Inspection on 22/09/05 for Bramcote House Care Home

This inspection was carried out on 22nd September 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

Bramcote House Care Home 22/08/06

Bramcote House Care Home 07/02/06

Bramcote House Care Home 17/03/05

Bramcote House Care Home 19/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Bramcote House Care Home Town Street Bramcote Nottingham NG9 3DP Lead Inspector Meryl Bailey Unannounced Inspection 22nd September 2005 09:30 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 Bramcote House Care Home DS0000026420.V250052.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. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bramcote House Care Home Address Town Street Bramcote Nottingham NG9 3DP 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) 01159257316 0115 9257316 Bramcote Nursing Home Limited Ms Azza Hebeshaw, Mr Mahmood Saba Mrs Ann Elizabeth Warner Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Terminally ill (1) of places Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th March 2005 Brief Description of the Service: The home is situated 5 miles from the city of Nottingham, within the village of Bramcote. It is close to public transport and local amenities. Both residential and nursing care is provided to older people. There is a choice of sitting areas, 12 single and 5 double bedrooms, though some double rooms are used as single, and a passenger lift gives access to all floors. The entrance to the building and the gardens are accessible to wheelchair users Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one day. 18 service users were at home. Some of these service users and staff gave their views about the care provided and discussions were also held with the manager. Three care plans were examined and other records have been used to assist this inspection. Most areas of the home and gardens were seen. What the service does well: 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. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 6 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 Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 7 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): Needs are assessed prior to admission. EVIDENCE: The manager undertook pre-admission assessments to determine if needs can be appropriately met at the home. Additionally, assessments from social work staff were obtained for those funded by the local authority. Assessment material was stored separately from care plans, but examination of one assessment showed that initial care planning was based on this and further information was collected during the first few days. The terms and conditions clarified that the first six weeks were seen as a trial period. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 8 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 and 9 Care is planned and the written plans are developing to give clearer instructions to staff. Health needs are monitored and appropriately met and medication is well managed. EVIDENCE: The files of three service users were seen and care plans varied in their detail. Areas of need identified during assessment were addressed, but this ranged from just statements about the situation to giving clear direction to staff about actions to take. The manager had produced a new format for recording care plans and has started to introduce this. The one seen gave a clearer and more comprehensive plan of care with some standard actions needed aswell as space for personalised actions required. It is recommended that this be used for all service users. A trained nurse was always on duty to attend to immediate health needs and there was evidence of outside health professionals’ regular involvement in daily notes. A dentist visited one service user during this inspection and another was assisted to attend a hospital appointment. Care plans contained appropriate risk assessments for falls, continence, skin condition manual handling and nutrition. All plans were evaluated at least monthly and updated Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 9 as necessary. Bed rails were used when requested and risk assessments for their use was seen on files. All medication was held on behalf of service users and administered by trained nursing staff. Storage was appropriate and secure in a designated room. Medication records were well kept including records of controlled drugs. Photographs were on each service user’s medication sheet for identity purposes. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 10 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 and 15 Individual lifestyles are respected and activities provided. Meals are of a high quality, though the menu is not displayed. EVIDENCE: Individual routines were respected and this was observed and confirmed by service users and staff. Service users were given plenty of time to get up or go to bed and had a choice of where to spend their time within the home. A range of activities was available including sing-alongs, dominoes, books and newspapers. A music therapist visited regularly. It had been recognised that activities could be explored further and an activities worker had just been appointed and due to transfer from being one of the care staff to fully involved with activities a few days after this inspection. Meals were greatly appreciated by service users and food stocks seen showed a large proportion of fresh foods used. The kitchen and stores were very well organised. The meal served consisted of three courses: vegetable soup, chicken, stuffing, potatoes and fresh vegetables, followed by home made cheesecake with kiwi and oranges. A four weekly rotating menu showed a variety of wholesome food provided, but no choice of main meal. The manager and cook stated that alternatives were available for those who wanted them, but there was no menu displayed for service users. It is recommended that a menu be displayed offering an alternative choice for each meal. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 11 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 and 18 Service users and relatives have appropriate information regarding making complaints and relevant policies and procedures are in place to protect service users from abuse. EVIDENCE: The complaints procedure was displayed in the entrance hall. It was clear and contained all relevant points. One complaint had been dealt with since the last inspection and full records have been kept of the process and outcome. A new service user spoken with was aware of whom to approach to discuss any concerns. There is a copy of the Nottinghamshire Committee for the Protection of Vulnerable Adults policy and procedure. Recent amendments have been added. The manager was fully aware of the procedure and was able to discuss how it applied to particular situations. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 12 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, 24 and 26 Service users live in a safe, homely environment with comfortable bedrooms. All areas are kept clean and hygienic. EVIDENCE: The premises consisted of a large adapted house with extensive grounds. Some external maintenance work has taken place since the last inspection with rendering being completed, but paint was seen to be flaking off external wooden window frames. A handyman was employed to undertake minor maintenance work and internally the home was well maintained. Rooms are well decorated and a spacious homely environment was provided. There were extensive, well maintained grounds that were accessible to service users and a portable nurse call system was available for those who wished to sit outside. Individual bedrooms were personalised and service users were satisfied with what was provided. A fully equipped hairdressing room was also provided. The home was found generally very clean with some areas being cleaned during the morning. The laundry was situated in an out building and had appropriate washing machines. A domestic person was employed to do all laundry during the daytime. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 13 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 and 29 Sufficient staff are provided and recruitment practices protect service users. EVIDENCE: The rota showed there was always at least one trained nurse on the premises with three care assistants during the day and one at night. This was sufficient to meet the needs of the current service users. Catering and domestic staff were employed in addition. Staff turnover was low, but there had been recent appointments. Staffing records showed that all appropriate documents are collated and new staff were checked against the Protection of Vulnerable Adults list before commencing employment. Records were, though, disorganised and an improved filing system would make it easier to determine if all records were present (see Standard 37). Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 14 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, 35, 36, 37 and 38 The home is managed by an experienced nurse manager and staff are well supervised. Some records of monetary transactions are insufficient and staffing records should be better organised, but service users interests are protected by their records being held securely. Action is taken to protect the health and safety of service users and staff within the home. EVIDENCE: The manager is registered with the Commission. She worked some hours dedicated to management and other hours were either as the trained nurse or covering for care staff. Staff said that the management structure was clear and the manager was very approachable. There were some records of formal supervision meetings held and informal support meetings also took place. Service users money was generally looked after by relatives, but the manager was involved in transactions for one service user whose money was banked with the local authority. There were notes relating to this in a small notebook, Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 15 but these are insufficient records of the transactions and all incoming and outgoing cash and cheques must be recorded clearly and link with receipts. As stated under standard 29 the staffing records should be better organised, but all records were held securely in locked cabinets and locked offices. The visitors’ book was missing, but found later with pages missing. A record must be kept of all visitors to the home. There was evidence of action taken in relation to health and safety with up to date records of weekly fire alarm and emergency lighting tests and all staff had a fire lecture on 30th May 2005. The environmental Health officer visited to carry out a food safety inspection in June 2005. A tile and a strip light over the cooker needed replacement and this work was done immediately. The lift was regularly serviced and a date on the bath hoist showed attention given in May 2005. Staff spoken with had received training in all safe working topics. Some were receiving specific training with lifting and using the hoist during this inspection. The cook and assistant have been trained in food hygiene. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 16 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 2 3 2 3 Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 17 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 OP35 Regulation 17(2) Schedule 4. 9 17(2) Schedule 4. 17 Requirement Records must be maintained of all monetary transactions relating to service users’ own money. A record must be kept of all visitors to the home. Timescale for action 22/09/05 2 OP37 22/09/05 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 Refer to Standard OP7 OP15 OP37 Good Practice Recommendations Use the new care plan format for each service user to ensure staff are fully aware of how all needs are to be met. Display the menu for service users showing an alternative choice for each main meal. Organise staffing records into a consistent filing system. Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Bramcote House Care Home DS0000026420.V250052.R01.S.doc Version 5.0 Page 19 - 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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