Inspection on 19/01/06 for Branksome House

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Branksome House 03/01/07

Branksome House 23/08/05

Branksome House 11/03/05

Branksome House 18/11/04

Branksome House 10/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Branksome House 26 Tuffley Avenue Gloucester Glos GL1 5LX Lead Inspector Kath Houson Unannounced Inspection 19th January 2006 10:00a Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 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 House DS0000029218.V279028.R01.S.doc Version 5.1 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 Adults 18-65. 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 House DS0000029218.V279028.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Branksome House Address 26 Tuffley Avenue Gloucester Glos GL1 5LX 01452 535360 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) Mr Bahadar Singhera Mrs Taranjit Singhera Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One bed for named person in category LD (E). Registration to revert to LD only when named person leaves the establishment. 23rd August 2005 Date of last inspection Brief Description of the Service: Branksome House is a three story semi-detached house with accommodation for six adults with learning disabilities. The home is conveniently situated in Gloucester, which enables residents to access local community facilities. Residents also have transport that is provided by the home and this enables them to use facilities in several other local towns. The home is staffed 24 hours a day, seven days a week. Family and friends are welcome to visit the home at any time and residents can meet them in private if they wish. The residents attend various activities, which include Day Services provided by Gloucester Social Services/Health Authority and college courses. The home will be undergoing some changes to the external and internal structure that will be completed in May 2006 to increase capacity. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place in January 2006 with a second visit made one morning the following week. All recommendations and requirements have been met. The home will be undergoing an extensive work to the external part of the home, which will provide increased space for residents within he communal areas. Additional bedrooms will be added which will increase bed capacity from six to nine. Work is due to take place late January ‘06 work will be completed for the end of May 2006. The manager was available and was later joined by the second manger who remained throughout the inspection and able to assist and provide all relevant documentation on request. Twenty-five of the core standards were assessed and included an examination of the documentation provided; three resident’s record were case tracked, a short and informal discussion was conducted with the manager two residential care workers and a service user and a tour of the environment formed the inspection. The second visit was more themed in which documentation on service user incidences were examined which had been recorded in the home but not sent onto the Commission. A short succinct feedback was given to conclude the inspection visit. The inspector would like to extend her thanks to the service users, staff and managers for their assistance throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The mangers must ensure that all information relating to welfare of service users must be shared with the Commission of Social Care Inspection (CSCI) in the format of a Regulation 37. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 6 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 House DS0000029218.V279028.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Residents’ benefit from having an informed choice about their place of residence. EVIDENCE: The home has a statement of purpose placed in service user files and available for family and advocates. Information about the home is placed on the notice board by entrance into home. Terms and conditions of the home was seen and held in client file. The manager makes the initial visit to potential clients and performs an assessment. The managers are aware of their limitations and will involve other health professionals and other agencies during the assessment process, to evaluate whether the home can cater to service users needs. The documentation and record keeping of the care plans are in good order organised and easily accessible on request. All correspondence from other agencies is attached thus demonstrating partnership working towards the needs of service users. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Service users are able to discuss their changing needs and personal goals which is documented in individualised care plans which included personalised risk assessments EVIDENCE: Care plans are reviewed every six months and sooner according to changes in care needs of service user. The service users are always present at their reviews and discussed with informed consent with the consideration to individualise risk assessed changing needs. Risk assessments are performed according to changes in requirements and are documented in service user care plans. Copies of reviews are kept in client files to monitor progress and any changes that may occur. Information on new health conditions is made available for all staff for example a service user recently had an operation, information about after care was made available and shared within the home. With assistance and support the clients are able to make decisions about their lives. For example a service user is encouraged to manage her own money with a constructively written programme to assist the service user to exercise Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 10 life skills outside and independently to the home this was confirmed by the service user when asked “yes staff is good and give me help.” Service users have the opportunity to discuss with their key worker assistance that maybe required this was documented in the care plans. The manager’s recorded detailed information of personal goals one client enjoys going to church. The manager arranges the transport and drives the service user to church along with other members within the community thus making this into a community event that is beneficial for service users. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 and 16 Service users are encouraged to maintain their relationships with their family and friends. EVIDENCE: The managers have no restrictions on visitors to the home and encourage an open door policy. Many visitors have commented on “what good service their relative is receiving” another relative state “how clean and well dressed the client is…” Many of the clients are familiar with the area as many had grown up within the local community and have been able to maintain old relationships and form new contacts. One service user enjoys gardening and horticulture and has taken part in a horticultural course at the local college. Service users participate in personal development and training that promote independence. Some service users attend the local Adult Opportunity Centre. All the service users have an active social life and involved in education courses. Such activities include; skittles, boulés, karaoke, art and crafts. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Work on the continued medication review for residents remains commendable EVIDENCE: All the staff within the home are fully trained to administer medication in accordance with prescription. There have been no drug errors and good relations with pharmacy exist. Documentation for medication is kept in good order and a system exists for return of all medication. The mangers have continued to maintain a good communication link with GP that has continued to decrease the levels of medication service users are prescribed. Via observation the mangers demonstrate care and consideration to clients needs. Interaction showed warmth, sensitivity with humour. Client comment “staff are good.” Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Continual communications exist between management team and service users Service users benefit from having their views listened and acted on. EVIDENCE: The manager was able to produce several letters and feedback from eight months ago and still continues to receive comments on the standard of care. “Comment cards” that state that relatives were content with the service. Much of the positive comments state that relatives were happy with “ health and happiness of service user and that the management team has “ put our minds at rest.” “Can not fault the care kindness and commitment” good reflection on how the care is managed for the benefit of the service users. “ We are extremely please with the quality and treatment” another comment from clients relatives. The home has a satisfactory policy and procedure document that the manager said will be reviewed on an annual basis but will update if anything new to add. Observation of interaction between managers and service users is one o kindness and consideration The staff had completed training on protection and vulnerable adults issues. Comments made by the manger that their certificates were due and that the course was very good this was completed in January 2006. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27,28, and 30 The environment reflects the requirements of the service users. The home is due to undergo a transformation that will enhance and increase space for the residents. EVIDENCE: Branksome House is a three-storey end house located in central part of Gloucester close to local amenities and has an established community. The bedrooms are comfortably personalised the resident said “very nice home my room is very nice.” The home is planned to go through an internal and external building work that is due for completion in May 2006. The aim is to increase capacity from six to nine residents. The manger said the building work will not cause too much of a disturbance to the rest of the house and the internal work will be carried out at the very last minute it will be a little noisy. There will be a temporary loss to the garden but hopefully will be restored for the summer when all the work has been completed. The manager also mentioned that all repairs and replacement will take place after work has been completed. The residents have the opportunity to use their room key that would demonstrate the use of their independence. Home is clean and tidy free from offensive smells. Communal areas are spacious and lived in. The lounge area forms part of the refurbishment which will provide increase space for residents. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 15 The home has a pleasant decking area with a large risk assessed pond with a significant number of fish, which residents can enjoy, this will also be restored when work is completed provide a comfortable private area for residents and visitors to enjoy. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 3 and 36 Service users benefit from clear defined staff roles and responsibilities and are supported by competent and committed staff. EVIDENCE: Service users are very clear about whom to go to in case of problems. This is communicated via the means of clear communication book. Additionally all residents are aware of the role of other health professionals, agencies and advocates. Residents each have a key worker who works along side the client to ensure and maintain quality of care. The home was observed to be run for the benefit of the clients “it is their home” the mangers and staff members comment. The managers are always available for the home to ensure that standards are maintained and that the home is managed appropriately. The staff team are developing their skills of competency that is based on the completion of the NVQs and LADF courses. All mandatory training such as food handling, manual handling, health and safety, administration of medication first aid has been completed. In-house induction programme was made available and is based on the requirements of the policies and procedures. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 17 Certificates were seen in two staff files that is evidence that training and supervisory procedures takes place and forms part of the operations of the home. Managers must ensure however that two references are obtained before employment can commence at the home. Staff expressed satisfaction with working in the home, staff additionally felt appropriately supervised and encouraged to attend training courses. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, and 41 Residents’ benefit from a home that is well managed and the atmosphere is one of inclusiveness and openness. The home operates for the sole benefit of the service user in which the mannerism is one of respect and consideration. EVIDENCE: The home operates with a clear account of the standard of care and meets the aim and objectives as set out in the policies procedure and statement of purpose. One of the managers is a registered nurse and very aware of her limitations but ensures that the quality is maintained on a continual level. The home appears to have an open and inclusive atmosphere with the managers communicating a clear sense of direction and accountability. The service users are aware of whom to approach when necessary. Leadership and ethos of the home is one of “open door” with a pleasant mixture of kindness and consideration. This interaction was observed during breakfast time with residents. The mangers must ensure that records required by regulation for the protection of service users and for the effective and efficient running of the home are maintained up to date and accurate. Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 4 X 3 3 3 X 2 X X Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 20 No 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 YA41 Regulation 37(1) (a, b, c, d,e f, & g) (2) Requirement Managers must ensure that all information regarding welfare of service users must be shared with the Commission of Social Care Inspection (CSCI) in the format of a Regulation 37. Where the registered provider appoints a person to manage the care home information shall be shared forthwith the commission of social care inspection (CSCI) Timescale for action 19/01/06 2 YA41 8 (2) 19/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Branksome House DS0000029218.V279028.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 House DS0000029218.V279028.R01.S.doc Version 5.1 Page 22 - 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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