Inspection on 05/08/05 for Brantwood Residential Care Home

This inspection was carried out on 5th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Brantwood Residential Care Home 06/02/09

Brantwood Residential Care Home 02/06/07

Brantwood Residential Care Home 07/02/07

Brantwood Residential Care Home 27/01/06

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 112 Congleton Road Sandbach Cheshire CW11 1HQ Lead Inspector Judith Morton Announced 4 & 5 August 2005 th th 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. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Brantwood Address 112 Congleton Road Sandbach Cheshire CW11 1HQ 01270 760076 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robert Shaw Miss Sally Ann Bissett Care Home 21 Category(ies) of OP Old Age (21) registration, with number of places Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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) 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 24th February 2005 Brief Description of the Service: Brantwood is a large detached Victorian house situated in its own grounds in Congleton Road, Sandbach. It has 21 single bedrooms with the two largest of these being used as double bedrooms. All of the rooms have en suite facilities. The home was first registered in November 1994 and provides residential care for older people. Accommodation is on two floors and access between floors is 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. The home has three bath/shower rooms and six toilets, and is appropriately adapted to meet the needs of older people. There are large private gardens to the rear with a gazebo for services users to use. The home is furnished, decorated and maintained to a high standard. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days and lasted a total of 12 ½ hours. 10 of the residents’ care plans were reviewed, 6 members of staff and 10 residents were spoken with throughout the two days. Additionally, discussion was held with two relatives and a total of 10 CSCI comment cards were returned prior to inspection, 6 from relatives, 2 from GPs, 1 from a community nurse and 1 from a resident. What the service does well: What has improved since the last inspection? What they could do better: Minor improvements are needed to the care plans so they include all the residents’ care needs and how these will be met. Although there are appropriate policies, procedures and information in the home about adult protection, staff need training so that they are aware of how to protect the residents from possible harm and poor practice. Minor improvements are recommended to the complaints procedure and to the contract agreement between the home and each resident. It is recommended that the residents’ wishes in the event of their death should be discussed with them and recorded so that, if they die, the staff and the resident’s relatives will know what to do. Brantwood F51 F01 S62465 Brantwood V234549 040805 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. Brantwood F51 F01 S62465 Brantwood V234549 040805 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 Brantwood F51 F01 S62465 Brantwood V234549 040805 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) 1,2,3,4, & 5 There was sufficient and clear information available so current and prospective residents know what the home offers. On the whole, the needs of the residents have been assessed before they moved in so that residents and their relatives know their needs can be met at the home. EVIDENCE: The statement of purpose and service users guide for the home was extremely clear and informative. It is typed in a large dark font that made it easier for people who have a visual impairment to read. It contained all the necessary information necessary although the complaint procedure should indicate that people could complain directly to the Commission for Social Care Inspection in the first instance if they so wish. The residents have a contract agreement between them and the home. The manager is in the process of removing the names of the residents’ rooms and replacing them with numbers, as these will be easier for the residents to remember and make room identification easier in emergencies. Once this is complete, the room number occupied be each resident should be added to his or her contract. See recommendation 1 Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 9 There were assessments available for each of the residents from which the care plans had been devised. Assessments had been carried out before the residents moved into the home to establish that their needs could be met there. The manager said that she would welcome visits from prospective residents and would invite them to stay for a meal and visit as frequently as they wished before making a decision about whether to live there. A potential resident and her family were due to visit the home in the forthcoming week. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 &11 New care plans have been developed. These are very clear but minor improvements need to be made so that all the residents care needs are recorded, together with information on how they should be met. EVIDENCE: The manager has introduced new care plans for each resident since she took up the post in November 2004. They have been devised from information held on the current assessment forms. The care plans are exceptionally clear with good use of headings to enable staff to find relevant information quickly. Ten care plans were read in total. Overall they contained all of the information required to enable staff to deliver good quality care but there were some omissions of information that was essential to their care. For example, one resident used a hearing aid but there was no reference to this in her care plan. There was no diagnosis recorded for those residents who clearly had additional needs through ill health. For example, one resident has had a stroke. New staff would need to know this information and which side has been effected in order to deliver the care appropriately. (see requirement 1) Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 11 The health needs of the residents were clearly being met. On the days of inspection one resident had received a visit from her GP, another from the district nurse and another resident had just returned from hospital. The continence advisor and community nurse were also providing advice and treatment for residents in the home. The medication recording and storage was seen and was being well managed with medication administration records being completed appropriately. Four staff in total have completed medication training. The wishes of each resident in the event of them developing a terminal illness or their death had not been recorded. (See recommendation 2) Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 There are a number of activities so that the residents can keep stimulated and active and keep their links with their relatives and friends in the community. The residents said that the food was very much improved and they now receive a varied and wholesome diet that they enjoy. EVIDENCE: The residents said that visitors can call to the home at any reasonable time and this was seen to happen over the two days of inspection. The new owners have improved activities for the residents, including bingo, games and sing-alongs with an organist. The manager has hired a mini bus to take the residents out on day trips. A small number of residents are able to go out to shops and the market in the local area. This happened on the first day of inspection. Another resident had been out for an optician’s appointment with a member of staff and had followed it with a visit to a café. A volunteer calls to the home once or twice in the week to chat with the residents and play cards and a local vicar visits to give communion. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 13 All of the residents enjoyed the food offered and said it was fresh and wholesome. Two of the residents felt some meals were a little richer than they were used to but enjoyed trying new things. Although one resident felt the portion sizes were too big another was pleased that she was now the correct weight for her height, having gained 1 ½ stone since November 2004. The dining room is bright and airy with small tables for 4 people. Some residents likened it to a 4 star hotel, with tablecloths and napkins on the tables. The lunch was a pleasant, unhurried occasion for the residents who were able to chat with each other during the meal. The staff offered discreet help to residents who needed it. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 The complaints procedure is effective although minor improvements are needed to recording so that the outcome of complaints is clear. Staff must undertake training on awareness of abuse to adults so that residents can be protected from possible harm and poor practice. EVIDENCE: There have not been any complaints made since the new owners/manager took over the home. Complaints forms were seen and contained appropriate headings to ensure that the complaint is recorded adequately and it would be investigated but needed to include the outcome of the investigation and how the complainant was made aware of it. The complaint procedure should read that people can complain to the Commission for Social Care Inspection at any stage of a complaint. (See recommendation 3) Although there are policies and procedures in relation to No secrets and whistle blowing, a ‘No Secrets’ video and the Department of Health document available in the home, the staff have not undertaken any formal training on adult abuse awareness. They were not aware of what they needed to do if abuse was alleged or suspected so must undertake appropriate training in adult abuse awareness. (See requirement 2) Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22 23, 24, 25 & 26 The home is well maintained and clean so that residents are provided with a comfortable, homely place to live. EVIDENCE: The home is very clean and well maintained with further improvements planned. It is bright, airy and free from offensive odours, without the use of air fresheners. Environmental safety checks are being carried out and infection control procedures have been introduced to the home, ie, plastic aprons, latex gloves, linen bags for the transport of soiled linen to the laundry and sanitary bins/yellow bags for the disposal of soiled continence products. Ten new smoke detectors had been installed. The residents spoken with all said they were very happy with their room and liked the fact that they had an en suite bathroom. They had a number of their own possessions around them such as photographs, paintings, ornaments and some smaller items of furniture. There were additional bathrooms and toilets around the home. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 16 Some of the empty rooms had been or were being redecorated at the time of the inspection and a new kitchen was due to be fitted the week after the inspection. There were plans for a programme of re-decoration of the bedrooms once the bigger structural changes had been made within the home. The lounges and dining room were pleasant and although some were quite small they provided the residents with a number of alternative seating areas within the home. The conservatory added a pleasant space in which the residents could spend their time. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 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, 28 29 &30 The staff training that has been put in place will ensure that the knowledge and ability of the staff is maintained. Although the manager and owner are currently filling the hours that would be covered by senior care staff, this gap in staffing could place residents at risk if it continued over a long period of time. EVIDENCE: The home is lacking two senior carers and a cook. The manager has tried to recruit senior care staff without success and now plans to employ two workers from overseas who have a good knowledge of written and spoken English. The manager was able to describe fully the recruitment procedure and practice that she will undertake with any new employees. The current staff had not had the appropriate recruitment checks made when the previous owner employed them. As many of them had worked at the home for many years it was proving very difficult to request references. The manager should obtain other required information from existing staff such as passport and certificates of qualification, and hold photocopies of these on their file. The newly devised job application forms were seen and would provide adequate information for the manager to make a decision as to whether to interview and also to commence the appropriate checks. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 18 Two staff currently hold NVQ level 2 and a further two staff have been enrolled on to the course for September 2005. All of the staff are to undertake Working in Care Induction Standards. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 & 38 The manager has made a number of changes within the home that the staff and residents feel are positive and beneficial to all. Staff supervision and training will ensure appropriate and safe care is given to residents. EVIDENCE: The manager has worked in care services for many years and has managed a residential home before moving to Brantwood. She is registered with the Commission for Social Care Inspection. She has a good awareness of her role towards both staff and residents. All of the staff and residents spoke highly of her and the changes she had put into place since purchasing the home. All of the residents are responsible for their own finances, with relatives or representatives involvement where required so staff of the home have no dealings with these. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 20 There are two files containing policies and procedures to be followed; these are available to all staff who sign to say they have read and understood them. Staff supervision has been set up but not all staff have received formal supervision. The manager however, spends a lot of time working alongside the staff and is able to observe their practice and offer guidance where necessary. The residents had been consulted about their views of the home and the services provided, via a questionnaire, which many had completed independently and others with the help of their relatives. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 2 3 3 3 3 3 3 3 3 Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 22 yes 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 7 Regulation 15 Requirement The care plans must clearly identify all of the residents care needs and how these are to be met. All staff must undertake awareness of adult abuse training. Timescale for action 01/11/05 2. 3. 18 13 01/01/06 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 2 11 16 Good Practice Recommendations The number of the room occupied by each resident should be added to their contract. The wishes of the residents in the event of terminal illness or death should be discussed and recorded on their file. The complaints procedure should read that a person can complain to the Commission for Social Care Inspection at any time, and the recording of complaints should include the outcome of the investigation and how the complainant was informed of this. Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way, Gadbrook Park Northwich CW9 7LT 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 Brantwood F51 F01 S62465 Brantwood V234549 040805 Stage 4.doc Version 1.30 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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