Inspection on 05/05/05 for Bransfield Manor Rest Home

This inspection was carried out on 5th May 2005.

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

Bransfield Manor Rest Home 10/12/07

Bransfield Manor Rest Home 21/03/07

Bransfield Manor Rest Home 15/06/06

Bransfield Manor Rest Home 07/11/05

Bransfield Manor Rest Home 13/09/04

Bransfield Manor Rest Home 13/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Bransfield Manor Rest Home Church Lane Godstone Surrey RH9 8BW Lead Inspector Penelope Calthrop Unannounced 05 May 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Bransfield Manor Rest Home Address Bransfield Manor, Church Lane, Godstone, Surrey, RH9 8BW 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) 01883 742927 Family Care Private Company Limited 19 Smitham Downs Road, Purley, Surrey, CR8 4NH Wanni Aylward Care Home (CRH) 17 Category(ies) of Sensory Impairment over 65 years of age registration, with number (SI(E)), 1 of places Dementia - over 65 years of age (DE(E)), 6 Old age, not falling within any other category (OP), 17 Mental Disorder, excluding learning disability or dementia - over 65, 6 Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 The combined total of residents falling into the category DE(E) and/or MD(E) must not exceed six (6) Date of last inspection 13 September 2004 Brief Description of the Service: Bransfield Manor provides care for up to 17 older people, some of whom may suffer from confusional states or mental health diagnoses. The building is a large converted detached Victorian property, situated in a quiet country lane close to the local church. It is near to the small town of Godstone and has excellent views of the local countryside. Communal space for the use of service users is located centrally near the entrance to the home. Bedrooms are located at both ground and first floor level.There is equipment to assist frail older people in place. The home benefits from extensive gardens and car parking space. There is a cat belonging to one of the residents living at the home. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on one day, over a period of seven hours. The home manager was present and the homeowner arrived during the visit. Four of the seventeen service users were interviewed during the inspection. Two members of staff on duty were spoken with during the course of their duties. A tour of the home was made, although the garden was not accessed on this occasion. Records were also sampled as part of the inspection process. What the service does well: What has improved since the last inspection? The home has met the requirements made following the last inspection regarding redecoration and replacement of carpets in some of the communal areas, the repair of some room door locks, attention to the downstairs bath which was damaged and the tidying up of the yard area. Staff meetings have also been commenced in the home. An extra art and craft session has been arranged for residents who seem to enjoy this activity. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 5. The home has an adequate assessment process in place. The manager will not accept an individual into the home unless she is confident their needs can be met. EVIDENCE: The manager discussed a recently admitted individual and the process of admission. It emerged during conversation that there had been a number of enquiries about the vacant bed, but the manager reported that some of these she had judged as unsuitable for the home. Potential residents visit for a day or part of a day so that they can see the home for themselves. Families have the opportunity to visit, either with or without their relative. Following discussion about those individuals who may suffer from mental health problems, it was recommended that the home consider including an overnight stay as part of the assessment process for these individuals. It is also recommended that ‘life histories’ are obtained at the point of assessment, from family members where needed. These could then be further developed with the care plan; this would be particularly valid for those residents unable to contribute to this process. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 9 Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 &10 Care plans were informative with attention to differing areas of residents needs. EVIDENCE: A sample of care plans was viewed, these were found to be informative and included risk assessments. There was evidence that monthly reviews of these occur. It was particularly positive to see that it was documented on care plans where residents had a power of attorney and who that was. Two of the residents spoken with had not participated in developing their care plan and one did not know that she had a care plan. It is recommended that the home include residents in this, dependent on their level of understanding. It is also recommended that staff enlarge on the entries in resident’s daily records. One entry seen simply said ’’No problems’’ which does not adequately reflect the resident’s welfare on that given day. There was attention to health care needs, with the involvement of appropriate professionals where needs indicated this. The manager reported a positive relationship with the local mental health team; a member of this team rang during the inspection to discuss one of the resident’s medication with the home manager. Residents have an annual healthcare check with the GP as a Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 11 minimum. During the inspection visit the optician arrived to check a number of residents eyes. Residents spoken with reported that ‘‘the staff are very nice’’ and help if needed in a pleasant manner. One individual concluded that they were ‘’Always very busy’’ and indicated that they did not feel they could always stop them if wanting help. In the room that is shared by two residents screens are provided and used to maintain privacy. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 &15. Social activities need continued development, particularly for those with mental health problems. Meals would benefit from increased choice for residents. EVIDENCE: Of the residents spoken with, the food was generally thought to be ‘’Good.’’ One individual said it was ‘’Reasonable.’’ The main meal of the day is eaten at lunchtime, with most residents eating in the dining room at small tables. No choice is given, with generally one meal being cooked although the home does cater for its vegetarians. It was concluded that the home should increase resident choice by offering and cooking an alternative to the main meal each day. Comment was made by one resident that they ‘‘never know what is for lunch until it is served’’. It was suggested to the home manager that the menu should be displayed in one of the communal areas, so that residents can then anticipate their meal. The home has some organised activities for its residents provided by outsiders, such as armchair exercises and art and craft sessions, which have just increased to twice weekly. One individual reported that there ‘‘were not too many activities’’; although they went on to say this did not worry them. Most of the residents do not get out much and are therefore dependent on the home for entertainment and social stimulation. This was judged to be particularly so for those with mental health problems. It is recommended that the home Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 13 continue to work to develop this area, which could link to the residents known interests documented in their life histories recommended under standard 3. It was judged that resident choices could be increased in the home as outlined by the examples given above. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 17. The home has a satisfactory complaints system, with some evidence that residents feel their concerns are listened to and acted upon. EVIDENCE: The home has had no complaints since the last inspection. There is a complaints procedure in place and residents spoken with reported that if they had any concerns or complaints, they had confidence that the manager or homeowner would deal with these. This visit to the home occurred on an election day, however there was no indication of this in the home i.e. by discussion or residents exercising their right to vote. One individual spoken with had not been given their polling card and did not know if they had one. Although many residents would be unable to exercise their right to vote, it is important that this right to participate in the political process is upheld. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 23, 24 & 26. The standard of the environment in the home is good, providing residents with a homely place to live. EVIDENCE: Requirements made following the last inspection have been complied with and some areas have been redecorated and re carpeted. The home has a communal dining area, sitting room and small seating area in the entrance way or hall of the home. There is a music centre in this area for those who enjoy listening to music or the radio. There is also a large garden, with adjoining fields giving the feel of being in the country. Rabbits frequent the fields and garden. Some bedrooms were viewed and those seen were nicely decorated and personalised with residents own items of furniture and other belongings. One of the bedroom’s viewed had a cupboard the occupant used for locking valuables in, the lock was reported to be faulty and must be repaired. During the tour of the home, a bottle of disinfectant was found out and potentially accessible to anyone in one of the bathrooms. A requirement was made that items falling within COSHH (Control of Substances Hazardous to Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 16 Health) must be securely stored. A further requirement was also made regarding the labelling and dating of any unused food placed in the fridge. A plate of corned beef was found covered but not dated. The home appeared generally clean with no malodours evident. There were some cobwebs evident around the home, which it was assumed would be dealt with on a more in depth clean. Care staff are responsible for routine cleaning. In discussion with the home manager and owner, it emerged that although staff have a checklist of cleaning to work to, there is no method of recording what has been completed and by whom. It was recommended that a system be set up to address this and to ensure that daily, weekly and less frequently needed cleaning are clearly evidenced. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 & 30. Staff recruitment ensures the needs of residents are met. Some mandatory training was not up to date, improvements to the system are needed highlighting when training is due. EVIDENCE: More than half the staff at the home are qualified to NVQ level 2 or equivalent. One has almost completed NVQ level 3 and others previous qualifications assess them to be at this level. Staff were observed to know the residents and their needs well. Staff recruitment records were well ordered and easy to find your way around. However, it was noted that new CRB (Criminal Record Bureaux) checks had not been obtained on some staff that joined the home from similar jobs and brought their previous CRB checks with them. This was discussed with the homeowner, as CRB’s are no longer transferable. A requirement was made that all CRB’s must be valid and up to date. Training records were examined and staff spoken with. It was of concern that a member of staff who had been working at the home for some months, had had no formal manual handling training. Some mandatory training was up to date for staff, but there was not an easy system to identify when refresher courses were due. Consideration of more service specific training is also needed. The home is registered to admit those older people who may suffer from mental health conditions. One resident spoken with felt that most staff had little understanding of their condition and when they had relapses, how it affected their abilities. Provision of training in this area was discussed with the Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 18 home manager. A requirement was made in relation to the provision of training, both mandatory and service specific. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35 & 38. The manager has a background in nursing, has previously run her own care home and is working to achieve management qualifications. There is evidence she is striving to meet the National Minimum Standards for Older People. EVIDENCE: The manager is a Registered Mental Nurse and is working to complete NVQ level 4 management components, before completing the registered manager’s award. A staff member spoken with reported that the management atmosphere is relaxed, but that when needed the manager will assert her authority. The home has clear information recorded on which residents have others acting on their behalf with regard to their finances. The home does not act as appointees on behalf of any individuals living there. Records of any petty cash held on behalf of residents were not inspected on this visit and will be viewed on the next visit later in the year. The health and safety of residents and staff is generally promoted within the home. However, there are areas identified earlier in this report under the section on the environment and in staff training, that let the home down. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 2 15 2 COMPLAINTS AND PROTECTION 2 3 x x 3 3 x 3 STAFFING Standard No Score 27 x 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 2 x 3 3 x x 3 x x 2 Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 21 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 19 Regulation 23(2)(b) Timescale for action The cupboard with the faulty lock 2/6/05 in a residents bedroom, identified during the inspection must be repaired. All potentially hazardous Immediate substances must be securely 5/5/05 stored in line with COSHH guidelines. Leftover foodstuffs put for Immediate storage in the fridge must be 5/5/05 labelled with the date. All CRB checks on staff employed 5/7/05 at the home must be valid and up to date. Mandatory and service specific 5/8/05 training must be provided for staff. Mandatory training must be kept up to date. Requirement 2. 19/38 13(4)(a) 3. 4. 5. 19/38 29 30 13(4)(c) 19(1)(b) (i) 18((c)(i) 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. Refer to Standard 3 Good Practice Recommendations That the home consider overnight stays as part of the assessment process, for those individuals suffering from mental health problems. H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 22 Bransfield Manor Rest Home 2. 3. 4. 5. 6. 7. 8. 3 7 7 12 15 26 30 That life histories should be commenced at the point of assessment, particularly for those with mental health problems. Residents should be involved in the development of their care plan where able. Staff should enlarge on their entries in residents daily records. To increase the range of activities available, especially for those suffering from mental health problems. An alternative meal should be offered and available at lunch time. The menu should be displayed for residents to view in one of the communal areas. A system should be developed to record cleaning undertaken and by whom. A system should be developed to easily highlight when training updates are due for individual staff. Bransfield Manor Rest Home H58 S42991 Bransfield Manor V221272 050505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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