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Inspection on 26/07/05 for Brandon House

Also see our care home review for Brandon House for more information

This inspection was carried out on 26th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a group of staff most of whom have worked at the home for a long time providing continuity of care. They are keen to ensure the well being and comfort of the residents and were observed treating them with great respect and kindness. All residents spoken with praised the care they received from the staff and said they were very happy living at the home. Relatives spoke highly of the standards of care, the staff team and management. The environment is comfortable, homely and safe. A varied of activities are provided which residents said they enjoyed. Staff are provided with good information to help to meet residents` needs safely. Residents are provided with good information about the home and keep care plans and daily records in their rooms.

What has improved since the last inspection?

The provider has fitted radiator covers to all areas of high risk. Residents are provided with detailed information about how to complain, relevant polices and procedures and a service user guide.

What the care home could do better:

The provider / manager intends to carry out assessment on all residents. These will provide a good monitoring tool to highlight areas of deterioration or improvement. Care will be adjusting accordingly.The provider is attending a comprehensive course on nutrition for the elderly later on in the year. This will ensure that additional information relating to appropriate assessments and diets for older people is passed on to the relevant staff.

CARE HOMES FOR OLDER PEOPLE Brandon 29 Douglas Avenue Exmouth Devon EX8 2HE Lead Inspector Belinda Heginworth Unannounced 26th July 2005 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. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brandon Address 29 Douglas Avenue, Exmouth, Devon, EX8 2HE 01395 267581 01395 270806 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) Mrs Wendy Pamela Marsh Care Home 35 Category(ies) of OP - Old Age (35) registration, with number PD - Physical Disability (35) of places Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11/11/2004 Brief Description of the Service: Brandon is registered to provide personal care for up to 35 older people who may or may not have a physical disability. The detached property is situated in a residential area of Exmouth with large gardens and patio areas. There is a dining room and three lounges. Bedrooms are large and all have en suite facilities. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours and forty minutes. The registered provider / manager was present throughout. Sixteen residents and three relative were consulted and their views of the home discussed. The inspector looked around parts of the building and a number of records were inspected. What the service does well: What has improved since the last inspection? What they could do better: The provider / manager intends to carry out assessment on all residents. These will provide a good monitoring tool to highlight areas of deterioration or improvement. Care will be adjusting accordingly. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 6 The provider is attending a comprehensive course on nutrition for the elderly later on in the year. This will ensure that additional information relating to appropriate assessments and diets for older people is passed on to the relevant staff. 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. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 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 Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 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) 3 & 6 Residents benefit from good admission and assessment practice, which ensures that the home is able to meet their needs. EVIDENCE: All residents are visited by the manager or senior carer to undertake an assessment of their needs before deciding to live at Brandon. Residents are sent written confirmation that their assessed needs can be met. Relatives and residents said that they felt reassured by the assessment process and confidant that the home could meet the assessed needs. The home offers respite care if there are any vacancies. Residents receiving respite care felt happy with the care they have received. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 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 standard(s) 7, 8 & 10 Residents’ privacy and dignity are met and promoted by the staff. Care planning ensures residents personal and health care needs are met safely. EVIDENCE: Residents said they felt the home met their needs satisfactorily. They said staff were kind and caring and respected their privacy and dignity at all times. Relatives spoke highly of the care they had observed. The home promotes residents’ welfare in co-operation with families and health care professionals. Care plans set out residents’ needs, how they should be met and are reviewed regularly. The manager is in the process of using a detailed assessment tool to highlight any changes in need. From the information gathered using this tool, action is taken and recorded in residents’ care plans to address any changes. The manager is half way through this process and intends to complete the assessments in the next few months. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 10 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) 0 Not inspected on this occasion. EVIDENCE: Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Residents and relatives are confidant that they are listened to and their requests actioned. Arrangements for protecting residents from the risk of harm or abuse are good. EVIDENCE: The home has a detailed complaints procedure that is well displayed and all residents have a copy of. Residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to, say the manager is very approachable and understanding. Relatives said they felt confidant that any concerns would be dealt with quickly and satisfactorily. All staff receive training on abuse awareness, those spoken with demonstrated a good understanding of types of abuse and knew what to do if they suspected any. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 25 Residents live in a safe and comfortable environment. EVIDENCE: Residents’ bedrooms are decorated and furnished to their own taste and preferences. Residents said it was nice to have their own belongings, some of their own furniture and personal items around them. The remainder of the home is very comfortable with furniture and fittings that create a warm homely atmosphere. Radiators have been fitted with covers to ensure the safety of residents who were at risk. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 13 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, 29 & 30 Staff are employed in sufficient numbers to meet residents needs and are trained and competent to do their jobs. The procedures for the recruitment of staff provide safeguards for the protection of people living in the home. EVIDENCE: Residents said that the staff were kind and caring and always there to help. During the visit staff were observed spending time with residents and call bells were answered quickly. Staff said there was always 5 to 6 staff on duty each morning. Relatives said the staff team were always polite, caring and “nothing was too much trouble”. Three staff files were looked at. Recruitment practices were good all checks and documentation necessary, including police checks were completed. Staff said they had received training in healthy and safety issues such as fire, infection control, first aid and manual handling, training was also provided in abuse awareness, equality and diversity, NVQ and many more. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 14 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 & 38 There is clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment. EVIDENCE: The manager shows great empathy towards residents and their families and gives clear leadership, guidance and direction to staff. Residents feel the manager is approachable and seeks to ensure all their needs are met. Attention has been made to the safety of residents and staff with good environmental risk assessments and fire safety measures in place. Records indicated that regular safety and fire checks are carried out. The manager completed a questionnaire, which was sent to the CSCI before the inspection. This provides information about staffing and required policies that are in place. Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 15 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 x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 x x x x x 3 Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 16 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 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. Refer to Standard Good Practice Recommendations Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Exeter Office, Suites 1 & 7 Renslade House Bonhay Road EXETER, EX4 3AY 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 Brandon D54-D06 S21891 Brandon V230427 260705 Stage 4.doc Version 1.30 Page 18 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!