CARE HOMES FOR OLDER PEOPLE
Branthwaite Nursing Home Branthwaite Road Workington Cumbria CA14 4SS Lead Inspector
Elaine Brayton Unanounced 05 July 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. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Branthwaite Nursing Home Address Branthwaite Road Workington Cumbria CA14 4SS 01900 67111 01900 68339 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) Aspenframe Limited Pauline Armstrong Care Home 40 Category(ies) of Old Age - OP registration, with number Physical Disability - PD of places Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 40 service users to include - up to 40 service users in the category of OP (Older People over 65 years of age, not falling within any other category) - up to 5 service users in the category of PD (Adults with a Physical Disability) 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 3. The en suite bathroom in the room named Keddie 2 must be fully redecorated by 28th February 2005.. Date of last inspection 14 October 2004 Brief Description of the Service: Branthwaite care home is situated on the outskirts of Workington.The home is a care home that can provide nursing care for 40 people, 5 of whom may be aged between 18 and 59 with a physical disability.All of the rooms are for single occupancy. En suite facilities were provided in all but three rooms and those three had wash hand basins in the room with toilet and bathing facilities close by. There were pleasant communal areas. This comprised: One lounge/ conservatory at the front of the home and one smaller lounge at the other end of the home. There was also a conservatory and dining room at the rear of the home. The front lounge had a small area put aside for dining.Outside, there were raised gardens by the rear conservatory, and to the front and side of the home were paved areas with tubs and pots positioned for service users, visitors and staff to enjoy. These grounds were accessible to all residents. There was a large car park to the front and side of the home and access into the home was via a gentle slope allowing access for those in wheelchairs. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home and took place over one day, and the manager was present throughout. During the inspection time was spent talking with service users and their relatives in private and in small groups. A selection of records relating to the care of service users and the day to day running of the home were looked at, and most parts of the private and communal accommodation were visited. What the service does well: What has improved since the last inspection? What they could do better:
Cleaning fluids found in the domestics cleaning trolley were in unlabelled bottles; this is a health and safety risk to residents and visitors to the home. A requirement was made about this as a result of the last inspection. The requirement is repeated in this report, and the manager has been advised that immediate action must be taken to ensure cleaning fluids are stored correctly. Personal toiletries were observed in one of the communal bathrooms, and staff were unsure who they belonged to. An improved storage arrangement should be made for resident’s toiletries. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 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. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 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 Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 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) 1,2,3,5 The admission procedures of the home are thorough, and ensure service users needs can be met before they are admitted to the home. People are provided with information about the home, and can visit to look around the home before making a decision to move in. EVIDENCE: The home has a statement of purpose which includes important information about the care and services provided in the home, and this is available to people living in the home or thinking of moving into the home. When people move into the home they are provided with a service users guide, and after a trial period a statement of terms and conditions, which sets out the fee, the room to be occupied and services included in the fee. A thorough assessment of need is carried out, and those looked at contained information about all aspects of the person’s health and social care needs. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 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) 7,8,9,10 The home had a clear and consistent care planning system, which ensured residents health, and social care needs were met in a way that promoted their privacy and dignity. EVIDENCE: A selection of care plans were looked at during the inspection, and they contained a good level of information about the health and social care needs of residents and how those needs are to be met. The care plans were up to date, and were regularly reviewed and updated to reflect the changing needs of the resident. The plans are signed by the resident or a relative on their behalf. Healthcare needs are attended to, with details recorded of appointments and consultations. Residents said that they are cared for in a way that respects their privacy and dignity. There were some toiletries in one of the communal bathrooms, and staff were not sure who they belonged to, and the manager said she would ensure peoples personal toiletries were stored appropriately. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 Social activities varied and provided residents with a range of choices and opportunities on a daily basis. EVIDENCE: There are two activity organisers who work in the home, and they arrange various group and individual activities for people. They talk with residents to find out their interests and preferences, and then plan their time accordingly. They also arrange special events when various entertainers visit the home. Residents said that they enjoyed participating in the activities, and had enjoyed the magician who had visited the day before. Residents also enjoyed being able to do individual activities accompanied by one of the staff. Visitors are welcomed into the home at any reasonable time, and said they are always made to feel welcome and are offered refreshments. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 11 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 The home has a satisfactory complaints procedure, and has systems in place to protect service users from abuse. EVIDENCE: The home has a complaints procedure, which is accessible to all residents and their families, so people are clear about how they can complain if they are unhappy about anything. Written records are kept about any complaints and concerns raised, and how they are dealt with. Staff have received training about the protection of vulnerable adults, and are aware of their role and responsibilities in relation to this. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 12 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) 19,20,21,23,24,25,26 The communal and private areas in the home are well maintained, spacious, and clean and provide comfortable accommodation for residents. There is a range of equipment available to assist people in their daily life. EVIDENCE: The home is maintained to a good standard, and residents found their surroundings pleasant and comfortable. There is easy access to outdoor areas, which have seating and flower tubs. Most of the bedrooms have ensuite toilet facilities, and some rooms have a bathroom. There are also toilets and bathrooms around the home close to communal and private accommodation. Bedrooms had been personalised by the residents and their families and contained the persons’ own furniture, pictures, ornaments and photos, which made them more homely. The home was clean and hygienic on the day of the inspection. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 13 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) 27,29, The home has a robust and thorough recruitment procedure, and through this sufficient staff are recruited with the required skills to meet the needs of residents. EVIDENCE: Each day there were six members of care staff on duty in addition to the two nursing staff, there was also an activity organiser on duty during weekdays, cleaning staff, kitchen staff and a maintenance person. Residents said their needs were attended to promptly, by staff who were kind and caring. New staff are recruited through a robust recruitment procedure, and records of new staff appointed confirmed this. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 14 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) 31,34,35,36,37,38 The manager provided leadership and direction to staff to ensure residents received consistent, good quality care. The practices and systems in place, safeguard resident’s interests, financial affairs and health and safety. However, cleaning fluids were found on the cleaning trolley in unlabelled containers, which is a health and safety risk to residents and visitors to the home. EVIDENCE: The manager is in the process of completing the Registered Managers Award, and gives leadership and direction to staff. All staff have an annual appraisal and regular one to one supervision, which ensures training needs are identified, and that staff provide care for people in a suitable way. There are systems in place to safeguard resident’s money and financial affairs, and these records were looked at during the inspection. Tests and checks of the fire safety equipment and procedures were carried out and recorded as required.
Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 15 Cleaning fluids were found on the cleaner’s trolleys in unlabelled bottles. This was highlighted during the last inspection, when a requirement was made, but this is still happening. The requirement has been repeated, and the Manager had been informed that action must be taken to address this. Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 16 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 3 3 3 x 3 N/A 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 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 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 x x 3 3 3 3 2 Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 17 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 op38 Regulation 13 Requirement All cleaning products must be in labelled bottles in accordance with COSHH Regulations. Timescale for action 6.07.05 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 Good Practice Recommendations Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 18 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 Branthwaite Nursing Home F58 F10 s10100 branthwaite nursing home v203300 050705 ui stage 4.doc Version 1.30 Page 19 - 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!
