Inspection on 21/09/05 for Brant Howe

This inspection was carried out on 21st 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 15/09/05

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 Lancashire LA6 2DU Lead Inspector Ray Mowat Unannounced Inspection 21st September 2006 6:15 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 Brant Howe DS0000022581.V300710.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. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 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 Paul Martin Jackson Mrs Emma Louise Jackson Mr Paul Martin Jackson Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 25 service users to include: up to 25 service users in the category of OP (Old age, not falling within any other category) The home should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 15th February 2006 Date of last inspection Brief Description of the Service: Brant Howe is registered to provide personal care and support for up to 25 elderly people. The home is situated in a residential area in Kirkby 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. There is a modern extension that provides bedrooms and communal living space for an additional six residents and 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. Information is supplied to residents and prospective residents in the form of a brochure, which is kept under review. The fees for the home range from £363 to £490. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place at 6.15 am to enable me to meet night staff and experience the morning routines of the home. I met with most of the people living in the home during the day and also spoke to visiting relatives. I met with and spoke to staff on duty and spent time with the owner/manager Mr Paul Jackson. 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 Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the home. The home provides suitable information to new and prospective residents, to enable them to make an informed choice about moving into the home. Detailed assessments are completed to ensure individual needs can be met. EVIDENCE: The home has developed suitable information in line with the requirements of the National Minimum Standards for current and prospective residents including a statement of purpose and service user guide. These were under review to update the contents to reflect changes in the home. The home issues a contract of terms and conditions, which explains in detail the rules about living in the home. These were held on personal files and had been agreed and signed by the residents or their representative. There was evidence on file of both social work assessments and the home completing their own needs assessment as part of the admission procedure. I examined three residents’ files including one person who had been admitted Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 9 the previous day. This included a clear assessment of needs to guide and support staff in providing a personalised service. The manager and senior staff who complete the assessments are clear about the need to make sure the home’s environment and resources are adequate to meet people’s needs. There was evidence that the home makes appropriate referrals to other agencies or carry out reassessments when needs change. During my discussions with residents it was evident that people had visited the home prior to agreeing to move there, either for a short visit or staying at the home on respite. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is adequate. This judgement has been made using all available evidence including a visit to the home. Detailed care plans are developed based on individual assessments with input from relevant professionals. These provide staff with relevant information to provide a personalised care service, however information relating to social care needs could be strengthened. Medication procedures should be reviewed to ensure the effective management of medication in the home. EVIDENCE: Based on discussions with residents, relatives and staff and through examining personal care plan records it was evident personal and healthcare needs are well documented and responded to. Staff support residents with personal care tasks as agreed in their care plan as one resident described it “They help me to help myself”. Various health professionals have been involved including the Occupational Therapy service, District Nurse and local GP practice. The use of pen pictures or a social history, which documents people’s achievements and what has been and continues to be important to them, was discussed with the Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 11 manager. It is recommended these are included in people’s care plans to give staff a better understanding of the person and their idiosyncrasies. Residents I spoke to during the day said that staff helped them to make and attend appointments outside the home in addition to arranging home visits, an example of this was a person who had arranged a chiropody appointment at home. When I arrived at 6.15am breakfast trays were set out and dossette boxes of medication had been placed on individual’s trays. Although this was in the kitchen, which is not easily accessed by residents it is recommended this system be reviewed to maintain the safety of residents. I discussed the medication storage and administration procedures with the manager who acknowledged the need to review the procedures relating to medication storage and administration as a priority. This will also include how residents and medication are identified and stock control systems. Residents spoken to during the day all spoke positively about their life in the home. One said “It will never replace my own home but the staff are lovely and will help you with anything you ask”. Another said “I’m very happy in the home, they are good to us”. Whilst observing staff they were respectful of residents and their individual needs and enjoyed a “healthy banter” as they went about their duties. When residents had made personal preferences regarding their wishes upon death a record was made in the care plan file to ensure their wishes are respected. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the home. Residents spoken to during this visit expressed a high level of satisfaction with the support they receive to pursue their interests and the level of control they have over their lives. EVIDENCE: Based on the information gathered through the initial needs assessment and care plan individuals social, cultural and religious preferences are recorded. This enables the staff to provide a personalised service that respects the diverse range of needs and preferences. Residents talked to me about their interests and hobbies, which included activities both inside the home and in the local community. Several people take a daily paper and enjoyed discussing news issues. Some people chose to sit in communal areas of the home whilst others enjoyed the privacy of their own rooms. One person described the home, as “Lovely, everyone is very friendly”. Another person said how much they “enjoyed the company”, and looked forward to the “talks and parties”. A mobile library visits on a two weekly basis, which residents also look forward to. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 13 The home has good links with the local community including the local churches, who provide services in the home for people not able to attend the church. During the visit I spoke to visitors to the home who confirmed that they “are always made welcome”, “they also said they were pleased with the standard of care”. Breakfast was served both in the dining room and in resident’s own rooms dependent on personal preference. I spoke with several people who said they were able to choose “when they got up and what they had to eat”. One person when asked about the food in the home said, “You get what you want the food is marvellous”. I joined residents for lunch in the main dining room. This was freshly prepared and well presented. Extra portions were offered and alternatives provided. The planned menu had a good selection of nutritional meals, which were confirmed on a daily basis on a notice board in the lounge. Through the care plan reviews people’s weight and nutrition are monitored. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 the following standard(s): 16, 17, 18 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the home. Residents feel safe and secure in their home environment and able to raise any concerns they may have. EVIDENCE: The home has a suitable complaints procedure, which is made available as required. There were no recorded complaints since the last inspection, however when I was speaking to residents one of them said, and “If we raise any issues they are sorted out”. In addition to the formal complaints procedure the supervisor consults with residents on an individual basis every 2/3weeks, with a record maintained of any issues raised and actions taken, which is good practice. Residents are able to vote in elections through either the postal vote or visiting the local polling station. A record of legal or alternative representatives is recorded on individual files. Staff receive training and support in following procedures in relation to identifying and responding to actual or suspected abuse, thus ensuring residents are safeguarded at all times. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the home. Brant Howe provides a safe and comfortable living environment that is suitable to meet the needs of the current residents. The home is clean, well maintained and decorated and furnished to a good standard. EVIDENCE: On the whole Brant Howe provides residents with a safe and secure living environment both in the home and the grounds. Three bedrooms have recently been refurbished as part of a rolling programme of repairs and renewal. One resident described to me how important it was to them that they were able to bring some of their own furniture and possessions into their own room. Overall the standard of decoration and furniture and fittings is good, with repairs completed in a timely manner. Access throughout the home is good and people move freely between the communal areas, which provide contrasting environments for people to relax Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 16 and enjoy. There is ramped access to the patio and garden areas making them accessible to all the residents. There is a main lounge where activities may take place and there is a television and music centre. Adjacent to this is a conservatory, which is popular with residents who enjoy the company or a read of the paper or one of the many library books. There are also two smaller lounges, which provide a quiet space, where residents can meet with visitors in private as an alternative to their own rooms. Toilet and bathroom facilities are also accessible and suitable for the needs of the residents. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 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 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, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the home. Despite some disruption with two staff leaving the home has continued to provide a suitably trained and experienced staff team, with staff levels periodically reviewed. Some refresher training is required to update the skills and knowledge of staff in relation to manual handling. EVIDENCE: The home has sound recruiting procedures with all necessary information recorded and held on file. Effective systems have been introduced to ensure all checks and references are completed within an appropriate timescale to safeguard residents. Staff files were checked for staff recruited since the last inspection and were found to be in good order. The nighttime on-call staff position has just been filled so temporary arrangements had been put in place to cover the vacancy. The home has one waking night staff, with a second member of staff who lives in being on-call as required. The need for the monitoring of this situation was discussed with the manager, to ensure that if needs changed adequate support would be available. Day staff started their shift at 7am with the night shift finishing at 8am thus ensuring appropriate staff levels when the majority of people are requiring assistance. I observed people getting up at various times with call bells being answered in a timely manner. One resident I spoke to said they “chose when to get up and what they had for breakfast”. I examined the individual training records, which on the whole reflected good practice including a formal induction process. However manual handling Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 18 training is an area that needs to be updated. The home is in the process of purchasing a new hoist and various manual handling equipment has been purchased or provided by the Occupational Therapist. The manager is planning to either send a senior staff on a training for trainers course or buy in up to date training, to ensure all staff are suitably trained and residents and staff are safeguarded. Over 50 of staff have either completed or are working toward a relevant NVQ qualification. Brant Howe DS0000022581.V300710.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, 32, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the home. The management and staff team ensure the home is run in the best interests of the residents. They consult with them on a regular basis and respond appropriately to any feedback. Residents feel confident their views will be heard and their rights are promoted and safeguarded. EVIDENCE: The current supervisory and management team are suitably trained and experienced to manage the home effectively and in the best interests of residents. The supervisor completes a 2/3 weekly survey with each resident on an individual basis to find if they have any issues of concern. This is in addition to an annual quality review questionnaire sent to residents and their representatives. The results from this consultation are compiled by the Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 20 manager and included in the statement of purpose and brochure and forwarded to interested parties. The manager spends time in the home on a daily basis in both a management role but also in a hands on role, which gives him a good insight and direct contact with the residents. The manager provides regular formal supervision to the supervisor who in turn provides supervision to the care staff. Records of supervision are maintained and held on personal files. Routine health and safety checks are completed and records maintained as required by legislation. The fire log was up to date and fire services had been inspected. The registration certificate and insurance certificate on display were out of date, however new certificates were held by the manager and will be replaced. The need for liquid soap, as opposed to bars of soap, in all communal toilets and bathrooms was discussed with the manager in line with infection control good practice. Brant Howe DS0000022581.V300710.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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 22 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. 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 2 3 Refer to Standard OP7 OP9 OP30 Good Practice Recommendations It is recommended a pen picture/social history of the person is included in their care plan to give staff a better understanding of the person and their idiosyncrasies. It is recommended the home review their medication storage and administration procedures to ensure residents are safeguarded at all times. It is recommended manual-handling training be provided to update the skills and knowledge of staff. Brant Howe DS0000022581.V300710.R01.S.doc Version 5.2 Page 23 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 DS0000022581.V300710.R01.S.doc Version 5.2 Page 24 - 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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