Inspection on 28/06/05 for Brambletye

This inspection was carried out on 28th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Brambletye 27/09/07

Brambletye 16/01/07

Brambletye 22/11/05

Brambletye 11/10/04

Brambletye 02/06/04

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Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Brambletye New Mill Road Finchampstead Berkshire RG40 4BT Lead Inspector Sue Burton Unannounced 28 June 2005 @ 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brambletye Address New Mill Road Finchampstead Berkshire RG40 4BT 0118 929 7900 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) New Support Options Mrs Ann Marie Hunt Care Home 4 Category(ies) of Learning Disability (LD) registration, with number of places Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11/10/04 Brief Description of the Service: Brambletye can provide care to four male adult service users who have learning and associated physical and behavioural difficulties. The house is owned by the Maidenhead /Windsor Housing Association, and the care is provided by New Support Options.The house is a one-storey building with all accommodation on the ground floor.The home is in a very rural location, not on a public transport route. It is situated approximately five miles from Wokingham Town Centre, with Bracknell and Reading also within a short distance.The home has its’ own vehicle and is able to use taxis if necessary. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place on Tuesday 28th June 2005 between the hours of 09.00 am and 12.15 pm. The homes Registered Manager was on leave and the inspection was facilitated by the homes Deputy Manager. The Inspector met two of the three residents during the inspection and focused on one individual’s care and documentation for this inspection. The inspector was able to join in with two residents for a brief period of time in an activity they enjoyed and was able to observe the quality of staff support and communication. This was a most positive inspection, the home has a relaxed friendly atmosphere where residents were seen to receive good support and care from the staff team. What the service does well: What has improved since the last inspection? Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 6 The home has completely refurbished and refitted its assisted bathroom and now has a new electric bath with overhead hoist to provide safe and comfortable bathing for the residents. 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. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 The homes Statement of Purpose and Service User Guide were being updated and were not yet complete. There had been no new admissions since the last inspection. Residents were provided with a contract with the organisations terms and conditions. EVIDENCE: Since the last inspection in October 2004 one individual has moved to another home that could cope with his challenging behaviour and another resident passed away in January. The manager and deputy are changing and updating their Statement of Purpose and Service User Guide; a copy is to be sent to CSCI upon completion. There is one vacancy in the home and there have been no new admissions. A residents contract/ terms and conditions were seen and contained details of costs and service provided, this was signed by the individuals advocate. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 The residents changing needs, goals and aspirations are detailed within their personal plan. The residents are enabled to make choices and decisions in their daily lives. Consultation takes place with residents and individuals are enabled to participate. Residents are supported to take risks and hazards are identified. EVIDENCE: One individuals daily diary, annual care review, activity book, risk profile and support package were reviewed during the inspection and evidenced that the individuals care needs are well documented and regularly reviewed. From examination of the records and observation it was clear that the individual is encouraged and enabled to make decisions for himself or with the support of the staff. He has been out shopping recently and chosen a new sofa for his new room and plans to buy a new TV for himself in the near future. The individual has been given a picture and pictorial information on his advocate and the service they provide. Staff have documented how the individual is to be supported in the management of his finances and what his wishes are. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 10 The individual has a well formatted and organised risk profile which covers basic risks to his safety and instructions to staff on how the hazards are to be minimised. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16,17 in part The residents are enabled to take part in fulfilling activities but are not in paid employment or training. Residents participate in the local community and are aware of local resources. Residents enjoy a range of activities both within the house and externally. Family links are encouraged and maintained. The daily routines of the house promote independence and choice. Meal choices are enabled and the residents are supported to eat a healthy diet. EVIDENCE: The homes activity book records the resident’s daily activities and other pursuits such as attending the local “challenge” club. One resident has submitted artwork for a display at a national conference. One individual enjoys buying his newspaper at the local shop whose staff have got to know him well. Residents had recently visited the garden of remembrance with staff and placed flowers for their recently deceased friend. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 12 Evidence was seen of family visits, trips to the local pub, meals out and games played within the house. The inspector was able to join in with residents to play “bottle top bingo” and observe the staff interacting with residents, and how they communicate with them. Residents were observed and heard making choices in regard what they wore and what they did during the day, appropriate household tasks are undertaken where able. Staff have compiled a pictorial book of meal choices for the residents and have an organised menu in place, which included the recommended five portions of fruit and vegetables. Guidelines were available for the staff on what constitutes a healthy diet for the residents. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21 Staff provide personal support maximising residents independence and dignity. Residents health care needs are met. Residents medication is administered by the home and is kept securely. The death of a resident in the home was handled with care and support given to the other residents. EVIDENCE: Staff were observed and heard caring for residents in the house in a sensitive and appropriate manner. Residents were enabled to make choices in regard to what clothing they wore and their appearance. The home is in the progress of completing new health-care documentation for its residents. Records demonstrated that health care needs of residents are assessed and monitored and appropriate referrals made. Support was given during the day to one resident, who was having difficulty with his asthma, the care given was appropriate and enabled the condition to be kept under control. The homes medication is kept secure and records documented appropriately. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 14 A young resident of the home had passed away in January, the situation was discussed with the staff and certain aspects of the process had been quite traumatic for the staff team. The manager and team had sought advice, help and support from specialist services to facilitate the care of the ill resident, his family was involved at all times with the care and any decisions that needed to be made. The residents were supported by the staff throughout the bereavement process. The residents are encouraged to talk about their deceased friend and are taken to visit the garden of remembrance. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 in part The home had a copy of the organisations complaints procedure. The policy did not meet the regulation. The home has appropriate policies and procedures in place for the protection of vulnerable adults. EVIDENCE: The home provides pictorial information for the residents on how to make a complaint. There had been no complaints since the last inspection. The organisations complaints procedure was reviewed by the inspector, details of how to contact CSCI were not included which is a requirement. Residents in the home had designated advocates, each resident has a photograph of their advocate and pictorial information on what the service provides. The home had in place up-to-date documentation on the protection of vulnerable adults, with local guidelines available. Four members of staff have been on POVA training. The home has policies and procedures on how staff are to manage any physical intervention if required. The documentation in the home evidence that the homes registered manager is an appointee for the residents benefits. It is recommended that the registered manager confirms with CSCI the appointee details and arrangements for the residents in the home. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,29,30 The home provides a comfortable and safe environment for its residents. Bedrooms are spacious and meet individual needs. Furniture and fittings are suitable to meet individual needs and lifestyles. The home has an assisted bathroom which meets the needs of the residents. Specialist equipment is available in the home to meet mobility needs. The premises were clean hygienic and free from odour. EVIDENCE: The bungalow is light, airy and spacious and provides a comfortable environment to the residents. The home has a large garden, a level patio area with shading from the sunshine, and provides a stimulating and pleasant area for the residents. Transport for the residents to the local amenities is provided by the homes minibus. The inspector was able to see all the bedrooms in the home, all were furnished and decorated to meet the individuals tastes and lifestyles. One resident enjoys keeping fish and has a large fish tank in his bedroom and decor to match this hobby. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 17 The home has recently refurbished its assisted bathroom, this now provides an electric hoist and a new bath to provide a comfortable bathing experience for the residents. Equipment was seen provided in bedrooms and around the bungalow which promoted the individuals independence and mobility needs. The homes laundry was clean and tidy and had appropriate hand washing facilities. Discussion took place with the deputy manager in regard to improving their methods of handling contaminated or soiled linen. It was recommended that the home consider using alginate bags. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected at this time. EVIDENCE: Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 39, 42 The management arrangements in the home provided an open, friendly atmosphere. The organisation has carried out a generalised resident satisfaction survey of the homes in its ownership. Feedback from families and other stakeholders is not recorded. The home that needs to review its management of pest control in the summer months. EVIDENCE: Brambletye has a warm and friendly atmosphere, staff were heard and observed caring for the service users in a sensitive and responsive manner while enabling independence and choice. In the registered managers absence the deputy manager had a clear sense of direction and purpose and facilitated the inspection process most effectively. CSCI had been provided with a customer satisfaction survey of all the homes in the organisations ownership, which is good practice. The document contained no specific feedback from the residents in this particular home. The home is Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 20 recommended to actively seek feedback from the residents family friends advocates and stakeholders and record this feedback. The deputy manager advised the inspector that staff seek feedback from residents by observing their behaviour and body language. The home had a clean and tidy kitchen with a backdoor giving entry to a side passage way, the door was opened to keep the kitchen cool but allowed potential entry of any flies and pests. It was recommended that the home review its arrangements and consider fitting a fly screen or chain-link door curtain. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 x 3 2 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brambletye Score 3 3 3 4 Standard No 37 38 39 40 41 42 43 Score x 3 2 x x 2 x H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 22 1 Regulation 22 (7) 4&5 Requirement The complaints procedure is to contain the contact details of CSCI. A copy of the homes finalised statement of purpose and service user guide are to be sent to CSCI. Timescale for action 28/9/05 28/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 23 30 42 39 Good Practice Recommendations A copy of the details and arrangements of the appointee procedures for residents finaces is to be sent to CSCI. The home considers the use of alginate bags for soiled laundry to ensure no spread of infection. The home considers installing appropriate mechanisms to prevent the entry of flys and pests into the kitchen. Feedback is actively sought and recorded from families and other stakeholders. Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Berks RG7 4SA 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 Brambletye H52-H01 51756 Brambletye V228945 280605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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