Inspection on 11/07/05 for Brampton Lodge

This inspection was carried out on 11th July 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 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 Lodge 26/02/07

Brampton Lodge 31/10/05

Brampton Lodge 28/02/05

Brampton Lodge 31/08/04

Similar services:

The Shelley

Springfield House

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 Brampton Lodge 4 Dixwell Road, Folkestone Kent CT20 2LG Lead Inspector Penny McMullan Unannounced 11/07/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brampton Lodge Address 4 Dixwell Road, Folkestone, Kent CT20 2LG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 258227 01303 258227 bramptonlodge@nickollsgroup.co.uk Nickolls Care Limited Mrs Claire Ebbs Registered Care Home 18 Category(ies) of Old Age registration, with number of places Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/11/05 Brief Description of the Service: Brampton Lodge provides care for older people aged 65 years and over. The property is a large detached house in a quite residential area in Folkestone. There are two floors, which are accessed by staircase or a shaft lift. The rooms are all single accommodation with en suite facilities and there is a spacious lounge and dining room. The garden is well maintained with seating areas for service users and easily accessible for wheelchair users. The décor of the home is of a high standard and there is a television, telephone and call point. In all of the bedrooms. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7 hours. Mrs Claire Ebbs, Registered Manager was in attendance. She was working with direct care to the services users to cover for staff sickness and annual leave. There was one other senior carer on duty to 11 residents in the home. There was also a Chef and two housekeepers on duty. The Registered Provider, Ms Helen Nichols also visited the home at the time of the inspection. The home currently has an application for a variation to their registration of older persons aged 65 years. They have applied for the home to be considered to admit residents who are aged 55 years and over for respite care. The application is currently with the Commission and will be considered once all the relevant documentation is received. Seven residents were spoken to and two members of staff. The atmosphere in the home was calm and relaxed. Overall feedback from residents was very complimentary with regard to the Manager, care staff and services provided. What the service does well: Meals are nutritious, varied and well presented. The lunch is a three-course meal with juice or wine and each resident chooses their meal on the previous day. All residents spoken to say the food is consistently of a high standard. The décor of the home is of a high standard and the staff is experienced and will trained. One resident said that the home was a ‘wonderful’ place to live and the home cannot be ‘faulted’. Overall service users said the staff were excellent and responsive to their calls, night or day and there was nothing in the home to complain about. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 6 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. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,6 The Statement of Purpose is in place, providing service users with the information they need to make a decision about moving into the home. Arrangements are in place to carry out a detailed and through assessments of needs of service users prior to admission to the home to ensure that all care needs will be met. EVIDENCE: The Statement of Purpose is being updated with information to include the proposed admission of service users from the age of 55 years. This is being forwarded to the Commission for consideration with regard to the application for the variation to the current registration. The admission procedure of the home is thorough and a full assessment is carried out on each service user prior to admission. Te Registered Manager or senior member of staff completes a Prospective Client Assessment Form, which covers all aspects of health and social care. This information forms part of the residents care plan. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 9 Standard 6 does not apply to this home. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 There is a consistent care planning system in place to ensure that the health and social care needs of the service users are met. However the lack of clear risk assessments potentially puts service users and staff at risk. The system of the administration of medication is not satisfactory which has resulted in some unsafe practices. Privacy and dignity are upheld in the home. EVIDENCE: Resident care plans contain detailed information covering all aspects of health and social care needs of individual service users. Moving and handling risk assessments are in place but require further detail to identify a safe practice of work. The plans were up to date and reviewed however the home must ensure that residents or their representative signs them. Residents said that the staff accompanies them to their medical appointments including hospital outpatients. All health care needs are monitored in the resident care plan and when required the District Nurse and Continence Nurse supports the home. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 11 The home has a Medication Policy and uses the NOMAD system for the administration of medication. The receipt of medication was not always recorded on the MAR sheets and the home must review the system of handwritten entries in the MAR sheets and the administration of half tablets. It is not acceptable for the home to break tablets to administer the correct dosage. The home must contact the Pharmacy to provide the correct dosage required. Service users who self medicate require risk assessments to be carried out. This was an outstanding requirement from the last inspection and will be carried forward with a reduced timescale for compliance. Mar sheets must also identify the reason why medication is not given, when ‘other’ is recorded the reason why should be stated. All senior staff has received medication training. Residents said that their privacy and dignity are respected at all times, and staff were observed knocking doors before entry. Residents confirmed that they see their relatives or friends in private and the GP visits them in their own room or at the surgery. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15 The home provides activities, which may benefit from a review as feedback from service users suggests a review or additional activities may need to be provided. Visitors are able to visit the home at any time and see their relative in private. Personal choice of service users is promoted in the home. The meals in the home are of a high standard providing a varied nutritious balanced diet. This standard has been scored as 4 which exceeds the standard and rated as commendable. EVIDENCE: Activities are offered in the home such as whist, scrabble, puzzles, etc., however residents said they wished there was more to do in the home. Staff said that activities are planned on a monthly basis but the programme was not on display at the time of the inspection. One resident said that she enjoyed whist, solo and reading. Residents confirmed that they also go out with their relatives and friends. Entertainment has also been provided in the home. Residents said they were able to choose if they joined in the activities. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 13 Although activities are provided resident feedback was that they wished there was sometimes more to do in the home. Visitor information is included in the Statement of Purpose and Service User Guide. Residents said they are able to see their visitors at any time and were able to go out to lunch or shopping with their relatives. Two residents are assisted with their finances. Residents said that they had their choice with regard to meals, going out, getting up and doing what they wished to do in the home. Some service users have their own personal furniture in their rooms and although residents are aware of their records no one wished to view them. The home provides three meals a day and the Chef changes the menu weekly. There is a three-course lunch every day and service users choose from two main dishes or request an individual meal. Wine, juice or water is served with the meal and the Chef checks with service users each day to ensure alternatives are offered. Residents are served individually with their vegetables and after lunch coffee is served in the lounge. Meal times are relaxed and unhurried and there are currently no therapeutic diets and one resident requires support when eating. All of the residents spoken to say the meals were of a high quality and were varied and nutritious. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 standard(s) 16,18 The home has a satisfactory complaints procedure in place and residents are confident that should they have a complaint it will be resolved by the home. There are robust arrangements in place for protecting service users. EVIDENCE: The complaints procedure was on display in the lounge and residents spoken to confirm they would complain to the staff or Registered Manager if they had a complaint. All service users stated there was nothing to complain about and the home does its best to ensure that everyone is happy. There have been no complaints since the last inspection. The home has an Adult Protection Policy including whistle blowing. Staff have received in house training and are all booked to attempt POVA training in the future. All POVA checks and CRB checks have been carried out for all staff and the home is currently accessing training in physical/verbal aggression and intervention. Personal possession of the residents are recorded in their individual care plan. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 standard(s) 19,26 The overall quality of the furnishings and fittings of the home is excellent and the garden and grounds are well maintained providing a very comfortable environment for those living there. The home is very clean with excellent laundry services and facilities. This standard has been scored as 4 which exceeds the standard and rated as commendable. EVIDENCE: The home is well decorated and furnished. The grounds are attractive and well maintained with easy access and seating for residents to enjoy the garden. There are no outstanding issues from the last environmental health visit and the home has a fire risk assessment in place. The home was very clean, tidy and free from offensive odours. There are separate laundry facilities with hand washing facilities. Residents said that the laundry service was excellent and perfect, with laundry taken and washed, Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 16 ironed and replaced the same day. Policies and procedures in place for the control of infection and the home have two sluicing facilities. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The home is adequately staffed to meet the needs of the service users. There is over 50 of staff who hold an NVQ 2 qualification or above and are competent to carry out their role as a carer. Recruitment procedures are in place to ensure that residents are protected and in safe hands at all times. The current staff are experienced and well trained committed to providing a quality standard of care. Mandatory, induction and foundation training is provided creating a well-qualified team of care staff. EVIDENCE: At the time of the inspection the following staff were on duty: The Registered Manager who was working with the senior carer to provide direct care to services users. The Registered Manager was covering care duties as agency staff were not available to cover for sickness and annual leave. There is one waking and one sleep in night staff. The home is currently recruiting, as they are using agency staff to cover some night duties and require a part time carer. The Chef and two housekeepers were also on duty. Residents said that staff were responsive to their needs and worked hard to ensure the home is well run. They said the staff were very caring, helpful and cheerful. When the home is fully covered there is a minimum of two care staff on duty Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 18 together with the Registered Manager, Chef, Kitchen Assistant and two housekeepers. There is a number of very experienced staff working in the home with over 50 of NVQ 2 and above. There has been no recruitment of staff since the last inspection. All staff have been POVA and CRB checked and all staff have terms and conditions of employment. All staff have just completed an update in fire training and staff said that training was always provided when requested or required. There was evidence on file of induction and foundation training on file and the home has training booked in the Protection of Vulnerable Adults and NAPPI. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33,35,36,38 The Registered Manager has effective leadership skills to ensure that a high quality of care is provided to residents. The home is well managed, has an open and inclusive atmosphere and benefits from a committed staff team. This standard has been scored as 4 which exceeds the standard and rated as commendable. The arrangements for resident consultation are good and they benefit from a well run home. The home has implemented an effective financial system to support residents with their finances. Staff supervision is in place ensuring that staff are valued and supported. The home is endeavouring to provide a safe environment for residents, however the lack of risk assessments puts service users at risk. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 20 EVIDENCE: The Registered Manager has many years experience as a Manager, is a RGN and has completed her Registered Manager Award. She has completed a Supervisory Management Course and a Counselling Course. The staff work well as a team and from observation at the time of the Inspection it is apparent that the home is very well managed. At the time of the inspection the Registered Manager demonstrated her skills and ability of managing residents’ needs. Residents said that she works really hard to ensure they are happy living in the home. The home has an atmosphere of openness and is positive and inclusive. Staff confirmed that they felt supported by the Company and the Registered Manager. The home was running smoothly accommodating an unannounced inspection whilst the Registered Manager was providing direct care to the service users. From speaking to the residents and observation of team work by all of the members of staff it was clear that their needs were being met. The Registered Manager speaks to each service user on a daily basis to ensure they are happy with the service being provided. A quality assurance survey was carried out in April for residents and relatives and the home is in the process of including other stakeholders for their views of the home. There are only two residents who are assisted with their finances and the Registered Manager deals with their finances personally. All receipts and transactions are recorded and the home does not keep any valuables on behalf of the residents. The Registered Manager carries out supervision with all staff and the senior carer confirmed that supervision was taking place. All mandatory, induction and foundation training is provided to all staff. All the necessary safety checks have been carried out in the home and the fire book was up to date. Accident/incidents were tracked through to the care plan and recorded and monitored appropriately. Risk assessments are in place but require to be reviewed. The home needs to implement a risk assessment on the use of footplates for one resident. A requirement will be made to ensure that risk assessments are completed. Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 2 x x x x x x 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 3 x 3 3 x 2 Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 22 yes 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 1 7 Regulation 4 13 Requirement To update the Statement of Purpose To provide more detailed risk assessments to identify a safe practice of work To ensure residents sign and agree their care plan To provide risk assessments for residents who self medicate, this was an outstanding requirment from the last inspection To review the administration re dosage of half a tablet To accurately record other on MAR sheet To record the receipt of medication To review the system for adjusting recrods of medication on MAR sheets, handwritten entries To review environmental risk assessments To implement risk assessment re footplates on wheelchair Timescale for action 21/8/95 30/8/05 3. 9 13 Revised timescale 30/8/05 4. 38 13 30/8/05 Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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 Good Practice Recommendations Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 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 Brampton Lodge H56-H05 S23762 Brampton Lodge V236356 110705 Stage 4.doc Version 1.40 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. 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