Inspection on 26/07/06 for Braywood Gardens Care Home

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Braywood Gardens Care Home 14/12/05

Braywood Gardens Care Home 25/05/05

Braywood Gardens Care Home 05/03/05

Braywood Gardens Care Home 02/08/04

Braywood Gardens Care Home 15/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Braywood Gardens Care Home Millbrook Drive Carlton Nottingham NG4 3SR Lead Inspector Richard Ramsden Key Unannounced Inspection 26th July 2006 09:15 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.V302707.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. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 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.V302707.R01.S.doc Version 5.2 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 14th December 2005 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. The monthly accommodation charges for those Residents who are self funding would be £1508 per calendar month. A copy of the most recent inspection report is available in the home. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one-day it took approximately 8 hours. It included the inspection of care and other records, a discussion with the registered manager, one team leader, one senior care assistant and the cook. The inspector spoke with six residents. A partial tour of the building was also completed. Prior to completing this visit the inspector assessed the homes previous inspection reports, the information provided by the homes manager and the service history. What the service does well: This is a well-managed home run in the best interests of the residents. There were many aspects of good practice highlighted in the main body of this report. The manager is very experienced and qualified and makes considerable effort to ensure that residents and staff have an opportunity to influence the way in which the home operates. The residents spoken with during the inspection said that they are very satisfied with the services provided by the home. They said that the staff are always friendly and respectful and confirmed that they ensure that their privacy and dignity is maintained at all times. The home provides a comprehensive range of activities, entertainment and outings to provide social stimulation for the residents. All of the residents said how much they enjoyed the food provided at the home; they confirmed that there is always a choice of food and if they do not want the food suggested on the menu an alternative will be provided. The home has regular catering meetings where residents are encouraged to voice their views and opinions. Staff are ensuring that they to meet the assessed needs of prospective residents prior to their admission to the home. Individual residents care plans are comprehensive and are being reviewed on a regular basis, to ensure that staff always have up-to-date information detailing what assistance and support each resident requires. There is evidence that residents and where appropriate their representatives are involved in the care planning review process. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 6 The building, which is purpose-built, has been decorated furnished and maintained to a very good standard. All of the residents spoken with said that they like their bedrooms and confirmed that they can use them at any time. People said that they had been encouraged to personalise their rooms with small items of furniture ornaments and photographs. Residents confirmed that they can have visitors at any time and that their visitors are always made welcome. The staff training records show that a considerable amount of staff training has been provided since the last inspection. The home participates in the Nottinghamshire County Council Social Services Quality Assurance Scheme. The manager has used the information gathered from service users, their relatives and stakeholders in the community, to produce a development plan for 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. Braywood Gardens Care Home DS0000035596.V302707.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 Braywood Gardens Care Home DS0000035596.V302707.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,6. All residents are now being provided with written contracts/ statement of terms and conditions of residence. The homes staff ensure that they can meet the assessed needs of prospective residents by obtaining written assessments prior to their admission to the home. Residents who are admitted for intermediate care are helped to maximise their independence and return home. “Quality in this outcome area is good. This judgment has been made using available evidence including a visits to the service”. EVIDENCE: Of the three residents whose records were assessed as part of this inspection two have been provided with terms and conditions of residence documents, which had been appropriately signed. The manager stated that this document would be provided to all residents in the near future. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 9 Three residents care plans were assessed during this visit and two contained comprehensive preadmission assessments, which had been completed by a social worker. The third care plan only contained very brief details and did not address the residents’ cultural needs. The manager stated that this resident had been admitted when the home first opened and that this level of preadmission assessment would no longer be acceptable. (The care plan produced by the homes staff did address the residents’ cultural issues). The manager showed the inspector a new letter that will be provided to all prospective residents, stating that having regard to the assessment, the care home is suitable for the purpose of meeting their needs in respect of health and welfare. (This is good practice). One of the residents receiving intermediate care was spoken with during this inspection. She confirmed that she had been encouraged to participate in a rehabilitation program, which would enable her to return to her home. This residents care plan showed that a multidisciplinary team approach was providing effective rehabilitation. Braywood Gardens Care Home DS0000035596.V302707.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Residents individual care plans contain sufficient information to ensure that staff are always aware of what support and assistance each resident requires. The care plans viewed during this visit had all been reviewed and where necessary updated each month. Residents’ health care needs are being met. The homes medication systems are well maintained but staff must ensure that the temperature in the rooms where medication is stored is recorded every day as medication can deteriorate if it is stored above 25°C. Residents are treated with respect and their rights to privacy are upheld. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. EVIDENCE: Three residents care plans were viewed as part of this inspection, the care plans appear to address the issues highlighted in the residents’ assessment process. It was noted that all of the care plans viewed had be reviewed and where necessary updated each month to ensure that staff always have up-to-date information about the care and support each resident requires. Where possible Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 11 residents or their representatives are signing to confirm their involvement in the planning and review process. (This is good practice). The residents spoken with during the visit said that they believe their health care needs are being appropriately met. The records viewed as part of the visit confirmed this. The medication was assessed on Bluebell Unit. The medication systems were well maintained and a photograph of the individual residents is attached to their medication administration records. The records of receipt and disposal of medication were also well maintained. None of the residents on Bluebell Unit were administering their own medication at the time of this inspection. The manager stated that an individual risk assessment would be completed with every resident who wished to administer his or her own medication. The units controlled medication was checked, the storage receipt and administration was well maintained. Staff must record the temperature in the rooms where medication is stored. It is important that the temperature is recorded every day to ensure that it does not exceed 25°C as medication can deteriorate and become less effective if is stored at a higher temperature. All of the residents spoken with during the inspection said that the staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. The inspector observed staff interacting with residents in a friendly and respectful manner. Braywood Gardens Care Home DS0000035596.V302707.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The home provides an extremely good variety of activities and entertainment. People are encouraged to maintain contact with family and friends. Where possible residents are encouraged to make decisions about their individual lifestyles. The residents spoken with said that they enjoy the food provided by the home. “Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to the service”. EVIDENCE: Staff have obviously worked hard to provide a good range of activities, entertainment and outings for the residents. The residents’ spoke with during the inspection said that they are very satisfied with the level of stimulation provided by the home. Although two people said they choose not to participate in activities provided. One person said that he feels that he is too young to socialise with the older residents in the home. Although the inspector was unable to speak any visitors during this visit, the residents say to that their visitors are always made very welcome. They confirmed that they can see visitors at any time. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 13 Accesses to Records Policies have been provided to all residents and leaflets are available in the main reception hall. The team leaders spoken with during this visit was clear about the procedures she would follow if a resident or their representative asked to see a residents personal records. Leaflets are available informing people how they can contact an independent advocate. One of the residents spoken with during the inspection said that they had used the services of an independent advocate and that they had found this very helpful. Residents are asked as part of the admission process if they wish to manage their own finances. This issue is also discussed as part of the review process. One of the residents spoken with said that he manages his own personal finances other people said that their families manage their finances. All of the residents spoken with during this visit said that they are very satisfied with the food provided by the home. They confirm there is always a choice of food and that an alternative will be provided if they do not want the food suggested on the menu. The meal provided at lunchtime appeared wholesome and nutritious. The manager stated that there are regular catering meetings and residents’ representatives are always invited. (This is good practice). The home also provides food-tasting evenings to give the residents extra exposure to a variety of different foods. (This is good practice). Braywood Gardens Care Home DS0000035596.V302707.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Residents believe that their complaints would be taken seriously and that appropriate action would be taken, the homes complaints records support this view. The registered person is taking appropriate action to protect residents from abuse. “Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to the service”. EVIDENCE: The home has an appropriate complaints procedure, which is displayed, in the main reception area. Since last inspection the manager has introduced a complaints book in which staff record brief details about all complaints received by the home. However these records do not show what investigation has been completed and whether any subsequent action was necessary. The records cannot be viewed in a confidential format and consequently the manager has now decided to use these records only as a quick reference listing details of the complaint, the name of the person making the complaint and where the full complaints records will be located. The complaints received by the home have all been appropriately dealt with. The manager confirmed that there have been no incidents of abuse in the home in the last 12 months. The manager provides training in adult protection for all Nottinghamshire County Council Social Services residential staff. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 15 Records show that she ensures that all staff at Braywood gardens receives appropriate training. (This is good practice). The home has an appropriate Whistle Blowing Procedure; the member of staff spoken with during the inspection was able to demonstrate a clear understanding of this procedure. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 16 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): 19,26. The premises are purpose-built and maintained to a very good standard. All areas of the home viewed as part of this visit were appropriately clean and there were no offensive odours. There were cleaning products left unattended in the training kitchen on Lilac Unit. This could be a potential health and safety hazard to residents. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service”. EVIDENCE: All of the residents spoken with during this visit confirm that they are very satisfied with their bedrooms and they said that they can use their rooms at any time. One person said that he chooses to spend most of his time in his bedroom, as he does not like socialising with the other older residents’. All of the residents who were asked said that the home is always kept very clean and tidy. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 17 All areas of the home viewed as part of this visit were clean, well decorated and comfortable is furnished. There were cleaning products left unattended in the training kitchen on Lilac Unit. The manager was advised that these products must be stored securely when there are no staff in situ, as this could present a health and safety risk to some residents. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30. The rota provided for the week of this inspection showed that good staffing levels are being maintained. The homes recruitment policies and practices are supporting and protecting residents, however copies of staff criminal records bureau checks must be kept on all individual staff personal files. (Note these are available on most staff files). The manager was able to demonstrate the homes commitment to staff training and development. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service”. EVIDENCE: The rota provided for the week of this inspection showed that sufficient staff are being provided to meet the residents assessed needs. The personal records of two members of staff are assessed as part of this visit. One member of staff who had transferred from another social services older persons home did not have the required references or a copy of their application form. These were faxed through to the home during the visit. The second member of staffs records contained confirmation that the person had received a satisfactory Criminal Records Bureau Check and the manager stated that staff are not permitted to start work prior to the necessary Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 19 recruitment checks being received. However there was no copy of the CRB check available for inspection. CRB guidance on some other employment sectors states that disclosures should be destroyed after six months, however the guidance states that, for CSCI regulated services, disclosure should be kept for up to 12 months or more to enable CSCI inspectors to see a Sample at the next inspection, one of the legal requirements for retaining disclosures. The information supplied by the manager prior to this visit shows that a considerable amount of staff training has been provided over the last year. Eighteen members of staff have completed NVQ level 2 or above and 12 people were completing the training at the time of this visit. (This is good practice). Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 20 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): 31,33,35,38. The homes manager is very experienced and well qualified. The home is run in the best interests of the residents. Residents’ financial interests are safeguarded. Where checked the health and safety of residents are generally protected and promoted, however the homes fire tests need to be completed more frequently. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. EVIDENCE: The registered manager is well qualified and very experienced. She has been a unit manager since 1971 and her qualifications include CSS, CMS, the Registered Managers award and City and Guilds 7307. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 21 Residents and staff said that the manager is very approachable and that she seeks their views about the way in which the home is run. Quality monitoring systems are in place, which show that residents and stakeholders in the community are being encouraged to express their views about the services provided by the home. From the information gathered as part of the quality monitoring system the manager has produced a development plan for the home. (This is good practice). Aspects of health and safety, assessed as part of this visit had generally been well maintained but there were a few occasions where the homes Fire Systems had not been checked on a weekly basis. The manager was advised that the checks must be completed each week and the results of the tests accurately recorded in the homes Fire Records to ensure the health and safety of residents and staff. The inspector noted that a number of residents had died in the home since the last inspection. Regulation 37 states that the Commission For Social Care Inspection must be notified of all deaths of people who are resident at the home. Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 22 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 X 3 3 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 4 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 2 Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP9 Regulation 13 (2) Requirement It is required that staff record, on a daily basis, the temperature in all rooms where medication is stored. The temperature must not exceed 25°C. It is required that all chemicals used in the home are stored securely when not in use. It is required that staff personnel files contain copies of CRB checks and that these are available for inspection at all times. It is required that the homes Fire Systems are tested at least once each week and that the results of the tests are accurately recorded in the homes Fire records. It is required that CSCI are informed of the death of any residents including the circumstances of his or her death. Timescale for action 26/07/06 2. 3. OP26 13 (4) 19 17 (2) Schedule 4 4 (c) 26/07/06 01/09/06 OP29 4. OP38 26/07/06 5. *RQN 37 26/07/06 Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 24 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 Braywood Gardens Care Home DS0000035596.V302707.R01.S.doc Version 5.2 Page 25 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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