulation 26, to speak to staff and residents and to inspect the premises and documentation. The CSCI request that each report is sent to the CSCI office so they can monitor the homes progress. This was requested at the last inspection also and must be consistent. Considerable financial input has been put into the home and upgrades have been made. Funding for training is made readily available. There is nothing to indicate that the home is not financially viable. Residents’ money held for safekeeping is securely locked away. Access is only available when the manager is present. Residents have access to petty cash when the manager is not on duty. Records and cash were not checked at this inspection. At the last inspection the manager was made aware of the need to undertake formal staff supervision. Although it was being introduced only one record of supervision was available of the three staff files inspected. Some staff were previously unaware of the need for supervision and it should cover all aspects of care, the philosophy of the home and career development and training. It is recommended that staff receive a minimum of six supervisions a year and one appraisal. Safety and welfare of the residents was considered as part of the inspection. Safety certificates for PAT testing, the lift and fire equipment all required up to date inspections. Details of safety checks are part of the Pre-inspection Questionnaire. The home has had a detailed Fire Risk assessment undertaken by a specialist company. The Food safety agency has recommended that the food storage area is upgraded. The home plans to make changes in the kitchen which will be more convenient for staff and meet food hygiene standards. The inspector was informed this would involve the relocation of the food stores upstairs and the possibility of a new room being made on the lower ground floor. Before this happens the proprietor should inform the CSCI of their intention and submit plans and a schedule of works, and consider the impact of any internal building works to existing residents. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 Standard No Score 16 2 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 2 X 2 Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1) Requirement Timescale for action 17/07/07 2 OP7 15 3 OP8 13(1)(b) The needs of prospective residents must be assessed by a suitably qualified or trained person prior to admission and the home must confirm in writing that they are able to meet the resident’s needs in respect of their health and welfare. 17/07/07 The Registered Person must prepare a written plan with consultation with the resident as to how their needs will be met The Registered Provider must ensure that care plans have sufficient detail to provide clear guidance to staff on the actions to be taken to meet the residents health and welfare needs. Care plans must be kept under review. 17/07/07 The Registered Person must ensure that residents receive where necessary treatment, advice and other services from any health care professional. This refers to providing evidence of medical appointments and instructions given by medical staff DS0000063786.V337609.R01.S.doc Version 5.2 Brambles Care Home Limited Page 24 4 OP9 13(2) 5 OP12 16(2) 6 OP16 17 (2) Schedule 4 13(4) 7 OP25 The Registered Person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. The Registered Person must consult with residents about their interests and provide a programme of activities and provide facilities for fitness and recreation. A record must be kept of all complaints made and includes details of investigation and any action taken. The Registered Provider must ensure that all parts of the home are as far as reasonably practicable free from hazards and that unnecessary risks to residents are identified and as far as possible eliminated. Hazards and risks identified at this inspection are: Windows without restrictors. The Registered Person must ensure that at all times there are suitably qualified, competent, and experienced persons working at the Home in such numbers as are appropriate for the health and welfare of the residents. The Registered Person must ensure that robust recruitment procedures are in place, and applied consistently. Records required by regulation in respect of staff recruitment must be obtained prior to a staff starting work. The Registered Person must ensure that staff receive training DS0000063786.V337609.R01.S.doc 17/07/07 17/07/07 17/07/07 17/07/07 8 OP27 18(1)(a) 17/07/07 9 OP29 17(2) Schedule 2 17/07/07 10 OP30 18(1) 17/07/07 Page 25 Brambles Care Home Limited Version 5.2 appropriate to the work that they perform. This refers to the need for robust induction processes to be in place for new staff. 11 OP31 9(b) The Registered Person must appoint an individual to manage the Home who has the skills and experience necessary 17/07/07 12 OP36 18(2) 13 OP38 13(4) The Registered Person must 17/07/07 ensure that persons working in the home are appropriately supervised. The Registered Person must 17/07/07 ensure that the Home is conducted so as to promote and make provision for the health and welfare of the residents. This includes Fire safety and staff fire training Risk assessments must be undertaken Safety certificate must be up to date and available for inspection. 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 OP1 Good Practice Recommendations The Service User Guide including the latest inspection report and the Statement of Purpose should be made more readily available to prospective residents and their supporters. Each resident should have contract or statement of terms and conditions. Written confirmation from the home should be received by each prospective resident following assessment detailing DS0000063786.V337609.R01.S.doc Version 5.2 Page 26 2 3 OP2 OP4 Brambles Care Home Limited 4 OP11 the home can meet their specific needs. Residents wishes on afterlife issues and or death and dying should be ascertained sensitively and recorded. Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brambles Care Home Limited DS0000063786.V337609.R01.S.doc Version 5.2 Page 28 - 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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