Inspection on 23/11/05 for Brandon Lodge Care Home

This inspection was carried out on 23rd November 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

Brandon Lodge Care Home 21/01/08

Brandon Lodge Care Home 14/09/06

Brandon Lodge Care Home 10/08/05

Brandon Lodge Care Home 20/01/05

Brandon Lodge Care Home 14/07/04

Brandon Lodge Care Home 02/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Brandon Lodge Care Home Commercial Street Brandon Durham DH7 8PH Lead Inspector Mr. Paul Emmerson Unannounced Inspection 23 November 2005 9:45 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 Brandon Lodge Care Home DS0000000702.V267700.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. Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brandon Lodge Care Home Address Commercial Street Brandon Durham DH7 8PH 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) 0191 3781634 0191 3781636 brandon.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Anna Marie Clark Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 August 2005 Brief Description of the Service: Brandon Lodge was custom built as a care home. There are 38 bedrooms, located over two floors. All bedrooms are single rooms, 37 have en-suite facilities. Brandon Lodge caters for service users who require general nursing and residential care. The home is located in a semi-rural setting and is surrounded by small, well-maintained gardens. There is a varied social and recreational programme available for those who wish to participate. Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. By law we have to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this obligation. The inspection took place over 7 hours, on the morning and afternoon of Wednesday 23 November 2005. 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 were assessed during the last inspection of the home. The inspector looked around the building and a number of records were examined. 7 service users, 3 visitors, the manager and 8 members of staff were spoken to. What the service does well: What has improved since the last inspection? Some bedrooms have been re-decorated and the dining room floor covering has been replaced As required in previous inspection reports, each service user has been provided with a statement of terms and conditions (or a contract if purchasing their care privately). As also required, although further work is needed, a number of care plans have been updated – the progress made is acknowledged. Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 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 DS0000000702.V267700.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 Brandon Lodge Care Home DS0000000702.V267700.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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, it was noted that ‘Service Users Guide’ documents have not been distributed to everyone living at Brandon Lodge. Although it acknowledged that ‘Service Users’ Guide’ documents are made available to prospective and new residents, they should also be given to current residents. Further, it is acknowledged that, as required in previous inspection reports, contracts / statements of the terms and conditions of occupancy have been distributed to service users and / or their families. However, from speaking to people in the home, some of the wording in these documents has caused some confusion and questions, which may require some clarification. For example about ‘top fees’ within the ‘Terms and Conditions of Admission and Residence (Placement made by Local Authority)’ document. It is recommended that such clarification should be provided. EVIDENCE: NA Brandon Lodge Care Home DS0000000702.V267700.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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, although it is acknowledged that progress has been made to update and regularly review care plans, as highlighted in the previous inspection report, care plans must be reviewed to ensure that they are evaluated regularly. EVIDENCE: NA Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 & 15. Social needs are recognised and provided for. The home has open visiting arrangements. Service users’ rights are respected and choice is provided. Meals are of a good standard. EVIDENCE: An activities co-ordinator is employed for 21 hours a week. On the afternoon of the inspection the activities co-ordinator organised a game of bingo. Other events are also arranged. A number of people spoken to said how much they enjoy these events. Social stimulation is considered within care planning arrangements and records are kept of events organised. It is also acknowledged that care staff provide activities wherever possible. Staff were seen to engage with service users in social interaction. Brandon Lodge has open visiting arrangements. The inspector spoke to 3 visitors who provided positive feedback. One visitor said. “The staff are always busy, but they are friendly and I’m made to feel welcome.” Another visitor said, “I’m welcomed here, when they come round they give you a cup of tea”. Service users were asked about the choices they were given. One person spoke about being asked if they preferred to be called by their first name or Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 11 more formally by their surname. Another person said, “There’s no strict bedtime, I can watch my television until when I like”. Staff were seen to treat people with respect. For example, by knocking on the door before entering a bedroom. A person living at Brandon Lodge said that the staff, “Always knock before coming into my room, even the head one. They always knock and wait before coming in. A visitor said, “The older staff seem very skilled. They protect my mother’s dignity by always closing the door when she uses the toilet”. Food served was seen to be of a good standard. People spoken to gave positive feedback. One person spoken to said, “The food is pretty good, get plenty of it – you’re not pinched, and if you like something the chef’ll make it”. Another person said, “The food is good”. Service users’ nutritional needs are considered and recorded in care plans. Specialist diets are provided where necessary. However, it was noted that records of menu choices and food served have not been kept up to date recently. Kitchen staff should be reminded that records of the food provided for service users must be kept in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 12 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): 16 & 18. Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed on the home’s notice boards and in the home’s ‘Service Users Guide’. Although some comments were raised from some people who thought there had been a lack of communication from the parent company about new contract documents that have recently been given out, service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents / Family meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. The home, through its parent company has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. However, it was noted that although complaints are adequately dealt with, the recording of complaints in the home has become somewhat haphazard. The company’s complaints procedures are not always being followed and the company’s standard documentation to record complaints is not always being used. Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 13 A record must be kept of all complaints made by service users or representatives or relatives of service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint. Company policy and procedure documents relating to adult protection provide information and guidance to staff. Staff training in this area is also provided. However, a copy of ‘Durham & Darlington Adult Protection Committee’s InterAgency Adult Protection Policy & Procedures’ on abuse and the protection of vulnerable adults should be obtained and be available in the home. The home’s own policies and procedures in this area should be reviewed to reflect any local protocols and contact information. Brandon Lodge Care Home DS0000000702.V267700.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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, although it is noted that bathroom facilities have been upgraded, bath hoists have not been fixed into the bathroom floors. This means that these bathrooms cannot be used. Only shower rooms are currently available. One service user said, “I like a bath, a shower is better than nothing, but I’d prefer a bath”. Whilst it is acknowledged that there are some problems associated with the thickness of the concrete under the floor to secure bath hoists, these problems must be addressed. Sufficient numbers of bathrooms and shower rooms must be available. It should also be noted that some people spoken to said that the home did not have enough commodes. Additional commodes should be provided. EVIDENCE: NA Brandon Lodge Care Home DS0000000702.V267700.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, 28, 29 & 30. The home has a settled, well-trained and well-led staff team. However, staff vacancies must be filled. EVIDENCE: Although a number of recent appointments have been made, there is a settled staff team. Many of the staff spoken to have worked at Brandon Lodge for a number of years and they know the service users well. Excluding ancillary staff, current staffing levels for Brandon Lodge are: a qualified nurse on duty throughout the day and night; plus, between 8am – 2pm 6 care assistants, between 2pm – 8pm 4 care assistants, and between 8pm – 8am 3 care assistants. From discussions with management and staff, and from an examination of duty rosters, sufficient staff are generally employed and rostered to work within the home. Although these staffing levels should be kept under review, they are considered adequate to meet the needs of the people currently accommodated. However, although shifts are being covered, it is noted that the home has a number of staff vacancies, particularly for qualified nurses. These vacancies must be filled. Recruitment procedures within the home, and through the parent company are safe. Records confirm that CRB (Criminal Records Bureau) disclosure checks are carried out for all staff. Applicants for employment complete an application Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 16 form and 2 references are obtained. A reference from the last employer is requested, plus another; any gaps in employment are explored at interview. Each member of staff receives a contract of employment and a job description. Although some difficulties have been experienced accessing training, staff training is being given a high priority. Core training such as in First Aid and Moving and Handling is arranged, along with other courses such as continence and catheter care. Nevertheless, excluding qualified nurses only 33 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. Although it is acknowledged that staff have recently started NVQ and others are to enroll, a minimum ratio of 50 of staff (excluding the registered manager and other qualified nurses) must be trained to NVQ Level 2 or equivalent by 2005. Brandon Lodge Care Home DS0000000702.V267700.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): 33 & 35. Brandon Lodge is well run. Appropriate quality assurance systems are in place to identify and rectify any concerns. EVIDENCE: The registered manager is a registered general nurse. She sates that she expects to finish a Registered Managers Award training course shortly. She has a range of care related experience, training and certificates including the D32 Practice Assessors Award. Nevertheless the manager must complete the Registered Managers Award course she has started, or another appropriate management course, by September 2007. Although some comments were raised from some people who thought there had been a lack of communication from the parent company about new contract documents that have recently been given out, service users’ views are obtained through daily contact and an ‘open door policy’. Similarly, the views Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 18 of family and significant others are also obtained. Staff meetings and residents meetings’ are held as additional forums to discuss any concerns or potential difficulties. Quality assurance systems operating in the home ensure that the home runs smoothly. Routine audits, for example relating to health and safety are carried out and any issues raised are rectified. Records required by regulation to be kept within the home are to a good standard. Appropriate systems are in place to ensure service users’ health and safety is protected. For example, risk assessments relating to the use of bed rails in the home have been carried out and any safety measures required have been implemented. However, where service users insist on their doors being wedged open, this must be subject to a full and sufficient risk assessment, which must consider the different risks by day and by night. Any control measures identified must be implemented. Brandon Lodge Care Home DS0000000702.V267700.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 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Brandon Lodge Care Home DS0000000702.V267700.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) Requirement As highlighted in the previous inspection report, care plans must be reviewed to ensure that they are evaluated regularly. Records of the food provided for service users must be kept in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. A record must be kept of all complaints made, which should include details of any investigation and action taken. Sufficient numbers of bathrooms and shower rooms must be available. Staff vacancies must be filled. A minimum ratio of 50 of staff (excluding the registered manager) must be trained to NVQ Level 2 or equivalent by 2005. The Registered Manager must complete an appropriate management course. DS0000000702.V267700.R01.S.doc Timescale for action 01/02/06 2. OP15 17(2) & Sch. 4(13) 31/12/05 3. OP16 17(2) & Sch. 4(11) 23(2)(j) 18 18 31/12/05 4. 5. 6. OP21 OP27 OP28 01/02/06 31/12/05 31/12/05 7. OP31 9 30/09/07 Brandon Lodge Care Home Version 5.0 Page 21 8. OP38 13 Where service users insist on their doors being wedged open, this must be subject to a full and sufficient risk assessment, which must consider the different risks by day and by night. Any control measures identified must be implemented. 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP1 OP2 OP18 Good Practice Recommendations Although it acknowledged that ‘Service Users’ Guide’ documents are made available to new residents, they should also be given to current residents. Where necessary, the home’s contract and statement of terms and conditions of occupancy should be clarified. A copy of Durham & Darlington Adult Protection Committee’s Inter-Agency Adult Protection Policy & Procedures on abuse and the protection of vulnerable adults should be obtained and be available in the home. The home’s own policies and procedures in this area should be reviewed to reflect any local protocols and contact information. Additional commodes should be provided. 4. OP21& OP22 Brandon Lodge Care Home DS0000000702.V267700.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Darlington Area Office 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 © 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 Lodge Care Home DS0000000702.V267700.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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