Inspection on 14/06/05 for St Brannocks

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

St Brannocks 17/11/08

St Brannocks 12/12/06

St Brannocks 06/10/05

St Brannocks 06/10/04

St Brannocks 04/05/04

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Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 St Brannocks Dymchurch Road New Romney Kent TN28 8UF Lead Inspector Wendy Mills Announced 26 July 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Brannocks Address Dymchurch Road, New Romney, Kent, TN28 8UF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01797 366663 Parkcare Homes Limited Caroline Jane Davies Care home only 7 Category(ies) of Learning Disability x 7 registration, with number of places St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: St Brannocks is a small Home providing care for seven people with learning disabilities. It is part of the Craegmoor Group of companies and the registered manager is Mrs Caroline Davies. The Home is arranged over two floors and has seven good-sized single bedrooms, a lounge/dining room and separate activities room situated in the large, flat and enclosed garden. The seventh bedroom has only recently been created and registered with CSCI. In addition a large conservatory has been added to rear of the property. St Brannock’s is situated on the main road at St Mary’s Bay, close to the small town of New Romney and within half an hour’s drive of the larger towns of Folkestone and Ashford. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection began at 09.20hours and lasted five hours. Mrs Caroline Davies, the registered manager, assisted the inspector throughout the inspection and she is thanked for her help. During the course of the inspection the inspector spoke to all seven clients and three members of staff. Detailed discussions were held in private with three clients and one member of staff. A pre-inspection questionnaire was sent out to the clients and their relatives. The responses were positive and demonstrated a high level of satisfaction amongst the respondents. A tour of the home was undertaken, key documentation inspected and sample care plans examined in detail. Both direct and indirect observations were made throughout the inspection. The Home continues to maintain a high quality of care that meets the National Minimum Standards. The clients who spoke with inspector said that they are well cared and like living in the home. They are able to put their views forward and participate in the running of the home if they wish to and are able to do so. The accommodation and grounds are comfortable and the addition of a large conservatory at the rear of the property has given the home much more communual space. The Home is well maintained and well decorated. Staffing levels are good and staff told the inspector that they really enjoy their work with the clients. Staff training is linked to client needs and there is a good level of training and development taking place. The residents and staff are thanked for the welcome they gave the inspector and their help with the inspection What the service does well: The home provides a welcoming and homely atmosphere and uses the space available very well. The management of challenging behaviour in the home is good and staffing levels reflect the very specific needs of the clients. All staff, including the manager, take a consistent approach to the way in which they support the clients to take control of their behaviour and gain further independence. Activities are managed very well. There is an activities room that is equipped with computers and art and craft work facilities. An activities organised is employed and she is both creative and consistent in her approach. The clients all have education programmes, college or work placements and have been on two holidays already this year. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 6 The home looks after the health of the clients well. They have forged good relationships with health care specialists and local health care professionals to ensure correct levels of medication are in place. it also provides good support for clients facing bereavement. 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. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 standard(s) 1,2,3&4 The statement of purpose and the service user guide are comprehensive and good. The clients are aware of their roles and responsibilities and know that their independence will be promoted. They know that their goals and aspirations will be supported by the Home. EVIDENCE: Clients said that the Home helps them do the things they want to and helps them live interesting and enjoyable lives. Indirect observation confirmed that staff encourage them to be as independent as possible. Individual needs and goals are reflected in the care plans and risk assessments are in place. Inspection of the care plan of the most recently admitted client showed that a thorough pre-admission assessment had been undertaken and appropriate visits made to the home. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 6,7,8,9&10 The clients know that the Home will respect their confidentiality and value their views. There is a clear and consistent care planning process that the clients and their supporters understand and records are maintained securely. Clients are encourage to take appropriate risks and their independence is encouraged. EVIDENCE: The clients said that they can talk freely to staff and that the staff respect their views. Conversation with staff confirmed that they are supported to gain as much independence as possible and are given clear boundaries for behaviour. Responses to the CSCI questionnaire that is aimed at relatives and supporters were all positive. Relatives said that they were happy with the care at the Home and that the Home fosters good communication. Inspection of care plans confirmed that they are in order, up-to-date, and clearly identify client needs. Staff are clear about their responsibility in respect of confidentiality and record storage. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 11,12,13,14,15,16&17 The home offers excellent opportunities for personal development and is proactive in the way it assists and encourages the residents to lead fulfilling lives. The quality of meals is very good and special diets are catered for when indicated EVIDENCE: On the day of inspection some clients were participating in household tasks, others had gone out to various activities such as the gym and the rest were in the activities room working on computer activities or craft work. . The inspector was shown some of the craft work that the clients have achieved. The standard is high and there is a great deal of creativity in this work. Some of this artwork has been framed and now hangs in the home. The clients are commended for the way they work with the activities co-ordinator to produce such good work. Both staff and clients spoke enthusiastically about the various leisure and educational activities in which they are involved. The home has also purchased a season ticket for the local small gauge railway to enable the clients to make more frequent journeys on this line. Since the last inspection St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 11 all the clients have improved their levels of independence. One has achieved success in gaining part-time employment and is now able to go out more independently. Inspection of care plans and discussion with staff confirmed that the clients are all involved in appropriate leisure, educational and cultural activities. There is a plentiful supply of good quality produce. Clients are involved with the planning of menus, shopping and food preparation. There is a choice of meals and support is given for those needing a special diet, for example, for weight reduction. Responses to questionnaires showed that clients enjoy their meals. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 standard(s) 18,19&20 Personal support is offered in a way that protects the privacy and dignity of the residents and promotes their independence. The home manages the administration of medicines well. EVIDENCE: Clients said that the staff respect their confidentiality and that they are happy to discuss personal issues with the staff. Care plans show that the physical and emotional needs of the clients are well documented and clear directions for appropriate action are recorded. Good relationships are maintained with local health care professionals and health care specialists. Discussion with the manager demonstrated that the home is making progress towards supporting one client to self-medicate. Storage of medication is safe and policies and procedures for the administration of medication are sound. The home monitors the effects of medication closely and, where appropriate, liaises with specialists in order to reduce medication if possible. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 standard(s) 22&23 Staff have good knowledge and understanding of Adult Protection issues and how to protect the clients from all forms of abuse. The clients and their supporters know that their concerns will be listened to and acted upon. EVIDENCE: The clients said that they can talk to the staff if they are worried. They know that staff will only share important information with the appropriate people. Mrs Davies said that day-to-day comments and concerns are dealt with as they arise. There have been no formal complaints since the last inspection. Induction training is structured and adult protection training is ongoing Staff are knowledgeable about the action they should take if they were to witness any form of abuse. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28,29&30 The standard of the environment within the Home is very good and provides the residents with an attractive and homely place to live. The layout of the Home promotes the independence of the residents EVIDENCE: A tour of the Home was undertaken. An internal re-decoration and refurbishment programme has recently been undertaken. New furniture has been purchased for the lounge and conservatory. There is a pleasant and homely atmosphere in the home. Inspection of individual rooms showed that they reflect the different personalities and interests of the clients. The space in the communual areas has been greatly improved by the addition of a large conservatory. A new shower room and staff toilet has been created and this has improved the bathing facilities. However, the upstairs bathroom has not received any attention. The toilet, bath and wash hand basin are in different colours. This bathroom would benefit from a new bathroom suite. The bath surround has gaps there is some growth of black mould. The tiles would now benefit from replacement. All areas of the Home were very clean and free from all offensive odours on the day of inspection. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33&36 There is an enthusiastic workforce that positively promotes improvement in the quality of life of the clients. Staffing levels are good. The arrangements for staff induction are good and staff demonstrate clear understanding of their roles and responsibilities. There is a good training and development programme. EVIDENCE: Staff to whom the inspector spoke were clear about their roles and responsibilities. They spoke enthusiastically about their work in the Home and about the way in which they support the clients to achieve their goals. They said that they receive both statutory and specialist training and that there are clear reporting mechanisms and good team working. Staff said that they had noticed improvements in the independence levels of the clients since the last inspection. Inspection of staff files and discussion with Mrs Davies, confirmed that all appropriate checks are made on staff before they are offered work at the Home. There is an organisation structure that establishes clear lines of responsibility and reporting mechanisms. There is a staff training and development programme that is linked to the specialist needs of the residents. One-to-one staff supervision is now fully established. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41&42 The Home is well managed and provides a caring and supportive service that promotes the independence, health, safety and welfare of the clients. There are good quality assurance systems that take into account the views of the clients, staff and other stakeholders. EVIDENCE: Mrs Davies, the registered manager, has over twenty years experience in care and in managing care homes. She has completed the NVQ IV in management and care. Staff said that they have great respect for their manager and that she both supports them and promotes their training and development. They said that they believe that she listens to their ideas and gives them credit for their achievements. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 17 Conversation with Mrs Davies showed that she has an extensive knowledge of the client group for whom the Home cares; of the Care Standards Act 2000 and the National Minimum Standards. The Home is well maintained and Mrs Davies has a clear vision for the home. There is clear evidence of improvements to the fabric of the building, both inside and out. The CSCI has received regular, reports in accordance with Regulation 26. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 18 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Brannocks Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 27 Good Practice Recommendations The upstairs bathroom suite should be changed so that it matches. In the interim, bath surround and tiling should be given attention. St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 St Brannocks H56-H05 S23556 St Brannocks V230893 260705 Stage 4.doc Version 1.40 Page 21 - 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. 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