Inspection on 20/12/05 for Bramshaw House

This inspection was carried out on 20th December 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 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

Bramshaw House 21/12/06

Bramshaw House 16/12/04

Bramshaw House 26/04/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Bramshaw House 13 Shakespeare Road Worthing West Sussex BN11 4AR Lead Inspector Beth Tye Unannounced Inspection 20th December 2005 09:30 Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 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 Bramshaw House DS0000049116.V271288.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 Adults 18-65. 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. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bramshaw House Address 13 Shakespeare Road Worthing West Sussex BN11 4AR 01903 238945 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) Miss Rebecca Karen Ward Mr Jonathan Shepherd Miss Rebecca Karen Ward Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accomodated at any one time shall not exceed ten. 1st August 2005 Date of last inspection Brief Description of the Service: Bramshaw House provides a home for ten adults with Physical and Learning Disabilities between the ages of 18 and 65 years. The service is based in a detached house in Worthing, which is fully adapted to meet the needs of the residents. Accommodation is split over two floors. A lift is available for residents to access both floors. The property is situated in a residential area close to the town centre, local amenities and sea front. Rebecca Ward and Johnathan Shepherd are the Registered Providers of Bramshaw House. Ms Ward is also the Registered manager of the home. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over three hours. Prior to the inspection, information held on file was examined including the last two inspection reports and any official documentation relating to the home. During the inspection a tour of the home was undertaken and records relating to the residents care and health needs were examined. Staff files and health and safety records were also reviewed. The inspector spoke to the deputy manager, who was present throughout the inspection, and spent time with staff and residents. Where evidence found during this inspection remains unchanged, the report will state the same as the previous report. What the service does well: What has improved since the last inspection? Since the last report the manager has obtained relevant personnel information to ensure all staff files are now complete and up to date. This includes records for two new staff members who have commenced employment since the last inspection. Both managers at the home have recently completed Adult Protection training with the intention to provide additional in-house training for staff in the early 2006. This will ensure all staff are equipped to deal with an Adult Protection incident, should the need arise. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 6 One resident has been provided with additional funding to enhance her daily activities. The home has organised a member of staff to assist her on a one to one basis for these additional hours. 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. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 The home and the prospective resident have access to all relevant information to assess whether the service can appropriately meet the needs of prospective residents. EVIDENCE: Prospective residents are provided with all information needed to make an informed decision about the home. The inspector reviewed an updated Statement of Purpose and Service Users Guide. Each potential resident has the opportunity to visit the home prior to admission. They are given the opportunity at this stage to choose their preferred room décor. This process contributes toward a smooth transition and a sense of ownership. The manager assesses potential residents to gain detailed information about them, prior to admission. This process ensures the home can meet the residents needs appropriately once they arrive. Evidence of pre-assessment information was seen on residents files and provided a basis for on going assessment and care planning. Terms and conditions are provided and signed by each resident, and a copy is kept on file. This ensures residents have an understanding of their rights and exactly what the home has to offer them. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 Residents have the opportunity to contribute and review the care planning process. Reviewed documentation and discussion with residents confirmed that the home meets residents changing needs and personal goals, promoting independent living where possible. EVIDENCE: The inspector examined some of the residents care plans. Each plan is generated from pre admission assessments, which relate to all aspects of the individuals health, personal and social care needs. All plans seen were detailed and easy to follow which means care staff can transfer the information into daily practice. Changes to care plans are discussed with the manager in monthly staff support sessions, ensuring staff members are clear and accountable for the care they are providing. Records included reference to monthly reviews between the resident and their key worker. Providing the opportunity for residents to be consulted on and participate in their care planning on a regular basis. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 10 Individual risk assessments were evidenced on residents files, providing staff with clear guidelines about residents agreed limitations and promoting independence where possible. A record of residents meetings is kept at the home. The inspector noted that a meeting had not been held since the last inspection. It would benefit the residents if these were held on a more frequent basis, as they provide residents with the opportunity to contribute to the way the home is run. This will be monitored at the next inspection. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 16 and 17 The outcome for resident’s personal development and activities provided was good. Three of the residents spoken to, confirmed the home offered a good range of activities, which is appropriate to their assessed needs and interests. Residents confirmed they are offered a healthy diet and enjoy the meals provided at the home. EVIDENCE: The structured activities programme incorporates college attendance, with a range of outings, sports and leisure opportunities. Residents are encouraged to pursue individual interests in the wider community such as shopping, dog walking, visits to local pubs and restaurants, bowling, horse riding and regular attendance at day centres. It is clear residents are provided with opportunities to develop their personal lives through activities and regular contact with family and friends. Goals have been set out in individual care plans to support this and there was evidence these are reviewed on a regular basis according to the individuals changing needs. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 12 Menus are drawn up on a weekly basis and records are kept of what is cooked each day. Staff confirmed they will adapt the menus to suit the residents preference. Special diets are catered for, and where appropriate nutritional intake is monitored and recorded. The kitchen area was very clean and tidy. Food is stored appropriately and it was noted there was lots of fresh fruit and vegetables, to ensure residents benefit from a healthy balanced diet. The inspector observed residents enjoying their mealtime and there was a relaxed and friendly rapport between staff and residents whilst they ate. Staff assisting residents who required help at mealtimes, did so in a sensitive and caring manner. It was noted that liquidised foods were blended in separate portions and presented in an appetising way. Staff confirmed residents assist with cooking and food preparation where possible, to encourage independence and help develop life skills. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21 The inspector concluded all medication was dispensed, stored and recorded in line with the homes policies and procedures. A policy in relation to death and dying was available at the home to ensure residents wishes were respected. EVIDENCE: Policies and procedures relating to all aspects of healthcare and medication are in place and up to date. The deputy manager is responsible for ordering on a monthly basis and monitoring all records relating to medication. The local pharmacy provides up to date medication training and audits the home on a regular basis. Records showed that staff have undertaken relevant training to dispense medication safely to the residents. Medication is stored appropriately at the home. The inspector examined all medication charts and found they were up to date and in good order. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 14 The home has a policy in place for Death and Dying. It specifies residents wishes are paramount when providing care to them at this time. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The inspector concluded the home protects its residents from abuse and neglect and staff are able to respond appropriately should an incident occur. Residents feedback to the inspector that they felt listened to and would complain if they needed to. EVIDENCE: The home has a complete and full policy on complaints. Detailed risk assessments for daily living enable staff to respond appropriately to challenging behaviour and health needs, therefore reducing risk to individuals. Both managers have completed Adult Protection training since the last inspection. They intend to impart this knowledge to staff through in-house training in the New Year. A recommendation has been made to ensure this occurs. This will build upon information staff have gained at induction and promote good practice should an incident arise. The home has a detailed Complaints procedure and policy, which is included in the Statement of Purpose and Service Users Guide. This provides residents with clear information about how to complain. The complaints log was examined and the inspector found one recorded incident since the last inspection. The manager had resolved this and appropriate action had been taken. The home currently has established links with two local advocacy agencies who promote the rights and interests of the residents as needed. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 16 Residents meetings provide individuals with peer support to discuss any issues of concern. The inspector felt the residents would benefit if these occurred on a more regular basis. The deputy manager agreed that this would be implemented at the earliest opportunity. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 - 30 The communal areas and residents bedrooms clearly met all aspects of the standards, therefore the outcome for residents was very good. Specialist equipment is provided to maximise independence of the residents and the home provides a comfortable, safe and pleasant living environment. EVIDENCE: All areas of the home are clean, light and airy. Communal areas are comfortable and spacious. Furnishings are modern and new providing a pleasant living environment. Bedrooms are all a good size and decorated to a high standard, reflecting the personality of their occupants with personalised décor, pictures and possessions. En suite facilities are available in all bedrooms providing each resident with more privacy than the shared facilities. There are two additional bathrooms and a shower room with overhead hoists and specialist equipment to meet residents assessed needs appropriately. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 18 In addition the home has a sensory room, which provides lights, colourful mobiles, music, water and lava lamps. The residents are encouraged to use this room to promote relaxation and sensory stimulation. All rooms have locks and residents have keys where appropriate. Lockable spaces are provided to promote privacy. The attractive rear garden with a lawn and paved area is accessible to all service users. The house is cleaned daily by staff with appropriate support from residents, this encourages a sense of ownership and promotes independent living skills. Laundry facilities include a sluice cycle. Policies and Procedures are in place for safe handling and disposal of clinical waste. The management of the home is currently in the process of arranging Infection Control training for staff. Training in this area would enhance existing hygienic practices and minimises the risk of infection within the home. This will be monitored at the next inspection. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 36 The staff employed to work at Bramshaw house have all been recruited and trained to meet the assessed needs of the residents. Residents benefit from a well supported and supervised staff team. EVIDENCE: Recruitment procedures are in place and records indicated all staff checks were fully up to date. Records seen on file were in excellent order. New staff had appropriate checks and references in place. All staff had undertaken a detailed induction, evidence of which was held on individual files. The home currently has a full staff compliment and does not use agency workers. This provides consistency of care to residents. There was evidence of staff supervision taking place on a regular basis from records of dates in the staff diary. However on the day of inspection the recent supervision notes had not been written up in staff files. Keeping records up dated from meetings as they occur would ensure information required, was easily accessible to the inspector. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 20 The inspector viewed staff team meeting minutes. These meetings provide staff with the opportunity to contribute to the running of the home and gain peer support in relation to practice issues. Feedback from residents, staff interviews and observations led the inspector to conclude that the staff functioned effectively as a team and were supported by the management in doing so. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40 and 42 Good practice in the home was evident. This was supported by efficient administrative systems, which promote the health, safety and welfare of the residents. EVIDENCE: The inspector examined all safety records and concluded they were up to date and in good order, with the exception of the hot water temperature and tank checks (this has been implemented since the inspection took place). Overall the records showed that the home promoted the welfare and safety of its residents. Records showed the new staff had not yet undertaken a fire training evacuation drill. This should be completed at the earliest opportunity to ensure staff respond appropriately in the event of fire. The home has up to date policies and procedures in line with current legislation to safe guard the rights and interests of the staff and residents. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 22 Efficient administrative systems are in place to support staff in their day to day care provision and ensure accountability in relation to work practices. Discussions and observations on the day of inspection, confirmed staff are given clear direction in their roles and good working practices are promoted through staff support and training. The latest inspection report from the Commission is held on file in the staff office and is accessible to residents and parties involved in the home. All care records were kept in a locked cabinet to maintain confidentiality. In the absence of the manager (on the day of inspection) it was evident that the Deputy was clear about her role and responsibilities within the home and was able to manage the service effectively. The inspector concluded that the care provision at Bramshaw House continues to be of a high standard and the overall conduct and management of the home served the best interests of the residents. Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 3 3 3 4 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bramshaw House Score X X 3 3 Standard No 37 38 39 40 41 42 43 Score X X 3 3 X 3 x DS0000049116.V271288.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 3 3 Refer to Standard 8 42 23 30 Good Practice Recommendations For residents meetings to be held on a more frequent basis within the home For all new staff to complete a fire training evacuation drill For managers to provide in house Adult Protection Training to staff, in line with the existing induction module To provide Infection control training to staff in line with homes induction and policies Bramshaw House DS0000049116.V271288.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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