Inspection on 23/08/05 for Branksome House

This inspection was carried out on 23rd August 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 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 House 03/01/07

Branksome House 19/01/06

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 Peter Still Unannounced 23rd August 2005 09:30 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 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 D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: One bed for named person in category LD(E). Registration to revert to LD only when named person leaves the establishment. Date of last inspection 11/03/05 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 to. The residents attend various activities, which include Day Services provided by Gloucester Social Services/Health Authority and college courses. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours. The inspector observed and spoke with two staff and four residents. The two other residents were away on holiday with staff. The inspector also talked to an NVQ assessor who visited. No family, friends or other professionals visited during the inspection. The atmosphere in the home was warm and friendly and residents were relaxed, content and indicated to the inspector that the care they received in the home was good. The inspector looked around the home and inspected a number of records. The manager and a member of staff were helpful on the day of the inspection and were positive and clearly committed to their work. They were open to suggestions and keen to seek continual improvement. What the service does well: The skills of the manager and good communication with GP’s has led to positive review of resident medication, with positive effects for resident wellbeing. Documentation and recording was clear and thorough and resident involvement in setting personal goals in care plans has ensured a positive outcome. The home has done well to bring about significant change in the wellbeing of residents, vital for them and rewarding for staff. A member of staff said the home was the best ever worked in and a high staff moral and commitment was evident. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 standard(s) 2 Residents benefit from good admission and assessment that ensures that the home is able to meet their needs. EVIDENCE: The inspector read one file concerning the only new resident to the home since the provider has been running the home. The pre admission assessment document and care plan were of a good standard, however since this admission experience is so limited, the manager will need to revisit the National Minimum Standards 1 – 5 as well as current good practice guidance, in advance of any new admission to ensure all steps are taken. The home does not admit residents for intermediate care. Details of the Commission for Social Care Inspection need to be included within the homes’ Service User Guide. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 standard(s) 6, 7, & 9 Well documented care plans are in place to provide staff with the information they need to satisfactorily meet residents’ needs. EVIDENCE: The inspector read two care plans. Care reviews are held and involve residents; supporters are invited and included in the process. One care plan, where there were complex needs, included detailed recording and information of personal goals. The resident confirmed to the inspector, their involvement and that progress had improved their quality of life. The care plan of another resident gave evidence of clear recording about activities, resident decision making, and also important detail concerning risk taking. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 10 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 standard(s) 12, 13 & 17 Residents enjoy activities and the time they spend in the local community. The meals are good and offer both choice and variety. EVIDENCE: One resident told the inspector they enjoy trips out that include local shops and a pub. Three residents talked about holidays, that two were away on holiday and that they were looking forward to going too, on the day after the inspection. They also talked about the places they enjoyed best. The menu was read and considered balanced and varied. Residents said they enjoyed the food and one resident talked about their own diet, which they enjoyed and providing detail about healthy eating; there was also reference to the residents’ care plan and personal goal. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 11 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 standard(s) 18, 19, & 21 Personal support in this home is offered in such a way as to promote and protect residents’ privacy dignity and independence. Work on the review of resident medication has been commendable. EVIDENCE: Two care plans reflected that personal support is provided in the way residents prefer. The inspector observed the manager protecting the modesty of a resident and another resident with a personal need was responded to immediately. Interaction between residents and staff showed warmth, sensitivity and humour. One resident has undergone surgery and the manager should be commended for her care and commitment during this time, being able to remain with the resident, providing very direct personal support. The managers skills and ease of communication with GP’s has also led to a significant decrease in the levels of medication residents use and eradication of a number of inappropriate repeat prescribed medication. A care plan recording concerning final wishes for a resident showed sensitivity and care for such difficult discussion. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 12 Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 standard(s) 22 & 23 Residents are protected by the homes’ policy and procedures, though a review is recommended. EVIDENCE: One resident was clear with the inspector that they would go to their key worker or staff on duty if they had a concern and if the matter were of significance, they would talk to the manager. Two residents indicated that they are listened to. A resident had the phone number for his/her social worker. The home does not hold a complaints book for the manager or the inspector to review and it was recommended that this could be helpful and the manager agreed to establish this. Any complaints would be detailed on residents’ files, but none have been recorded. The inspector was not able to see that residents are helped to understand that they can communicate directly with the Commission at any time and new approaches should be considered to include other agencies. Staff have received training concerning protection from abuse however the inspector was not able to check that it has been specific and it is recommended that staff training is reviewed to ensure appropriate training about the protection of vulnerable adults is provided to all staff and that this is reinforced within individual staff training programmes. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 standard(s) 24 & 30 The standard of the environment within this home is good, providing residents with an attractive, clean and homely place to live. EVIDENCE: The inspector found a homely and comfortable property, which was clean and tidy. Bedrooms were personalised and clearly very special and enjoyed by residents, who also confirmed this. An assessment has been sought for one resident, concerning mobility and this may lead to a review of moving and handling equipment for the home. Outside, the inspector found a delightful area with comfortable seating which provides an excellent additional area for residents when they wish to enjoy the garden. The inspector noted a large pond with a significant number of fish and a good point of interest for residents. The inspector did not read the risk assessment for this but did put to the manager that it should be reviewed carefully to ensure resident safety. This may also lead to a review of individual resident risk assessments regarding the pond. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 15 The manager said that the stair carpet mentioned in the last inspection report will be replaced within this years budget as agreed at the last inspection. The inspector had some difficulty in ringing the correct front door bell and the number of these should be reviewed and reduced or labelled. A small area of wall paper in the upstairs bathroom needs repair. The manager said she would attend to these matters immediately. Plans have been drawn up for an extension to the property, which would further improve facilities at the home and these will now be considered carefully. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff have a good understanding of residents’ needs and this is evident from the positive relationships, which have been formed. High staff morale results in enthusiastic staff who work hard to improve residents’ quality of life. EVIDENCE: The inspector read two staff files, noting good staff induction, and both included a clear CRB check and references. The inspector also read a clear CRB check for the manager. The manager and her partner both hold the registered managers award, level 4 and the manager is a currently registered nurse. Two staff are currently completing their NVQ Level 2 award; the home will be in compliance with the required level of training once they have achieved this and it is necessary for them to complete the work in the near future. The inspector talked to one member of staff who said they should finish their work by April 2006. An NVQ assessor who was meeting with a member of staff had only one point to make, which was to make clear that students must move their work forward to completion. One member of staff gave the inspector a clear account of the high moral amongst staff and of how the home is run for the benefit of the residents Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 17 rather than for ease of staff. The manager and her partner were said to always be available and fully committed to ensuring the home is run well. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 Views being sought from all involved will ensure that there is a clear vision for the home. Systems within the home promote the safety and well being of resident. EVIDENCE: A User Survey has been sent out and once analysed will provide valuable information to help the home review their practice and to seek continual improvement. The homes’ recording is of a good standard and thorough. The inspector read the key worker file for one resident, which was clear and covered important aspects, risk assessments provided further evidence of good recording and systems. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.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 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Branksome House Score 3 4 x 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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 1 Regulation 5 (1) (f) Requirement The service users guide shall include the address and telephone number of the Commission Timescale for action 16/12/05 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 22 23 35 Good Practice Recommendations Review further ways of ensuring residents and supporters know they may contact CSCI or other agencies at any time. Review staff training programmes to provide specific training concerning adult protection. Provide encouragement to staff undertaking NVQ level 2, to ensure their training is completed soon and the home becomes compliant with this Standard. Branksome House D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 D51_D03_S29218_BranksomeHouse_V240377_230805_Stage4_U.doc Version 1.40 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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