Inspection on 12/12/07 for Brampton Court

This inspection was carried out on 12th December 2007.

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

Brampton Court 15/05/06

Brampton Court 27/01/06

Brampton Court 14/07/05

Brampton Court 18/01/05

Brampton Court 27/09/04

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

CARE HOMES FOR OLDER PEOPLE Brampton Court Wharrier Street Walker Newcastle Upon Tyne NE6 3BR Lead Inspector Suzanne McKean Key Unannounced Inspection 09:30 12th December 2007 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 Brampton Court DS0000000494.V338257.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. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brampton Court Address Wharrier Street Walker Newcastle Upon Tyne NE6 3BR 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) 0191 224 3679 0191 224 3684 Brampton.Court@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mr Michael Cave Care Home 48 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (47) of places Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th May 2006 Brief Description of the Service: Brampton Court is a purpose built care home providing nursing and social care to older people over the age of 65 years with Dementia. The home is on the same site, and it attached to another care home with a shared entrance. The same company home owns the adjacent. The homes share both the laundry and kitchen. The building is on two floors with passenger lift access to the first floor. Within each floor there is level access to all parts of the home. The parking is to the front of the building. Brampton Court is situated in the Walker area of Newcastle, within easy reach of shops and other amenities, public transport access is good. The home charges fees of between £365 and £510 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the visit: We looked at: • Information we have received since the last visit on 15th May 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals, including surveys. The Visit: An unannounced visit was made on 20th December 2007 and a further visit was made on 18th January 2008. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. • Carried out a specific observation of the resident’s well being called a “Short Observational Framework for Inspection”. • Sent out 10 relative and 10 resident surveys to find out what people thought about the service. • Sent out three surveys to visiting professionals. We told the manager what we found. What the service does well: The staff have a good understanding of residents individual needs and were seen managing some potentially challenging behaviour in a professional and sensitive manner. The residents were complimentary about the staff. For example “they are always nice” and “nothing is too much bother for them”. The home has good links with the local Mental Health Care Teams and works with the NHS primary health care team to make sure that the residents get the care they need. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 6 The residents have been encouraged and supported to bring personal items with them to personalise their rooms, showing their personal tastes and previous lifestyles. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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 Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 (the home does not provide intermediate care) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A detailed pre admission assessment, taking into account the views of the resident and their representative, is carried out before a placement is offered. This makes sure the resident and home can be confident that their need can be met. EVIDENCE: The care plans contained good information to make sure that the home can meet the needs of the prospective resident before they are offered a place. The Manager is involved in the decisions and in the majority of instances he visits the residents himself prior to their admission. The care plan of a recently admitted resident was detailed and contained the information the staff would need to make sure that they could care of them Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 9 safely and well. A relative said that she had visited the home before her relative had moved in and that the staff had been open and honest about what would be available and how the home is organised. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents have their needs met by staff who are skilled in providing the care in a sensitive and dignified way. This is supported by the documentation and care plans. EVIDENCE: The care plans are completed to a good standard and showed the care that was being given to the residents. There are relevant risk assessments for the prevention of falls, nutrition, wound care, moving and assisting, continence promotion and mental health status. The plans showed that they are regularly reviewed and updated. The care staff are involved in making sure that the necessary information is in the care plans by keeping the nursing staff informed. This includes the welfare of the residents and their activities and events on a day to day basis. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 11 The care plans have all been changed to the organisations most recent documentation and this has resulted in improvements to the way they are organised. A number of assessment tools are in use, and they were reviewed monthly, and were dated and signed by the author. Daily reporting of residents care was generally satisfactory, and the changing health care and mental health care of residents was reviewed and changes to the plan made as necessary. The care plans showed that the residents have access to all NHS services and facilities. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. The staff have a good knowledge of residents psychological health care needs with evidence of good partnership workings with other professionals. Throughout the visit staff were treating residents with respect and dignity. Personal care was given in privacy, staff used residents’ preferred name at all times. A number of the staff have recently completed a training course in person centred care and they were very motivated to use what they have learnt to improve the care they give. Residents were complementary about the staff in the home and felt that they were able to have privacy in their own rooms and the staff respects that this. A relative said that they felt that the care staff always tried to do their best for the residents. The medicines in the home are well managed and safely disposed of as necessary. The treatment room was very tidy and was well organised. The manager has recently changed the times that the medicines are given. They are no longer given at meal times. This improves the mealtime experience for the residents and prevents the residents from being distracted during this important time. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a flexible routine and people living in the home are helped to take part in activities and maintain contact with family and friends taking into account their individual wishes, abilities and interests. EVIDENCE: There is an activity co-ordinator employed in the home and each person living in the home has his or her social care needs assessed. A care plan is then developed to identify the way they can be met. It is acknowledged that providing effective social opportunities for this client group presents a challenge for all of the staff. However, the staff in the home are aware of the need to be flexible in this. A relative said that they felt that the way the staff deal with their relative “makes their life better” and spontaneous conversations and everyday activities such as looking at a magazine or the television gives them the opportunity to enjoy each others company. The residents are encouraged to go to places in the local area such as the Public houses and arrangements have been made for them to get discount for meals when they Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 13 use the Bistro in Byker and the Lightfoot stadium (which has a café). Families are also encouraged and supported to take residents out and about. The manager has also arranged for residents to attend day centres, which is quite unusual for people living in residential care. The home has arrangements for children from the local schools to visit at holiday times e.g. Christmas and Easter. Generally through the day the residents were choosing where they spent their time. Two visiting relatives and the staff in the home said that residents are encouraged to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. A resident said that they could make choices about how they spend their day. Although most residents could not have a conversation with the inspector they appeared to be “happy” as they were smiling with the staff or were enjoying spending time with other residents. Some of the residents were moving around the home and were being supported to do so even when they were at some risk of falling. A specific observation of the resident’s well - being was carried out on the second visit. This is called a “Short Observational Framework for Inspection” and involves a period in which the residents are observed using an assessment framework, which measures the state of being, engagement and interaction of the people. This was positive and showed that the residents were experiencing a good quality of life. The lunchtime meal looked well prepared and the residents appeared to be enjoying it. The tables were set with condiments on the table and the residents were being given assistance on a 1:1 basis. Comments heard during the lunchtime were “do you want some, it’s lovely” and “we always get nice meals”. The residents’ bedrooms were personalised reflecting individual choices and preferences. Residents have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. Relatives are given information about visiting in the service user guide. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home and their representative are given the information about how to complain. All complaints are investigated using the company’s policies and procedures. The residents are kept safe by the home working within the vulnerable adults processes and by good staff training and supervision. EVIDENCE: The complaints procedure is in the service users’ guide and copies are displayed in the home. The records of the complaints made to the home were examined. Two of the residents said that they knew problems were dealt with and how this would be done. A relative visiting the home was aware of the complaints procedure but had not needed to use it. There have been six complaints made in 2007 and the records of these were complete and in line with the companies policies and procedures. The home has been involved in protection of vulnerable adult procedures since the last inspection and these have been dealt with in partnership with the Social Services department. They showed Mr Cave’s commitment to ensuring the safety of the residents in his care. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents live in a safe environment with good communal areas, and bedrooms that are personalised and comfortable. Although the décor has recently improved additional work is necessary to make sure that all of the areas of the home are to the same standard. EVIDENCE: The location and layout is suitable for the residents who live there. There are lounges and dining rooms on each floor. Residents were able to use the entire home and there was a range of television and audio equipment available for their use. There are now very large televisions in the lounges which are wall mounted and a resident said that she could see it better and spent some time talking about the programme she was watching. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 16 The corridor carpets have been replaced and the ground floor corridor and it has been redecorated. However this has not been repeated on the first floor and although there is a cleaning programme in place the carpets were still stained and had a strong odour. The smell was evident on entering the corridor from the stair well and remained throughout the visits. The first floor is generally less well decorated than the ground floor, which has been significantly improved. This results in the residents having differing experiences depending upon where their rooms are situated. Some of the chairs particularly in the communal areas are now worn and damaged making them very difficult to keep clean. A number of residents need seating which would assist support and encourage them to maintain effective posture. Consideration should be made to replacing some of the worn chairs with suitable chairs to meet the needs of these residents. There are bathrooms, shower facilities and toilets near to all communal areas and residents bedrooms. These have recently been improved and only await the completion of the decoration to make them pleasant rooms for the residents to use. The residents have been encouraged and supported to bring personal items with them resulting in individualised rooms reflecting personal taste and previous lifestyles. Several of the bedrooms have been refurbished, and some of the bedroom furniture has been replaced. A number of the bedrooms, however still have stained and worn carpets and there are a number of items of bedroom furniture that are damaged and need to be either replaced or repaired. The only entrance to the secure garden area is via a stairwell and two fire doors. This courtyard garden is well maintained and enjoyed by the residents especially in the warmer months. There is another large garden area, which is not used, as there is no secure fencing. A recommendation was made at the last inspection to consider improving the access to the outdoor facilities and this remains in place. The laundry has recently been changed, this area was generally tidy, and there are suitable laundry baskets and laundry rails to take clean linen and clothing back to resident’s rooms and linen cupboards. There are sluices on each floor, which are locked when not in use. Sluice disinfectors were in working order. The sluice rooms were clean, tidy and odour free. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager makes sure that there is enough staff on duty that have appropriate skills and experience to care for the residents safely. EVIDENCE: On both of the days of the inspection there were enough staff on duty to provide the care to the residents. The staffing rota showed that there are sufficient staff identified for each shift period. When sickness and staff holidays occur the Manager usually covers these periods by offering additional shifts to the staff. However, when this is not possible agency staff are being used, late reporting does occasionally result in fewer staff being on duty for short periods. Staff are undertaking NVQ level 2 or 3 and the home has an induction and training programme for all staff. The staff are being offered both statutory training for moving and assisting, fire, health and safety and first aid as well as opportunities to undertake more specific training. The records for training have been improved and the manager is now able to identify where any gaps occur and can identify additional training needed. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 18 The staff were very enthusiastic about the recent training they had received in dementia care and are looking forward to planned training in dementia care mapping. They were keen to discuss what they had learnt and were very motivated to use their new knowledge to improve the care they provide. This training has created an atmosphere where the routines and normal practices can be looked at and the manager confirmed that carers have already begun to challenge some of the ways things are done to make them more individual and person centred. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has systems in place to organise the home effectively taking into account the needs and wishes of the residents. He is continuing to ensure safe working practices in the home in line with the company policies and procedures. EVIDENCE: The manager has been in post now for and more than three years and is registered with the Commission for Social Care Inspection. He is a registered nurse and has continued to maintain his skills and competencies through ongoing an extensive post registration study. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 20 Records for safe working practices in relation to first aid, food hygiene, moving and handling and infection control were in place and were satisfactory. Regular meetings are held for both resident’s relatives and staff. The records of these contain a wide selection of appropriate topics. These meetings are generally on a monthly basis but vary according to the issues in the home. The attendance is good. There are always a number of resident attending their meeting. Staff supervision records indicated that staff are receiving supervising at the appropriate timescales of six per year, the contents of these were not examined on this occasion. However the Manager confirmed that he is satisfied that he is able to use them to make sure that the staff are able to carry out their work safely and effectively. The manager takes the necessary action to ensure the health and safety of the service users through regular tours of the building, risk assessments and recording of action taken to respond to hazards. The staff are aware of the need to maintain a safe environment in the home. This is supported by the policies and procedures examined and by discussion with the Manager. Accidents are recorded effectively, accident analysis is completed and the Manager is records separate analysis of specific incidents in the home. There are records in place to show the way people living in the home receive support to manager their finances. The records are held electronically and on examination they were detailed. Individual records support these with receipts being kept for purchases made and money received into the home from relatives. One relative who was being assisted to deal with the personal finances of his relative was very happy with the way this was managed. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 21 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 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 2 X X X X X X 3 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 3 X 3 X 3 X X 3 Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 Requirement The home must be kept clean and reasonably decorated. This is particularly in relation to: • First floor lounge and corridor carpets. • Appropriate seating in the communal areas. • Bedroom carpets. • Bedroom furniture. • Decoration in bedrooms. Timescale for action 01/09/08 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 OP20 Good Practice Recommendations The registered person should consider improving the access to the outdoor facilities being mindful of the Disability Discrimination Act. Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Brampton Court DS0000000494.V338257.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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