Inspection on 21/12/06 for Bramshaw House

This inspection was carried out on 21st December 2006.

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

Bramshaw House 20/12/05

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 Ms B Tye Unannounced Inspection 21st December 2006 10:00 Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 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.V326707.R01.S.doc Version 5.2 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.V326707.R01.S.doc Version 5.2 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.V326707.R01.S.doc Version 5.2 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. 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.V326707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection the inspector read the last two reports and all other correspondence or documentation regarding the service. The manager of the home had completed a pre-inspection questionnaire and information from this document was also used to inform the inspection. Comment cards were received prior to the inspection and all made very positive comments about the home, the staff team and manager. On the morning of the inspection, all residents were dressed and either in their rooms or socialising in the communal areas. During the day the inspector spent time with the residents and observed care. Two staff were interviewed and the inspector spent time discussing the service with the homes manager Three residents care files were case tracked, including the most recent admission. Personnel records were examined, alongside Policies and Procedures, Risk assessments, Training files, Medication records and all Health and Safety Records. In addition, a tour of the premises was undertaken. Overall quality of care was found to be very good. This was supported by comprehensive administration systems and a committed staff team. This is the first inspection of 2006/2007. This is called a key inspection and will determine the frequency of visits/inspections hereafter. What the service does well: Bramshaw house offers its residents a very good standard of care, a good choice of food and the opportunity for the residents to engage in a wide range of activities and interests. All residents care needs are appropriately recorded and reviewed on a regular basis. Staff and residents relatives spoke very highly of the care provided at the home . The building is maintained safely, and is decorated and furnished to an excellent standard. All relevant records in place to ensure the safety and welfare of the people living there. The management and staff undertake regular training relevant to the specific needs of the resident group. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 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.V326707.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Prospective residents are provided with all the information needed to make an informed decision, prior to admission of the home. Detailed pre-admission assessments enable the service to make informed decisions about whether the home is able to meet the prospective residents needs appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All assessment completed and information transferred to care plans. The most recent admission was in September 2006. The residents file contained a very detailed assessment and evidence of a visit prior to the resident coming to the home. The Acting manager had completed second assessment as good practice. She will be covering maternity leave when the current manager goes off in January 2007. The Statement Of Purpose and Service Users Guide are both up to date and contain all relevant information for prospective residents to make informed decisions about the home. Residents files that were case tracked all contained contracts and terms and conditions. These were signed by residents or their representatives. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 9 Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Individuals, their families or representatives are involved in producing detailed care plans. These reflect their changing needs and personal goals. Residents confirmed they were supported to make choices about their lives. Detailed risk assessments have been completed for each individual in respect of their needs and agreed limitations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were seen for three residents including the new admission. They were comprehensive and up to date and easy to track the care provided. What was identified in individual care plans was relevant to specific resdient needs. There was evidence of specialist care avaible to meet the needs of the individuals. The home has good health care support from GPs and health professionals where relevant. Care plans are updated on a monthly basis following key work meetings and evidence of statutory reviews was seen on file. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 11 The equipment in the home is modern and in good condition. Specialist and holistic needs of individuals have been considered and detailed information relating to these was contained in careplans Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Feedback from relatives and residents reflected positive views about the activities the residents took part in. Relationships outside the home are encouraged and supported by staff. The menu at Bramshaw House offers a range of healthy balanced meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities programme is in place at the home and each is devised on an individual basis dependant on need. Where communication is an issue, picture formats are used. Residents go on outings together and daily as individuals. These were seen recorded in daily diary sheets and individual files. Each activities plan is specific and flexible according to the needs and wishes of the individual. Examination of recording sheets, daily diary sheets and care records supported this information. The inspector noted that each activity is risk assessed in detail and residents abilities and limitations are considered. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 13 Activities attended by the residents are recorded as part of the care planning process. The inspector noted the residents are encouraged to seek support from the local advocacy service, which now has established links with the home. The inspector observed a relaxed and friendly rapport between staff and the resident during the inspection. Written feedback from families confirmed family contact and relationships outside the home is promoted. Some residents have home visits on a regular basis. All contact visits are recorded in residents care plans. A Visitors policy is in place to support this. Care plans reflected detailed information relating to dietary requirements and records showed residents are involved in choosing their menus on a weekly basis. The inspector observed that food is stored appropriately at the home and it was noted there was fresh fruit and vegetables available. The inspector examined menus for the home. A staff member stated if residents changed their minds on the day an alternative could be offered. A record of what the residents ate on a daily basis was seen for the residents whose weight needed to be monitored. The kitchen area was very clean and tidy. The inspector observed adaptations in place to ensure residents can participate in preparation and cooking of food safely. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents receive personal care and support in the way they prefer, all aspects of this is detailed in their care plans. Medication is stored and labelled correctly. The inspector found that medication sheets are accurate and signed, there were no recent gaps in recording. All staff are trained in this area to ensure good practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care files examined by the inspector held information relating to all aspects of healthcare and medication for individuals. These were divided under specific headings such as; Mental Health professionals information, personal care, behaviours, daily routines, GP contact sheets, diet, weight monitoring charts, toileting charts and MAR Charts. The records are all detailed and up to date. Management plans to ensure consistency in relation to personal care were examined. All were detailed and corresponded with information held on care plans. Residents preferences in respect of health issues and personal care are detailed on files. Individual files showed residents have access to community health specialists. Records of all dental, optician, chiropodist and GP Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 15 appointments are recorded on file in daily sheets and in the residents care plans. A key worker system is in place and records of these meetings were seen on individual plans. Following each meeting the care plan is reviewed and updated. Staff have a linked supervision for staff to reflect on issues and practice with the manager of the home. Policies and procedures relating to all aspects of healthcare and medication administration are in place and up to date. Medication was seen to be suitably stored in a locked cabinet. On examination of medication charts, the inspector found records completed correctly and there were no recent gaps where staff signed for medication. Medication training is undertaken by all staff. Records of completed training is held on staff files. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home ensures that both residents and staff are protected through the homes abuse policy and procedures, induction for staff and training. Risk assessments and health and safety checks are all complete and monitored on a regular basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed procedure for complaints, which is included in the Service Users Guide and Statement of Purpose. All complaints information is printed in a format suitable for residents to ensure they are clear about their rights within the home. The complaints log was seen and were two complaints recorded since the last inspection. Both of these had been dealt appropriately by the manager and the outcomes recorded in full. All incidents at the home were recorded and kept on file. The commission had received a copy of a Regulation 37 report. The manager had dealt this with appropriately and no further action is required. Residents have monthly meetings. The minutes of which were seen on file. Adult Protection policies and procedures are detailed and up to date. Staff will use these alongside County Procedures and guidelines, which are available in the staff office. All staff have received POVA training in respect of working with vulnerable adults. Files for staff members were examined. These demonstrated that appropriate checks had been carried out prior to employment. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 17 Detailed risk assessments for individuals and the environment were examined by the inspector. These were specific to individuals and where possible all possible risks had been identified and reduced or eliminated. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. The homes environment is of a very high standard, offering safe and clean living space for residents and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premise was carried out. Bedrooms were furnished and decorated to an extremely high standard. Residents have the opportunity to chose their rooms prior to admission and re-decorate to their own preference. The inspector observed residents have their own personal items and pictures in their rooms. Radiators throughout the house are covered. An on call system in bedrooms and communal spaces is in place so ensure a sppedy response from staff should an emergency arise. There is a large modern communal lounge with TV, DVD and Hi Fi, which has patio doors leading to the garden. The dining room is large and well lit with modern furnishing. The home has a large modern kitchen, where the residents were observed spending time with staff while lunch was being prepared. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 19 The home has a large, mature garden with a lawn and seated patio area, for residents to make use of in the warmer weather. A sensory room overlooks the garden which contains lights, optic lamps and sensory stimulation. Residents are encouraged to use this space for relaxation. A laundry room provides a large washing machine with sluice facilities and tumble dryer this is kept locked for reasons of safety. The inspector noted there is sufficient storage space throughout the home. Staff training files contained Food and Hygiene and Health and Safety certificates. (Seen for staff on shift) The training programme also includes infection control and COSHH training for all staff. This promotes good practice in respect of hygiene and reduces the risk of infection spreading throughout the home. A fire alarm and emergency lighting system is in place. Records showed these are checked and serviced on a regular basis to ensure the safety of staff and residents. The inspector examined detailed environmental risk assessments for the premises. The registered manager has identified all areas within the home, which pose a risk to the occupants and identified ways for these to be eliminated or reduced. A maintenance man is employed by the home to undertake all repairs. A log was seen, which records all action required and completed in the home. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Bramshaw House has an efficient recruitment procedure in place. The staff employed to work at the home receive on going training to meet the assessed needs of the residents. The inspector concluded the residents benefit from a well supported and effective staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection Bramshaw House had had no new recruitment. Existing staff records hold appropriate POVA/CRB checks and additional information seen demonstrated the homes recruitment procedures had been adhered to. Evidence of staff inductions and the on going training programme for staff members, including specialist training relevant to individuals assessed needs were evidenced on individual staff files. Training records for staff indicated all staff to date have attended relevant training and records were efficient and up to date. Interviews with staff supported these findings. Records of meeting minutes and feedback from staff confirmed they attend staff meetings. All staff spoken to praised the manger for her supportive and inclusive approach. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 21 The inspector concluded, following observation and discussion with the staff on duty that they were clear about their roles and responsibilities within the home. The home currently has a full staff compliment, and does not employ agency workers to ensure consistent practice. Feedback, recording, staff interviews and observations led the inspector to conclude that the staff currently in post functioned effectively as a team and were supported by the management in doing so. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Good practice in the home was evident. This is supported by efficient administrative systems, which promote the health, safety and welfare of the residents in respect of their assessed care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector examined all safety records at the home including, fire records, training, food logs, maintenance records, individual and environmental risk assessments, accident book and incident sheets. They were all up to date and in good order promoting the welfare and safety of the residents. Sensitive information was stored appropriately to maintain confidentiality. The company insurance is up to date and the registration certificate is displayed appropriately. Fire notices have been posted throughout the building to raise awareness in the event of fire. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 23 To date the Commission has received regular Regulation 26 reports from the Registered Provider, in addition to any relevant Regulation 37 reports. The home has detailed up to date policies and procedures in line with current legislation to safe guard the rights and interests of the staff and residents. Discussions and observations confirmed staff are given clear direction in their roles and good working practices are promoted through staff support and on going training. One staff member stated she felt the management were ‘very supportive’. Records demonstrated staff received monthly supervision and interviews with staff supported this. A Quality Assurance report has been undertaken and includes feedback from residents. Through observation, interviews and examination of relevant records, the inspector concluded good practice in the home was evident. This was supported by efficient administrative and recording systems. Overall the care provision at the home is of a very high standard and the conduct and management serves the best interests of the residents. Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 X 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 15 16 17 X 4 4 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000049116.V326707.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bramshaw House Score 3 3 3 X 4 X 4 X X 4 X Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Bramshaw House DS0000049116.V326707.R01.S.doc Version 5.2 Page 27 - 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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