Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 28/01/09 for Branthwaite Care Home

Also see our care home review for Branthwaite Care Home for more information

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Branthwaite Care Home 34 Welham Road Retford Nottinghamshire DN22 6TN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Branthwaite Care Home 34 Welham Road Retford Nottinghamshire DN22 6TN 01777706720 01777706720 rocky@fbccarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): FBC Care Homes Limited Name of registered manager (if applicable) Mrs Leelah Manee Sooriah Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Non ambulant service users shall be accommodated on the ground floor Service Users shall be within categories MD/E (21), DE/E (21) or MD (2) within a total registration of 21 beds Date of last inspection Brief description of the care home Branthwaite is an older style adapted and extended home offering accommodation for 21 people. There are 17 single bedrooms and 2 shared bedrooms which can be reached either by stairs or a shaft lift. Many of the bedrooms have direct access to the gardens. There are a variety of day spaces well furnished in a homely style. There are attractive well-maintained gardens, which provide security and privacy. The home is situated in a quiet residential area close to the town facilities of Retford and is on a main bus route. The current weekly fees are £367 - £390 per week depending upon needs. Hairdressing and chiropody fees are not included. Care Homes for Older People Page 4 of 28 0 2 Over 65 21 21 care home 21 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2008. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year. Care Homes for Older People Page 6 of 28 The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming to the home will know their needs can be met as they have been assessed. Evidence: Care files seen included a pre admission assessment which had been completed by the Local Authority. The files for two people admitted within the last six months had a further needs assessment completed shortly after admission. A senior carer said there is usually a waiting list for people to come to the home, and information sent to the home is shared with staff before anyone moved in. One of the most recent people to move into the home said she knew she needed to come somewhere like this, as she needed some help, and had talked about what she needed. Care Homes for Older People Page 11 of 28 Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are met by care practices in the home, and in a manner that promotes their privacy and dignity. Evidence: A sample of five care plans were seen and these were clearly written, regularly reviewed and updated. There were risk assessments seen in care files for things such as moving and handling, mobility and tissue viability. A risk assessment for nutrition identified one person to be at risk, and a care plan had been prepared for this. A senior carer said that all staff are involved in keeping care plans up to date through a keyworker system. Staff said that the care plans provide them with the information they need about peoples needs. One person spoke about plans for her to move to a rehabilitation unit in the future. Care Homes for Older People Page 13 of 28 Evidence: A record is made in the care file of any healthcare appointments and entries seen showed people access a variety of community based services, including community based nurses, dentist and optician. Staff said when they get everyone up in the morning they check to see how they are and ask them how they are feeling. Staff said they call a doctor if someone is not looking or feeling well. During this visit staff were seen making appointments and contacting a doctor to discuss someones well being. One person spoke of going to a local hospital for some treatment and another said, The doctor comes to see me if I ask. There is a medication trolley on each floor and controlled drugs are stored in a locked cupboard in the office, however this does not meet the required standard. It was unclear from some of the entries in the controlled drugs book about changes to one persons medication. Staff on duty were able to explain what had happened, but this should have been recorded. One person said, I take my medication when I am given it. There were references seen in care files to promoting peoples privacy and dignity. There were details of peoples preferences, for example one plan described when a person should wear a continence pad as they did not like to wear it all the time. One person was heard asking a member of staff if they had locked their bedroom door. Staff said they felt the staff team were good at promoting peoples privacy and dignity and they always attend to people in private. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to take part in social activities, but could have greater opportunities to make decisions and choices for themselves. Evidence: There are different activities organised on each floor daily, to take into account the different interests people have due to the age differences. On the lower floor people were seen joining in a ball game and those on the upper floor were listening to music and discussing a shopping trip with staff. There are two people from the upper floor who attend a local day centre. A record is made of the activities provided in a book and these showed activities such as dominoes, painting, sing song and movement to music have taken place recently. Staff said they are planning a land army day on Valentines day to bring back some memories. One person on the upper floor said, I would like to play dominoes and we watch television at night and someone from the lower floor said, I like the ball games, it Care Homes for Older People Page 15 of 28 Evidence: keeps me moving. One person was going out shopping for some new clothes and another was seen returning from a trip out. Staff said there are always plenty of people here visiting, and another member of staff was heard discussing with one person about a relative coming to see her later. Staff said they offer people choices but felt there were probably some areas where more could be offered. During the visit it there were a number of situations where people could have been offered choices. These included a choice of morning drink, what music to listen to and what game to play. One person said, I go to bed when I want, I sometimes go at 9 and sometimes 10. The main meal is served at lunchtime and the same dish is served on both the upper and lower floors, even though there are differences in their ages. There is not a choice of meal but staff said an alternative is available. However the meal records did not show that one was provided very often. Lunch today was chicken in white wine sauce, mashed potato, swede, broccoli, carrots and cauliflower. Meals were plated up in the kitchen and taken to people in the dining rooms on the lower and upper floors. This did not take into account peoples preferences or likes and dislikes. The following comments were heard, This is too big, I only like carrots in a stew, I dont like carrots or swede and I cant eat all of this. People on the upper floor were seen scraping food they didnt want off their plates. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place for people to raise any concerns and staff know how to safeguard people. Evidence: There is a complaints procedure in place where anyone can raise any concerns or complaints they may have. There is a complaints book to record any complaint in, however the last entry was in 2006. Staff said they were aware of the complaints procedure but they had not had any complaints made to them. One person said, I would tell staff if I had any complaint but everything is how I like it. A copy of the Nottingham and Nottinghamshire Safeguarding Adults procedures were seen on the managers desk. Staff said they were aware of the procedures and had received training in safeguarding adults. A recently appointed member of staff said she had been made aware of these as part of her induction. The manager said there have not been any safeguarding investigations in the home and showed the staff training records which showed staff had received training in adult Care Homes for Older People Page 17 of 28 Evidence: protection. Five people were asked if they felt safe in the home and all replied that they did. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Current rooms are dated, however once the recently agreed refurbishment plan is completed people will be living in a significantly improved environment. Evidence: Plans have recently been approved for a major refurbishment of the home. The work is currently out to tender and is expected to begin in May 2009. This will replace many of the current rooms which the provider described as dated. People living in the home and their relatives have been informed about the changes. Staff said they were looking forward to the changes, there will be more space and all bedrooms will have ensuites. The provider said the work is to be done in stages to minimise the disruption to people living in the home. Staff were seen wearing protective clothing when assisting people and serving food. Staff said they have had training in infection control and they follow safe practices. The laundry was well organised and there are systems in place to was soiled laundry and Care Homes for Older People Page 19 of 28 Evidence: dispose of any waste. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient and suitably trained staff on duty. Evidence: The rota showed that their are four care staff on duty during the day and two at night. There was always at least one member of staff on the upper floor and staff were seen spending time with people in the lounge. Staff said that staffing levels were satisfactory and they were able to spend time with people living in the home. One person said, We enjoy a good chat. All staff have either completed or are working towards National Vocational Qualification level 2. A recently appointed member of staff confirmed that she had completed and application form, provided the names of two referees and sent of a form to the Criminal Records Bureau (CRB) to under go a CRB check. Care Homes for Older People Page 21 of 28 Evidence: The application form and returned references were seen on file as was a Protection of Vulnerable Adults check (POVA), but the CRB check had not yet been returned. The member of staff concerned was working at the time, and had been seen working unsupervised, whereas anyone who has got a POVA check returned but is still waiting for a CRB check must be supervised at all times. The manager said she would ensure the person is under supervision from now on. The manager said regular training is provided and she ensures that staffs training is kept up to date. Training records showed that staff receive regular training. The manager said that she is arranging for a dementia care course and some discussions have taken place about the Mental Capacity Act, and that she will be going on a course about this shortly. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: The manager, who is also one of the providers, has been the manager of the home since it was opened in 1990. The manager undertakes regular training and is a State Enrolled Mental Health Nurse. The manager has completed the Registered Managers Award and is a National Vocational Qualification Assessor. Staff said the manager and provider are very supportive. One person living in the home said, I think the home is managed very well, I couldnt say a bad word about them. The manager said she had recently sent out some quality assurance surveys, eight of which have been returned so far. A relatives meeting was held last week. Care Homes for Older People Page 23 of 28 Evidence: The manager said that most people have assistance in managing their finances from relatives, but there is a system in place to help people manage their personal allowances. Records for these showed each transaction is witnessed and receipts are kept of expenditures. The manager said that all safety checks and tests are carried out at the required frequency. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 A record must be made of any changes to someones medication. This will ensure that people receive their correct medication. 10/02/2009 2 9 13 Controlled medication must be kept in an approved cupboard. This will ensure that peoples medication is looked after safely 01/03/2009 3 14 12 Staff must give people living 01/03/2009 in the home greater opportunities to make choices. This will ensure that people living in the home will have some control over their lives. 4 15 16 The current catering arrangements must be reviewed to take into account peoples 01/04/2009 Care Homes for Older People Page 26 of 28 individual preferences and likes and dislikes. This will ensure that people have meals they enjoy. 5 29 19 Staff who have got a Protection of Vulnerable Adults check but not yet received the Criminal Records Bureau check must be supervised at all times when working. This will ensure that people are not placed at risk of abuse from new staff. 01/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!