Inspection on 15/05/06 for Brampton Court

This inspection was carried out on 15th May 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

Brampton Court 12/12/07

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 Tyne & Wear NE6 3BR Lead Inspector Suzanne McKean Key Unannounced Inspection 15th May 2006 09:30 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 Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brampton Court Address Wharrier Street Walker Newcastle Upon Tyne Tyne & Wear NE6 3BR 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 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) Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (47) of places Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 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 a range of fees between £365 and £510. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took ten hours. It is the second key unannounced inspection the home has had in this calendar year. All of the key standards have been assessed during these visits and from other information provided to the Commission. Ten residents and three staff were spoken to. Others were chatted to briefly. Three relatives were spoken to during the visits. Four care plans, training records and records for medication were examined. Staff files, training records and health and safety documentation were looked at. The response from ten questionnaires sent out to residents and relatives (20 in total) was positive although only 3 relative and 2 resident questionnaires were returned. The details are contained in the report. What the service does well: What has improved since the last inspection? What they could do better: The home must replace the assisted bath and improve the shower area. The improvements identified by the Health and Safety inspection must be completed for the safety of staff and residents. The action plan following the protection of vulnerable adults investigations (POVA), must be forwarded. There should have been 50 of the carers trained to NVQ level 2 by 2005. The formal POVA training should be provided to support the informal training being given in practice and supervision with staff. Training files could be better Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 6 prepared enabling the home manager to identify short falls in mandatory training. Staff supervision should be given six times per year. The home should consider improving the access to the outdoor facilities being mindful of the Disability Discrimination Act. It is recommended that the use of jargon and medical terminology (without explanation) be reviewed. 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. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home undertakes a detailed pre admission assessment and liaises with the residents and family prior to admission. The home does not provide intermediate care. EVIDENCE: Care plans had good information to ensure that the home can meet the needs of the prospective resident. The Manager is involved in the decisions and in the majority of instances visits the residents himself prior to their admission. The relative of a recently admitted resident said that Mr Cave spent time with them prior to them making the decision for their relative to be admitted. The service user guide met the standards, Mr Cave, the Registered Manager feels that it provides information to relatives although it is of limited use to the majority of the residents due their particular needs. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The residents are having their needs met by the staff in the home and the staff are skilled in providing the care in a sensitive and dignified manner. This is shown in the documentation and care plans in place. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are well managed and safely disposed of as necessary. EVIDENCE: Four care plans were examined, they were of a satisfactory standard, with 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. They however contain some “jargon” which may not be understood by some of the staff, residents and relatives. They are currently being changed to the organisations new documentation and this will make the necessary improvements required as discussed on the day. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 10 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. 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 up dated. 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. 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. There was a poor response to the questionnaires, which were sent out prior to the visits. This is most likely due to the particular needs of the residents in the home. Two residents returned questionnaires and the responses were positive one example was “I visited the home with family, very impressed”. Three relatives’ comments cards returned, they all answered positively to the majority of the questions and there were no negative comments made. All were satisfied with the overall care. The responses contained written comments of the following “in the time my Mother has been at Brampton she seems a lot happier and contented from her previous home” and “on behalf of my Mother I would like say thank you to staff at Brampton Court for the care and attention given to my Mother”. The medicines in the home are well managed and safely disposed of as necessary. The treatment room was very tidy and was well organised. Two residents medication was examined as part of the case tracking. One had a short course of antibiotics prescribed and this was given appropriately and recorded effectively. It was collected on time from the pharmacy and course was completed. The controlled drugs were audited. Although there have been problems with destruction of controlled medications they were being managed safely and the system to allow for safe disposal was in place. There was a separate list of signatures of staff on record for auditing purposes and this was up date for new staff. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines for daily living and activities. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. There is a social programme in place with assessments and documentation for each individual resident. The food served is good and the residents are happy with the quality and the quantity. EVIDENCE: Although most residents could not have a conversation they were with the inspectors they appeared to be “happy” in that 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 encouraged to do so even when they were at some risk of falling. The lunchtime meal served on the first day was Sausage casserole, with both fresh and frozen vegetables or Egg and chips with tomatoes and brown sauce. 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 lunch time was “this is lovely” and “the food is always nice” Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 12 Each resident care plan had a need identified and a plan section regarding the resident social care needs. The residents are encouraged to go to places in the local area such as the Public houses; they get discount for meals and use the Bistro in Byker and the Lightfoot stadium (which has a café). Families are encouraged and supported to take residents out and about. The home has arrangements for children from the local schools to visit at holiday times e.g. Christmas and Easter. Two visiting relates 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. Two residents said that they are able to make choices about how they spend their day. The residents’ bedrooms were personalised reflecting individual choices and preferences. Two residents asked about their bedrooms said they were happy with the decoration. 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.V289761.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The home ensures that the residents and relatives are made aware of the complaints policy by making it available in a variety of places. Complaints are managed satisfactorily and the necessary action taken. The records of complaints and Protection of Vulnerable Adults referrals are kept to ensure that audits can be carried out. 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. The home has been subject to two Protection of Vulnerable Adult investigations since the last inspection both of which were reported by the Manager. These have been dealt with in partnership with the Social Services department and showed Mr Cave’s commitment to the ensure the safety of the residents in his care. These have been resolved by the home as far as the residents are concerned. They are ongoing for staff training, supervision and follow up action by the Manager. Mr Cave has North Tyneside training packs and he is planning in Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 14 house training for protection of vulnerable adults. All carers have been allocated a place on the POVA training and eight have already had it. Four staff are to do the Newcastle training programme. Mr Cave has sent the action plan outlining his plans to improve accountability and communication in the home. All staff have now been spoken to regarding whistle blowing and informing the Manager of any incidents or issues of which there are concern. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 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 & 26 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The service users live in a safe environment with good communal areas. There are suitable toilets and baths although not all of these are in use. The bedroom areas are personalised and comfortable. The décor in the home has improved for residents but further equipment and redecoration is required. EVIDENCE: The location and layout is suitable for the residents who live there. There are lounges and dining rooms on each floor. They are pleasantly decorated and furnished. Residents were able to use the entire home and there was a range of television and audio equipment available for their use. The corridor carpets have been replaced and the ground floor corridor redecorated, there are plans to do the first floor. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 16 There are bathrooms, shower facilities and toilets near to all communal areas and residents bedrooms. One of the bathrooms is out of use while they await the fitting of a “Malibu” assisted specialist bath. This has been arranged and will be viewed at the next inspection. The shower on the first floor requires repair to the flooring and some of the tiles as they are difficult to clean and are unsightly. 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 there has been recent replacement of bedroom furniture. 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. 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. Remedial work is required in this area and has been identified in the Health and Safety report. There are sluices on each floor, which are locked when not in use. Sluice disinfectors were in working order. The sluices were clean, tidy and odour free. There was no smell in the home except from one lounge for which there appeared to be an explanation. The smell was not there at the end of the visit. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. The manager ensures there are adequate numbers of staff on duty that have appropriate skills and experience to care for the residents. There is an in house training programme in place but training records were very disorganised making it difficult to clarify staff training and the Manager continues to work toward 50 of the staff having NVQ level 2. EVIDENCE: Staff are undertaking NVQ level 2 or over and the home has an induction and training programme for all staff working in the home. The training records examined were very disorganised and it was difficult to verify what training had been undertaken. Recent POVA issues raised concerns about the culture of the home. However all staff are undertaking additional abuse training and understanding of whistle-blowing policy. The Manager has taken rigorous steps to monitor the staff performance and undertake out of hour’s unannounced supervision visits and has started additional recording within the home. Staffing rotas showed that the Manager is ensuring that enough staff are on duty to meet the necessary staffing levels. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 18 A total of eight care staff have NVQ 2 or above which is 33 of the carer numbers. There are plans to ensure that the number of staff with level 2 is reached by 2007. When sickness and staff holidays occur home staff usually covers these occasions. 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. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgment 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. Staff are not appropriately supervised. The home has had a recent routine inspection from HM Inspector of Health and Safety and advice was given, this must be followed as identified. EVIDENCE: Records for safe working practices in relation to first aid, food hygiene, moving and handling and infection control were in place and were satisfactory. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 20 Regular meeting are held for both resident’s relatives and staff. The records of these were seen and contained a wide selection of appropriate topics. There were meetings in January, February, March and April when attendance was good. There are always a number of resident attending. The minutes for these are signed and dated, and there is evidence of lots of residents requests identified. Resident’s satisfaction surveys are being done which include relatives views the outcomes of these will be seen at the next inspection. Staff supervision records indicated that staff are not supervised at the given timescales of six per year. 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. The recent HM Inspector of Health and Safety identified some necessary improvements necessary. A separate report was sent to the home the contents of which must be addressed. Accidents are recorded effectively – accident analysis is completed and the Manager is undertaking a separate analysis of specific incidents in the home. Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 22 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 OP21 Regulation 23 (2) (j) Requirement The registered person must replace the assisted bath as planned. . The shower area must be improved and remedial work completed The registered must undertake the identified improvements as detailed in the HSE inspection. The action plan following the POVA investigations must be forwarded as planned. The registered person must have 50 of the carers trained to NVQ level 2 or equivalent by 2005. The registered person must provide a training programme detailing the dates of the mandatory and other training completed by staff. All staff must receive supervision at the given timescales of six per year. Timescale for action 01/08/06 2. OP38 13 (4) 01/08/06 3. 4. OP18 OP28 13 18 01/07/06 01/07/06 5 OP30 18 01/08/06 6 OP36 18(2) 01/10/06 Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 23 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 OP18 Good Practice Recommendations Formal POVA training should be provided to support the ongoing informal training being given during practice and supervision. The registered person should consider improving the access to the outdoor facilities being mindful of the Disability Discrimination Act. It is recommended that the use of jargon and medical terminology (without explanation) be reviewed. The changes to the care plans should be undertaken as planned. 2. OP20 3 OP7 Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Brampton Court DS0000000494.V289761.R01.S.doc Version 5.1 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. 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