Inspection on 27/01/06 for Brampton Court

This inspection was carried out on 27th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brampton Court 12/12/07

Brampton Court 15/05/06

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 Unannounced Inspection 09:30 27 January 2006 th 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.V249927.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. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 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 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) Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care) 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.V249927.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 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 adjacent home is owned by the same company and provides residential and general nursing care. 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. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over six hours. It is the second unannounced inspection the home has had in this year. All of the core standards have been examined over the two inspections. It is therefore suggested that both reports are looked at to get the full picture of the home. Seven residents and three staff were spoken to and others chatted to briefly. Two relatives were spoken to directly although others were in the home. Four care plans, training records and records for medication were examined. Also staff files, training records and health and safety documentation was looked at. What the service does well: What has improved since the last inspection? There has been extensive redecoration and replacement of carpets in the corridors and dining areas since the last inspection. The standard of décor has been greatly improved in the home. The care plans are now more detailed and reflect the standard of the care being delivered including the improvement to the risk assessments. The home has improved the way the meals are being planned and served to the residents. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 6 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. Brampton Court DS0000000494.V249927.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 Brampton Court DS0000000494.V249927.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): Standards 3 and 6 were examined at the last inspection and were met. The home does not provide intermediate care. EVIDENCE: Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 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, & 10 The service users 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 now being demonstrated through 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: The care plans cover health and social and personal care. 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 Manager has recently reviewed all of the use of bed rails and residents who at risk of falling, risk assessments are in place and are detailed. There is evidence in the care plans that professional advice had been sought from Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 10 wound care specialists. The home and advice from a dietician has been sought regarding providing good nutritious food for the residents. Wound management is being reviewed and the care plans contained the details of advice being sought. The staff have an excellent knowledge of residents psychological health care needs with evidence of good partnership workings with other professionals. Throughout the inspection visit staff were observed to treat residents with respect and dignity. Personal care was given in privacy, staff used residents preferred name at all times. The staff have a good understanding of residents individual needs and were observed to deal with some potential difficult behaviour issues in a professional sensitive manner. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 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 Standard 15 was examined at the last inspection and was met. Residents are satisfied with the flexibility of their routines for daily living and activities, which are appropriate to meet their cultural, social, religious and recreational interests and needs. 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 in place to ensure it is appropriate for each individual resident. EVIDENCE: The care plans identified and a plan section regarding the resident social care needs and these were detailed and specific enough to identify the individual choices and preferences. The “Detailed Social Care Assessments” which is a tool provided and used within the Four Seasons organisation were present in the care plans and had been completed. Separate records of the social activities each resident has participated in were completed by the activities coordinator. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 12 A number of the residents were moving around the home and were being encouraged to do so even when they were at some were at risk of falling, this is to be commended as the staff have looked at the risk and taken steps to minimise the risk without restricting the resident choice. Staff were seen on the day to be involved in activities with the residents on a one to one basis mainly because of the time of the visit (morning). These include hand massage, exercise (pom-poms) and one to one reminiscence. Two visiting relatives and the staff in the home confirmed 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. The majority of the residents are not able to communicate verbally and have to be supported to make choices about how they spend their day, staff were aware of this. 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 within the residents’ guide about visiting arrangements. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 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 Standard 18 was examined at the last inspection and was met. The home ensures that the residents and relatives are made aware of the complaints policy and that it is available in a variety of places. There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. EVIDENCE: There is a system for managing and dealing with complaints, which was seen to be available in a variety of places. The records of the complaints made to the home was examined, there has been no complaints recorded since the last inspection. A list of complaints with outcomes is available and this matrix allows the Manager to audit complaints as part of the homes quality assurance strategy. Two of the residents who were spoken to during the visit who were able to express their views were asked about the way in which they would have any problems dealt with, each were able to identify the way this would be done. Two relatives who was visiting the home was aware of the complaints procedure and felt that they could take their concerns to the Manager, one had needed to do so regarding a issue and felt that it had been addressed promptly and effectively. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 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 the following standard(s): 19, 21, 24, 26 Standard 20 was examined at the last inspection and was met. 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 home has recently had a significant improvement in the decoration and a number of carpets have been replaced improving the environment for the residents. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 15 EVIDENCE: The location and layout is suitable for the residents who live there. There are lounges and dining rooms on each floor. All were pleasantly decorated and furnished. Residents were able to access all areas and there was a range of television and audio equipment available for their use. The corridor carpets have been recently replaced and redecorated. 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 an assisted specialist bath, which has been arranged and will be viewed at the next inspection. 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. Residents only have access to a secure garden area via a stairwell and two fire doors. This courtyard garden is pleasantly 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 has been made 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. There are sluices on each floor, which are locked when not in use. Sluice disinfectors are available and in working order. The sluice upstairs was clean, tidy and odour free, and staff endeavour to keep it clean and tidy. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 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 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): 28 Standards 27, 29, & 30 were examined at the last inspection and were met. There home is continuing to arrange for the staff to undertake NVQ level 2 or over and the home has an induction and training programme for all staff working in the home. EVIDENCE: The home has records for the staff for their induction and evidence that they are given a training programme to ensure that they are able to work within the care home. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 17 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, & 38 Standard 35 was examined at the last inspection and was met. The Registered Manager, Mr Cave, ensures that he has systems in place to make sure that the home is managed 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. 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. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 18 EVIDENCE: There are clear lines of accountability both in the home and within the company. The records to support the Managers confirmation that he ensures safe working practices in relation to first aid, food hygiene, moving and handling and infection control were in place and on examination were satisfactory. Regular meeting are in place for both residents relatives and staff and the records of these were seen and contained a wide selection of appropriate topics. There was evidence that the home 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 improvements necessary. A separate report was sent to the home the contents of which must be addressed. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 19 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 X 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 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP21 OP38 Regulation 23 (2) (j) 13 (4) Requirement The home must replace the assisted bath as planned. The home must undertake the identified improvements as identified in the HSE inspection. Timescale for action 01/05/05 01/05/06 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 OP18 OP20 Good Practice Recommendations Formal POVA training should be provided to support the ongoing informal training being given during practice and supervision. The home should consider improving the access to the outdoor facilities being mindful of the Disability Discrimination Act. Brampton Court DS0000000494.V249927.R01.S.doc Version 5.0 Page 21 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.V249927.R01.S.doc Version 5.0 Page 22 - 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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