Inspection on 28/11/08 for Brendoncare Alton

This inspection was carried out on 28th November 2008.

CSCI found this care home to be providing an Excellent service.

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

Brendoncare Alton 22/11/06

Brendoncare Alton 14/10/05

Brendoncare Alton 16/05/05

Brendoncare Alton 02/08/04

Brendoncare Alton 07/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brendoncare Alton Adams Way Alton Hampshire GU34 2UU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kima Sutherland-Dee     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Brendoncare Alton Adams Way Alton Hampshire GU34 2UU 01420549797 01420549898 vcuff@brendoncare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Vivienne Cuff Type of registration: Number of places registered: The Brendoncare Foundation care home 75 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: All service users must be over 55 Date of last inspection Brief description of the care home Brendoncare Alton is a registered care home providing nursing and personal care for 45 service users in the older person category and 30 service users with mental health disorder. The home is owned by the Brendoncare Foundation and has two other homes in the Hampshire area. Accommodation is provided on two floors with passenger lifts that allows access to all floors. All bedrooms are single and have ensuite facilities. There is a variety of aids and assisted baths to meet the needs of service users. The home also benefits from large well maintained gardens that are enclosed and accessible to wheelchair users. The service is situated in Alton with some local Care Homes for Older People Page 4 of 27 30 0 0 Over 65 30 30 45 Brief description of the care home amenities close by. The current fees for the home were from 693 to 798 pounds per week for residency in the Elder Health Units and from 791 to 896 pounds per week for the Mental Health Units. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 Star. This means the people who use this service experience excellent quality outcomes. The inspection included a site visit to the home over a period of four hours and ten minutes on the 28th November 2008. During this time we spoke with the commercial manager and the operations manager, the service users and staff. We also observed the interactions between staff and service users,sampled the records and documents, and saw parts of the home environment. Other information used to make judgments about the standard of care in the home included the Annual Quality Assurance Assessment (AQAA) completed by the manager. Care Homes for Older People Page 6 of 27 This was received within the timescale requested by the commission and very comprehensively completed. What the care home does well: What has improved since the last inspection? The foundation has employed a development manager who works with staff to make sure all the policies are based on the best practice. The service has purchased new equipment including a special bath that will help the service users. Other aspects of the environment have improved including a continuing redecoration programme and the purchase of some new furniture. Care Homes for Older People Page 8 of 27 The home now produces a monthly newsletter, this helps the service users and their relatives to stay in touch with events and changes. The service has continued to improve the care plans so that they are individual to each service user and the staff can offer care that is tailored to their needs and preferences. The home has received a certificate for resident centered care, from the Registered care homes group after they came and looked at the care plans and how they are put into practice. The service have met both the requirements that were made at the previous inspection in November 2006. these were to ensure that all staff have a Protection of vulnerable adults check before they start work and to record all the training that staff take part in. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users and their relatives have the information they need to make an informed choice about this home. They can be assured that the service users needs have been assessed and if the service can meet their needs this will be confirmed in writing. Evidence: The service updated its statement of purpose in July 2008 and this is now available in large print. This gives prospective service users and their relatives information about the home, the care and the services that are provided. The AQAA states that the Brendoncare foundation has a website where service users and their relatives can get information about the foundation and the home. Prospective service users are encouraged to visit the home, look around and talk with the managers or team leaders. The team leaders will then make an appointment to assess a service user in their own homes or in hospital if necessary. A sample of these assessments were seen Care Homes for Older People Page 11 of 27 Evidence: and they included the information that is needed for the home to confirm whether they can meet a service users needs. The assessments included information from others such as doctors or social workers. An offer letter will be sent from the manager if the home has assessed that a service users needs can be met. The home manager explained that before someone moves in they would be given the choice of a colour and their room would be redecorated and if necessary re carpeted. Service users are welcome to bring their own possessions and their relatives are encouraged to do this prior to a service users move, so they feel more at home. A member of staff explained how they help a new service user to settle in and this included spending time with them and showing them around the home, as well as introducing them to other service users. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users have their health care needs met and they can expect to be treated at all times with dignity and respect by the staff. The service manages and administers medicines safely. The service managers are working with the staff to continually improve the care for the benefit of the service users. Evidence: A sample of the care plans demonstrated that the staff have all the information they need to care for each service user. This included the service users health care needs and how the staff can help service users to maintain as much independence as possible. The care plans also included risk assessments regarding pressure areas, nutrition and the risk of falling and what the staff need to do to minimise these risks. The operations manager said that staff were trying to increase the individual information about the service users so that they could really offer person centered care that met the preferences, likes and dislikes of each service user. In October 2008 the Care Homes for Older People Page 13 of 27 Evidence: service was awarded a certificate of commitment for working towards a resident centered standard. The home is arranged as three elderly care units and one two storey mentally frail unit, some of the units were better at reviewing the care plans and keeping them up to date. The operations manager agreed that the plans should be reviewed every month and they stated that they would ensure that the plans were regularly up dated so that the staff have the most recent information and they are aware of any changes to the care of the service users. A member of staff said that although at times they could be very busy they tried hard to slow down when they offered personal care so the service users didnt feel rushed. The service users said the staff were very good at meeting their needs and they rarely had to wait too long for staff to help them. The care plans had detailed records about the service users health care needs and any appointments or treatments. A service user said they could see a doctor whenever they needed to and the doctor came anyway every Monday to see how they were. The manager explained that they have a contract with a local G.P practice and they visit the home frequently, they are also able to offer telephone advice to staff and review medication. The records included details about Chiropody, opticians,continence advice services and other health services. The service has developed link nurses who are able to offer advice and train staff in best practice in the following areas, skin conditions and pressure area care, infection control,dementia,and end of life palliative care, medication and continence care. The service manages medication safely and medicine is given to the service users as it is prescribed. The service ensures high standards are maintained by training the staff and checking the procedures. Service users who are assessed as being able are offered the choice to continue to self medicate. The service has procedures to risk assess self-medication. Service users who choose to self medicate have secure storage available in their rooms. The AQAA states that the service introduces the principles of dignity and respect to staff as soon as they start work and during their training. This is then reinforced during all training and at meetings. The staff knew the service users well and they talked to them kindly and respectfully at all times. When service users choose to spend time in the nurses office this was accepted and the staff were kind and welcoming. A member of staff was overheard helping a service user with their exercises, they chatted quietly and listened to the service user, making sure they were comfortable at all times. Where it was possible to gain the information the care plans included information about end of life care. The service is working towards a system called The Liverpool pathways this is a gold standard way of managing end of life care that helps and supports the wishes of the service users and their families. The service does already Care Homes for Older People Page 14 of 27 Evidence: manage terminal care well and the staff have been trained. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from a wide range of activites from which to choose, these are increasingly based on individual hobbies and interests. The service users are offered a nutritious diet in pleasant surroundings. The service users are able to maintain contact with their family and friends who are welcome in the home and they are able to practice their choosen religion. Evidence: The AQAA states that there is a varied programme for physical and mental stimulation. This was confirmed during the visit by speaking to the service users and staff and by seeing advertising for future events and activities. The service users were particularly positive about the activities co-ordinator who spends time organising group activities and supporting individuals with their interests. One service user said the activities coordinator had improved the quality of their life by taking them shopping or getting items for them, by spending time chatting and going for an occasional meal in the homes own on site restaurant. The site also includes two day centres that are used by people in the community and by service users at the homes. Other activities take place in the lounges of the Care Homes for Older People Page 16 of 27 Evidence: separate units as well as large communal get togethers such as a monthly tea party and special occasions. The service now produces a monthly news letter that advertises events and keeps the service users and their families in touch with changes. There are three volunteers who help individuals to write letters, play games or just spend time chatting. The AQAA states that the staff are trying to focus on the individual interests and hobbies of each service user and finding ways to provide for these, rather than always providing large group activities which some service users choose not to participate in. The service users said that their visitors are welcome in the home and there are private areas where they can meet. The service users all said the food was good. The staff ask the service users daily about their choices and there are always alternatives available. The service users are offered food and drink throughout the day and home made biscuits and cakes are made for tea time. The service users nutritional needs are recorded in their care plans and the staff monitor how much fluid the more frail service users are having to maintain their hydration. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users can be assured that any complaints will be treated seriously and dealt with according to the homes own procedures. The service users are protected from abuse by trained staff and appropriate procedures. Evidence: The AQAA clearly states how complaints or suspicions of abuse are dealt with. The service has the procedures and policies to make sure all the staff are clear about how to protect the service users. Staff are also trained in dealing with suspicions of abuse. A member of staff was able to explain how they would respond appropriately if they had any concerns. The service informs outside agencies including Social Services and the commission of any events or complaints. One safeguarding concern and one complaint had been received and investigated by the service since the previous inspection. Both of these were dealt with appropriately and when they were concluded it was found that no service user had been abused and there were no grounds for the complaint. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from a comfortable, clean and safe environment that is suitable for their needs. Evidence: The service is continually updating the environment with a programme of improvements and redecoration. At the time of the site visit new carpets were being fitted throughout the reception area and the stairway. There are plans to refurbish the restaurant in the home. In the last twelve months new equipment has been fitted including a specialist bath and new furniture has been purchased. The service users said they liked both their own rooms and the communal areas of the home. The home was warm, clean and comfortably furnished. In an empty dining room there was loud popular music playing ,this added to a high noise level in that area. The manager agreed that this was unnecessary and not for the benefit of the service users and would be addressed with the staff in that area. The music was turned off by a staff member during the visit. The AQAA states that the service users are assessed for their need for specialist equipment such as beds, wheelchairs and hoists and this is then supplied. The AQAA also states that the service plans to improve the unit for the service users Care Homes for Older People Page 19 of 27 Evidence: who are mentally frail this is the services description for those service users who have dementia or other mental health needs. These improvements include introducing more colour and stimulation to help to orientate the service users and to assist them moving around the home. Toilet and bathroom doors have picture symbols and bedrooms either have photographs or names of the service users. Housekeeping staff keep the home fresh and clean. The training records show that staff have been trained in infection control, control of substances hazardous to health and health and safety. The equipment that staff need to control infection is available such as aprons, gloves and safe disposal of waste. The service users have a regular opportunity to give their views about the environment and how it could be improved by completing the satisfaction surveys. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from a safely recruited and suitably trained staff team. There are enough staff to meet the service users needs. Evidence: The service managers regularly monitor the needs of the service users and then adjust the staffing levels. The staff said that although at times they are very busy there are enough staff on duty to care for all the service users. One member of staff said that the staff try to slow down and spend as much time as needed with each service user when they are helping with personal care so the service users do not feel rushed. Another member of staff was overheard helping a service user with their exercises. They were chatting and making sure the service user was comfortable. The staff explained that when they are particularly busy extra staff are available to help. Staff are trained to do their jobs and the training records demonstrated that there was a wide variety of courses, these included the mandatory courses that all staff attend and more specialist courses. Overseas staff are encouraged to attend English courses which are funded by the foundation. The service has a higher than expected number of staff either qualified or working towards N.V.Q qualifications, this is currently percent of the staff team. Care Homes for Older People Page 21 of 27 Evidence: A sample of the staff files were seen and these demonstrate that the staff are safely recruited for the protection of the service users. Criminal records and Protection of Vulnerable adults checks had been completed before staff started working at the home. The staff explained that they have a period of induction training when they start work and the records confirmed this. The staff were clear about their roles and how they report to the management of the home or seek advice and support. The home holds the Investors in People Award this demonstrates that the service is committed to developing the staffs skills and working towards a good standard of performance. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service is effectively managed for the benefit of the service users and the staff. The service users have the opportunity to give their opinions and the managers are continually seeking ways to improve. Evidence: Brendoncare Alton is a large purpose built service that includes independent living flats, two day services and the residential and nursing home.The management of the home is divided between a commercial care centre manager who deals with the building and finance and the care manager who is the registered manager for the care and nursing home.There are two team leaders who report to the registered manager. The registered manager was on leave at the time of the site visit but the commercial manager was able to answer questions about the service.The operations manager was also available. Care Homes for Older People Page 23 of 27 Evidence: The staff and the management team are clear about the different roles and responsibilities and the managers work well together for the benefit of the service. The registered manager is qualified and experienced in care and the staff said they were approachable and supportive. The service has a robust system for Quality audits,this includes regularly asking the service users their opinions and people from outside the service coming in to look at quality and measuring quality against a yearly plan for improvements. The managers also regularly review the quality of the service in several areas,these include,medication,care planning and accidents or incidents. The results of these are used to improve the service. The staff said they are regularly supervised and the records confirmed this. The service ensures that all aspects of the home and the care comply with health and safety. There are regular health and safety meetings and staff are trained to maintain a safe environment. The manager continues to inform the commission about any events or incidents in the home, as they are required to do. They also maintain a full record of any accidents or incidents in the home. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!