Inspection on 03/01/07 for Branksome House

This inspection was carried out on 3rd January 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Branksome House 19/01/06

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 Paul Chapman Key Unannounced Inspection 3rd January 2007 09:00 Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 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.V326143.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 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.V326143.R01.S.doc Version 5.2 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 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (3) of places Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 3rd October 2006 Brief Description of the Service: Branksome House is a three story semi-detached house with accommodation for nine 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. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prospective service users are given a Service User’s Guide that provides them with information about the service provided at the home. In addition to this the home has a Statement of Purpose. Fees to live at the home range from £321.00 to £695.00 per week. This inspection was completed over a period of 6.5 hours from 9 0’clock on a day in January 2007. On arrival at the home the registered manager was on duty along with another staff member. Some of the service users were already out completing activities like attending college and day services. The manager was supporting another person to get ready to go shopping in Gloucester. The registered provider was present throughout the inspection whilst the registered manager went on a scheduled shopping trip with a service user in Gloucester. A tour of the premises was completed and service users made comments like “ I really like my bedroom”. All of the bedrooms were seen to be homely and personalised by the people living in them. Downstairs there is a communal lounge and dining room. The dining room appears to be the “hub” of the home and the inspector spent much of their time in there with a number of the service users going about their day to day business. Observations during the day showed that the relationships between the staff and service users were respectful, positive and supportive. One service user commented that the registered provider is really helpful, comments from staff were very positive about the owners and said they were really “hands on” and listened to them if they had any problems. The principle method used to gather evidence was case tracking. This involves examining the care notes and other related documents for a select number of people living at the home. This is followed up by talking to them or their relatives/representatives, or observing them. This provides a useful, in depth insight as to how people’s needs are being met from more than one source of evidence. The surveys returned to the CSCI from other professionals, relatives, staff were positive about the service. In addition to examining the service users care records other records and procedures required by these regulations were examined and the majority were found to be in order. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 6 What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 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.V326143.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before they move into the home, which minimises the risk of people being admitted whose needs cannot be met. People have contracts of residence that identify the responsibilities of the service provider and the expectations of the service user. EVIDENCE: Three people have been admitted to the home since the previous inspection. One of the person’s file was examined in detail. Their personal file contained a community care management team since they moved in to the home. All of the files examined as part of this site visit contained contracts of residency signed by service users or their representatives. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed care plans enable staff to provide a consistent approach when meeting people’s needs. People are supported to make decisions about their lifestyles and where people have a disability that may inhibit this techniques are employed to enable people. Risks to people are identified and minimised so that they are not put at unnecessary risks. EVIDENCE: The inspector examined personal files for four of the people living in the home. All of the files contained care plans covering the following areas: • Behaviour management DS0000029218.V326143.R01.S.doc Version 5.2 Page 10 Branksome House • • • • • • Personal care needs Social and Leisure activities (including hobbies and interests) Communication Finance and money Health and medication Meals and food Each of these areas was looked at in detail and identified people’s needs and how they should be addressed. All of the care plans provided evidence of them being regularly reviewed by staff. Each service user has a key worker. One person has been diagnosed with dementia, which has affected their ability to make some decisions and be able to communicate them to staff. To try and continue empowering the person to make decisions for themselves the staff have developed word and picture flash cards giving them choices about activities they wish to do. Observations during the site visit showed that services users were given opportunities to decide what they would like to do and that staff supported them in this. Each person’s file contained risk assessments and examples seen in the files included assessments for; personal care, leaving the home and completing activities, use of electrical equipment, using the stairs and the risks posed by room layouts. All of the assessments seen identified potential risks and the strategies to minimise them, whilst still enabling people to take acceptable risks. All of the assessments seen were regularly reviewed. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People take part in a range of activities that are age appropriate and chosen by them. Peoples’ rights are respected and they are supported to take responsibility for themselves in their day-to-day lives. People have a healthy diet that helps to support them with active lifestyles. EVIDENCE: The majority of people attend the local day services during the week. Others choose not to and other activities are completed. At the time of this site visit the registered manager was taking one person out “one to one” to do some shopping in Gloucester. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 12 Examples of activities that people are involved in regularly include visits to the local pub, shopping in Gloucester, going to Tewkesbury market, meals out, coffee/visits to other local registered care homes. The registered provider said that he plans to arrange a visit to the races at Cheltenham soon. One person has an interest in racing and likes to place a couple of small bets each week, the registered provider supports them to do this. A number of activities take part within the home and one person spoke about enjoying listening to music, dancing, karaoke, floor puzzles, art, embroidery, reading, writing and knitting. Last year four people went to a holiday camp in Weston-Super-Mare on holiday. Other people go on holiday with their parents or family. All of the comments to the inspector about holidays were positive. Records showed that people have regular contact with their families and friends. This contact may be via phone calls, or visits. The home has a two week set menu and the provider explained that people were asked what they wanted to eat. Although this is a set menu, people are able to choose other things to eat if they do not like what is on the menu. The provider says that it is reviewed periodically with the service users. A good range of different meals are available. Comments from the service users included “the meals are lovely”, and “I can choose want I like to eat”. The inspector would recommend that the provider defines the frequency of reviewing the menu and evidences the process used when it is done. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care needs are assessed and care plans provide staff with sufficient information to meet peoples identified needs consistently. Other specialist professionals are used appropriately to meet people’s needs where the home is not able to. Medication administration is managed effectively, which minimises the potential risks to people. EVIDENCE: Service users personal care needs are assessed and care plans are developed to meet those needs. Service users files provided extensive evidence of the input of other professionals to meet needs that the staff at the home were unable to meet. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 14 An example of this is the input from speech and language therapists and an occupational therapist for the person diagnosed with dementia. All of the files seen had good records of people attending appointments with doctors, dentists and opticians. The medication administration was examined. The home uses the MARS system. The only shortfall identified was that staff were not labelling all of the creams and ointments with the date they were opened. This was brought to the attention of the registered provider. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to make a complaint if they are unhappy about anything and the home’s complaints procedure supports them to do this. EVIDENCE: The home has a complaints procedure. No complaints have been made since the previous inspection. All new staff complete a comprehensive induction, which includes an element about the protection of vulnerable adults. It is recommended that the provider considers the use of the training provided by the Gloucestershire adults at risk team called “alerter’s training”. Observations of the interactions between staff and services users throughout the day showed that relationships were positive and respectful. All of the service users looked comfortable in the presence of the staff. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment meets the needs of the service users currently living at the home. EVIDENCE: Communal areas in the home consist of a lounge and dining room. The lounge has good quality furniture with the provider recently purchasing a reclining three-piece suite. Other items in the lounge included a television, DVD player and stereo. The dining room has two tables and a karaoke machine and stereo were in the corner. Staff spoke about the service users using it the evening before this inspection. All of the decoration is of a good standard. Since the previous inspection the major building work has been completed and now provides the home with an additional three bedrooms with en-suite facilities on the ground floor. All of these bedrooms were visited and showed Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 17 that the people living in them had personalised them with their possessions. All bedroom doors have locks and where people want keys they have them. A shortfall identified in a number of rooms was that they were missing lampshades. This was brought to the attention of the provider. It is a recommendation that lampshades are purchased and fitted. Other improvements since the previous inspection include: • • • The home is now completely double-glazed. All of the hallway and landings have been decorated. A number of bedrooms have been re-decorated. Service users commented they really liked their bedrooms. In addition to the bedrooms on the ground floor a new assisted bathroom has been fitted. This provides all of the service users with handrails, a lowered sink and a walk in shower. Upstairs is another bathroom that has been re-tiled recently. This bathroom has a toilet and a bath. The provider explained that they have plans to improve the environment further, this included: • The kitchen will be replaced. • Other bedrooms are to be re-decorated. At the time of the site visit the home was clean and free from offensive odours. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment procedures minimise the risk of service users being supported by staff without the appropriate skills. Staff training meets the current needs of the service users and minimises the potential risks to them. EVIDENCE: Records for staff recruitment since the previous inspection were examined and seen to be comprehensive and meet the criteria of the regulations. On the day of the inspection training records were poorly organised which made it impossible to confirm what training staff had completed. Between the inspection being completed and this report being published the provider supplied the inspector with up-to-date training records. These records showed staff completed training to minimise the risks to service users and meet their Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 19 needs. Records showed that the majority of new staff complete their key training within 14 weeks of starting work in the home. The provider explained that the manager and himself have their National Vocational Qualification (NVQ) level 4, one staff member is completing their NVQ level 3, another staff member has their NVQ level 2 in care and is waiting to start their NVQ level 3. Four other staff are currently working towards their NVQ level 2. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is committed to providing a quality service that is led by the needs of the service users. Outcomes for the service users are good and a quality assurance system would allow a regular review of the service and identify areas where improvement is required. The health and safety of the service users is maintained by the regular monitoring of potential risks by the staff team. EVIDENCE: Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 21 The registered manager has owned the home with her husband for the past five years. All of the staff spoken with during the day agreed that the manager was really good, open and had a “hands on approach”, this was confirmed by the comments from service users throughout the day and observations by the inspector. The registered provider stated that they were in the process of developing a quality assurance system for the home. This must be addressed and becomes a requirement of this report. The provider explained that in the past they have asked relatives to comment on the care provided. This could be developed further and this was discussed with the provider. Health and safety checks are completed regularly to minimise potential risks to service users, these include: • • • • • • Hot water outlet temperatures are recorded monthly. A fire safety risk assessment was completed in May ‘06 Gas appliances and the central heating boiler were tested in September ‘06 Portable Appliance Testing was completed in December ‘06 Accidents are recorded properly Fire safety equipment is checked as prescribed by the appropriate regulations. Branksome House DS0000029218.V326143.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 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 X 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 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Branksome House DS0000029218.V326143.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 YA39 Regulation 35 Requirement The registered person must develop a quality assurance system that involves the service users. Timescale for action 01/06/07 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. 3. 4. Refer to Standard YA17 YA20 YA23 YA24 Good Practice Recommendations The registered person should define the frequency for the review of the menus. The registered person should ensure that all of the creams and ointments are labelled with the dates they are opened. The registered person should send staff to the Gloucestershire Adults at Risk “Alerter’s training”. The registered person should ensure that all of the rooms have lampshades. Branksome House DS0000029218.V326143.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 House DS0000029218.V326143.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!