CARE HOME ADULTS 18-65
Branwell Lodge Nursing Home Smith Road Off Southfield Lane Bradford West Yorkshire BD7 3NJ Lead Inspector
Linda Trenouth Unannounced Inspection 20th October 2005 12:00 Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 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 Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 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 Adults 18-65. 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. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Branwell Lodge Nursing Home Address Smith Road Off Southfield Lane Bradford West Yorkshire BD7 3NJ 01274 521731 01274 527279 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) Brunel & Family Housing Association Limited Mr Mark Coup Care Home 22 Category(ies) of Learning disability (22) registration, with number of places Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th October 2004 Brief Description of the Service: Branwell Lodge is a 20 bedded registered care home providing nursing care for people with learning disabilities situated approximately 3 miles from Bradford city centre. The shops and local community facilities are within walking distance. The home is a purpose built property originally registered in 1980. There are pleasant gardens with patio area and ample car parking space. The accommodation compromises of eight flats with single bedrooms, communal living/ kitchen areas and bathrooms. The post of manager is presently vacant. There is an acting manager in place until the appointment of a new manager. The Bradford Community Health Trust employs the home’s nursing and care staff and the ancillary staff are employed by Brunel Support Works. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has to carry out at least two inspections of care homes every year. The inspection year runs from April to March and this was the first inspection visit for 2005/2006. Copies of previous inspection reports are available at the home or on the Internet at www.csci.org.uk. The last inspection of the home was on 25th October 2005. This was an unannounced inspection carried out by one inspector who was at the home from 12.00 until 16.00. The main purpose of this inspection was to make sure that the home continues to provide a good standard of care for the residents. The methods used at this inspection included looking at care records; observing working practices and talking to staff, residents and the manager. Comment cards were sent to the home to provide residents and visitors with the opportunity to comment on the service. What the service does well:
Care is provided in a clean, tidy and well maintained building. Residents observed were treat with respect by staff. The staff encourage individuals to be independent and to reach their full ability. Residents have an activities co-ordinator who aims to provide a varied range of leisure activities for the residents. The residents have opportunities for personal development and joining in the local community. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 6 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. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, and 5. The service user guide needed reviewing and updating to make sure that relevant and up-to-date information is available to residents and their relatives. Prior to living at the home individual needs did not appear to be adequately assessed, without this, the manager and staff could not know if they could meet all the individuals aspirations and needs. Whilst each resident had a copy of their individual contract, they were unsigned and remain ineffective. EVIDENCE: The service user guide needs updating to reflect the changes in the care service. This also must reflect any staff changes. There was little evidence of pre-assessment of a resident prior to moving into the home. The manager felt that this information was available, but not easily to hand. It was difficult to see the extent information was gathered prior to admission. The manager confirmed that the resident would visit the home prior to moving in and be given the chance to stay for a meal and stay overnight, if they were comfortable to do this. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 9 The contracts seen were not signed by the residents or their relatives/advocate. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9. Residents social and cultural needs are not adequatley assessed or reviewed with the individual. The care plan is not person centred and does not reflect what is important from the resident’s perspective. EVIDENCE: The care plans reviewed, contained no assessment of individual aspirations, social and cultural need. The assessment and care plans were clinically orientated defining health care needs only. Thorough risk assessments are included within the care plan in areas such as medication, finances, aggression and behaviour. Observations of the residents and discussion with staff confirmed that they participated in and were consulted in the day-to-day decision making within the home. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15.. Residents are encouraged to join in social and leisure activities and to keep links with their friends and family. EVIDENCE: An activities coordinator has been appointed to organise a varied range of activities for residents with in the home. Holidays have been organised for some individuals of the home, although the choice has been limited, the manager, felt that holidays were a difficult problem due to staffing levels and funding for some residents. Nearly all service uses now remain at home during the day due to the withdrawal of day services. This has increased the need for more staffing and activities based at the home. The residents have house meetings where discussions regarding food and activities are discussed. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. Residents physical and emotional needs are met. EVIDENCE: The care plans clearly identify health needs and are regularly reviewed and informative. Regular medical reviews are undertaken and individuals access additional health services. The involvement of specialist health care professionals are recorded in the care plans and their recommendations are implemented. Part of the assessment seeks the opinion of residents about how they wish to be cared for and whether they would prefer a same sex carer. From review of the care plans it was clear that staff managed complex, and at times, demanding needs. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents and their relatives have their views listened to, taken seriously and action is taken to resolve issues. EVIDENCE: House meetings and staff meetings are held regularly. Staff have regular supervision and appraisal. Some residents live in smaller groups in their own flats, where they have the opportunity to raise concerns with staff and their key workers in a more comfortable environment. The complaints procedure is available for residents and their families. No concerns had been raised in the last inspection year. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not reviewed. Not reviewed. EVIDENCE: Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 and 36 Specialist training for staff is inadequate to meet the mental health needs of the residents at the home. The home does not meet the minimum requirement of 50 of the care staff trained to NVQ level 2. EVIDENCE: Good induction training is provided, which is followed by the foundation training in learning disabilities. Some specialist training has also been provided in the area of Autism and Asperger Syndrome. However, training is necessary for all levels of staff in Adult Protection and Mental Health issues. Some of the service, users have a Mental Health diagnosis where they have a high level need. Training must therefore be provided to meet this specialist need, in areas such as Schizophrenic conditions and depression. Four of the care staff have NVQ level 2 and six staff registered on the course. The home does not yet meet the requirement of 50 care staff to be trained NVQ level 2, but has an ongoing commitment to attain this target. Staff spoken to confirmed that staff supervision, team meetings and training was regularly being undertaken. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38, 39, 40 and 43. The home has a responsible approach to ensuring all the residents rights and best interests are safe guarded by the homes policies and procedures. EVIDENCE: The responsible individual visits the home regularly and reviews the conduct of the home. A report of this visit is sent to the CSCI. All staff have access to the policies and procedures. The service user guide contains policies and procedures relevant to the residents and their families. Meetings have been increased with positive improvements in the consultation processes for all staff in the organisation. The management has recently changed with the recruitment of a temporary manager whilst the registered manager has been seconded. It is hoped the positive leadership within the home continues and management continue to reaffirm the roles within the organisation and review the care practices. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 x 3 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Branwell Lodge Nursing Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 3 3 x x 3 DS0000019900.V258251.R01.S.doc Version 5.0 Page 18 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 2 3 Standard YA1 YA2 YA5 Regulation 5 15 5 Requirement The service user guide requires updating. Assessment and care planning must include social and cultural needs. Terms and conditions must be provided to all residents. Previously agreed timescales 1.1.05. Staff must have training in Mental health and associated conditions. Timescale for action 20/01/06 20/01/06 20/01/06 4 YA33 18 20/01/06 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 Refer to Standard YA35 Good Practice Recommendations A minimum of 50 staff should be NVQ trained by 2005. Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Branwell Lodge Nursing Home DS0000019900.V258251.R01.S.doc Version 5.0 Page 20 - 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!
