CARE HOMES FOR OLDER PEOPLE
Braywood Gardens Care Home Millbrook Drive Carlton Nottingham NG4 3SR Lead Inspector
Richard Ramsden Unannounced Inspection 14th December 2005 12:00 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 Braywood Gardens Care Home DS0000035596.V269631.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 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. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Braywood Gardens Care Home Address Millbrook Drive Carlton Nottingham NG4 3SR 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) 0115 9381300 0115 9381371 Nottinghamshire County Council Mrs Fiona Rosemary Carolyn Moore Care Home 60 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (60), Physical disability (15) Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Out of the total number of beds (60), there will be 30 beds for DE 55 and over and/or DE(E) Out of the total number of beds (60), 15 may be used for PD 55 and over A maximum of 5 PD 55 years and over to be accommodate outside of the intermediate care unit Service users shall be within category OP Date of last inspection Brief Description of the Service: Braywood Gardens is owned by Nottinghamshire County Council Social Services and is a purpose-built care home for up to 60 older people. The home opened in 2002 and is a two-storey building divided into four residential units. There is a shaft lift to assist independent access between floors. All of the homes bedrooms are for single occupancy with ensuite facilities. The home is located within a housing estate, close to local amenities, which include shops, pubs and a leisure centre. There are well-maintained gardens, which are accessible to residents. Car parking is provided at the front of the building. One of the units provides intermediate care and is jointly funded and staffed by National Health Service and Social Services personnel. There is also a day centre for people living in the community, the day centre has separate facilities and operates seven days each week. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was completed by one inspector and lasted for approximately 3.5 hours. It included the inspection of care & other records, a discussion with the manager, two members of staff and four residents. A partial tour of the building was also completed. What the service does well:
The residents spoken with during this inspection said that they are very satisfied with the services provided by the home. People said that the staff are friendly and helpful and that they ensure that their privacy and dignity is maintained at all times. One resident who chooses to have all her meals in her room said that the staff that assists her at mealtimes couldn’t be faulted. The observed interaction between residents and staff was of a very good standard. The home provides an impressive range of activities and entertainment. The residents said that they are looking forward to Christmas as there is a wide range of festive activities and entertainment planned. One person said that she had already had to Christmas meals outside the home and one person said that they had enjoyed a childrens carol concert. The premises are purpose built and maintained and decorated to a good standard. The residents spoken with said that they liked their bedrooms and confirmed that they had been encouraged to personalise them with small items of furniture, photographs and ornaments. The administrative procedures checked as part of this inspection had all been well maintained. There were many aspects of good practice highlighted in the main body of this report. Braywood Gardens Care Home DS0000035596.V269631.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. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 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 Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 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 the following standard(s): 1. The literature supplied to prospective residents now contains sufficient information to enable them to make an informed choice as to whether the home will be able to meet their assessed needs. EVIDENCE: Since the last inspection the manager has included the “views of the residents”, in the literature supplied to prospective residents. This literature now contains sufficient information to enable people to make an informed decision as to whether the home will meet their needs. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 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 the following standard(s): 7. The care plans contain appropriate information. However some were not being reviewed frequently enough to ensure that staff have up to date information identifying what assistance and support each resident requires. Residents are also not signing their care plans to confirm that they have been involved in the planning and review process. EVIDENCE: Three residents care plans were viewed as part of this inspection. The care plans contained appropriate information and where required risk assessments have also been completed. Two of the three care plans had been reviewed each month the remaining care plans had not been reviewed in October or November 2005. The manager stated that this is because the team leader responsible for reviewing the care plans has left the home and his replacement will not be in post until February 2006. The inspector advised that care plans must be reviewed, and where appropriate updated, at least once each month to ensure that staff are always aware what support and assistance each resident requires. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 10 Residents or where appropriate their representatives should always sign to confirm that they have been involved in planning and reviewing their care plans. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12,15. An impressive range of activities and entertainment is provided by the home. Residents receive a wholesome and appealing diet. EVIDENCE: The residents spoken with during the inspection were full of praise for the type and frequency of activities and entertainment provided. One person said that she had been out for two Christmas meals already and another person said that she had enjoyed going to a childrens carol service. There were posters throughout the home displaying details of the activities and outings available. (This is good practice). The residents spoken with said that they are satisfied with the meals provided by the home. They confirmed that there is always a choice of meal and that if they do not want the food suggested on the menu an alternative will always be provided. One resident said that she requires a “soft” diet and that she chooses to have all her meals in her bedroom. She stated that because she is blind a member of staff helps her to eat their meals. She said that the staff are always friendly and ensure that her mealtimes are always an enjoyable sociable occasion. (This is considered good practice).
Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 12 The refrigerator, freezer and food temperature records were checked and they had all been well maintained. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 13 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 the following standard(s): X None of these standards were assessed as part of this inspection. EVIDENCE: Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 24,26. Residents are satisfied with their bedrooms. All areas of the home viewed as part of this inspection were appropriately clean and there were no offensive odours. EVIDENCE: All of the residents spoken with during the inspection said that they are very satisfied with their bedrooms. They confirmed that they had been encouraged to personalise their rooms with small items of furniture, ornaments and photographs. Everyone said that the home is kept spotlessly clean. The areas of the home viewed as part of this inspection were clean well decorated and comfortably furnished. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29. The homes staff recruitment policies and procedures helped to ensure the safety and protection of the residents. EVIDENCE: The records of the two most recently recruited members of staff were viewed as part of this inspection. One of the personal records contained all the required information. The second records assessed during the inspection only had one written reference. The manager telephoned the homes personnel department and the second satisfactory reference was faxed through during the inspection. One of the new members of staff were spoken with during the inspection, he confirmed that he had received induction training and that he had commenced a TOPS induction programme. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33. The home is run in the best interests of the residents. EVIDENCE: Since the last inspection the manager has produced a questionnaire seeking the viewers of visiting professionals, such as general practitioners, nurses, chiropodists etc. At the time of the inspection 14 completed questionnaires have been returned to the home, all had made very positive comments about the services provided. (This is considered good practice). Braywood Gardens Care Home DS0000035596.V269631.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 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X 3 X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X X Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes. 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 OP7 Regulation 15 Requirement It is required that care plans are signed by residents or where appropriate their representatives. It is required that care plans be reviewed at least once each month in consultation with the individual resident, and where appropriate their representative. The home should produce some method of evidencing that this process has been completed. (this requirement is outstanding from 25/05/05) Timescale for action 25/05/05 2. OP7 15 25/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. X Refer to Standard X Good Practice Recommendations None. Braywood Gardens Care Home DS0000035596.V269631.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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