Inspection on 11/10/05 for Branch Hill

This inspection was carried out on 11th October 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

Branch Hill 23/09/08

Branch Hill 02/08/06

Branch Hill 11/05/05

Branch Hill 29/11/04

Branch Hill 10/06/04

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

CARE HOMES FOR OLDER PEOPLE Branch Hill Branch Hill House Branch Hill Hampstead London NW3 7LS Lead Inspector Ms Pippa Treadwell-Smith Unannounced Inspection 11th October 2005 12:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Branch Hill Address Branch Hill House Branch Hill Hampstead London NW3 7LS 0207-794-8075 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) London Borough of Camden Ann O`Keeffe Care Home 49 Category(ies) of Dementia - over 65 years of age (52) registration, with number of places Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 Brief Description of the Service: Branch Hill House is a care home, which caters for49 older people within the category of dementia. The home is owned by the London Borough of Camden and under the management of the Housing and Adult Social Care directorate of the council. The building is an old country house, which has been extended and adapted to provide accommodation and facilities for service users. It is situated in open parkland and reached through double gates. Parking is available to the front of the home. Accommodation is over three floors both in the original part of the building and the new extension. A shaft lift and stairs gives access to the upper floors. Internally the home has been divided into five separate living units. Each unit is self-contained with a sitting-cum-dining area, bedrooms and a kitchenette. There are assisted baths, showers and toilets in each unit. All bedrooms have a wash hand basin and fitted wardrobes. There is a large activity room on the ground floor, which also acts as a designated smoking area. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second visit within the inspection schedule from 1st April 2005 to 31st March 2006. It took place over one afternoon and lasted about four and a half hours. The manager was available for part of the inspection. The focus of the inspection was looking at the remaining key standards which were not inspected during the May visit. Most of the inspection was spent talking to service users, relatives and staff. A variety of records were also looked at including care plans and training records for staff. What the service does well: What has improved since the last inspection? What they could do better: There is still no clear and consistent approach to the development of care plans. The manager was made aware that one service user had been in the home for three and a half weeks and there was no information available in the care file. The involvement of the residents and relatives in the development of written care plans is still evident. Staff training records need to be updated. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 6 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. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 6 is not applicable to this home. EVIDENCE: Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 There is no clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet the needs of the service users. The systems for the administration of medication are reasonable and safe so that service users are not placed at risk. Personal support in this home is offered in such a way as to protect service users’ privacy and dignity. EVIDENCE: At the last inspection the manager confirmed that a new care planning system was to be introduced. This was to be more person centred and will apply to new admissions. A sample of care plans was taken, a service user from each unit was case tracked. All but one service user had a care plan. Similar issues were found as at the previous inspection whereby there was a large gap in information. Previously new admission had much better care plans however on this occasion, one service user had been admitted on 16th September and although they had been in the home for three and a half weeks, there was no relevant information available in the file. There was no assessment of care needs, the personal history had not been completed and a service user plan had not been developed. It was not possible to determine whether this person’s cultural and religious needs were being met. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 10 The home has a medication policy, which includes the administration of homely remedies. Risk assessments would be available if service users chose to self– administer their medication. Medication is kept secure in medicine cabinets within the individual units. The inspector was able to observe medication being administered on one unit and it was carried out safely. An inspection of the medication administration records showed that they were accurate and upto-date. There are arrangements in place to meet the health care needs of the service users. The home has policies on promoting privacy and dignity on behalf of service users. The promotion of these core values is discussed within the team meeting. The service users who participated in the inspection confirmed that their privacy and dignity was respected. They said that staff close doors whilst giving personal care, they are able to lock toilet, bathroom and bedroom doors. The interaction between the service users and the staff was observed to be respectful. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Branch Hill is good at making the service users feel at home and comfortable. It is not clear from the records whether the cultural and religious needs of people from ethnic backgrounds are understood and met. The service users have nice food in comfortable surroundings and their individual preferences are taken into consideration. EVIDENCE: “I am well content here”. This was a comment from one service user who wanted to express that Branch Hill House suited him very well and was meeting his needs. Service users felt that staff treated them as individuals and understood their likes and dislikes. Staff also respected the service users preferred routine and lifestyle. This practice was not always reflected in the care records, as personal histories were not completed. There is evidence to confirm that service users are able to retain links with their previous way of life and attend day centres. Social activities are discussed as part of the resident’s meetings and a programme is available. Staff were observed engaging in social interaction with service users. Discussions with service users confirmed that the food is very good in the home. One service user described the food as being “great”. Choices are available and cultural needs are met. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 12 Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users are protected from harm by the home’s policies and procedures. EVIDENCE: The home has clear policies and procedures in respect of adult protection and whistle blowing. Staff have attended adult protection training and where a training need has been identified then training has been planned. Staff are receiving training in respect of dementia so that they have a good understanding of the behaviour of the service users and to look for positive interventions. The organisation operates a robust and thorough recruitment and selection process. Service users said that they felt safe living in the home and felt confident that if they had any concerns then they could approach the staff. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The service users at Branch Hill House enjoy a comfortable living environment with a good standard of cleanliness, which adds to their quality of life. EVIDENCE: A partial inspection of the home showed that the communal areas are clean and tidy and repairs are carried out. The bedrooms are personalised and the service users said that they found their accommodation to be warm and comfortable. Throughout the inspection the home was found to be clean and hygienic. Comments from service users and relatives indicated that they considered a high standard was being achieved in this area. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 It is not clear from the training records whether the staff have the knowledge and skills to meet the needs of the service users. The standard of vetting and recruitment practices remains robust thus protecting service users. EVIDENCE: A good deal of positive feedback about the staff at the home was received from the service users and the relatives. A typical comment being “The staff are very kind”. As a result the service users feel that they experience a caring environment where they feel they will be looked after and allowed to make choices. The service users said that they could follow their own preferred lifestyle. They had the choice to mix with other service users or to spend time alone in their rooms. Staff respected both choices. Some of the staff have worked at the home for a number of years and have built up a good understanding of the needs of older people. One relative commented that in her opinion there was not always sufficient numbers of staff on duty. The rota does show that the permanent staff team are supplemented by a lot of agency staff and these tend to be regular. The home has a training plan and each staff member has a training record. There is also a training file for agency staff but on inspection, there was no upto-date record of courses attended. There was a similar finding when looking at the training records of permanent staff. Twelve of the care staff, two catering staff and two ancillary staff had not recorded any training for the Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 16 current for the current year despite the fact that training needs had been identified through supervision and the jobholders self–appraisal exercise. It was confirmed by the manager that training had been dome but the records not updated. The registered manager is engaged on the Registered Manager’s Award but it was not possible to ascertain from the training records how many of the care staff will achieve NVQ Level 2 by the end of this year. The organisation operates a robust and thorough recruitment and selection process based on equal opportunities. An inspection of the staff records shows that formal supervision has been patchy in the past but efforts are being made to arrange sessions more regularly. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 35 The home is run by an experienced manager. Service users’ views are sought from time to time and acted upon locally but this is not done through a formal process. Service user’s finances are protected by the home’s policies and procedures. EVIDENCE: One relative had written on a comment card “Branch Hill House is run very well in my opinion”. The manager has successfully completed the fit person process to become registered. She is an experienced manager who keeps in daily contact with the service users. There is confirmation that she is undertaking the registered manager’s award. Relatives said that they been made aware of previous inspection dates and always had access to a copy of the latest inspection report. Service user’s meetings are held, usually on a monthly basis. These are minuted and the last recorded meeting was dated 1st August 2005. Feedback has not been actively sought from service users, Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 18 family and stakeholders in the community on how the home is achieving goals for service users. The home has a policy on handling service user’s personal finances. There is a secure facility for the safekeeping of monies and valuables. There are receipts for monies and valuables accepted by staff. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) (2) 12(4)(b) Requirement Timescale for action 30/01/06 2 OP28OP30 18.1(c)(i) 3 OP33 24(1)(2) & (3) All service users must have a care plan. The person centred planning approach is to be used for all service users in the home. The daily entries and monthly reviews must reflect the contents of the care plan. The care plans must demonstrate that the home is meeting the religious, racial and cultural needs of all new service users. This requirement is being restated All staff training records must be 30/11/05 kept up-to-date in order to demonstrate that they suitably qualified and competent to meet service user’s needs. The registered persons must confirm in writing how the home will achieve 50 of the care staff trained to NVQ Level 2. The registered persons must 30/01/06 seek the views of service users, relatives and stakeholders as a means to reviewing the quality of the care in the home. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 21 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 OP7 Good Practice Recommendations It is recommended that service users and relatives are asked to sign their completed care plans. Where this is not possible, it should be recorded on the care records. Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 Branch Hill DS0000037333.V250227.R01.S.doc Version 5.0 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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