Inspection on 08/08/05 for Bramshall`s Old Rectory

This inspection was carried out on 8th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Bramshall`s Old Rectory 13/06/08

Bramshall`s Old Rectory 30/07/07

Bramshall`s Old Rectory 02/11/06

Bramshall`s Old Rectory 04/01/06

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

CARE HOMES FOR OLDER PEOPLE Bramshalls Old Rectory Leigh Lane Bramshall Nr Uttoxeter Staffordshire ST15 5BQ Lead Inspector Lynne Gammon Announced 8 August 2005 9:30 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. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bramshalls Old Rectory Address Leigh Lane Bramshall Nr Uttoxeter Staffordshire ST15 5BQ 020 8423 8804 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) Tudor Care Plc Mrs Helen May Stainer CRH 30 Category(ies) of DE(E) - 3 registration, with number OP - 15 of places PD - 20 PD(E) - 25 Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: PD minimum age 60 years Date of last inspection N/A Brief Description of the Service: Bramshall Old Rectory is registered as a care home with nursing for 30 people, three of whom have dementia and are over 65 years of age, and old age with physical disability over 65 years of age. The home has 26 single and two double rooms for married couples or those who prefer to share. The home is situated in the village of Bramshall with good road access to Uttoxeter, some three miles away, in delightful country surroundings. The building is a converted church residence with modern extensions added over the years. The home is well suited to meet the needs of the stated categories of service users. Many rooms have impressive views of rolling countryside; all are well equipped and pleasantly furnished. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced visit was made on the 8th August 2005 at 10.00 a.m. The inspection was carried out by one inspector who used the National Minimum Standards for Older People as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to 8.5 hours. The registered provider, Mr Anil Patel for Tudor Care Ltd, and the registered care manager, Helen Stanier, an RGN, were present throughout the inspection. Also on duty were an SEN, 1 Senior Care Assistant, 4 care assistants, an activities co-ordinator, a cook, a kitchen assistant, 2 housekeepers, a laundry assistant and a handyman /gardener. There were 28 residents living in the home at the time of the inspection and these staffing levels were satisfactory to meet their needs. The inspection included a tour of the building, inspection of records, observation, and discussions with service users, the registered provider and staff. Since the last inspection on 10th December 2004, no complaints nor any incidents or reports of abuse of any kind had been received and no requirements or recommendations, against the regulations or the minimum standards, were outstanding from the last inspection report. The Statement of Purpose and the Service User Guide provided adequate information for prospective service users to enable them to make an informed choice about the home. All service users had received a pre-admission assessment and were invited to visit the home before making a decision to move there. A trial period of 4 weeks following admission enabled the individual to decide if the home was the right place for them. Care plans had been well written and health, personal and social care needs had been met and well documented. Service users confirmed that they were treated with dignity and respect and were very happy living in the home. The home was generally well maintained, homely, and very clean. A significant amount of work had taken place to improve the home such as decorating half of the total number of bedrooms, repairs to the roof, replacement of 2 out of 3 boilers and new carpeting to the lounge and dining area. All of the bedrooms contained a range of personal items belonging to the individual service user and a good standard of furniture and fittings. The communal areas were bright, comfortable and warm, and had been redecorated recently. Food was well presented, varied and nutritious with choices available to meet a range of needs. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 6 Staff training had been provided and over 50 of trained care staff had achieved NVQ Level 2 in Care. Staff supervision had commenced and the home was well managed and organised. Recruitment and selection procedures within the home were thorough and detailed for the protection of service users. Service users were able to make their own choices and decisions about the day-to-day activities within the home. What the service does well: 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. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 and 5 The information provided by the home ensured that service users could make an informed decision; assessments were carried out and trial visits were offered so that the service user and their representative were confident that the home could meet their needs. EVIDENCE: The Statement of Purpose and the Service User Guide were well presented and easy to understand and seen to contain all the relevant information to enable service users to have a clear understanding of all aspects of the service provided by the home. Documentation evidenced that the registered care manager or her deputy carried out in depth pre-admission assessments providing a comprehensive understanding of the needs of the individual which was then transferred into care plans. Trial visits were available to all potential service users who were invited to visit the home, have a look around with their relatives, to have lunch and/or stay overnight if required. Some service users who were spoken to confirmed that Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 9 they had been able to visit the home before choosing to stay. A trial period also enabled service users to decide if the home was right for them. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 and 10 The care planning processes within the home were clear and concise providing adequate information for staff to meet the needs of the service users. Health care needs were met very well. The administration and handling of drugs was well managed and documented to protect the service users. Service users were treated with dignity and respect and their requests for privacy supported. EVIDENCE: All service users had care plans in place and two care plans were examined thoroughly and seen to be well written, meaningful and reflected the current condition of the service users. The documentation seen and a discussion with both service users and staff members evidenced that health and personal care needs were being well met. In particular, short-term care plans for chest infections, varicose ulcers etc were reviewed daily and all records evidenced a very good standard of nursing care. All care plans and risk assessments were reviewed monthly. NHS facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, and these events were seen recorded. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 11 The medicines within the home, medication administration records and controlled drugs book were all checked and no errors were noted. It was observed that a safe system was in operation for the protection of the service users. A list of signatures was in place of those authorised to administer medicines and a recommendation of this report is for this list to be updated. During the inspection it was observed that privacy and dignity were being afforded to service users during their interaction with staff. Staff were seen knocking on doors before entering. Service users told the inspector that they were treated with respect, and that the staff were ‘good as gold’ and ‘very kind’. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 and 15 There were a range of social, religious and recreational opportunities available to meet the expectations of the service users within the home. Visitors were welcomed in an open and friendly manner and service users were supported and encouraged to maintain contact with family and friends. Dietary needs of service users were catered for to meet a variety of individual needs. EVIDENCE: The home had not had an activities co-ordinator for some time but a care assistant who had worked at the home for some years had been given responsibility for organising activities for the benefit of the service users. These included: arts and crafts, filling planters with bedding plants, visits from an organist, a ‘birdman’, a library service providing reminiscence boxes, a hairdresser, games such as skittles, quoits, darts etc, celebrating key events such as VE Day, Halloween and outings to the local pub, garden centres etc. Religious needs were also catered for and a Holy Communion service was held each week, and Jehovah Witnesses attended the home to see an individual service user regularly. The home was preparing for a Garden Fete in the grounds of the home which was planned to take place early September. The inspector was shown posters that had been made by the service users inviting their friends, relatives and the local community to come along and join them at the Fete, and was impressed by the artistic talent in the home. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 13 During the inspection, staff were observed welcoming relatives and friends of the service users and one relative, whose mother lived at the home, told the inspector that ‘This home is absolutely fantastic, I can’t praise the home enough, everyone is fabulous and Mum really enjoys the activities’. Several service users spoke of their satisfaction with the meals and choices offered. One said ‘We have the most wonderful meals and they are very kind’. The cook was very knowledgeable about the needs of the service users and spoke directly to them to determine their likes and dislikes. Catering records were examined and evidenced that the dietary requirements of service users were met. The cook when asked said that fresh good quality food from local suppliers was delivered on a weekly basis. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 and 18 The home had a satisfactory complaints procedure and service users confirmed that their views were listened to and acted upon. Service users were protected from abuse by the home’s Adult Protection procedure but regular training in Adult Protection and Abuse Awareness should be undertaken to ensure a proper response to any suspicion or allegation of abuse if the need arose. EVIDENCE: The Commission had received no formal complaints since the last inspection and none had been received by the home over the last 12 months. The complaints procedure was observed in the hallway of the home for the benefit of service users and visitors alike. Minor complaints were received by the registered care manager and resolved to the satisfaction of the service users. One completed questionnaire received by the Commission from a relative of a service user within the home wrote ‘Whenever there is a problem which needs attention, a chat with the Sister in charge concerning whatever the problem always leads to a satisfactory conclusion without making a big complaint’. The home had an Adult Protection procedure which ensured the safety and protection of service users. However, no records of abuse awareness training were recorded for staff and it is a requirement of this report that all staff receive this training to ensure the continued protection of all service users. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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) 20, 22, 24 and 26. Indoor communal facilities were accessible and maintained to a good standard and clean, bright and comfortable. Outdoor facilities were generally well maintained but there was no easy access to the large rear garden for wheelchair users. Specialist equipment was used to support service users to promote their independence. Service user’s bedrooms were homely, personalised and generally well maintained. The home was very clean throughout which contributed to the overall control of infection. EVIDENCE: The home was located in the rural village of Bramshall and benefited from stunning views over rolling fields. Outside the home, the grounds were large and well maintained. At the front of the home there was ample space for parking and an area where service users sat to enjoy the outdoors. This area had attractive planters and large pebbles which had been decorated by the service users. The rear garden was large and overlooked fields, but access was difficult for wheelchair users and no formal seating area was available for those service users who had mobility problems. Some windows were in need Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 16 of repair/redecoration and the registered provider confirmed that these would be addressed. Internally, the communal areas were clean, bright and homely. Furnishings were of good quality and suitable for the service users living in the home. A significant amount of work had been undertaken to improve the home including repairs to the roof, re-pointing of chimney pots and replacing 2 out of the 3 boilers within the home. The large lounge and dining room had recently been refurbished and had new carpets in place. Corridors within the home had also been redecorated and a new nurse call system had been installed to replace one of the two systems operating within the home. There was a range of specialist equipment to meet the needs of the service users such as hoists, pressure mattresses and cushions, and a significant number of variable height beds. Bedrooms had been individually personalised by the service users and contained good quality furnishings and fittings. Half of the bedrooms had been redecorated and all were homely, bright and very clean. Each bedroom was of a good size and it was observed that radiators were protected, adequate numbers of sockets were available and smoke detectors were fitted. The laundry was inspected and seen to be very small but well organised and satisfactorily equipped. Soiled linen was contained within appropriate, easily identifiable, red bags and held separately from other laundry. Foul laundry was washed at the appropriate temperatures to ensure it was thoroughly clean and to control the risk of infection. The home was very clean throughout and free from offensive odours. The domestic staff were to be credited for the standard of cleanliness within the home. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 and 30. Staffing numbers and skill mix was appropriate to meet the assessed needs of the service users who were in safe hands at all times. A thorough recruitment and selection procedure was in place and ensured the continued protection of the service users. Staff training took place as required and enabled them to meet the needs of the service users. EVIDENCE: At the time of the inspection, there were 28 service users accommodated at the home with a staff complement of 1 Registered Nurse, 1 Enrolled Nurse and 5 care assistants. Staff rotas were examined and staffing levels were satisfactory to meet the needs of the service users. More than 50 of the care staff within the home had achieved NVQ Level 2 in Care and 4 care assistants were in the process of completing NVQ Level 2 and 6 were in the process of completing NVQ Level 3. The recruitment and selection procedures within the home were robust and provided ongoing protection for service users. Two staff files were examined and each contained an application form, CRB clearances, two references and details of qualifications and training. Proofs of identity were also held on each file including a recent photograph of the individual member of staff, and the management of the home were to be credited for the well-documented and thorough approach to ensuring the protection of those living within the home. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 18 A comprehensive staff training record was examined and evidenced that all mandatory training had taken place for all staff. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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) 32 and 36 There was an open and positive atmosphere within the home for the benefit of the service users. Formal supervision sessions had commenced to enable staff to have regular, documented, one-to-one meetings with their line manager. EVIDENCE: The Commission received a significant number of completed questionnaires from both service users and relatives regarding the standard of care at Bramshall’s Old Rectory. The comments within some of these, discussions with service users and relatives, and direct observation evidenced that the style of management within the home promoted an open and positive atmosphere which created a ‘home from home’ environment for those who lived there. The Matron of the home confirmed that she regularly undertook informal audits where she spoke to all residents to make sure that they were happy with their care. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 20 Staff meetings took place every 3 months and minutes were recorded and seen to include actions taken. Staff supervision sessions had commenced and the format was seen to be extremely professional and comprehensive. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 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 4 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x 3 x 4 x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 4 x x x 3 x x Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 22 NO 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 OP 18 Regulation 13 (6) Requirement For all staff to receive Abuse Awareness training to ensure the continued protection of all service users. Timescale for action 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP 9 Good Practice Recommendations To update signature list of authorised staff responsible for adminstration of medication. Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Bramshalls Old Rectory E51-E09S59275 Bramshall old Rectory S238033 8.08.05 Stage 4.doc Version 1.40 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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