Inspection on 14/01/09 for Bramblings Residential Home

This inspection was carried out on 14th January 2009.

CSCI found this care home to be providing an Good service.

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

Bramblings Residential Home 09/02/10

Bramblings Residential Home 07/09/07

Bramblings Residential Home 09/08/06

Bramblings Residential Home 11/11/05

Bramblings Residential Home 26/07/05

Bramblings Residential Home 07/09/04

Bramblings Residential Home 26/04/04

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bramblings Residential Home Hartley Road Longfield Kent DA3 7PE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gary Bartlett     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Bramblings Residential Home Hartley Road Longfield Kent DA3 7PE 01474702332 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bramblings (Kent) Limited care home 42 Number of places (if applicable): Under 65 Over 65 42 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 42. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Bramblings Residential Home provides accommodation and 24 hour care for up to 42 older people. Bramblings is situated in a quiet close, within walking distance of the village of Longfield. Public transport is available nearby. The home is surrounded by gardens and there are car parking facilities on site. Current weekly fees range from £397 to £475 per week. There are additional charges for chiropody, hairdressing, newspapers and magazines ordered by residents, toiletries and personal phone costs. Full information can be obtained from the provider. Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Bramblings from 9.45 a.m. until 4.00 pm. Judgements about quality of life and choices were taken from direct observation and by discussion with the residents, staff and a visitor. Some records and parts of the building and grounds were inspected. The Manager had previously completed an Annual Quality Assurance Assessment, from which information was used to inform the inspection process. The Manager and staff gave their full assistance throughout the inspection. Care Homes for Older People Page 5 of 26 The Care Homes Regulations 2001 and the National Minimum Standards for Care Homes for Older People refer to people who use the service as service users. People living at Bramblings prefer to be referred to as residents. Accordingly this shall be done in the text of this report. The Inspector would like to thank everyone involved for their contribution to the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 7 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that they are appropriately placed due to good preadmission assessments and benefit from being able to visit the home prior to admission. Evidence: The Deputy Manager described how a pre-admission assessment is made of each prospective resident to ensure the home can meet his or her needs. If practical, a member of the management team would visit the prospective resident in their home or hospital to ensure the necessary information was current and accurate. Records show that prospective residents, their families, advocates, and relevant health care professionals are involved in the assessment process. Specialist advice is sought from external sources where required. Residents said they or their families had been able to visit The Bramblings before Care Homes for Older People Page 10 of 26 Evidence: moving in. A residents relative confirmed this and said staff are very helpful in assisting new residents to settle in. The Bramblings does not provide intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal health needs are assessed and maintained through their individual care plans and with good liaison with relevant health care professionals. Staff treat residents with respect and maintain their privacy and dignity. Evidence: Each resident has a care plan and four were inspected in detail. The care plans include the information that staff need to know about individuals needs and how they are to be met. Residents preferences are clearly indicated. Some contain very good penpictures provided by relatives. The care plans seen are up to date and are reviewed regularly. The standard of daily record keeping is good and accurately cross reference to other records such as accidents forms. Records seen show the home addresses key needs and areas of healthcare such as nutrition, pressure area care, oral hygiene and continence. There is a key worker system and staff spoken with have a very good understanding of Care Homes for Older People Page 12 of 26 Evidence: residents individual needs, preferences and current welfare. Residents consider their health needs are well met. References were made to a wide variety of healthcare professionals including local doctors, chiropodists, dentists and opticians. Staff say they receive good support from healthcare professionals such as District Nurses and GPs. A resident can keep their own G.P. if practicable, but the majority are with a local medical centre that assigns a member of its team to the home on an annual basis. The GP visits the home when required and one day every week to see non-urgent cases. Records are maintained of any consultations and input received including outcomes. Risk assessments are continually being written or reviewed in response to changes in welfare and incidents. The Manager said she will be reviewing the current facilities for the storage and preparation of medicines to ensure they fully comply with the latest guidelines from the Royal Pharmaceutical Society in the immediate future. The Medication Administration Record (MAR) sheets seen were completed appropriately. Medications are only administered by staff authorised to do so. The administration of medicines was not observed on this occasion. Residents feel that staff are kind and gentle, this was confirmed by observation. It is clear that staff have developed friendly and positive relationships with residents and are considerate of their age and dignity. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to maintain contact with family and friends. They would benefit from there being a more structured activities programme. Residents enjoy the meals from menus that offer a choice of good quality food. Evidence: Staff spoken with are aware of the rights of residents to have the opportunity to have choice in daily routines and activities. Residents confirm they choose when they get up and go to bed, for example. Since the last inspection, an Activities Co-ordinator has been appointed to work each weekday afternoon. This person has not received specific training in providing meaningful activities for older people and there is not a structured programme of activities. Residents are asked what they would like to do at the time, which may be board games or a chat. Many residents spend their time in the bedrooms. A structured programme of activities, based on residents preferences, would provide more incentive for people to participate and lessen the risk of social isolation. The Manager said the home does not provide outings as interest is minimal and, instead, brings entertainers Care Homes for Older People Page 14 of 26 Evidence: to the home. Family and friends feel welcome and know they can visit at any reasonable time. During the inspection, a number of visitors were seen in the home and the visitors book records regular visits by families, friends and others. The design of The Bramblings provides seating areas within the communal areas where residents can entertain their visitors, in addition to the privacy of their own room. Residents are encouraged to personalise their rooms with their own possessions if they wish. Some residents have brought items of furniture and personal effects with them. Residents are encouraged to take responsibility for their own financial affairs and to use their money as they wish. Where a resident can no longer manage their own money, the home will hold small amounts of cash on the residents behalf. Residents wishes in respect of any religious observances are ascertained at time of admission. If residents have strong spiritual beliefs the home supports them in meeting these. One resident currently goes to church each week with friends and others may attend a service conducted by a visiting Minister. Residents said they like the food and think it is well cooked and well presented. There is a planned menu and an alternative is available to the main course. Staff have a good knowledge of residents individual tastes and these are catered for. The meals are generous in portions and look appetising. Mealtimes are relaxed, staff are patient and helpful and allow residents the time they need to finish their meal comfortably. Some residents choose to eat in their rooms. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives know their complaints are listened to and acted on. There are systems to protect residents from abuse. Evidence: Residents state they feel safe and well supported and are satisfied with life at the home. The complaints procedure is readily available to residents and their relatives. They say they feel confident they are listened to and any necessary action is taken. The Home keeps a record of all complaints received by them, the result of the investigation and how the complaint has been resolved. The Commission has not received any complaints about the home since the last inspection. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The Manager has attended a trainers training course on safeguarding vulnerable adults. She provides all members of staff with information about the concept of protection of vulnerable adults. Staff spoken with have a sound understanding of need to report suspected abuse without delay. Residents care plans have a facility to record any areas of concern. There have not been any safeguarding alerts since the last inspection. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Bramblings provides a clean and comfortable environment in which to live. Evidence: Since the last inspection, an extension to the home providing additional en suite bedrooms has been opened and redecoration of the older parts of the premises is underway. The Manager stated that residents were given the option of moving to the new part of the home. Some work is needed to make parts of the new extension more inviting. For example, staff say that residents rarely use the lounge on the first floor. There are no pictures in there that would make the room more homely and the kitchenette there is used for storage of activities equipment. This denies residents and relatives a facility that could be used for making drinks and snacks should they so choose. The Manager explained a priority had been given to improving some residents bedrooms and this would be addressed as soon as possible. Residents say they find their bedrooms comfortable some have personalised them to their individual tastes. The home is clean and free from offensive odours. Residents and a visitor said the home is always like this. Care Homes for Older People Page 18 of 26 Evidence: Residents can gain access to the upper floors by passenger lift. A staff call system is available with calls being answered promptly at the time of the inspection. Aids and adaptations are available for use by residents with mobility difficulties. There are facilities and systems to reduce the risks of cross infection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are in the care of people who are hardworking and enthusiastic. Evidence: Residents and their relatives speak very highly of the staff and of the care given. People applying to work at the home have to complete an application form, attend an interview, provide references and satisfactory POVA and Criminal Record Bureau (CRB) checks. The files of the most recently recruited staff show that appropriate checks were made prior to them commencing duties. The Manager was advised that the staff application form should be updated to comply with current employment legislation and to obtain guidance about storing CRB checks from the CRB website. New staff are required to undertake an induction programme and there is ongoing training for all staff. NVQ training is encouraged. The Manager described how she is about to review the recording of staff induction. Staff speak of regular training and there are certificates on their files. The Manager acknowledges the training matrix needs updating to give a management overview of courses attended and those booked. Residents say there are enough staff available when needed. They like the staff and Care Homes for Older People Page 20 of 26 Evidence: find them friendly, polite and kind. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of residents. There is an open and friendly atmosphere. Evidence: The Manager, Bernadette Ramsey has many years experience of managing residential care homes. She is a Registered Nurse, has a BSc in Health Studies and has ENB 998 (teaching and assessment) and END 941 (care of the elderly). She has the Registered Managers Award, is an NVQ assessor and is a trainer in safeguarding vulnerable adults and moving and handling. The Manager is very ably supported by a Deputy Manager who is currently working towards her NVQ level 4 and Registered Managers Award. She is also a moving and handling trainer. Residents, visitors and staff say they find the management team approachable and supporting. Staff speak of ongoing supervision. Care Homes for Older People Page 22 of 26 Evidence: The home has some quality assurance processes including resident and relative surveys. The Manager said it is intended to include health care professionals and Care Managers in future surveys. Residents manage their own financial affairs or have assistance from their family or representative. Payments made on behalf of residents are carefully recorded. There are records of fire systems checks and fire drills and training. Staff spoken with have a good understanding of safety and emergency procedures. The Manager stated that records of maintenance and safety checks are in order. These were not inspected on this occasion. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 It is recommended a more structured programme of activities, based on residents preferences, is provided to give incentive for people to participate and lessen the risk of social isolation. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!