Inspection on 12/07/05 for Branksome Care Home

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Branksome Care Home 02/08/07

Branksome Care Home 20/04/06

Branksome Care Home 31/01/06

Branksome Care Home 01/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Branksome Care Home 56 St John`s Road Buxton Derbyshire SK17 6XB Lead Inspector Ray Coonan Unannounced 12 July 10:40 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. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Branksome Care Home Address 56 St John`s Road, Buxton, Derbyshire, SK17 6XB 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) 01298 26230 Tamaris Healthcare (England) Ltd, (wholly owned subsidiary of Four Seasons Health Care) Mr Guilbert Ian A Magno Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 1/3/05 Brief Description of the Service: The Home, which is located close to Buxton town centre and a wide range of local amenities, provides nursing and residential care for up to 34 elderly service users. All accommodation is in single rooms and spread over 2 floors. The Home has extensive garden areas. There are 2 lounge areas and a dining room situated on the ground floor and a sitting area close to the main entrance. The Home is suitably resourced with bathroom and toilet facilities and 4 bedrooms are en suite. Support services are in place with a choice of G.P. and links are established with other community health professionals. The Home employs qualified nursing staff together with care workers. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of five and a half hours on the 12th July. The manager of the Home was not on duty during this visit and therefore several areas particularly relating to administration and management were not assessed on this occasion. However, there was ready assistance from the nurse on duty and the Home’s financial administrator. There were also discussions with several care and domestic staff. A sample of care plans was examined in detail together with other relevant records and documentation. Various parts of the premises were viewed such as lounge areas, bedrooms and bathroom and toilet areas. There was also the opportunity to talk to many of the residents individually and one visiting relative. What the service does well: What has improved since the last inspection? What they could do better: Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 6 The general décor remains in need of freshening up throughout the Home. Consistency in the maintenance of individual resident care plans also continues to require attention. Whilst some improvements have been made to the administration processes for medication there were some areas that had yet to be satisfactorily resolved in relation to security. 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. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 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 Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 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) 1, 2, and 3. A satisfactory range of information on services provided at the Home was available for prospective residents and their families. However, the lack of clear and up to date contracts disadvantaged prospective residents. The care of residents was enhanced through the Home ensuring that suitable assessment information was obtained prior to admission. EVIDENCE: The Home’s statement of purpose and service user guide was viewed and these were satisfactory and informative. However, up to date contracts were not available. Following concerns raised since the last inspection by relatives of a prospective resident regarding the availability of information on terms and conditions and fees, it became evident that the provider organisation had withdrawn their established contracts for review following guidelines issued by the Office of Fair Trading. Care plans demonstrated that suitable assessment information was obtained prior to any admission, such as hospital nursing assessments or information from previous residential placements through care managers. The Home also Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 9 undertook their own admission assessments, which informed subsequent care plans. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 10 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, and 10. The Home had a generally considered and committed approach to assessing and meeting the care needs of residents and in a manner that respected their individual rights. There remained some inconsistencies in the maintenance of individual care plans. Improvements had been made to the administration and recording systems for medication though the security of medicines during administration remained a cause for concern. EVIDENCE: A sample of 3 care plans was examined and 2 of which were for residents who received nursing care. These nursing care plans were generally well organised and structured with good care planning detail, particularly regarding physical health needs, informed by relevant risk assessments in areas such as mobility, nutrition and skin integrity. There was evidence of the ongoing monitoring of plans and of regular contact with community health services where appropriate. Specialist equipment such as pressure relieving mattresses was obtained by the Home. However, there were inconsistencies as only one of the plans had a social care assessment, which in itself was of a good standard, informative and provided a Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 11 real sense of the resident as an individual with their own preferences detailed and notes on their social history. It was also noted that the non-nursing care plan was less detailed and had not been updated since 2003. The daily reports in this case were also of a poor quality. There was a comment from staff discussions that more time needed to be allocated for the maintenance of residential plans. Arrangements for the handling, storage and administration of medicines were examined and improvements had been made in recording and labelling processes. Stocks were satisfactory and storage and disposal systems appropriate. However, a list of the authorised initials that staff use when signing the MAR charts was not available and not all residents had a photo for purposes of identification prior to the administration of medication. Medication administered in the monitored dosage system were still placed on the top of the trolley during administration and could not be locked away if the staff member was called away in an emergency. Discussions with residents and personal observation indicated that staff interactions with residents were warm and respectful. Staff were described as considerate and patient by individual residents and there were no problems raised in terms of respecting personal privacy. Conversations with residents also indicated that the involvement of family, friends and any other advisers was encouraged at the Home. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 12 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) 12,13,and14. The Home has an open atmosphere that encouraged family and community contact. The social and leisure interests and needs of residents were met in an organised way. There was no undue emphasis on routines and residents’ preferences were respected. EVIDENCE: The Home has an activity coordinator (15 hours per week) who has developed recreational programmes with residents. These include various trips out and small group activities within the Home. Entertainers also visit and several residents enthusiastically referred to recent V.E. Day celebrations organised at the Home. Residents had a wide range of needs and it was mentioned that relating activities to such a diverse group could be difficult. Some residents mentioned going into town to visit local shops though this was dependent on the availability of staff. The Home also published its own newsletter, which contained lists of events and features on individual residents. From discussions with residents it was clear that visitors and family contacts were encouraged at the Home. A visiting relative stated that the Home were welcoming and kept him informed regarding any changes. Residents were observed to use the various parts of the Home as they wished and several residents stated that their individual preferences were respected, Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 13 for example, as to what time they wished to get up in the morning. Discussions with staff evidenced an appropriate awareness of residents’ rights to independence. Catering standards were not fully examined on this occasion, as the senior cook was not on duty. However, there were several positive comments from residents regarding meals provided, though it was noted that none were aware as to what was on the menu for the day and this was not displayed. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 14 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) Standards in this section were not assessed on this occasion. EVIDENCE: Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 15 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, 20, 21, 23, 24, 25, and 26. Residents benefit from spacious and comfortable surroundings though general décor in the Home remains in need of freshening up. The Home was kept clean and hygienic, however some factors such as the storage of laundry and problems with toilets could undermine infection control in the Home. EVIDENCE: Most parts of the building were viewed during the course of the inspection visit, including several resident bedrooms. These were comfortable and well personalised by residents with door locks fitted if residents wanted their own key. However, in one room in the older part of the building on the first floor the window hinge had been broken for some time and there was also problems with glass fittings. Décor in communal areas throughout the Home generally required freshening up and repainting. The large greenhouse to the rear of the building was still in a state of disrepair and presented a safety hazard. Many external window frames needed repainting. The Home’s large and established grounds were well - maintained and accessible to residents. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 16 Bathroom areas were clean and odour free though some staff reported that there was an ongoing problem with flushing toilets and that this could be distressing for residents. The new Parker bath was now operational and although work on the new shower room was completed this was not yet in use and a television was stored there. The Home was clean and there were no offensive odours evident. The laundry area was viewed on this inspection. This was suitably maintained and satisfactorily equipped. However, it is a quite compact area in relation to the size of the Home and it was noted that soiled clothing was piled up outside opposite a resident’s bedroom. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 17 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, 28 and 30. The Home maintained satisfactory overall staffing levels and staff morale was generally good, though according to several staff and residents there were some problems due to the lack of domestic staff at weekends. Whilst the Home had a systematic approach to developing staff skills there were several areas of training which needed to be given more priority. EVIDENCE: Staffing rotas were examined and these were presentable and demonstrated that satisfactory staffing levels were maintained. However, several staff and residents said that a shortfall in domestic cover at weekends was problematic. Discussions with staff indicated that staff morale was generally good and several staff said they were well supported by colleagues and management. Training records were viewed and these demonstrated that there was a systematic approach to staff development. Staff spoken to all felt that they were provided with a satisfactory range of training opportunities. However, records showed that some areas such as NVQ training, First Aid, and Health and Safety were ‘light’ and there were also gaps in POVA training amongst the staff group, including the manager. It was also noted that relevant training opportunities for domestic staff in such areas as control of hazardous substances and Health and Safety had not been arranged Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 18 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) Standards in this section were not assessed on this occasion. EVIDENCE: Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 2 3 2 x 3 2 3 2 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 Standard No 16 17 18 Score x x x x x x x x x x x Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 20 yes 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 2 Regulation 5 Requirement All residents must be issued with contracts that clearly detail terms and conditions of residency The maintenance of individual care plans must be more consistent, with social care needs fully asssessed and evidence of management monitoring. (Previous timescale of 31/5/05 has not been met). There must be a system to enable identification of all service users prior to the administration of medication. (Previous timescale of 31/5/05 has not been met). There must be a system to enable medication dispensed in the Monitored Dosage System to be quickly locked away if an emergency occurs during a medication round. (Previous timescaleof 30/4/05 has not been met). Plans for the redecoration of the Home must be implemented The greenhouse to the rear of the premises must be made safe (Previous timescale of 30/6/05 C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Timescale for action 31st October 2005 30th September 2005 2. 7 15 3. 9 13 31st August 2005 4. 9 13 30th September 2005 5. 6. 19 19 23 13 30th September 2005 31st October 2005 Page 21 Branksome Care Home Version 1.40 has not been met 7. 19 23 External window frames must be repainted and internally any damaged windows must be repaired. Arrangements for the laundering of clothing must be reviewed The Home must ensure that all bathroom and toilet facilities are fully serviceable NVQ training must be promoted further 31st October 2005 31st August 2005 31st August 2005 30 September 2005 8. 9. 10. 26 21 28 13 23 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. 2. 3. Refer to Standard 15 30 27 Good Practice Recommendations The menu for the day should be displayed. The training needs of staff should be reviewed in relation to areas identified in the main body of the report. The deployment of domestic staff hours should be reviewed. Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby. DE1 3QT 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 Branksome Care Home C52 C02 S44486 The Branksome V238606 120705 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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