This inspection was carried out on 10th August 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.
CARE HOMES FOR OLDER PEOPLE
Brandon Lodge Care Home Commercial Street Brandon Co. Durham DH7 8PH Lead Inspector
Susan Lowther Unannounced Inspection 10 August 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 Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Brandon Lodge Care Home Address Commercial Street Brandon Durham DH7 8PH 0191 3781634 0191 3781636 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) Tamaris Healthcare Mrs Anna Marie Clark Care Home 38 Category(ies) of OP - 38 registration, with number of places Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 20 January 2005 Brief Description of the Service: Brandon Lodge is a custom built home. The facility provides 38 beds located on two floors and all are in single rooms 37 of which have en-suite provision. Brandon Lodge caters for service users who require general nursing and residential care. The home is located in a semi-rural setting surrounded by small well maintained gardens. There is a varied and active social and recreational programme available for those who wish to participate. Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. CSCI has a statutory duty to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this duty. The inspection took place on the 10th August 2005. Records were examined and a tour of the building took place. Time was spent talking to 6 service users and 4 staff and 2 relatives. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. What the service does well: What has improved since the last inspection?
Since the last inspection there has been some improvement in the plans of care that are kept for each resident. They now provide more information about the care needs of each individual, including what risks affect them and the action that needs to be taken to minimise these risks. The manager has been registered with the CSCI as required by regulation. The floors have now received attention and are considered to be level and safe.
Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 6 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. Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3&4 Service users are unaware of the terms and conditions that apply to their stay within the home. The assessment process in the main demonstrates how the home will meet the individual needs of the service users placed. EVIDENCE: The contract for service users is being reviewed by the Company and is not yet available. Assessments from Care Managers are obtained for all new admissions funded by the Local Authority. The home also carries out its own assessments on service users; some of the areas within these were blank, not all had a completed social assessment and risk assessments were not fully completed. Assessments form the basis from which the individual plan of care will be written and demonstrate how the home will meet an individuals needs. The information provided within assessments must cover all areas of physical, social, emotional and psychological needs. Where possible service users and/or their relatives should be involved in the assessment process. Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 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) 7,8,9,10&11 Service users views should be sought when care planning to ensure that the needs and wishes of service users are identified and met. EVIDENCE: Four care plans were audited. Although it was noted that some improvements had been made since the last inspection, evaluation of these was inconsistent as to when this was undertaken and where this had been done the information was sometimes very limited. The plans contained written evidence of input from other professionals and each service user is registered with a local General Practitioner. Service users spoken to confirmed that staff treat them with dignity and respect and always knock before entering their rooms. This was observed during the inspection process. Several staff have undertaken short training courses in the area palliative care. Policies are available for staff to consult and specialist services are utilised when required. No concerns were raised during interviews with service users, staff or visitors and no adverse observations were made during the inspection process.
Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 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) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 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) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 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) 19,22,24,25&26 Brandon Lodge was purpose built and therefore meets the needs of the people who live there. The overall quality of furniture and fittings is good and redecoration is carried out on a rolling programme. EVIDENCE: The home was purpose built and meets the room sizes as stated in the National Minimum Standards. There are a range of lounge areas and a dining room available. During the tour of the building the inspector noted the home to be clean and tidy with no unpleasant odours apparent. Whilst talking to people in their bedrooms, the inspector saw that service users could bring in their own furniture and belongings should they wish to do so. The family of one service user recently admitted to the home confirmed that they had been given a choice with regard to the redecoration of the room.
Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 13 The door of one bedroom was noted to have the lock removed and the gap had not been obscured. There was a range of specialist equipment seen around the home and bathrooms were noted to be appropriately equipped. Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 14 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 The deployment and number of staff available in the early morning is not sufficient to meet the needs of the people who live there EVIDENCE: Service users spoken to said that the staff were very kind but that they were very busy and that sometimes it took a long time for them to answer the call bells. During the visit the inspector observed that one call bell took 10minutes to answer. This was discussed with one staff member who confirmed that during the early morning when residents needed the most assistance, it was sometimes difficult to answer call bells quickly with the staff available. She stated that the periods of the day where staff had more time to spend with the resident’s was during the early afternoon and again during the early evening. Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 15 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) 31,32&38 The Registered manager is positive towards self-development to enhance her skills and abilities to provide a good standard of care delivery to service users. EVIDENCE: Since the last inspection the manger has been registered with the CSCI. However she must continue with her studies to complete an appropriate management qualification. Maintenance records seen confirmed that as far as practicable the safety and welfare of service users and staff are promoted and protected, with appropriate training in place. Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 16 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 2 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x 3 x 2 3 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 3 x x x x x 3 Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP 2 Regulation 5(1)(b) Requirement The home must ensure that each service user is provided with a statement of terms and conditions (or a contract if purchasing their care privately) at the point of moving into the home. (The previous timescale of 30/04/05 was not met). Care plans must be reviewed to ensure that they are evaluated regularly. Where locks to service user bedroom doors are removed, the hole must be covered immediately. A review of staffing arrangements is required to ensure that there are sufficient staff deployed during the early morning io meet the needs of the people who use the service. The Registered Manager must complete an appropriate management course. Timescale for action 31/10/05 2. 3. OP 7 OP 24 15(1)&(2) 16 30/09/05 Ongoing 4. OP 27 18 30/09/05 5. OP 31 9 31/12/05 Brandon Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 18 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 Lodge Care Home B54 S702 Brandon Lodge V227388 100805 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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