Inspection on 29/11/05 for Bramley House

This inspection was carried out on 29th November 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

Bramley House 04/09/07

Bramley House 18/09/06

Bramley House 01/08/05

Bramley House 15/11/04

Bramley House 18/05/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Bramley House Bramley House Bromley Green Road Upper Ruckinge Ashford Kent TN26 2EG Lead Inspector Wendy Mills Unannounced Inspection 29th November 2005 01:30 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 Bramley House DS0000023350.V270136.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. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bramley House Address Bramley House Bromley Green Road Upper Ruckinge Ashford Kent TN26 2EG 01233 732629 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) Rooks (Care Homes) Limited Mrs Caroline Rose Rooks Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2005 Brief Description of the Service: Bramley House is registered to provide residential care for up to 18 older people and admits people with low to medium dependency needs. It is situated in a rural area approximately five miles from Ashford. A regular bus service runs into Ashford from just outside the Home. Bramley House is a detached property that has recently been extended to provide an additional six bedrooms, all with ensuite facilities. All rooms have a call bell and television point. Telephones can be provided in the individual bedrooms, by arrangement. The residents have the use of three bathrooms. There is a spacious dining room with an additional seating area. The residents have the use of two lounges one which has a television. In addition there is seating in the front porch. There are gardens to the front and rear of the home. These are well maintained and include a large patio/seating area and a water feature with fishpond. The rear garden also includes an aviary with birds, rabbit, and guinea pig. There is ample parking space to the front of the property. The Home employs eight carers five of which are fulltime. There are currently fourteen residents in the home, two of whom are receiving respite care. The home is owned by Rooks (Care Homes) Ltd. The Managing Director, Mrs Caroline Rooks, is also the Registered Manager. A manager, however, Mr Mark Taylor, has recently been appointed and he is currently in the process of making application for registration with the Commission for Social care Inspection (CSCI). Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 29th November 2005 and took three hours. Additional time was spent in preparation and report writing. During the course of the inspection, in depth discussion took place with both the manager, Mark Taylor and the registered manager/provider, Caroline Rooks, seven residents and one relative were spoken to, in the privacy of their own rooms. Key documentation, including a twenty percent sample of care plans, was examined and a tour of the home undertaken. Both direct and indirect observation was used throughout. What the service does well: What has improved since the last inspection? Improvements have been made to the way the home stores medication. A new medication storage cupboard has been provided and temperatures are recorded daily. Care plans and risk assessments have been updated and now contain sufficient up to date detail to ensure the resident needs can be met. Care plans now contain details of resident’s medication and details of how they like to spend their time. Radiator guards been fitted to all radiators. A manager has been appointed with the view to the current registered provider/owner, spending less time in the home. He is in the process of Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 6 preparing his application for registration with the Commission for Social care Inspection (CSCI). Radiator guards have been fitted to all radiators. Recruitment procedures have been strengthened and staff files are better maintained. 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. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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 Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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): 1, 2 & 3 The home provides prospective residents and their relatives and supporters with the information and opportunities they need to make an informed decision about living in the home. EVIDENCE: The home has a detailed statement of Purpose and Service User Guide. However, the insurance certificate was not available for inspection. Mrs Rooks said that it had probable been mislaid during the recent alterations. She agreed to write to the CSCI to confirm that the home has a current valid insurance certificate. Prospective residents, their relatives and supporters are encouraged to visit the home prior to making a decision to move in. The Registered Manager also visits prospective residents within their own environment. A full needs assessment is carried out prior to admission to the home. Inspection of care plans confirmed that assessments of all new residents had been carried out appropriately. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 9 Written terms and conditions of residency were on file and readily available for inspection. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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, 9 & 10 The home meets the individual health and care needs of the residents very well. Residents are treated with respect and their right to privacy upheld. EVIDENCE: Residents and relatives all said that they receive very good care. They said that staff respect their privacy and dignity. Both direct and indirect observation showed that they home is aware of the individual likes and dislikes of the residents and encourages them to keep up their interests. For example, delivery of a foreign language newspaper has been arranged for one resident, another maintains a keen interest in the aviary and others enjoy cookery sessions. The care plans have been revised since the last inspection. Mark Taylor said that he had spent time with each resident, talking about their care plans and adding details such as life histories, choices and a description of how they like to spend their days. Risk assessments are in place. Work continues to improve the care plans and other documentation. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 11 The management of medicines in the home has improved significantly. A new and secure storage cupboard has been provided and temperatures are now closely monitored. Discussion with the new manager confirmed that he has a clear understanding of the importance of taking due care in the overall management and administration of medicines in a care setting. The home maintains good relationships with local doctors and other health care professionals. Evidence of their visits and advice was found on both the care plans and the daily record. Residents are weighed monthly and a record is maintained, however, the home should consider ensuring that the record contains a column to note any action taken if there is a significant change in a resident’s weight. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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, 14 & 15 Routines within the home are flexible and residents are able to exercise choice in their individual and group activities. The home acknowledges, respects and supports their cultural backgrounds. Meals are varied and residents are offered a wide choice of appetising and wholesome food. EVIDENCE: There is a welcoming and relaxed atmosphere in the home. Staff provide organised activities such as bingo, cards, and cookery. On the day of inspection some of the residents were taking part in a cookery session. They said that they enjoyed this. Others said that they prefer to spend time in their own rooms. They said that the staff respect their privacy but always answer their buzzers quickly if necessary. Individual activities include crosswords, reading, daily newspapers, television, scrabble, jigsaws and other games. A foreign language newspaper is delivered for one resident and a local vicar visits once a fortnight. The main meal is at lunchtime and there is a good choice and variety of food. The residents said that the food is good and that they enjoy their meals. They Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 13 said that they could always ask for something different and there is a wide range of light snacks and sandwiches at teatime. Residents are encouraged to go to the dining room for their main meals. Most residents do eat in the dining room, which is pleasant and overlooks the front drive. Table are laid with linen clothes and napkins and a small vase of flowers. Special diets are catered for. Weight is recorded on a monthly basis but there is no provision on the weight chart to record what action, if any, is taken should a resident’s weight fluctuate significantly. It is recommended that the weight record charts are re-designed in order to accommodate this. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 14 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 & 18 The home has a satisfactory complaints system and there is evidence that the views of the residents and staff are listened to and acted upon. EVIDENCE: All the residents and relatives who met with the inspector said that, although they had not had any need to complain, they know about the complaints procedure. They said that if ever they have any concerns they speak to the staff or the manager. They said that they feel confident that any concerns they may have will be acted upon. Staff said that they would always complain on behalf of a resident if they felt they needed to. Care staff have a good understanding of abuse and how to report incidents of abuse both in the home and outside. A shortfall relating to protection and also standard 29 was noted at the last inspection. Discussion with the registered provider/manager and the new manager confirmed that they have now revised their procedures and are taking mush more care when recruiting staff. Inspection of a sample of staff files showed that all appropriate checks had been carried out. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 15 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, 20, 23, 24, 25 & 26 The standard of the environment within the home is good, providing the residents with an attractive, safe and homely place in which to live. EVIDENCE: Just before the last inspection the home had completed a major refurbishment project, which included an extension of six ensuite bedrooms. The kitchen was also refurbished and a new laundry and office created. All communal areas have also been redecorated, re-carpeted and have new curtains. The refurbishment was completed to a high standard and there is now a very pleasant, comfortable and homely environment. There is an ongoing maintenance plan. A tour of the home was undertaken. All the rooms inspected reflected the individual interests and tastes of the residents. They were all comfortable, well furnished, clean and homely. All residents say they are very happy with their rooms. They said that they had been able to bring some their own possessions with them when they came to the home. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 16 Two minor health and safety hazards were noted during the tour of the home; the front door mat is not fixed and this could present a trip or slip hazard; the boiler room door in the new extension was unlocked and this could present a hazard should any resident become confused. The registered manager said that she would address both hazards immediately. More decorative radiator covers have been fitted to radiators since the last inspection. The home was clean, tidy and hygienic throughout on the day of inspection. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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, 29 & 30 The staff have a good understanding of the residents’ needs. This is evident from the positive relationships that have been formed between the staff and the residents and their relatives. Staff morale is high resulting in an enthusiastic workforce that works positively with resident to improve their whole quality of life. There are adequate numbers of appropriately trained staff on duty at all times. EVIDENCE: Staff said that they enjoy working at the home and express a high level of job satisfaction. There is a low staff turnover and inspection of staff rosters showed that there are always enough staff scheduled on each shift. Inspection of a sample of staff files showed that appropriate training has been undertaken and all necessary checks have been carried out to ensure that only properly vetted staff are now employed. The residents said that the staff are always kind and caring. They said that their buzzers are always answered promptly. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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, 32, 33, 36, 37 & 38 The home benefits from an open and positive leadership. Both the manager and the registered provider have a clear vision for the home. They are well supported by senior staff. This means that the residents benefit from a well run home. Effective quality assurance ensures the home is run in the best interests of residents. EVIDENCE: The Registered Manager, Caroline Rooks, has four years experience managing Bramley House although she does not have an NVQ at level 4 in care. She creates a clear sense of leadership and residents comment that she is easy to talk to and listens to them. A new manager, Mark Taylor, has now been appointed, as Mrs Rooks is anticipating spending less time in the home in the coming year. Discussion with Mr Taylor showed that he has good experience Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 19 in care and a clear understanding of the core principles of good care practice. He is currently preparing his application for registration with the CSCI. Effective quality assurance systems are in place including six monthly questionnaires for residents, relatives and others. The Commission has the results of the last survey on file. A formal committee meeting is also held twice a year where those involved in the home can discuss any issues or concerns. The home does not have any dealings with residents’ finances. Records showed that supervision had been completed within the recommended timescales. Staff said they felt well supported. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 2 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 21 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 2 Standard OP1 OP8OP Regulation 4 12, 13 Requirement Written confirmation to be sent to CSCI to confirm that valid insurance is in place Weight charts should record the action taken when significant weight changes are noted Timescale for action 31/12/05 31/12/05 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 Refer to Standard 1 25, 38 Good Practice Recommendations The external sign for the home should be made more prominent The home should pay more attention to small details that might present health and safety hazards. Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Bramley House DS0000023350.V270136.R01.S.doc Version 5.0 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. 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