Inspection on 12/09/06 for Branston Court Nursing Home

This inspection was carried out on 12th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Branston Court Nursing Home 10/06/08

Branston Court Nursing Home 18/01/06

Branston Court Nursing Home 14/07/05

Branston Court Nursing Home 24/01/05

Branston Court Nursing Home 14/09/04

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

CARE HOMES FOR OLDER PEOPLE Branston Court Nursing Home Branston Road Burton On Trent Staffordshire DE14 3DB Lead Inspector Mrs Joanna Wooller Key Inspection 12th September 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Branston Court Nursing Home Address Branston Road Burton On Trent Staffordshire DE14 3DB 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) 01283 510088 01283 565675 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Miss Donna Waldron Care Home 45 Category(ies) of Dementia (45), Dementia - over 65 years of age registration, with number (45) of places Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The category of DE shall be a minimum age of 60 years One DE under 60 years ( as per letter) Date of last inspection 18th January 2006 Brief Description of the Service: Branston Court is a purpose built Care Home, which offers 24 hour Nursing Care for service users with Dementia Care needs. The home was built in 1989 on the site of disused school. Originally it was registered for 56 beds but has been altered to 45 beds due to double rooms becoming single and two rooms used as lounge areas. Branston Court is set back off Branston Road, Burton-on-Trent. It has close access to public transport and is reasonably close to the main shopping area in Burton. The home consists of single bedrooms with en-suite facilities situated on two floors. Each floor has a spacious lounge and a bright, airy dining area. The ground floor benefits from a quiet room for use of relatives, which can be used by service users also, if accompanied. On the 1st floor a previous activities room is a quiet lounge. The philosophy of the home is choice, Individual service users make personal choices relating to their day, allowing ample opportunity to join in social activities on a daily basis. Fees Highest £588.50 Lowest £319 RNCC Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Lead Inspector, Joanna Wooller accompanied by Kath Marks, carried out this unannounced Key Inspection. The visit was commenced at 09.00 and the Inspectors met with the Deputy Manager who assisted them throughout the visit. There were 45 Service Users in the home and ten staff was on duty including two Registered Nurses. The inspectors evidenced care records, all necessary documentation and inspected all the environment, including the kitchen, laundry, and the Service Users bedrooms. Service Users and their relatives spoken to at the visit were content with the home and felt reassured by the lovely staff. The environment was very generally clean and clutter free however the inspector did make a requirement for the laundry to be deep cleaned and monitored as it was less than satisfactory in the condition it was found. The Inspector observed lunch being served by the staff in the dining room, Service Users were offered discreet assistance and promotion of independence was encouraged. Plenty of drinks were served throughout the time at the home including fresh fruit chunks at coffee time, visitors and relatives were also offered drinks whilst visiting. Feedback cards were complimentary about the service and the staff. Comments included “I do find the home very friendly and the staff are lovely” “Caring staff and lovely home” “ My Family and friends cannot fault any part of my Mothers care, it’s just like home from home. I never thought I would say that about a nursing home but my Mother is looked after very well and is happy” What the service does well: The home continues to offer an environment that is well maintained and comfortable. The atmosphere in the home remains quiet and calmer. Staff were again seen to support Service Users, whilst also encouraging and promoting independence. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 6 The management and the team of nurses and carers continue to promote individualised care practices so enabling more choice for the Service Users and their individual needs. The environment is much improved and thought continues to go into the positioning of furniture and fittings. Development work is planned to encourage a group of visitors who are welcomed in to the home to become a volunteer group within the home. What has improved since the last inspection? What they could do better: • • The inspector evidenced that the laundry cleanliness was less than satisfactory and required a deep clean and monitoring following this. The inspector noted that although excellent activities were offered on a daily basis, individualised to each Service User, however individual social care plans should be introduced to evidence that social care needs are being met and reviewed by the nurse using the information recorded individually by the activity organiser. The grounds at the front of the home have become very unkempt and do not set the scene for a caring environment. The inspector has since been informed that the front grounds have been attended to and will be maintained in the future. • 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 Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 3 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. Individual health, personal and social cares needs continue to be established through robust preadmission assessments. Staff, which individually and collectively had the necessary skills and experience, was able to ensure that these identified needs were being met. EVIDENCE: The care records evidenced at this key inspection enabled the inspector to be assured that service users had been assessed prior to admission and they had been enabled to make a choice about the home. Documentation was clear and precise. One relative confirmed to the inspector that she had been impressed with all the details they needed to make the assessment and she was given the opportunity to visit the home prior to choosing it for her husband to stay. She confirmed that she and her family had been fully involved and were in agreement with the individual assessments. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 10 Again as at the last visit several service users and their relatives spoken to had visited the home, and had a meal prior to deciding to stay, and this was documented within the care plans. If possible community care plans were provided by the social worker, as part of the individual needs assessment process. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 7 - 10 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Individual health care needs are identified in Service Users care plans, which are reviewed monthly. Policies and procedures are followed to ensure compliance with regard to medication and Service Users are treated with respect and their privacy is respected. EVIDENCE: Each Service User has an individual plan of care that documents their individual needs; this is reviewed monthly or as required. Monitoring charts are in place for all Service Users and these are completed on an hourly basis regarding aspects of daily living. Individual risk assessments are in place in the care plan, which identifies risks and ways to avoid them occurring. Falls, nutrition, waterlow (skin integrity) and manual handling assessments were all reviewed monthly. No issues were raised with regard to medication or its administration. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 12 Intervention from specialist nurses and other professionals are documented I the care plan and the actions taken. GP visits were documented in the records. Equipment required for individual care is provided by the home to support the Service Users needs. Opportunities for exercise are promoted and Service Users are encouraged to freely mobilise around the home as much as is possible. Review of care records with a representative must be further developed and signed as being done so. Relatives spoken to were very reassured about the care their family member was receiving at the home and complimentary about the staff and the management. Individuals were observed being treated with respect and their dignity protected through gentle interaction with staff and discreet assistance. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 12 - 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a relaxed and friendly atmosphere with Service Users moving freely around the home. Contact with the local community is good - a number of Service Users are from the local area. The cook and her staff at the home provide excellent food with a choice at all meals. There is however no detailed activity records available for individuals. EVIDENCE: Throughout the visit observations were made of flexible routines being in place and Service Users appearing comfortable with their lifestyle and being encouraged to exercise choice. The home has an activities organiser 30 hours a week over 5 days half a day morning or afternoon. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 14 There were no individual records of activities available activities were shown to be all recorded in one diary. There was no record of who is involved in what and therefore no indication that all Service Users have received social stimulation or contact on a daily basis. Most Service Users do have family visitors; one Service User has an advocate to assist them with decision-making. To ensure compliance with National Minimum Standard 12.3 “ Service users social interests are recorded and they are given opportunities for stimulation through leisure or recreational activities” “Particular consideration is given to people with dementia and other cognitive impairments” The home must maintain individual records within a social care plan. The home provides a choice at all meals the menu was seen and offered a varied nutritional diet taking into account personal preferences of Service Users and seasonal foods. Special diets are catered for as required. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is displayed in the home and action is appropriately taken when complaints are received. Legal rights are discussed with Service Users and their needs are documented. EVIDENCE: The inspector evidenced the relevant policy and procedure documentation for BUPA complaints and a discussion with relatives confirmed that complaints were listened to and dealt with in the correct manner. Since the last inspection two complaints had been recorded and brought to the attention of this Commission For Social Care Inspection. Each had been dealt with sympathetically and one was unresolved at present. Thank you and complimentary gift cards were seen in the home sent from appreciative relatives and visitors. One relative spoken to felt sure that should she need to complain but she felt she would not have, she would be dealt with professionally. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Observations when walking around the home were of a warm relaxed atmosphere however some areas of the environment needed attention. EVIDENCE: The location and layout of the home is suitable for its stated purpose and provides easy access to the town centre of Burton-upon-Trent. Generally accommodation is comfortable and well maintained with areas of the home that have been refurbished having been done to a high standard. The inspector understands that there is an ongoing programme of refurbishment in place. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 17 However there are areas that need attention and must be dealt with. On arrival at the home the gardens surrounding the car park are overgrown, hanging over car parking spaces and looking generally untidy. To the side of the home there is water and slime over the drive that appears to be coming from the laundry drain. With regard to the laundry itself the Inspector was told that night staff are doing some laundry and this is not good practice as it takes away care hours at night times and causes undue noise to the Service User in the bedroom opposite the laundry from the door banging and the hum of washers/dryers. There was a large build up of dirt between the washing machines, the laundry itself was untidy, and the inspector observed poor transfer of clean washing from the washing machine to the linen basket. There were a container of communal net knickers, socks and stockings. The home must comply with regulation 23 (2) (d) all parts of the home are to be kept clean and reasonably decorated Timescale 2 weeks to completely clean the laundry top to bottom. The home must comply with regulation 13 (3) the registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home. (With regard to the appropriate transfer of clean washing from washing machines to linen containers.) Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed needs of service users had been met by an adequate number of suitably trained staff. Recruitment procedures had been correctly addressed which had contributed to the protection of service users. Staff training is given high priority. EVIDENCE: Staffing levels were being maintained as at 1st April 2002 and following a discussion with the deputy manager and her staff it was agreed that the shift cover was adequate for the existing Service Users needs. However an issue was highlighted regarding the laundry and night staff; staff on duty was putting the washing in the machines and this took them away from care duties. Adequate ancillary staff must be provided daily to ensure all areas are adequately covered to perform their duties. The laundry needs to be covered in an afternoon and possibly some evening hours to ensure that care staff is not required to attend to the laundry tasks. Other areas of the home are suitably covered and staffing rosters were checked. Recruitment and staff training had been well addressed and the management have to report this to head office monthly. The Operations Manager performs regulation 26 visits. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 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 31, 33, 35 and 38 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, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and her ethos for the home support the Service Users and staff. Quality assurance systems are in place to ensure the service is run in the best interest of the Service Users. Health, safety and welfare of Service Users and staff are promoted and protected. EVIDENCE: Following discussions with the deputy manager, relatives, staff and the ethos within the home it was clearly evident that the home was being run in the interests of service users. The deputy manager was extremely open and helpful throughout the inspection and assisted the inspectors in a professional manner. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 20 Quality assurance is paramount within the home to ensure the service is being offered as it should be and feedback from Service Users representatives was seen documented. A check on the records and a discussion with both service users and representatives evidenced for the inspector that all service users had the opportunity to handle their own finances and all Service Users and families had chosen to do so. No health and safety issues were noted during this inspection, including a tour of the home. The documentation seen for checks and examination of all equipment was all correct and up to date. Another maintenance person was completing checks at present. The deputy manager and staff spoken to again confirmed that health and safety issues are given a high priority. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 22 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 OP19 Regulation 23 (2)(d) Requirement Timescale for action 26/09/06 2 OP26 13 (3) 3 OP27 18 (a) 4 OP19 23 (2)(o) The registered person must keep all parts of the home clean and reasonably decorated. The laundry must be completely cleaned. The registered person shall make 26/09/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home. (With regard to the appropriate transfer of clean washing from washing machines to linen containers.) The registered person must 12/11/06 ensure that staffing in all areas of the home is suitable to the requirements of their duties, with regard to the laundry tasks. The registered person shall 12/11/06 ensure that the front grounds of the home are made tidy and appealing to the eye and then maintained. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 23 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 Refer to Standard OP24 OP12 Good Practice Recommendations Doors to Service Users private accommodation should be fitted with locks suited to the Service Users capabilities and be accessible to staff in emergencies. Staff must consult service users about their social interests and meaningful individual records be maintained. Branston Court Nursing Home DS0000022316.V306598.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Branston Court Nursing Home DS0000022316.V306598.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. 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