Inspection on 02/06/07 for Brantwood Residential Care Home

This inspection was carried out on 2nd June 2007.

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

Brantwood Residential Care Home 06/02/09

Brantwood Residential Care Home 07/02/07

Brantwood Residential Care Home 27/01/06

Brantwood Residential Care Home 05/08/05

Brantwood Residential Care Home 24/02/05

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 Brantwood Residential Care Home 112 Congleton Road Sandbach Cheshire CW11 1HQ Lead Inspector Paul Ramsden Unannounced Inspection 2nd August 2007 10:30 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 Brantwood Residential Care Home DS0000062465.V342166.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. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brantwood Residential Care Home Address 112 Congleton Road Sandbach Cheshire CW11 1HQ 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) 01270 760076 01270 753013 brch@btconnect.com Mr Robert Shaw Miss Sally Ann Bissett Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 21 service users in the category of OP (old age not falling within any other category) 23rd April 2007 Date of last inspection Brief Description of the Service: Brantwood is a large detached Victorian house set in its own grounds in Congleton Road, Sandbach. It is a privately owned home that provides care for older people. It has 21 single bedrooms but two of these could be used as double rooms if necessary. All of the rooms have en suite facilities. Accommodation is on two floors and is accessible via two staircases, one of which has a stair lift. There are two lounges, a dining room, conservatory and a sitting room, which is adjacent to the reception area. There are enough toilets and bathrooms for the number of residents living in the home. There is a kitchenette next to the dining room where residents or visitors can make themselves drinks and snacks if they wish. There is a large enclosed garden at the back of the house with a gazebo for the residents to use; this is fully accessible to residents and is well maintained. Information on the fee payable for this service is available from the home owners. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 2 August 2007 and lasted six hours and forty-five minutes. Paul Ramsden, Inspector, undertook the visit. All of the key standards for older people were looked at. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a quality assurance assessment of the service in order to provide up to date information about the home. Questionnaires were made available for clients, families and care managers to find out their views and other information received since the last key inspection was reviewed. Five resident, four relative and one care manager survey forms have been returned. During the visit various records and the premises were looked at. A number of clients, relatives and staff members were spoken with; they gave their views about the home and the service provided. A random inspection visit was undertaken on the 23rd April 2007, this identified a number of shortfalls within the service and as a consequence seven requirements were made. A considerable amount of work has been undertaken and all of the requirements made have now been addressed. Reference to the work carried out is included within the report. What the service does well: The staff members at Brantwood provide a good standard of care to the residents that live at the home, they were seen to be treating clients with respect and dignity and were able to demonstrate an awareness of their diverse needs. Good relationships were seen to exist between residents and staff and those people that commented all said that the staff members were good. Comments from residents and relatives included; “The staff are friendly and helpful, they treat me with respect”. A relative said; “The staff are brilliant”. There were a number of positive comments on the survey forms returned; one resident said, “The staff are excellent”. A new activity co-ordinator has recently been appointed and a variety of activities/social events are organised, these include both external trips and in– house events. A visiting relative said, “She is smashing”. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 6 A good selection of training courses is available for the staff members working in the home. 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brantwood Residential Care Home DS0000062465.V342166.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 Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission assessment gives prospective clients confidence that the home will be able to meet their needs. EVIDENCE: The statement of purpose and service user guide for the home was clear and informative. It is typed in large dark font so it is easier for people with problems with their sight to read. These documents include enough information to enable the residents to make a choice about whether their needs could be met at the home. All of the information required under the Care Homes Regulations 2001 and Standard 1 of the National Minimum Standards for Older People is contained within these. A resident has written on a survey form, “I have previously spent a little time in another residential home which was quite satisfactory. However it doesn’t even come close to the level of care and support I now receive at Brantwood”. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 9 Pre-admission assessments are carried out to ensure the home can meet an individuals needs. The files seen for the most recently admitted residents covered all aspects of the prospective resident’s life. Residents’ health needs were assessed before they moved into the home and this continues to be assessed once they are living there. Any medication they were on and a detailed medical history were recorded. It has been ascertained previously that the manager would welcome visits from prospective residents and would invite them to stay for a meal and visit as often as they wished to do so before making a decision about whether to live there. Brantwood does not provide intermediate care. Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans seen generally provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The care plans seen as part of the case tracking process provided sufficient information to look after a person’s needs. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. Since the random inspection visit in April 2007 the manager has improved the quality of the care planning system. A new risk assessment process, including falls has been implemented and although this is not quite completed for everyone it will be in the near future. Due to the fact that the manager completes the care plans electronically it is still not always possible to confirm that the care plans are being reviewed regularly or as the relevant standard recommends at least monthly. During a discussion with her it was agreed that she would introduce a new monitoring form and record whenever the plans were reviewed. This will be looked at during the next inspection visit. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 11 There have been a number of other changes since the random inspection took place; these include a greater involvement of the senior carers in the care planning system, the introduction of a key-worker system within which there is an expectation that the key staff member meets with their key residents weekly. A record of these meetings was seen in the care plans inspected and is considered to be a very positive step in involving individuals in their own care. The residents and staff members spoken with all confirmed that this was happening and said that it had been a positive move. A new diary and communication book system has been implemented; this has improved the recording of appointments and has encouraged greater communication between staff members between shifts. Staff members spoken with had a good understanding of the people they were supporting and were able to meet their diverse needs; they continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. The residents spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. Brantwood has a written policy on the receipt, administration [including selfadministration] safekeeping, handling, recording and disposal of medication within the home. The home uses a blister pack system dispensed by a local pharmacist. Whilst the documentation seen demonstrated that medication was being well managed within the home; [The amount received is being recorded and there were no issues identified on the medication record forms] the record of any medication returned to the pharmacist was not well recorded. The manager explained that she had requested a returns book from Boots [the supplying pharmacist] but they had still not provided one. The manager had considered changing pharmacists because of this. It was agreed that she will address this matter as a matter of priority and would ensure that a record of any medication returned would be kept from the day of the inspection visit. As this matter is to be addressed and there were no other issues observed no requirement has been made. Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People spoken with were very positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend their time and with whom and participation in planned activities. Staff members were seen to knock on the door and to await permission before entering a resident’s bedroom. One of the residents said, “I treat it like home”. The home has recently employed an activities co-ordinator whose role is to work with people both individually and in groups. A variety of social and other activities are organised and information about these was displayed on the notice board. The residents and family members spoken with made a number of positive comments about this appointment. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 13 Links with the local community are maintained and people are able to come and go from the building. Visitors are free to visit the home at any reasonable time. Personal mail was delivered unopened, or given to relatives if appropriate. Meals can be taken in the dining areas or in the privacy of a person’s own room. The menu has the flexibility to meet individual needs and choices. Although the majority of the people that commented said the food was good and that choices were available; a number of them said that they were fully aware of the owners attempts to recruit a new cook [the two owners are currently doing the cooking]. Some of the residents said; “We would like a new cook to take the pressure of the owners”. These comments were also made on some of the survey forms returned. It was confirmed that special diets could be prepared where necessary. Drinks and biscuits/fruit were readily available whenever people wanted them. Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of people staying in the home. EVIDENCE: There is a clear complaints procedure for the home and information on how to raise any concerns or complaints are readily available. Information on how to complain is also included in the statement of purpose and service user guide. There is a complaints record for recording any complaints made. The people spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The survey forms received also confirmed this; one resident has written on a survey form, “If I felt I had a complaint and needed to voice it, I know how to deal with it”. Brantwood provides policies and procedures for the protection of vulnerable adults, which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. Staff members working in the home have recently received training in this area. Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, homely, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included the lounges and communal areas. The home continues to be well maintained, clean and comfortable for the residents. Furnishings, fittings and lighting in the lounges and communal areas are of a good quality and are domestic in character. There is a small kitchen off the lounge/dining room for residents and family members to use. Bedrooms seen during the inspection were personalised, comfortable, wellfurnished and contained items of furniture belonging to residents’. All bedroom doors have locks that can be overridden by staff in an emergency. A lockable drawer is provided in each bedroom. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 16 The home provides adaptations for use by residents with mobility problems: these include bath and toilet aids, hoists, grab rails and wheelchairs. The home was found to be clean and tidy on the day of the visit. The laundry is appropriately equipped and good systems are in place for the care of peoples’ clothes. Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents and families to improve the quality of life of people living in the home and a robust staff recruitment process is in place in order to protect people from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly. Residents and relatives spoken with were complimentary about staff attitude and competence. A resident said, “The staff are very good/excellent, they always treat me well”. All staff members have signed to say they has read and understood the home’s policies and procedures. The staff members working at the home are able to undertake NVQ training, a recognised qualification for staff involved in delivering care. The staff members spoken with said that they are able to access a wide range of training courses and that in their opinion this had improved recently. The staff training matrix showed that staff have been able to attend the following courses during the previous 6 months; NVQ, continence care, moving and handling, fire training, first aid, health and safety, food hygiene and POVA. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 18 The files for the two most recently appointed members of staff were inspected. Although it was seen that the first of these was appointed prior to the home having received either a POVA First or a CRB disclosure the most recently appointed staff member did not commence employment until a POVA First was received, she was also working under supervision. During a discussion with the home manager she confirmed that this was the process that was now in operation and in the future no staff members would commence employment until the home had received a POVA First. The home uses the Skills For Care induction programme for new staff. This is completed within six months of employment. The induction record for a staff member that had been working at the home for approximately four months was seen during the visit. This person confirmed that the process had happened and that it had been really useful when she had started at the home. Brantwood Residential Care Home DS0000062465.V342166.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis and there are appropriate procedures in place to make sure that clients are safe. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. She has completed the registered managers award and has attended courses/training in order to fulfil her management responsibilities. She was able to demonstrate an awareness of the diverse needs of the client user group and how to manage the staff team. A number of positive comments about the two homeowners were made during the visit. Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 20 A quality assurance survey to ascertain whether people are happy with the standards of care being provided is an ongoing process. Brantwood does this by sending out questionnaires to residents and their families, the findings are to be collated and a report will be made available. Brantwood does not handle any finances for residents. There is a comprehensive health and safety manual as well as policies and procedures in relation to safe working practices in place. There was evidence that staff were receiving training in areas such as moving and handling, first aid and adult protection. The manager keeps a record of statutory and other training undertaken by staff. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place. Brantwood Residential Care Home DS0000062465.V342166.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 X 3 X X 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Brantwood Residential Care Home DS0000062465.V342166.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. Refer to Standard Good Practice Recommendations Brantwood Residential Care Home DS0000062465.V342166.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 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 © 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 Brantwood Residential Care Home DS0000062465.V342166.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. 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