Inspection on 15/09/05 for Brant Howe

This inspection was carried out on 15th September 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

Brant Howe 22/08/07

Brant Howe 15/02/06

Brant Howe 21/09/05

Brant Howe 06/12/04

Brant Howe 17/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Brant Howe Fairbank Kirkby Lonsdale Carnforth Lancs LA6 2DU Lead Inspector Jane Strawbridge Unannounced 15 September 2005 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. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Brant Howe Address Fairbank Kirkby Lonsdale Carnforth Lancashire LA6 2DU 015242 71832 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 Paul Martin Jackson Care Home 19 Category(ies) of OP - Old Age registration, with number of places Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 06 December 2004 Brief Description of the Service: Brant Howe is registered to provide personal care and support for up to 19 elderly people. The home is situated in a residential area in Kirby Lonsdale with easy access to shops and transport. The home has four floors with the ground and first floor only being used to accommodate service users. The top floor is used for staff accommodation and the laundry is sited in the basement. There is ample communal space for the service users to enjoy.There are 11 single bedrooms and 4 double rooms although not all of these are used to accommodate 2 people. A recently completed modern extension to provide bedrooms and communal living space for an additional six residents has been built in a style that complements the existing building. There is also a new single storey building in the grounds to provide an office for the manager and staff accommodation. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home that took place over one day. Mr Paul Jackson the owner and registered manager, and Wilma Thompson the home’s head of care were present throughout the inspection. The inspector spent some time talking with the residents either in small groups or individually, with their visitors and with the staff on duty. Records to do with the care of the residents and the day to day running of the home were looked at and the inspector visited all parts of the home. What the service does well: What has improved since the last inspection? What they could do better: The home has a recruitment and selection policy in place although there is a very low staff turnover and many staff members have been employed for a significant number of years. However they do not use a formal application form or C.V to seek relevant information about potential employees that would form the basis of an informed early judgement about their suitability to be employed in the home. A good practice recommendation has been made to cover this shortfall. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 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 Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 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, 4 The home uses an admission procedure that ensures a proper assessment takes place before people move into the home. This practice together with the information given to prospective residents ensures that care needs can be met EVIDENCE: Discussion with the registered manager confirmed that he and the Head of Care were aware of the category of the registration and were careful not to admit any potential residents unless they were confident that they could meet their identified needs. All staff who were interviewed were able to show that they recognised and understood the difficulties faced by some of the residents. They said that they knew what the limitations were with regard to the layout of the home for people with mobility problems, but would do whatever they could to ensure the best quality of life for everyone living in the home. Records for each resident contained the initial assessment details and other personal information that were used to form the basis of their individual plan of care. Standard 6 does not apply to this home because they do not provide intermediate care. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 9 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, 9, 10, 11 Health care needs of residents are identified, recorded and met in a way that respects their dignity and privacy and safe practices ensure the residents are protected from harm. EVIDENCE: All residents have a comprehensive plan of care. These are reviewed monthly with the involvement of the resident and/or their representative and wherever possible they are signed by the resident. Information in the care plans together with up to date risk assessments enable the care staff ensure the correct level of care is available and given to each service user. The home uses a monitored dosage system working with the local pharmacist to ensure that there are safe procedures for the storage, handling and administration of medication. The medication is securely stored, the records were correctly and neatly completed and all staff with a responsibility for administering medication had completed the appropriate training. Interviews with the manager and members of staff confirmed that the privacy and dignity of the residents is extremely important at Brant Howe. Residents said they were impressed with the attitude of the manager and staff and that Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 10 all personal care was handled sensitively in private. The staff who were on duty were seen to behave in an exemplary and professional manner showing respect and courtesy for each of the residents. This was confirmed during conversations with residents when they stressed how “kind the staff are, nothing is too much trouble for them” and “ I have no regrets about moving here.” All staff said that they recognised the importance of people being able to die in their own home and wherever possible this would be respected provided it did not go against medical advice. Staff recognise that importance of supporting each other through difficult situations and time would be made available if needed. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 11 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) 13, 15 The home provides a relaxed and friendly, welcoming environment for visitors. Meals are balanced and nutritious to offer a healthy variety of food that meets the residents’ tastes and choices. EVIDENCE: Brant Howe has an open door policy where visitors are welcome at any time. This means that there is some flexibility for all visitors, especially for family and friends who live a distance from the home. Residents can see their visitors in private in their room or in communal spaces away from the main lounges. All residents said that they were able to keep in touch “with what is going on in Kirby Lonsdale” either by going out and bringing news back with them” or through visits from family and friends and groups. Some of the residents said they look forward to visits from members of the local churches and school children because they “brought a breath of fresh air into their lives and it was a nice change.” Menus are changed weekly providing a well balanced, varied and appealing diet with a choice available at all meals. Breakfast is served in the bedrooms or in the dining room, dependent on the wishes of the individual. Residents said that “the food is good here” and “we look forward to our meals.” Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 12 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, 18 Residents in this home are confident that any concerns they may have are taken seriously and dealt with. The home has a procedure to protect people from harm. EVIDENCE: The head of care speaks individually with each resident once a fortnight to ask if they have any concerns. These are recorded in confidence and an immediate plan of action agreed. The resident is informed of the progress of any action needed and as soon as the concern or complaint has been dealt with. This system is seen as good practice and means that residents are confident that they can raise matters of concern and they do not have to worry that they will not be taken seriously. All residents spoken to said that they thought this was an excellent idea and they were less anxious and more relaxed and would not hesitate to speak to the head of care about any problems they might have. Staff said that they knew what to do in response to any suspicion or allegation of abuse. This subject is covered in the staff induction programme as well as during staff supervision. They were aware of the home’s policies and procedures and of Cumbria’s Adult Protection Policy (POVA), which is available for reference. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 13 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, 21, 24, 26 Brant Howe is in the midst of an improvement programme to build a modern extension and to improve the accommodation in the main building. This has been planned to minimise the risk of harm and disruption to the daily lives of the residents. EVIDENCE: The extension was almost ready for occupation with all building work completed to a high standard. The extension provides six en- suite bedrooms and communal living space for a further six residents. A major variation has been approved to this effect. To further improve the facilities for residents the space in existing communal toilets on the ground floor have been extended and a new shower room has been created. A number of bedrooms in the main house have been refurbished with other work planned. All work has been planned to minimise the effect on the residents of dust and noise. Residents said they had enjoyed watching the activity during the works and were looking forward to seeing the finished result. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 14 All residents were offered the opportunity to bring their own possessions and pieces of furniture to make their own rooms personal and homely and this was seen to be the case. All personal and communal living spaces were homely, comfortable, clean and tidy and free from any hazards that might jeopardise the safety of the residents. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 15 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) 29, 30 The home’s recruitment policy requires further work to ensure it offers protection to people living in the home. Staff members are well trained and competent. EVIDENCE: The home has a stable and committed staff team and turnover is very low. Therefore recruitment is rarely an issue. A recruitment policy and procedure is in place and as far as possible all the essential checks have been done to protect residents from harm. However the home did not use a formal application form and in the past has relied on verbally obtained information about applicants for jobs. This practice is not robust enough to ensure that applicants are suitable for the post they are applying for, and is a vital omission from the recruitment and selection process. Therefore a recommendation has been made that all applicants for jobs in the home should complete a formal application form or submit a comprehensive C. V. that are suitable for the purpose. There is a commitment to training for staff in this home with five members having achieved NVQ level 2 or above and three commencing their training. As an incentive the home pays staff the taxi fare and travelling time to and from college, training time and an increased hourly rate once they are qualified. The head of care has achieved NVQ level 4 in care and the Registered Managers Award. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 16 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, 36, 38 The leadership and guidance from a qualified and competent manager ensures that the home is run properly for the benefit of the residents. There are practices in place to safeguard the health, safety and wellbeing of the people living and working in the home. EVIDENCE: The registered manager has completed NVQ level 4 in Management and Care and the Registered Managers Award and has significant experience in senior management in residential care. He and the head of care work together to form the senior management team with their areas of responsibility and accountability clearly defined. The head of care is responsible for the day - to - day management and supervision of the care staff. Staff members are supervised “on the job” and at handover sessions between shifts when matters were addressed to ensure safe and appropriate working practices and then followed up in the formal staff supervision sessions. The formal supervision is Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 17 planned to take place six times per year and is audited by the registered manager. Records showed that staff had been given training to protect themselves and residents from harm. This training included moving and handling, infection control, fire training, food hygiene and first aid. Records showed that risk assessments had been undertaken to identify potential and actual hazards and actions taken to ensure the health and safety of everyone living, working and visiting the home. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 x 3 Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 19 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 Regulation Requirement Timescale for action 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 29 Good Practice Recommendations The home should use a formal application form or C.V. as part of the recruitment / selection process. Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Brant Howe F58 F10 s22581 brant howe v248760 150905 ui stage 4.doc Version 1.40 Page 21 - 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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