Inspection on 02/08/07 for Branksome Care Home

This inspection was carried out on 2nd August 2007.

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.

Other inspections for this house

Branksome Care Home 20/04/06

Branksome Care Home 31/01/06

Branksome Care Home 12/07/05

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 Inspection 2nd August 2007 10:00 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 Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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 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) 01298 26230 01298 72194 the.branksome@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) 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 DS0000044486.V340555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th April 2006 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 lounges 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. At the time of this inspection charges for accommodation ranged from £540 to £550 for a standard room. Premium rooms, depending on size and facilities, were from £550 to £750. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection covered all the key national minimum standards and took place over a period of six hours on the 2nd August. The Home’s registered manager, Ian Magno was present throughout the visit. There was the opportunity to meet with many of the staff on duty at the time. This included nursing, care and domestic staff. There was also the opportunity to speak with many of the residents, either individually or in small groups, and also with two visitors. A range of documentation was viewed including individual care plans, training records, staff files, health and safety records and a range of relevant policies and procedures. A full tour of the premises was not undertaken, though communal areas and a sample of resident bedrooms were seen. There was no staff or resident pre-inspection survey material available on this occasion. However, the Home had completed an Annual Quality Assurance Self Assessment document and this information was taken into account when planning the inspection. What the service does well: What has improved since the last inspection? Staff supervision and appraisal has been more firmly established and further quality assurance processes have been introduced at the Home. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 6 A programme for developing staff awareness of abuse and protection issues has also been introduced. Registered nurse staffing levels in the morning have increased. 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. The summary of this inspection report can be made available in other formats on request. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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 Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable as the Home does not provide an intermediate care service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home obtains a full range of relevant assessment information on prospective residents so that their needs can be properly planned and met following admission. EVIDENCE: A sample of three individual care files were examined in detail, including the file for a resident admitted in the past three months. These showed that a range of relevant assessment information was obtained by the Home prior to any admission. This included nursing assessments, and relevant social care information and plans from social services care managers. The Home also Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 9 undertook their own admission assessments, which informed subsequent care plans. There was evidence that the initial stage assessment process, introduced last year, was now firmly established and fully used. This contained set checklists relating to the physical and emotional health of new residents and focussed on daily living activities. A separate format was in place for social history and background information, which was also well used. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home had a thorough approach to assessing and planning the care of residents so that their individual physical and emotional needs were clearly promoted and monitored. EVIDENCE: The care planning documentation that was being introduced at the time of the last inspection was now fully in place. The care plans viewed in detail were well –structured and comprehensive with clear instructions and guidance for staff on actions needed. The plans were based on a thorough assessment process that covered daily living skills, mental health and well - being, any multi professional interventions, and social needs. There was evidence of detailed risk assessments for such areas as mobility, skin integrity and Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 11 nutritional/dietary needs. Monthly review notes on plans were made, though these were not up to date on one of the care plans seen. The manager also undertakes a regular audit of care plans. There was no record of residents themselves or their representative signing their agreement to the plans. Records of G.P. visits and other community health contacts were maintained with communication sheets in use for any specific issues. Detailed wound assessments were evident on plans with clear ongoing records kept of wound/pressure sore treatment. There were regular up dates on residents’ skin integrity and detailed notes on fluid intake as necessary. Appropriate pressure relieving equipment was also in use. Overall dependency of individual residents was assessed and monitored on a regular basis, as well as a resident’s weight and appetite. Arrangements for the storage, handling and administration of medicines were also viewed and these were generally satisfactory. The Home has a treatment/storage room, which is kept locked. Stock levels were appropriate and there were suitable arrangements for the storage of controlled drugs with specific recording procedures in place. Overall recording processes were satisfactory. There were two residents administering some of their medication and the Home has a policy for self – medication. One resident spoken to expressed a wish to administer her own medication, but it transpired that she had not expressed this view to staff, that there was a degree of risk in this course of action and some medicines would have to be administered by a nurse. Residents did not sign for their consent to the Home holding and administering their medication. Feedback from residents indicated that staff attitudes were warm and supportive. One resident described his care as “5 star” and felt he “couldn’t be in a better place”. Comments from two residents indicated that their privacy and independence was generally respected “though some staff were better at this than others”. Staff spoken to had a suitable sense of residents’ individual rights and interests. Staff were observed interacting with residents in a friendly and appropriate manner and residents were observed to have a generally good rapport with care staff. Residents’ wishes regarding privacy are noted and their bedroom doors not routinely left open. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home had an active approach to promoting the social needs of residents so that they enjoyed a generally stimulating environment. Catering was satisfactorily organised so that residents enjoyed a good standard of meals that were nutritious and took into account individual preferences and dietary needs. EVIDENCE: Since the last inspection there has been some gaps in the employment of an activities coordinator at the Home. However, a former care assistant has been in post since June, and the hours have been increased from 15 to 30 per week. There is a regular daily programme of internal activities that include word games, crafts, quizzes and bingo. Some reminiscence work takes place and musicians and entertainers visit the Home. Gentle exercise is not currently Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 13 provided with the coordinator stating that she would like some training in this area. The Home now has a new minibus, though recent weather conditions have precluded many trips out. On the day of the inspection the minibus was being used to take a resident to a luncheon club in Chapel en le Frith. Records are maintained on care plans regarding individual resident’s interests and participation in activities is recorded regularly. There were no residents with specific religious or cultural needs. Local clergy visit the Home and religious services are usually conducted on a monthly basis. There were several visitors to the Home and they were clearly encouraged to join in activities and interact with the daily life of the Home. Residents were seen using the various parts of the Home as they wished and there was no sense of any undue emphasis on routines at the Home. Residents confirmed that they got up in the morning and went to bed at times that were in line with their own wishes. All residents spoken to were happy with the standard of catering at the Home and confirmed that alternatives were available and that their individual dietary preferences/needs were taken into account. Weekly menus are on each table in the dining area and these were nutritious with good variety. Most residents had their meals in the dining room, though some had meals in their bedroom out of choice. Menus, as well as activities, are regularly discussed at resident meetings. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has clear systems in place for responding to any complaints or concerns and promote the protection of residents so that their interests and safety are enhanced. EVIDENCE: The Home has a comprehensive complaints policy, which is included in the service user guide. There had only been one formal complaint since the last inspection and records showed that this was investigated and responded to appropriately within suitable timescales. There have been no complaints made directly to The Commission since the last inspection. The Home has experience of adult protection procedures and relevant policies are in place, including information on local interagency protocols and procedures. Since the last inspection the manager has completed a course provided by local social services, enabling him to deliver training in this area. Subsequently a programme of awareness training for the majority of staff at Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 15 the Home has been delivered. Feedback from staff indicated that the day session was informative and useful. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is well – maintained so that residents enjoy a comfortable, safe and pleasant environment, though garden areas are not fully accessible. EVIDENCE: Communal areas at the Home were pleasantly decorated and comfortably furnished. Fixtures and fittings were of a good standard. The comments from residents indicated that they were very positive about the overall environment at the Home, with one resident describing it as “immaculate”. The sample of bedrooms viewed was also comfortable and personalised by residents. The Home was clean and hygienic with no offensive odours evident. Residents Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 17 clothing and appearance was observed to be satisfactory and residents commented that the laundry system works well. The Home’s grounds were attractively maintained, though work to make the front gardens accessible to residents had not been progressed with pathway surfaces uneven and no functional ramp. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has a systematic approach to recruitment and staff development so that the safety and interests of residents are satisfactorily promoted. EVIDENCE: There has been a low turnover of staff since the last inspection, though the manager said that recruitment has been slow and just in the past week they have had to use some agency care worker staff to maintain necessary staff numbers. The level of nursing staff has been reviewed and an extra nurse is now on duty for each morning shift. Clear staff training records were maintained and demonstrated that a wide range of relevant and mandatory training opportunities were offered to staff on a regular basis. Staff spoken to confirmed that training is encouraged at the Home and discussed at supervision/appraisal sessions, which are now up and running. The Home has over 50 of the staff group completed or involved in with NVQ training. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 19 A sample of staff files was examined and these were in good order with clear employment and recruitment documentation evident. Appropriate references were obtained and also Criminal Record Bureau clearance. There was evidence of thorough induction training for new staff and general training and appraisal records were also kept on individual files. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is effectively managed and the quality of services purposefully monitored so that the general welfare and interests of residents are clearly promoted and protected. EVIDENCE: The Registered manager has relevant professional qualifications and several years of management experience at the Home. Staff were very positive about Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 21 the general support they received and staff and residents commented that they felt management at the Home were readily available and accessible. The Home has a range of systems in place for monitoring the quality of services. This includes regular meetings between the manager and residents and the use of annual survey questionnaires that are returned to the Provider’s regional office. Ongoing feedback leaflets are also used by the Home. A Team Audit Process has also been introduced this year, which is undertaken by staff at the Home and then submitted centrally together with a Remedial Action Plan for dealing with priority issues. This contained good detail covering the general functioning of the Home. Some areas, such as medication, care plans and Health and Safety continued to be audited internally on a monthly basis. Fire safety was still audited externally by the Provider’s estates supervisor and a fire risk assessment had taken place at the end of last year. Fire safety records were up to date and regular fire drills take place. The Home handles personal spending monies for many of their residents. A detailed and secure system is in place for recording any financial transactions with clear computerised records backed up with suitable manual records. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 X X 3 Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP19 Regulation 23 Requirement Plans to improve access to garden areas must be followed through. Timescale for action 30/09/07 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. 2. 4. Refer to Standard OP7 OP7 OP9 OP22 Good Practice Recommendations Residents or their representative should sign their agreement to care plans. Monitoring records for care plans should be kept up to date. Residents or their representative should sign for their agreement to the Home holding and administering their medication. An assessment for the fitting of a loop system in communal areas should be made in order to assist residents with hearing difficulties. Branksome Care Home DS0000044486.V340555.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000044486.V340555.R01.S.doc Version 5.2 Page 25 - 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. 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