Inspection on 02/08/06 for Bramhall

This inspection was carried out on 2nd August 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 12/01/06

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 2nd August 2006 08:10 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.V306295.R01.S.doc Version 5.2 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.V306295.R01.S.doc Version 5.2 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 bonnie@bramhallcare.co.uk www.bramhallcare.co.uk Mr Garry Mercer Miss Bonnie Mercer, Mrs June Rosetta Mercer, Mr Reginald George Mercer Miss Bonnie Mercer Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category: Old age, not falling within any other category (OP) up to 23. The category of OP applies to service users who are over 65 years of age. The maximum number of service users to be accommodated is 23. Date of last inspection 12th January 2006 Brief Description of the Service: Bramhall Care Home is registered to provide personal care for up to 23 people over the age of 65 years. On the day of the inspection there were 17 people in the home. 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. The owners of the home are actively involved in the running of the home. 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 new 4 bed single storey extension has also been built and registered by CSCI in March 2006. 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 fees at the inspection on the 2/8/2006 ranged from £368 to £455 per week. Extras are for hairdressing which range from £8.75 to 29.75, chiropody £10, toiletries, personal newspapers and magazines Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 5 Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.10 am. It was undertaken using a review of all the information available to the inspector about Bramhall Care Home. It took place over 5½ hours. The inspector spoke to 7 residents, 3 visitors, 5 members of staff, a senior care assistant in charge of the home and two of the owners of the home. The main method was called “case tracking”. This involved selecting two residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents. What the service does well: What has improved since the last inspection? What they could do better: Where there are areas, which require improvement they are already being addressed by the manager. Internal audits have been introduced to ensure that the care is delivered correctly. Please contact the provider for advice of actions taken in response to this Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 8 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.V306295.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Bramhall Care Home meets the needs of residents coming into the home. People receive an assessment, which results in their needs being met. EVIDENCE: A copy of the statement of purpose and service user’s guide had been placed on the back of each bedroom door. The information gave clear information and had been updated to include information about the new bedrooms. All comment cards received confirmed that all people felt they had enough information about the home. The manager, prior to admission to the home assesses each person using an assessment document. The assessment wherever possible included 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.V306295.R01.S.doc Version 5.2 Page 10 A newly admitted resident confirmed this and commented, “I have just arrived and am beginning to settle. I received a warm welcome and find everyone very friendly” The home does not provide intermediate care. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. There is good care planning in this home. The health, welfare and social needs of the people living in his home are fully met. Medication is safely administered. Resident’s privacy and dignity is protected 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. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 12 Residents commented, staff are always kind and helpful”, “I am very satisfied with the all the care given”, “I have been here 9 years and am very happy” and “when I need help it is there”. Where required, residents are referred to GPs, Community Nurse, Tissue Viability Nurse, Community Psychiatric Nurse, Dietician, Chiropodist, Dentist and Optician. Medication was safely administered by staff who had been trained. Staff were seen to go about the work in a confident, friendly and relaxed manner talking and laughing with residents. They were also seen to knock on doors before entering rooms. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 13 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, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. People can do what they wish to do. Residents received good and nourishing meals. Social activities were well managed with the involvement of residents. EVIDENCE: The home employs 2 entertainment managers 6 days a week. Activities included cards, arts and crafts, bingo, board games, gardening, baking and lawn games. Comment cards showed that residents were satisfied with the range of activities provided. Specific comments were, “I enjoy playing bingo and dominoes”, we are lucky as there is always something going on for us”, “Activities are plentiful, staff do encourage mum to take part which she sometimes needs to be encouraged” and “Mum really likes walking around the garden in the evening”. A Gold Food and Health Award from East Lindsey District Council had been awarded to the home because of the quality of its catering service. The home also received a smoke free Lincs award. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 14 Three residents have their own scooters to enable them to have independence and have access to local facilities in the villages. They also go shopping. All residents who spoke to the inspector said they liked the food. Comments were, “they give you a good selection, if you don’t like what is on the menu”, “The meals are very nice”. Dining room tables were laid with clean, ironed table cloths with fresh flowers. The menu was also displayed in the dining room for residents to see what they were going to eat. Residents told the inspector they could choose what time they got up and went to bed. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home takes the issue of addressing complaints and ensuring that residents are safe very seriously. Resident’s are also protected from abuse. EVIDENCE: Each resident receives a detailed complaints procedure, which is in the service user’s guide on the back of each bedroom door. The CSCI was aware of a concern about infection control, which was brought to both the commission’s and the home’s attention. The manager to the person’s satisfaction addressed this but the issue was also followed up this visit. There were no issues of concern about how the manager had addressed the issue. None of the residents or visitors 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. All staff receive adult protection training and staff knew what to do if adult abuse was suspected. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. 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: Since the last inspection a 4 bed single room extension was registered in March 2006. All these rooms had an en-suite toilet. A small seating area and disabled access shower room had also been provided. Residents have been involved in choosing the colours for their bedrooms. The home is 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. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 17 A laundry is provided with one commercial washing machine with sluice cycle, 2 commercial tumble dryers and ironing press. All comment cards confirmed that residents were satisfied with the cleanliness of the home. Two members of staff was cleaning the home and talking and laughing with residents. The home was clean, well organised and odour free throughout. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 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 and 30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. 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 had 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. Staff training has covered qualifications in care (National Vocational Qualifications) levels 2 and 3, first aid, administration of medication, care practice, induction, moving and handling, nutrition and food hygiene. Future training will cover cross infection, challenging behaviour, supervisory award, food hygiene and health and safety and fire prevention. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 19 Staff felt they had sufficient time to care and support the residents. Fifty per cent of staff had obtained a qualification in care (NVQ). Residents commented, “Staff are always friendly and ready to help” “Staff are not always available when I need them but they on hand as soon as possible”. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 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 and 36 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. 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.V306295.R01.S.doc Version 5.2 Page 21 The manager has 17 years experience in caring for elderly people. She is registered with the commission and is to studying 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. . All comment cards showed residents were satisfied with the management and staff in the home. Specific comments were, I do not believe my mother could be cared for and loved more”, “Support from the home is excellent”, “I enjoy being at Bramhall, the staff and residents are very nice”, “staff are always kind and helpful”, ”very satisfied with the all the care given”, “I have been here 9 years and am very happy”. Residents commented, “I am very satisfied” and “staff are very kind”. Staff commented, “I feel confident in what I am doing and supported in my work” and “we all work well together”. Resident’s monies where required were being safely looked after by the home. Records were well maintained with signatures. Training and on the job supervision is provided together with formal supervision for care workers at least 6 times a year. Records examined were well maintained and up to date. Resident’s records were also kept securely. The home had detailed policies and procedures including health and safety. Gloves and aprons were provided and all staff had hygienic hand rubs. Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 22 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 x 3 x x 3 Bramhall DS0000002332.V306295.R01.S.doc Version 5.2 Page 23 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.V306295.R01.S.doc Version 5.2 Page 24 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.V306295.R01.S.doc Version 5.2 Page 25 - 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!