Inspection on 31/08/05 for Bramhall

This inspection was carried out on 31st August 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

Bramhall 02/08/06

Bramhall 12/01/06

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 Toby Payne Unannounced 31 August 2005 8:20 a m 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 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 C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bramhall Address Butts Lane Tattershall Lincs LN4 4NL 01526 342632 01526 342163 bonnie@bramhallcare.co.uk Mr G Mercer Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss B Mercer Care Home PC only 19 Category(ies) of Old age (19) registration, with number of places Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 9th March 2005 Brief Description of the Service: Bramhall Care Home 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. The home 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. Bramhall Care Home is registered to provide personal care for up to 19 people over the age of 65 years. The home also provides day care for 2 service users every week. The home 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.The home was awarded a Heart Beat award in July 2002 and also the Investors in People award.The home has also been a smoke free home since September 2002. The owners of the home are actively involved in the running of the home Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 5 hours. The inspector spoke to 7 residents, 4 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. The inspector also examined a pre-inspection questionnaire, which had been completed by the manager and comment cards from 9 residents and 7 relatives. There were no adverse comments. Written comments were ”my mother is warm and comfortable, we would not consider moving her due to the kindness and care she receives from the staff.” What the service does well: What has improved since the last inspection? What they could do better: There is little which can be improved as the manager is already addressing issues such as internal audits to ensure that the care is delivered correctly. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 6 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 C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 standard(s) 1,2 and 5 Bramhall Care Home meets the needs of residents coming into the home. EVIDENCE: All residents are assessed before entering the home and written confirmation is sent to them that the home is able to meet their needs. A survey of 5 residents was carried by the home and a comment received was “I was welcomed in a kind, unhurried way and all my questions were answered”. There is a detailed statement of purpose and service user’s guide and a copy of the service user’s guide is given to each person when being admitted to the home. Trial visits can also be arranged before admission. These can be a visit to the home with lunch to meet other residents or an overnight stay. This trial can last a day, week or a period of a month. Each person receives detailed and clear terms and conditions when being admitted to the home. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 9 and 10 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 identifying their individual needs. The care plans included admission information including where possible social history, a brief over view of the service user’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. Since the last inspection the manager has been auditing the care plans every 2 weeks and monitoring their content and ensuring that they are up to date. Staff responsible for the administration of medication had received training. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 10 Residents said that staff respected their privacy and dignity. All bedrooms have a lock to ensure the person’s privacy. Resident’s comments were “staff are very kind and polite” and “I am very satisfied”. Staff were seen to be knocking on resident’s doors before entering and respecting their privacy in a calm and sensitive manner. The home also has a policy on privacy and dignity and this is also covered at induction of new staff. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13 and 15 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 superb”. 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. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 12 The home has a 4-week menu. At breakfast there is a choice including a hot meal. At lunch there is a set menu with an alternative if required. Records examined on the day of the inspection showed a variety of food being available. Required records of food temperatures and cleaning rotas were evident. The cook was correctly dressed and the kitchen clean and well organised. The menu was displayed on a board in the dining room. Dining tables were laid with tablecloths and flower decorations. Meals can be taken in the dining room or the resident’s bedrooms. There are regular meetings with residents. The home has produced an activities programme with service user’s involvement. The home had a successful Summer Fete in August 2005 Current activities included arts and crafts, bingo, board games, gardening, baking and lawn games. The home employs an entertainment Manager 4 days a week. There are also large colourful, well-maintained accessible gardens at the front and side of the home. Four residents have their own scooters to enable them to have independence and have access to local facilities in the villages. They also go shopping. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 The home takes the issue of addressing complaints and ensuring that residents are safe very seriously and has a comprehensive complaints and adult protection procedure. 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 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. This issue will be further covered in future training. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 standard(s) 20, 21, 24 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: 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 people can sit. The garden has bird feeders placed in bushes for service users to view from the lounges, bird tables and fruit trees. Residents who spoke to the inspector spoke of how satisfied they were with the decoration and cleanliness of the home. They all spoke of how much they liked their bedrooms. The domestic staff monitor how clean the home is and the condition of laundry. In order to improve the facilities a 4 bed extension was being built. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 15 On the ground floor there are 2 bathrooms with toilet and washbasins. On the first floor there is one bathroom with toilet and washbasin. Two of these bathrooms allow access for disabled persons. In addition, there are 5 toilets one of which is used by staff. All these facilities have locks to them. Before the admission of a new resident, staff make a room assessment. This involves discussing with the person their choice of colours for their room. Resident’s bedrooms included small items of furniture, ornaments, pictures, television and personal mementoes. All bedrooms have locks, which are accessible to staff in case of an emergency. Radiator covers to enable a guaranteed surface temperature not exceeding 43º Centigrade have been installed throughout the home. For bedrooms in the extension on the ground floor all have low surface temperature radiators. Thermostatic controls have been installed to all washbasins and bathrooms. New taps have also been installed in service user’s bedrooms to ease access. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 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. There was an extensive training programme for staff, which included NVQ, internal lectures and training from outside trainers. Staff told the inspector how the training provided had helped them to improve the care and support for the residents. One member of staff commented “I have a worthwhile job” and “the training I have received has given me self confidence to care for the residents”. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 17 Each member of staff has a training and development programme. The home has received the Investors in People Award. Training has included eye care, personal development, first aid, moving and handling, fire prevention, risk assessment, health and safety, equality and understanding and managing behaviour. This is in addition to National Vocational Qualification levels 2 and 3. Residents did not express any worries about the level or availability of staff. During the inspection staff were seen to promptly attend to residents needs. Staff also felt they had sufficient time to care and support the residents. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 38 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. EVIDENCE: The manager has 16 years experience in caring for elderly people. She is registered with the Commission and is studying for a management 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. There are regular staff and residents meetings. Residents and staff spoke of how they could approach the manager if they had any concerns. Comments were “I am very satisfied”, “I can’t fault anything”, “I am very content” and “the home is excellent”. Staff felt the manager was very supportive and approachable. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 19 The home has a detailed health and safety policy, which included the Control of Substances Hazardous to Health (COSHH) and risk assessments. A formal fire risk assessment had been carried out in March 2004 and the Fire Safety Officer from Lincolnshire Fire and Rescue Service had no concerns. Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION x 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 x x x x x 3 Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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. 1. 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. 1. Refer to Standard Good Practice Recommendations Bramhall C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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 C53 C04 S2332 Bramhall V246567 310805 Stage 4.doc Version 1.40 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!