Inspection on 12/01/06 for Bramhall

This inspection was carried out on 12th January 2006.

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

Bramhall 02/08/06

Bramhall 31/08/05

Bramhall 09/03/05

Bramhall 20/10/04

Bramhall 10/03/04

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 Bramhall Butts Lane Tattershall Lincs LN4 4NL Lead Inspector Mr Toby Payne Unannounced Inspection 12th January 2006 08.25 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 Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 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. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bramhall Address Butts Lane Tattershall Lincs LN4 4NL 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) 01526 342632 01526 342163 Mr Garry Mercer Miss Bonnie Mercer, Mrs June Rosetta Mercer, Mr Reginald George Mercer Miss Bonnie Mercer Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Bramhall Care Home is registered to provide personal care for up to 19 people over the age of 65 years. It is situated on the border of the villages of Tattershall and Coningsby. The home is set in approximately one acre of mature gardens. There is limited car parking space at the side of the home but there is off road car parking. It is within reach of the local shops of both villages. The home is close to local churches, chapels and other community facilities including a luncheon club. Both villages are served by a daily bus service, which links the towns of Boston, Sleaford and Horncastle. The home also provides day care for 2 people every week. It is privately owned and managed as a family business. It has been extended and adapted from a private 2 storey residence to offer the present accommodation with a purpose built single storey extension with 12 single bedrooms. Bedrooms are all single, on ground and first floors and served by a stair lift. In order to improve the facilities a 4 bed extension was being built. A Gold Food and Health Award from East Lindsey District Council was received by the home because of the quality of its catering service. The home also received a smoke free Lincs award. The owners of the home are actively involved in the running of the home. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and started at 8.20 a.m. It took place over 4 hours. The inspector spoke to 7 residents, a visitor, 5 staff and the manager. The main method of the inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how care was delivered. The inspector also observed how care was delivered and how staff responded to other residents living in the home. Comment cards were received from 3 residents and 2 relative/visitors. There were no adverse comments. What the service does well: What has improved since the last inspection? Two bedrooms have been repainted with new carpets and new furniture. Six new beds have been purchased. One new central heating boiler has been purchased which has improved the heating in the home. A new 4 bed extension is being built to improve the facilities in the home. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 6 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. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 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 Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 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): 3, 4 and 6 Bramhall Care Home meets the needs of residents coming into the home. People receive an assessment, which results in their needs being met. EVIDENCE: The manager, prior to admission to the home assesses each person using an assessment document. The assessment wherever possible includes the resident, their family/advocate and other relevant people. Written confirmation is sent to the person to confirm that the home can meet their needs. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 9 The induction programme includes policies and procedures for the home, care issues, the needs of residents and how staff were to approach the resident with the emphasis on how to talk and understand their needs. A comprehensive in-house training programme and opportunities to undertake qualifications in care (NVQ) to follow up the induction programme is also available. Staff confirmed the benefit and self-confidence they had obtained from the amount of training provided. Where required, additional training would also be provided. The home does not provide intermediate care. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 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 and 11 There is good care planning in this home. The health, welfare and social needs of the people living in his home are fully met. Resident’s privacy and dignity is protected. The home provides support to residents and their relatives at time of death. EVIDENCE: Each resident had a care plan describing their individual needs. The care plans included admission information including where possible social history, a brief over view of the resident’s care needs, medical history, medication, moving and handling assessments, room assessment plan, information concerning their particular needs and specific care needs. Care plans were individual, clearly written and person focused. They also showed evidence of being reviewed regularly with the involvement of the resident, their family/advocate and representative of the home. There was evidence of the resident’s signature. The manager audits the care plans every 2 weeks and monitors their content and ensuring that they are up to date. Residents commented, “staff are so good and caring” and “staff are very kind”. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 11 Staff were seen to go about the work in a confident, friendly and relaxed manner talking and laughing with residents. Where required, residents are referred to GPs, Community Nurse, Tissue Viability Nurse, Community Psychiatric Nurse, Dietician, Chiropodist, Dentist and Optician. The home has a written policy and guidance for staff concerning death and dying. This gives guidance to the support of the resident, their family/advocate and staff. Staff who spoke to the inspector spoke of the support and comfort, which was offered to the people living in the home, their family/advocate and staff. Staff had also attended a bereavement and counselling course provided by a local undertaker. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 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 and 14 Residents receive good and nourishing meals. Social activities are well managed with the involvement of residents. EVIDENCE: All residents who spoke to the inspector said they liked the food. Many of the residents commented, “the food is lovely”. A Gold Food and Health Award from East Lindsey District Council was received by the home because of the quality of its catering service. The home also received a smoke free Lincs award. The home has produced an activities programme with resident’s involvement. Current activities included cards, arts and crafts, bingo, board games, gardening, baking and lawn games. The home employs 2 entertainment managers 6 days a week. Residents told the inspector they could choose what time they got up and went to bed. Comments were, “There are lots to do”. This was also evidenced in the care plan. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 13 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 17 The home takes the issue of addressing complaints and ensuring that residents are safe very seriously. Resident’s legal rights are protected. EVIDENCE: Each resident receives a detailed complaints procedure when they are admitted to the home. No complaints have been received by the CSCI and home since the last inspection. None of the residents or visitor had any complaints about the home and felt they could discuss any concerns with staff or the manager. Staff also knew what to do if they received a complaint from a resident. Residents were made aware of their rights to vote at elections and assisted where required. On request the home can obtain legal and financial advice for any person living in the home. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 14 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, 22, 23, 25 and 26 The home was well maintained, clean and attractively decorated. Furnishings were of a high standard and any maintenance required was attended to swiftly. Residents were also safe. EVIDENCE: Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 15 The home is situated in its own private grounds laid to lawn with mature trees, flowerbeds, shrubs and a pond. There are also areas where residents can sit. The garden has bird feeders placed in bushes for people to view from the lounges, bird tables and fruit trees. The home has an identified maintenance and refurbishment programme Residents have been involved in choosing the colours for their bedrooms. The home is now a smoke free home. However provision is made for those people who wish to smoke to do this in the grounds of the home. Residents commented that they liked the decoration and furnishings. In order to improve the facilities a 4 bed extension was being built. There is a ramp leading to the front door and a further one at one of the side entrances, which are accessible for wheelchairs. A stair lift serves accommodation on the first floor. The home has 2 mobile hoists. There are different types of slings, turntable, slide sheets, safety belts and a banana board. In addition, there were special mattresses and pressure relieving cushions, raised toilet sheets and grab rails in toilets and bathrooms. Where required, advice can be obtained from an Occupational Therapist Records kept by the CSCI shows that the home meets the minimum size requirements. All bedrooms are single and range from 10.35 to 15.34 square metres. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 16 Radiator covers to enable a guaranteed surface temperature not exceeding 43º Centigrade have been installed throughout the home. Bedrooms in the extension on the ground floor all have low surface temperature radiators. Thermostatic controls have been installed to all washbasins and bathrooms. A risk assessment concerning Legionella was undertaken on the 14/2/2005. Hot water temperatures were also monitored every 2 weeks and records kept. These were within safe limits. A separate laundry is provided with one commercial washing machine with sluice cycle, 2 commercial tumble dryers and ironing press. Residents commented. A member of staff was cleaning the home and talking and laughing with residents. Residents commented, “the home is always clean and tidy” and “my clothes are washed well and cared for. The home was clean, well organised and odour free throughout. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 There was a well trained and competent staff team. The numbers of staff were sufficient for the numbers of residents. Staff were correctly recruited and there was a very well established team. EVIDENCE: An Investor’s in People award was received in February 2005 in recognition of its commitment to the education and development of the staff. The home employs separate staff for care, domestic, catering, entertainment and gardening services. The home has a recruitment and equal opportunity procedure. All staff had received checks by the Criminal Records Bureau and new staff have been recruited in line with the requirements. This was confirmed by 2 staff who spoke to the inspector. They commented, “we receive a lot of training and support”. Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 18 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, 36 and 37 The home is well lead by a competent, well trained and committed manager. This in turn has given rise to a confident, supported and trained staff team. There are good up to date management systems. EVIDENCE: Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 19 The manager has 17 years experience in caring for elderly people. She is registered with the Commission and is to study in the near future for a care qualification. She has obtained a City and Guilds Award in Management and the Health and Supervisory award as well as a Diploma in Performance Coaching. She has also completed a management qualification. As part of its quality assurance the home sends out a questionnaire to new residents one to two weeks after admission in order to obtain their views about the home and the admission procedure. A quality assurance survey to obtain the views of residents and their relatives about the services provided by the home is sent out every 6 months. The last survey was carried out in November 2005. 17 responses were received with no negative comments. Residents commented, “it is now my home”, “the home is fantastic”, “I love it here and staff are only too pleased to help”. Staff commented, “it is a lovely place to work” and “I like working here”. The home has detailed policies and procedures concerning employment, induction and training. Training and on the job supervision is provided together with formal supervision for care workers at least 6 times a year. Records examined were found to be well maintained and up to date. Servicing documents for equipment were also examined and showed evidence of a maintenance programme. Resident’s records were also kept securely Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 20 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 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 x 11 3 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 3 18 x 3 x x 3 3 x 3 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 4 x 3 x 3 3 3 x Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Bramhall DS0000002332.V277085.R01.S.doc Version 5.1 Page 23 - 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!