Inspection on 30/06/06 for Brambles Care Home Limited

This inspection was carried out on 30th June 2006.

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 26/04/07

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 Mrs Nikki Gibson Key Unannounced Inspection 30th June 2006 11:30 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.V298019.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.V298019.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.V298019.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 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 an ornamental pond. 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 £450. Residents paid additionally for hairdressing, chiropody, newspapers, toiletries and transport. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was initially an unannounced inspection which covered all the key National Minimum Standards. The site visit took place over two days, the first day lasted from 11.30 am until 5.00 pm. The second day was announced and lasted nine hours. During the visits there were tours 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. Thirteen residents were spoken to about life at the Brambles. The inspection process also included discussions with the proprietor, most staff on duty and three 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 proprietor, acting manager, staff, and residents were most helpful and this was greatly appreciated. Discussion of the inspection findings took place with the acting manager and proprietor during the inspection and guidance was given. The new acting manager has been in post four months in that time there has been a number of changes in staff and routines. Staff and residents expressed some concerns regarding the changes that have taken place. One residents said, ‘It used to be too rigid and now it is too lax.’ What the service does well: What has improved since the last inspection? Some improvements to the way that medication was administered were noted and staff training has been booked. There are two clear choices provided at Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 6 lunchtime and residents can also make further requests. The acting manager wants residents to be able to have more choice in their daily routines, however initially this has caused some confusion with both residents and staff. Paper towels and liquid soap dispensers have been fitted in bathrooms which will reduce the risk of cross infection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brambles Care Home Limited DS0000063786.V298019.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.V298019.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 5.6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents would benefit from being provided with more information about the home so that a more informed choice could be made. EVIDENCE: Residents spoken to said that they were not given the Service User Guide until they were signing the contract. 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 displayed in the hallway, but a resident said they did not know that they were at liberty to read it. The acting manager said that she would discuss the residents and 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. Contracts or statement of terms and conditions were not in place for all residents. The acting manager said that they were in the process of being reviewed. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 9 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. The Brambles does not provide respite care. Brambles Care Home Limited DS0000063786.V298019.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents needs are not recorded which puts them at risk of poor or inconsistent care. EVIDENCE: Care plans were generally blank and lacked any instructions for staff. The acting manager said that information about residents is shared at handover. Very limited written information about the residents was available and this was not shared with care staff. There were no risk assessments. Residents’ personal and oral hygiene needs were not recorded. Residents at risk of falls or pressure sores had not been identified. Support for maintaining continence was not recorded. Residents psychological health was not know or monitored and management plans were not in place and known to staff. Nutritional screening was not in place and some residents missed meals without adequate consideration to their nutritional needs and weights were not recorded. Due to the lack of records the home could not evidence that residents’ health and welfare were being promoted. This is a very serious situation which puts residents at risk and an Immediate Requirement form was issued requiring the home to address this as a matter of urgency. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 11 Previous care plans in the home had been poor and these had been removed but not replaced with new comprehensive working tools. It is of concern that the acting manager and proprietor were unaware of the lack of care plans and that senior staff, carers and agency staff all work without adequate information about the residents. Daily notes are written by senior staff and it is recommended that 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 be preferable for the daily notes to be an integral part of the residents care plan. Considerable 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 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 present month were studied and no gaps were noted and medication had been appropriately booked in. There were clear signs of improvement as there had been poor medication practice in the previous month and also noted at the last two inspections. The acting manager said that she had been discussing these with staff. 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 without risk assessments being undertaken or appropriate lockable facilities being provided. Staff were testing blood sugars although not all had been trained to do so and there were no protocols or care plans in place. These are serious issues which put residents at risk. Drugs waiting to be returned to the pharmacy were stored in the staff toilet which is inappropriate. 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 as ‘like family’. There had been an incident with one member of staff raising her voice to a resident which the acting manager said would be dealt with by the home using their disciplinary procedure. Due to the lack of care plans there was no record of residents wishes regarding their terminal care or arrangements for after their death. At the time of the inspection it was exceptionally hot weather and staff were conscientious in offering extra drinks. Residents affected by the heat and wishing to remain in their rooms were helped to do so. Changes in the residents needs were not recorded. Brambles Care Home Limited DS0000063786.V298019.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents were unsettled by the changes in staff and routines, but were pleased with the increased choices in the menu. EVIDENCE: A number of residents expressed concern about the recent staff changes. They felt that standards had dropped. Residents said it used to be like one big family, they knew the staff and the staff knew them. One resident said the new staff were very nice but they bring them tea with sugar when they take coffee without sugar. The resident said that they drink it and don’t complain. Four residents said that there was now a lack of routine. For example in the past they always had sufficient supplies of towels and pads and laundry was returned quickly but now this is not the case. Residents and relatives complained of a lack of stimulation. During the two day inspection the television remained on the whole time even during the meal times and no other stimulation was provided. The acting manager is trying to promote an ethos that all staff spend time talking to residents. Residents said that some of the new 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. The home may wish to obtain advice on Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 13 appropriate activities for the elderly from the National Association for Providers of Activities for Older People on 02070789375 Fax 02077359633 Email: info@napa-activities.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 member of staff. Visitors to the home said that they are made welcome and offered drinks. Visitors said that they had noticed a change in atmosphere in the home and there were now often staff on duty that they did not know. The acting manager may like to consider a social evening for relatives to introduce herself and new staff. It would be an opportunity to explain to relatives and residents her plans for the home and to seek their views. The acting manager is trying to introduce greater choice and autonomy for the residents, but staff and residents have seen this as a lack of routine and it has lead in some circumstances to a lowering of standards. The acting manager wants to address the practice of residents being woken in the morning or being prepared for bed early in the evening. 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.V298019.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The acting managers understanding and investigation protects residents from abuse. EVIDENCE: The home has a complaints policy which was not studied at this inspection. A meeting was arranged with the acting manager and documented for a relative who was not happy with the standard of care provided. There is a comments book in the hallway where visitors are at liberty to record their concerns or compliments. A concern was raised that a resident had unexplained bruising. A member of staff reported this immediately. The acting manager worked closely with the Social Services Adult Protection team, the police and the Commission for Social Care Inspection to investigate and document her findings. There was no evidence of direct abuse but training in manual handling was arranged for all staff and staff were reminded of the importance of recording accidents fully. Most staff have undertaken adult protection training and refresher courses are being arranged. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 24 25 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some safety issues in the home must be addressed to protect residents. The garden is being tended so that it will shortly be a suitable place for residents EVIDENCE: The Brambles has 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 has now been cleared and new garden furniture was being delivered on the day of the inspection. One resident said she was 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. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 16 There is a choice of communal areas where residents can sit. It was of concern to see staff cigarettes and lighter and over flowing ashtray in a sitting area at the top of the stairs. A number of large opening windows tested on the first floor had no restrictors and a risk assessment is required. The home has three bathrooms, one has an assisted bath and one has been upgraded with a bath hoist. In general the bathrooms were untidy and a set of unnamed teeth remained in one bathroom for at least four days. Toiletries, toothbrushes and hairdressing material were left lying around. Each resident should have their own toiletries which are discreetly labelled. Bedrooms are comfortable, well decorated and furnished. Residents had been encouraged to bring items with them and each room had been personalised. Not all rooms had the name of the occupant and a resident suggested that this would assist staff to return laundry to the correct room. 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. It was pleasing to see 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.V298019.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: Adequate staffing levels have not been maintained. This is a very serious situation which puts residents at risk and an Immediate Requirement form was issued requiring the home to address this as a matter of urgency. Staff have walked off shift or arrived late leaving residents at risk. Recruitment is taking place and agency staff are used to try and address the situation. 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 particularly at this time of change. The rota was studied and confirms that there is no designated cook at the weekends and the above staffing level was not being maintained. In the afternoon of the first day of the inspection there were only two staff on duty to care for 21 residents and they were also responsible for preparing the evening meal. At that time the acting manager was interviewing for new staff. The acting manager has 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 Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 18 positively as a way to provide residents with more choice in the times they get up and go to bed. Staff training levels are good and seven of the care staff have NVQ 2 and two have NVQ 3. The acting manager is reviewing training records and booking training and she is supported in this by the proprietor. Three staff files were studied at random and this evidenced that the recruitment system was not robust. 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 not in place. References from their previous employer or when they have previously worked with vulnerable people were not taken up. Reasons for leaving were not obtained. A full employment history was not available with written explanation for any gaps. The acting manager must obtain a copy of the amended Care Homes Regulations to ensure that future recruitment practice meets statutory requirements and protects residents. The present induction programme used in the home is basic and does not meet, ‘Skills for Care‘ standard. Staff have not completed an adequate induction within the first six weeks of employment. The acting manager is aware of this shortfall and has downloaded information from the Internet which she plans to introduce. All staff will be involved in the induction so that senior staff can support new and inexperienced staff. A new member of staff was in the home reading policies. The acting manager said that until her Criminal Records Bureau check was through she would not have unsupervised access to the residents. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 36 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is going through a very unsettled period and residents, staff and relatives have expressed concern. EVIDENCE: The acting manager has been in post four months. This has been a difficult time and she feels this is due to staff being resistant to change. She has 12 years experience in the care business and previously managed a home for adults with learning difficulties. She is presently studying for her NVQ level 4 in care. The acting manager will need to continue her training to update her knowledge in the care of the elderly. The acting manager was asked to complete a Pre-inspection Questionnaire and return it to the CSCI as part of the inspection process and this has yet to be done. Several staff and a relative have contacted the Commission for Social Care Inspection since the employment of the acting manager to express concern Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 20 and they have been advised to discuss these directly with the acting manager or proprietor. A relative and member of staff reported seeing staff in tears and hearing the acting manager raise her voice to staff. Staff spoke of being worried about losing their jobs. The acting manager’s style is direct and rather negative and at present the staff team is not working together. The proprietor is a regular visitor to the home and is respected by staff, relatives and residents. He has arranged meetings and spoken to staff and is anxious to address the concerns. The acting manager wants to provide a first class service where residents have freedom and choice. This she has not been able to communicate well and staff feel threatened and de-motivated. Some residents also feel anxious about the changes. Considerable thought needs to be given to how this is to be addressed. An outside consultant or additional management training may prove helpful. The acting manager feels the situation is improving and some staff feel supported by her. One resident said the acting manager had given her valuable support with her particular medical condition. A member of staff said she found the manager approachable and she had been very supportive with a personal problem. The acting manager is introducing a Quality Assurance system and 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. 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 checked for one resident and found to balance. The acting manager is aware of the need to undertaken formal staff supervision. Although it is being introduced no records of supervision were available of the three staff files inspected. Some staff were unaware of the need for supervision and the acting manager has explained that it will cover all aspects of care, the philosophy of the home and career development and training. Safety and welfare of the residents was considered as part of the inspection. Safety certificates for gas, electricity, hoist, lift, and water would normally be viewed, however these could not be found at the time of the inspection. Details of safety checks are part of the Pre-inspection Questionnaire which the acting manager agreed to provide for the CSCI within five days. The acting manager said that Portable Appliance Testing has not taken place and this Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 21 needs to be addressed. The home has had a detailed Fire Risk assessment undertaken by a specialist company. This has highlighted a number of areas of risk, some of which are considered high risk and action must be taken as a matter of priority to address these. 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. Brambles Care Home Limited DS0000063786.V298019.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X 3 1 3 STAFFING Standard No Score 27 1 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 1 3 3 3 2 X 1 Brambles Care Home Limited DS0000063786.V298019.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 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. (Previous time scale of 01.07.05 not met) 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. (Previous time scale of 01.07.05 not met) The Registered Person must ensure that residents receive where necessary treatment, advice and other services from any health care professional. DS0000063786.V298019.R01.S.doc Timescale for action 01/08/06 2 OP7 15 01/08/06 3 OP8 13(1)(b) 01/08/06 Brambles Care Home Limited Version 5.2 Page 24 4 OP9 13(2) 5 OP11 12(2) 6 OP12 16(2) 7 OP25 13(4) 8 OP27 18(1)(a) This refers to providing evidence of medical appointments and instructions given by medical staff The Registered Person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. (Previous timescale of 01.01.05 not met) The Registered Person must as far as practicable enable residents to make decisions with respect to the care they receive and their health and welfare, this includes their wishes regarding death and dying The Registered Person must consult with residents about their interests and provide a programme of activities and provide facilities for fitness and recreation. (Previous timescale of 01.01.05 not met) 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: Fire hazard from cigarette lighters and full ashtrays on landing. 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. DS0000063786.V298019.R01.S.doc 01/08/06 01/08/06 01/08/06 01/08/06 01/08/06 Brambles Care Home Limited Version 5.2 Page 25 9 OP29 17(2) Schedule 2 10 OP30 18(1) 11 OP31 9(b) 12 OP32 12(5) 13 OP36 18(2) 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. (Previous timescale of 01.01.05 not met) The Registered Person must ensure that staff receive training appropriate to the work that they perform. This refers to the need for robust induction processes to be in place for new staff. (Previous timescale of 01.03.05 not met) The Registered Person must appoint an individual to manage the Home who has the skills and experience necessary The Registered Person must maintain good personal and professional relationships with the staff and service users and encourage staff to maintain good relationships with each other. The Registered Person must ensure that persons working in the home are appropriately supervised (Previous timescale of 01/03/05 not met) 01/08/06 01/08/06 01/08/06 01/08/06 01/08/06 14 OP38 13(4) 01/08/06 The Registered Person must 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. Brambles Care Home Limited DS0000063786.V298019.R01.S.doc Version 5.2 Page 26 Electrical safety – PAT testing undertaken Food storage 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. Relatives should be helped to understand the changes that are being made and why. Improvements to the garden should be maintained so that it is a safe and pleasant facility for residents. Care staff should have formal supervision at least six times a year 2 3 4 5 OP2 OP13 OP19 OP36 Brambles Care Home Limited DS0000063786.V298019.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: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brambles Care Home Limited DS0000063786.V298019.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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