Inspection on 17/10/05 for Brambling House

This inspection was carried out on 17th October 2005.

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

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

Other inspections for this house

Brambling House 10/12/08

Brambling House 12/12/06

Brambling House 21/04/05

Brambling House 02/11/04

Brambling House 17/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Brambling House 46 Eythorne Road Shepherdswell Dover Kent CT15 7PG Lead Inspector Mrs Michele Etherton Announced Inspection 17th October 2005 9:40 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 Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brambling House Address 46 Eythorne Road Shepherdswell Dover Kent CT15 7PG 01304 830276 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Kanagaratnam Rajamenon Mr Kanagaratnam Rajaseelan Mrs Lynn Catherine Kent Care Home 20 Category(ies) of Past or present alcohol dependence (1), Old registration, with number age, not falling within any other category (19) of places Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One (1) person with a past dependency on alcohol/drugs whose date of birth is 11.02.1937 21st April 2005 Date of last inspection Brief Description of the Service: Brambling House is an extended detached property set back from the main road above a grassed bank and accessed by a steep drive. Car parking is available off road in a small car park at the rear of the premises. The Home is located off the main road through the quiet and rural village of Shepherdswell. There is a limited public bus service, but the village has a train station with direct mainline access. The house provides residential care for up to 20 older people ( 1 bed is currently allocated to a person with alcohol dependency needs). Accommodation comprises of 16 single rooms, seven being located downstairs, with a further 9 single rooms and 2 shared rooms situated on the first floor. The Home benefits from having three communal spaces for Service Users downstairs, in the form of one small lounge, a lounge/diner and a large conservatory area. All parts of the Home are accessible to Service Users via a shaft lift. Each bedroom has a private wash-hand basin and call bell, a telephone is available for Service Users to use. Service Users have access to a garden that is mainly laid to lawn, and is located to the side and rear of the property. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector carried out an Announced inspection visit to assess those key standards not inspected previously. Progress made by the home on addressing outstanding requirements and recommendations, highlighted by the previous unannounced inspection was also assessed on this visit. The inspection was undertaken between 9.40 a.m. and 5.40 p.m. During this time the inspector toured the building, viewing all communal spaces and those user bedrooms currently in use (with service users permission where this could be obtained) and all other areas of the home. The inspector spent time in the conservatory, chatting with some service users and saw others in their rooms. Service users were relaxed and appeared happy to chat. A lunchtime medication round was assessed during the visit. In addition to the manager, a provider and area manager, the inspector was also able to speak with two care staff and one domestic. Five relatives in addition to six service users were also spoken with during the course of the inspection. Staff expressed support for the manager and demonstrated a commitment to improving and developing the service. Service users and relatives were generally complimentary of the staff, and longer-term service users and their relatives were supportive of clear improvements they perceive in the current operation of the home over the past year. Thirteen comment cards received from relatives and representatives indicated a high level of satisfaction, with some minor recommendations for improved consultation, and improvements to the environment. A range of documentation was reviewed including two new service user files comprising assessment, care plan, terms and conditions, risk assessments and medication information. Other documentation viewed included two new staff files, Medication administration sheets, staff meeting minutes, relative and service user meeting minutes, staff rotas and training information, activities information, the staff communication book, the complaints record, accident records, and staff supervision records. What the service does well: The Home offers a homely and comfortable environment in a pleasant setting, is well furnished and comfortable. The Home providers and management team are responsive to the inspection process and have demonstrated a commitment to improving and developing the service to achieve the required standards. Routines are relaxed and flexible, in keeping with service users preferences, who are supported to retain as much independence as possible. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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 Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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): 2,3, 6 Service users are made aware of their terms and conditions by the provision of a contract. Service users’ benefit from an assessment of their’ needs by the home manager prior to admission. The Home is unable to provide intermediate care. EVIDENCE: Although standard 1 was not assessed on this occasion, the inspector was able to confirm that day care and respite services offered by the home are highlighted within the Statement of Purpose. Feedback from relatives and a review of contract documentation confirmed that contracts are being routinely issued for all new privately funded service users. The home also need to ensure that council funded service users also receive a copy of the terms and conditions of the home. A review of new service user files provided evidence of assessment documentation. Five relatives were spoken with during the inspection, and those whose relatives were newly admitted, confirmed that the manager or another member of the management team, had undertaken an assessment of their relatives needs prior to making a decision to admit to the home. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 9 The home does not have the appropriate facilities or staffing to provide intermediate care, this service is therefore, not provided. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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 Care plans are in place for all service users and detail the health and care needs they require. Service users benefit from the administration of their medication by trained staff, and this affords them greater protection. Service users are satisfied with the care and support offered by the home staff which is in keeping with their preferences and wishes. EVIDENCE: The inspector viewed care plans belonging to two new service users, these contained detailed plans of care, and risk assessment information, care plans were signed by the respective service user and/or their relative/representative. Relatives spoken with confirmed they have seen and signed care plans, the majority of comment cards received from relatives confirmed they are consulted about their relatives care, a minority view held was that communication and consultation could be improved upon. User files viewed provided evidence that routine health checks and appointments in addition to more specialised hospital appointments and visits Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 11 are taking place, with the home supporting and enabling access to health care where possible. Only trained staff are able to administer medication to service users. A medication round was assessed during the inspection, the inspector was satisfied that medication administration procedures are being satisfactorily adhered to, and that service users are engaged with by the administering staff member and kept informed of what medication they are being administered. The home has addressed a previous recommendation to establish a system for staff to appropriately record medication errors, an outstanding recommendation for the home to establish a system for monitoring the ongoing competency of administering staff is still to be developed and implemented. The inspector has recommended that the home date liquid medications upon opening and undertake audits of these and PRN medications routinely. Although currently there is limited administration of PRN medication, user files viewed of those prescribed PRN medication provided no guidelines as to when these are to be administered, it is a recommendation that these are developed. The inspector met and spoke with a district nurse at the home during the inspection, who was satisfied that staff were following the correct protocols, were proactive in seeking advice and guidance from the district nurse service if they were concerned in respect of a specific service user, and were following advice given correctly. Feedback from service users and their relatives expressed overall satisfaction at the care and support offered. Service users feedback at inspection indicated a general consensus that their daily routines were in keeping with their own preferences. Discussion with staff indicated insight into the need to maintain the privacy and dignity of service users and the importance that staff attitudes have in making service users comfortable when receiving personal care support. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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, 14 Service users would benefit from the further development of an established activity programme. Service users are supported and enabled to exercise control over their lives. EVIDENCE: The home has responded to a previous recommendation to develop the activities programme. Two staff spoken with at inspection have a particular interest and commitment to developing this further, and have found that service users become easily bored with repetitive activities and are looking at rotating the activities on offer to sustain interest. Feedback from service users spoken with at inspection indicated that generally they appeared satisfied with the frequency and range of activities provided, and confirmed that they opt in and out depending on: how they feel, their own personal interests etc. Some indicated a desire to participate in activities outside of the home too. Feedback from relatives through comment cards and personal interviews, indicated minor concerns that stimulation could be improved upon, with more consideration given to the development of an activities programme that took account of those with visual impairments, it is recommended that consideration is given to further development of a more inclusive and stimulating activities programme. None of the present service user group manages their own monies; families or representatives are responsible for service user monies although the manager Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 13 and senior staff are responsible for personal allowance monies retained on behalf of service users for their day-to-day needs. Some service users confirmed in discussion with the inspector that they have brought possessions of their own into the home to personalise their bedrooms. Advocacy information is made available to service users in the home. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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 Service users and relatives would benefit for improved recording of expressed concerns. The protection of service users is promoted by improvements to the recruitment and training of staff. EVIDENCE: Only one formal complaint has been received by the home since the last inspection, details of the investigation and resolution of this complaint were recorded in the complaints record book. Feedback from relatives comment cards indicated that a minority were unaware of the homes complaints procedure, although this is clearly and openly displayed in the entrance to the home. In discussion with relatives at inspection, all appeared confident in approaching the manager or other staff members if they had concerns about their respective relatives care, this view was supported in relatives concerns raised with staff and recorded in the staff communication book. Whilst it is appropriate that actions to be taken by staff in response to expressed concerns should be made known to staff in the communication book, the concern itself should be more appropriately recorded in the complaints record, with details of actions taken and this is a recommendation. The Home have made improvements to the recruitment procedure to ensure all checks are undertaken in vetting new staff, in addition nine of the current staff team have attended adult protection training, and remaining staff will be trained as courses become available. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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, 20-26 Service users live in a clean, comfortable environment that would benefit from planned improvements to the premises being progressed. EVIDENCE: The home is maintained to a good standard of cleanliness, and feedback from relatives indicates they place importance on this fact and the lack of unpleasant smells and odours in the home. The Home has a cleaner on duty weekdays, but with increasing numbers and dependencies of service users, consideration will need to be given to increasing cleaning hours to cover weekends, to ensure that the cleanliness of the environment is maintained. Regulation 26 visit reports had indicated a need for a replacement second freezer, and repairs to a curtain track in a service user bedroom, progress on these areas were assessed at inspection, the inspector was satisfied that a replacement freezer has been ordered and the curtain track has been repaired. Bedrooms are pleasant and personalised, but some are in need of upgrading. Replacement carpeting has been installed in some bedrooms, and this has improved the management of some incontinence in those rooms. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 16 Bedrooms are pleasantly furnished and personalised to reflect individual tastes and interests, communal spaces are furnished with good quality furnishings in a domestic but uncluttered style that compliments the homely and relaxed atmosphere. There are informal plans to upgrade some areas of the premises now showing signs of wear, these plans have not been formalised and no development plan currently exists for the home to detail which areas are to be upgraded and over what period. The new manager and the current staff team have made some changes to the use and appearance of some of the communal areas, the inspector considers these have brought about a general improvement to the light and atmosphere in these areas, and the use made of them by service users. Feedback from relatives has highlighted several improvements to the external environment that they believe would be an improvement, these are the lopping and pruning of trees to the side of the home as these are currently reducing natural light into the bedrooms on that side of the home significantly. The inspector has been advised that the trees are subject to a preservation order and as such the local authority will need to be approached to seek permission to cut the trees and this is a recommendation. Relatives also felt the development of a patio area with garden furniture would provide a pleasant area for service users to use in good weather, and this is a recommendation. Whilst the home has addressed a previous requirement to make safe an area to the front of the home, where a steep bank exists, consideration will need to be given to improving the security of the rear garden to protect service users if a patio area is to be developed there. Discussion with service users at inspection, highlighted that although they enjoy the large television recently bought for the home and located in the conservatory, a number have hearing problems and cannot hear programmes on the television and do not wish to impose on others by having the volume louder, the home manager and owners are asked to consider the installation of a loop system in the television area and in those rooms where service users are experiencing hearing problems. A previous recommendation to install door-guards on those bedrooms left ajar at night by service users has been addressed, owing to concerns regarding the safety of one service user on the stairs, stair gates have now been fitted in consultation with the fire officer, an amended fire risk assessment has been developed taking account of these changes, the fire officer visited recently and was satisfied with current fire arrangements and the amended risk assessment. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 17 A review of bathroom facilities is an outstanding recommendation and will need to be addressed within the upgrade of the premises. A recommendation that the home obtain an OT assessment has still not been undertaken although the home have made enquiries as to how this might be done and the cost; there are no firm plans as to how this might be taken forward. A previous recommendation that the clinical waste bin be locked, has been implemented; the key is now kept in the office for easy access by staff. In discussion with a member of the domestic staff the inspector was satisfied that home staff are adhering to procedures for the management of commodes and their cleansing. Feedback from service users and relatives indicated general levels of satisfaction in respect of the homes laundry arrangements. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Improvements to the staffing, recruitment and training arrangements in place at the home, support and promote the needs and welfare of service users. EVIDENCE: The home has addressed a previous requirement to improve staffing levels, discussion with staff indicated that they feel that an adequate number of staff are currently in place to support the number and dependencies of the service users and provide flexibility to facilitate activities for service users. Feedback from relative comment cards and interviews confirmed satisfaction with current staffing levels. Service users spoken with commented that staff always appeared very busy, but, indicated that they were not kept waiting for any length of time for staff to help them, nor expressed views that staffing was inadequate. The home has actively encouraged staff to undertake NVQ qualification training and as a result the home has more than 50 of staff that have completed or are undergoing NVQ training at this time. Improvements have been made to the recruitment of staff, with evidence of POVA and CRB checks and two written references in place for new staff. The content and presentation of staff files was much improved and compliant with Schedule 2 of the Care Homes Regulations 2001. The home needs to ensure that photographs of staff are securely filed, as these had become loose in one file viewed. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 19 A staff-training matrix is in place, and a number of courses booked to ensure that all staff achieve training in mandatory core skills, and more specialised training. Consideration should be given to providing a more advanced foodhygiene training course for the cook and access to infection control training. The home may also wish to discuss with domestic staff whether there are appropriate NVQ courses that they might wish to access. Staff spoken with confirmed an induction-training programme is in place, the manager will need to review the induction programme against the new induction standards established by the social Skills council and amend accordingly. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Service users benefit from improvements’ to the management and leadership of the home, but have no evidence that their views are influential in the development of the service. The Home has implemented systems to ensure service users financial interests are protected. Service users welfare is supported by improvements to the supervision of staff and the implementation of appropriate health and safety measures. EVIDENCE: The manager has been in place for approximately one year, and has been instrumental in bringing about improvements to the operational management of the home, providing appropriate leadership and support to staff. The manager is currently undertaking the NVQ4 and RMA to support her HNC qualifications in care and management. The manager has re-introduced staff meetings with two having been held to date one involving the night staff. A meeting involving service users and their relatives has also been held, minutes of meetings were viewed at inspection. Discussion with two staff members Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 21 during the inspection indicated they felt supported and found the manager approachable. Relatives and service users spoke positively about the manager and the staff and overall improvements to the service. Consultation with service users has improved in response to a previous recommendation through the use of user questionnaires, and some basic analysis of this has been undertaken, however, the home is still to consult more widely with stakeholders, and are required to produce and publish an annual report of service user feedback, and evidence how user consultation is influential in service development. The home is still to produce an annual development plan. Whilst the home does undertake some internal audits and checks of its service, it is still to draw these together and develop a system for selfmonitoring using a verifiable method at least on an annual basis. Service users monies are managed and controlled by relatives and representatives. The home manager and senior staff look after personal allowance monies and satisfactory records of transactions were viewed at inspection. A secure facility is available to keep monies safe, and access is restricted to the manager and senior staff. The inspector checked the balance of two service users’ personal allowance monies and found amounts and recorded balances to be accurate. The Home manager has addressed an outstanding recommendation to review the format for supervision and implement supervision sessions for staff, discussion with staff at inspection confirmed these are now happening and the manager is attempting to maintain the recommended frequencies, examples of supervision notes were viewed at inspection and the inspector is satisfied that the format and content of supervisions are in keeping with the standard. The Home have addressed an outstanding requirement to implement a minimum of two fire drills for all care staff within a twelve month period, by incorporating them into fire training with an external provider. Induction training for new staff should also incorporate an understanding of the fire evacuation process and fire drill procedure. The accident book was reviewed again on this visit, following a previous recommendation that the manager review the cause of a higher number of nighttime accidents amongst service users. The manager has undertaken to meet with night staff to discuss this area of concern and a new system of nighttime checks of service users has now been implemented. Since the last inspection in April, there has continued to be a low level of accidents, but, despite the actions taken by the manager to date, almost half of the recorded accidents have occurred during the night shift. Feedback from discussions with service users during the inspection has given no indication that call bells are not being responded to in a timely manner, or that service users are attempting to mobilise without staff help as a result of waiting too long for assistance. The manager was recommended to continue monitoring the level of Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 22 nighttime accidents and to analyse call bell response times to ensure these are acceptable. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 33 Regulation 24 Requirement The home is still to consult more widely with stakeholders, and produce and publish an annual report of service user feedback, to evidence how user consultation is influential in service development. The home to produce an annual development plan, draw together current audits and checks into a system for self monitoring using a verifiable method at least on an annual basis. Timescale for action 01/04/06 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 9 Good Practice Recommendations Home to establish a system for monitoring the ongoing competency of administering staff is still to be developed and implemented. Liquid medications to be dated upon opening audits of liquid and PRN medication to be DS0000042612.V257023.R01.S.doc Version 5.0 Page 25 Brambling House 2 3 4 12 16 19 5 6 7 21 22 38 implemented, guidelines for use of PRN medication to be developed for individual users. Consideration is to be given to further development of a more inclusive and stimulating activities programme. All concerns expressed by relatives and service users to be recorded in the complaints book Home to seek authorisation from the local council to effect the lopping and pruning of trees to the side of the home, which are inhibiting light into user bedrooms. Home to consider the development of a patio area for service users in the garden and to address the security of the garden and service users overall safety if this is implemented. Home to consider installation of a loop system in the television area, also in those bedrooms where service users have hearing impairments. A review and upgrade of bathroom facilities is needed to provide improved choice of bathing options to service users The home is to seek occupational therapist assessment of the premises to ensure it continues to meet the needs of the service users Home manager to monitor level of night time accidents to service users, and analyse call bell response times by staff. Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Brambling House DS0000042612.V257023.R01.S.doc Version 5.0 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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