Inspection on 10/06/08 for The Brambles

This inspection was carried out on 10th June 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Brambles 02/08/06

The Brambles 13/02/06

The Brambles 15/07/05

The Brambles 21/12/04

The Brambles 14/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Brambles Six Acres Close Roman Road Taunton Somerset TA1 2BD Lead Inspector Sally Murphy Key Unannounced Inspection 10th June 2008 09:30 The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 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 The Brambles DS0000036187.V362601.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Brambles Address Six Acres Close Roman Road Taunton Somerset TA1 2BD 01823 327714 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) rxphillips@somerset.gov.uk Somerset County Council (LD Services) **Post Vacant** Care Home 7 Category(ies) of Learning disability (7) registration, with number of places The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be admitted with a concurrent physical disability. Date of last inspection 2nd August 2006 Brief Description of the Service: The Brambles is a single storey building situated close to Taunton town centre. There is a large lounge, dining room and two assisted bathrooms at the home. Building work to increase the size of bedrooms has been completed. The home is set in pleasant gardens that are accessible to people living there. The Brambles is registered with the Commission for Social Care Inspection to provide care and accommodation for up to seven people with learning disabilities and those that also have a physical disability. The home run by Somerset County Council. The home is managed by Kristopher Saint, who has applied to CSCI to become the Registered Manager for the home. The Responsible Individual is Mr. David Dick. Fees range from £63.95-102.90 each week. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and was completed by Sally Murphy, Regulation Inspector. The previous inspection was completed on 2nd August 2006 and was unannounced. Prior to the inspection the Registered Provider completed an Annual Quality Assurance Assessment, and surveys were issued to relatives, staff members and health and social care professionals. The findings from these documents have been incorporated within this report. During the course of the inspection, we conducted a tour of the premises, examined care records, staff files and health and safety documentation. Discussions were held with Manager Designate, staff members, and people living at the home. Care practice was also observed. The Inspector would like to thank the Manager, staff and people living at the home for their assistance during this inspection. What the service does well: Appropriate assessments are completed prior to any person being admitted. One person has moved into the home since the last inspection. Relevant training had been provided and necessary adaptations completed to ensure that staff would be able to fully and safely meet their needs. People are able to choose how they spend their day. During the inspection some people went out to college, whilst other spent time with their room or communal areas engaging in activities of their choice. Within the AQAA it states that ‘we promote independence and actively encourage the service users to be involved as much as possible in making decisions about their own lives’. Somerset County Council has a clear system for recording and auditing all financial transactions. Records were reviewed during inspection and it was found that these had been appropriately maintained. Staff spoken with during the inspection demonstrated a thorough knowledge of individuals’ dietary needs and preferences. The daily menu is displayed in picture format. Staff have sought to provide a varied and nutritious diet for each of the people living at the home. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 6 Medication records had been appropriately maintained. Staff have been provided with medication training and two staff sign for all medication given. There are appropriate protocols in place regarding the covert administration of medication and there is clear guidance provided regarding how each person prefers to receive their medication. The complaints procedure is available in Somerset Total Communication. There are appropriate policies and procedures in place to safeguard people living at the home. There are sufficient communal and private facilities available to meet people’s needs. A range of tactile and sensory equipment is available throughout the home. The home operates a robust recruitment procedure that protects people living at the home. Staff have been provided with a range of specialist training. What has improved since the last inspection? What they could do better: Due to the complex needs of people living at the home, it is recommended that staff record how they decide whether to administer a PRN or as required medication for each person. All staff working at the home must be provided with training on the Protection of Vulnerable Adults. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 7 Staff must be provided with updates in moving and handling training to ensure that they may safely care for people within the home. The home must ensure that appropriate hand washing facilities are available in all parts of the home where staff provide people with assistance with personal care. 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. The summary of this inspection report can be made available in other formats on request. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living and their families are provided with appropriate information regarding the home. Detailed pre-admission assessments are completed to ensure that the home will be able to meet peoples’ needs. EVIDENCE: The home has a Statement of Purpose and Resident Guide that provide details of the services and facilities offered at The Brambles. The Statement of Purpose is currently being updated following the change in manager at the home. The Statement of Purpose is only available in written format and therefore not accessible to a number of people living at the home. However a copy of ‘Our Promises to You’, which outlines what people should expect from the service is displayed in Somerset Total Communication within the home. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 10 Since the last inspection there has been one new admission. Appropriate assessments had been completed prior to this person moving in. Staff had been provided with relevant training and necessary equipment had been obtained. People are encouraged to visit the home before moving in. Within the AQAA it states that ‘prior to service users moving into the home we follow a series of visits and meetings to ensure correct placement and that the transition is comfortable for both the new service users and the existing service users’. Contracts were not examined during this inspection. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care and support plans provide appropriate guidance to enable staff to fully meet people’s needs. People are supported to make choices regarding their life, and individuals’ decisions and preferences are respected. Records relating to people living at the home are stored securely. EVIDENCE: Care and support plans are maintained for each person. The Manager Designate advised that they are in the process of updating care records for each person to ensure that they reflect peoples’ current level of needs and preferences, and to make sure that any historical practices are thoroughly reviewed. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 12 Care and support records were examined for two people living at the home. These contained appropriate guidance to enable staff to fully meet people’s personal care and social needs. The home operates a key team system to ensure that people individual needs are met and plans of care updated regularly. People are able to choose how they spend their day. During the inspection some people went out to college, whilst other spent time with their room or communal areas engaging in activities of their choice. Staff demonstrated a good knowledge of individual’s communication needs and offered choices in an appropriate manner for each person. Risk assessments have been completed in relation to the home and for individual people and activities as required. These included risk assessments relating to the use of bed rails for people living at the home and the risk of aspiration for one person. Risk assessments had been updated in response to peoples’ changing needs. The home supports people in managing their personal monies. Somerset County Council has a clear system for recording and auditing all financial transactions. Records were reviewed during inspection and it was found that these had been appropriately maintained. The Manager Designate advised that they plan to complete a financial risk assessment for each person, to ensure that people are provided with the appropriate level of assistance and that independence is promoted. Records relating to people living at the home are stored securely. Staff complete a detailed record of checks completed throughout the night. This currently includes the information for all people within the same record. The manager must review this practice to ensure that the recording of information upholds people’s privacy and complies with Data Protection legislation. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to participate in a range of activities, and are provided with opportunities to meet their religious needs. People are part of the local community and are supported to maintain relationships. Staff have a good knowledge of people’s individual dietary needs and preferences and ensure that people are provided with health and nutritious meals. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 14 EVIDENCE: People living at the home are able to participate in a range of activities. Social and spiritual needs are recorded within care records. Activity plans were reviewed as part of this inspection. It was found that each person goes out approximately 3-4 times each week. Some people attend college and go to social clubs locally. People regularly access local facilities, and the home has a mini-bus available. Feedback was provided from the relative of one person living at the home that the level of activities provision had reduced. This was being followed up through the review process. Within the surveys received one relative praised the commitment from staff in assisting people to fulfil their individual social needs. Within the AQAA it states that ‘we use person centred communication to involve service users in choices about their lives’. On the day of inspection two people were at college, one person was at the resource centre, and others were spending time within the home as they choose. As some people returned from activities other went out. The home supports one person to attend church services. Within the surveys received one relative praised the commitment from staff in assisting people to fulfil their individual social needs. A short holiday has been planned for some people living at the home. For other people evidence was seen within care records of quality days being provided within the local area. The Manager Designate has advised that the home has improved the way that they deal with mental capacity issues, to ensure that people’s rights are protected and assessments completed as appropriate. Staff at the home assist people in maintaining contact with relatives. Relatives confirmed that they are always kept up to date with important issues. One relative wrote in a survey that ‘staff are always very helpful’. People living at the home have a range of dietary needs. Staff spoken with during the inspection demonstrated a thorough knowledge of individuals’ needs and preferences. Staff have sought to provide a varied and nutritious diet for each of the people living at the home. The meal is displayed in picture format on a notice board. People living at the home are encouraged to express choices regarding the meals and are involved in the development of the menu. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to exercise choice regarding how they meet their personal care needs. Staff are provided with the appropriate training and guidance to meet people’s needs. The management of medication is safe and protects people living at the home. EVIDENCE: People living at the home are encouraged to choose which member of staff will assist them to meet their personal care needs. Information is provided within each person’s care plan regarding the level and type of assistance required. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 16 Staff support people in accessing healthcare services. On the day of the inspection one person was at hospital receiving treatment. Staff were present through their period at the hospital and provided sensitive care to them when they returned to the home later that day. Care plans included evidence of visits to the GP, opticians, dentist and chiropody services. Records are maintained of all professional visits. Staff are provided with appropriate to meet people’s individual health care needs. Recently training has been provided from the Motor Neurone Disease Society. Staff ensure that assessment regularly updated and appropriate equipment obtained as necessary. An overhead hoist has recently been fitted in one person’s room in response to their changing needs. Surveys were received from three health care professionals. These provided positive feedback on the service provided. One person wrote that the home provides a ‘family atmosphere’ and that are ‘generally very good indeed’. Staff at the home receive medication administration training. All medications are stored securely. Medication for internal and external administration are kept separately. Medication records were examined. It was found that a record had been maintained of all medication received into the home. Information is provided on the reason for this medication being prescribed and any side effects. Two staff sign for each medication given. There has been one medication error recently and appropriate actions taken in response to this. Medication records provide clear guidance on how each person prefers to take their medication. This is good practice. Due to the complex needs of people living at the home, it is recommended that staff record how they decide whether to administer a PRN or as required medication for each person. The residents’ GP reviews individual medications six monthly. Appropriate protocols were in place regarding the covert administration of medication. The home has a homely remedies policy. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 &23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are appropriate policies and procedures in place to safeguard people living at the home. EVIDENCE: The complaints procedure has been developed by Somerset Social Services and includes details of external agencies that may be contacted, including CSCI. The complaint’s procedure is available in written English, Somerset Total Communication and DVD formats. The manager designate should ensure that the copy displayed in the hallway is updated to reflect the change in manager. There have been no complaints about the service received by the home or the Commission since the last inspection. There are policies relating to the Safeguarding Adults, Whistle blowing and restrictive practice. Staff spoken with during the inspection confirmed that they would be able to raise any issues of concern. Four staff have completed training on the Protection of Vulnerable Adults. This training must be provided for all of the staff team. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27 28 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient private and communal facilities to meet people’s needs. Appropriate equipment has been provided to meet people’s individual needs. The home has been maintained to a good standard of cleanliness. EVIDENCE: The Brambles provides is a large bungalow situated close to two other care homes and the resource centre, near to Taunton town centre. Building work was undertaken to increase bedroom sizes approximately three years ago. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 19 Communal areas comprise of a large lounge, dining room and pleasant garden that is accessible to people living at the home. There are two assisted bathrooms and one level access wet room providing shower facilities. All bedrooms are single occupancy and include a hand basin. Bedrooms have been decorated and furnished to reflect individuals’ personality and tastes. Overheard hoists have been provided where required. An electronic entry system has been provided to enable two people who are not able to manage keys to lock their rooms. A range of tactile and sensory equipment is available throughout the home. Keypads have been fitted to the kitchen and laundry to ensure the safety of people living at the home. The laundry contains appropriate equipment and is well organised. The home had been maintained to a good standard of cleanliness. Hand washing facilities consisting of liquid soap, paper towels and foot operated flip tops had been provided in some areas. The home must ensure that these facilities are available in all parts of the home where staff provide people with assistance with personal care. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 & 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff require updates in some mandatory training to ensure that they are able to care for people safely. Staff have been provided with specialist training to meet people’s individual needs. The home operates a robust recruitment procedure that protects people living at the home. Staff are provided with opportunities to share their views and receive regular supervision. EVIDENCE: Duty rotas are maintained. These evidenced that there are generally 3-4 care staff on duty each morning and at least 3 each afternoon. During the night there is one waking and one sleeping in staff available. Domestic staff are also employed and a Cook works on Friday, Saturday and Sundays. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 21 Some staff spoken with during the inspection stated that the dependency levels of people living at the home had increased, but that this had not yet been reflected within the staffing levels. This was discussed with the manager designate who stated that they were aware of these changes and would be taking regular reviews of the dependency and staffing levels. The manager designate advised that recruitment and training files are currently being reviewed by the deputy manager. A number of staff have transferred to the home from other services run by the Local Authority. One new member of staff has been employed. It was found that two references, a POVA First check and CRB had been obtained prior to them commencing work at the home. Newly appointed staff are provided with Induction training and an appropriate record maintained. Staff training records were examined. It was found that 11 out of the 14 care staff employed required updated training in moving and handling. The last recorded training for some people was in 2004-5. This must be addressed as a matter of urgency given the complex needs of people living at the home. All staff had completed First Aid training within the last three years, and all but three of the care staff had updated food hygiene training. As previously stated under Complaints and Protection, staff require further training on the Protection of Vulnerable Adults. Staff had also completed specialist training related to their role. Staff had completed Equality and Diversity training during an away day. Most had complete training on the Mental Capacity Act. Staff had also received training on providing care to people with physical and multiple disabilities and had completed the course on Total Communication. Care staff are supported to complete NVQ qualifications. 10 staff have the obtained the NVQ level 2 or equivalent qualification and the remaining staff are working towards this. Staff spoken with during the inspection confirmed that staff meetings are held regularly and that they receive supervision approximately every six weeks. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 & 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. There is an open and relaxed atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and people living at the home. EVIDENCE: Since the last inspection the manager and deputy manager have been appointed. Kristofer Saint has been in post as manager since 1st April 2008 and has submitted an application to CSCI to become the Registered Manager for the home. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 23 On the day of inspection there was a relaxed and open atmosphere within the home. Staff confirmed that they would be able to raise any issues of concern with the manager. Interactions between people living at the home, and the staff team were observed to be friendly and respectful. The home has a range of quality assurance policies and procedures. A network manager conducts an unannounced visit each month and a quality report of the findings is sent to the home. Within the AQAA it states that ‘we have staff team that are committed to improving the service we provide’. As outlined previously within this report the manager has sought to review key areas such as care plans and staff training records to ensure that the care provided follows best practice. The home has appropriate polices and procedures in place. Employers Liability insurance is provided through Somerset County Council. During the inspection it was discussed with the manager that the registration certificate should be displayed in a conspicuous place so that it is clear what number of people and categories of care that the home is registered to provide care for. Fire records were examined. The manager advised that a fire risk assessment had been completed by staff from Somerset County Council. Fire safety equipment had been tested and serviced as required. All staff had received fire safety training. The home completes a comprehensive health and safety audit each month. Servicing records for lifting equipment, electrical and gas appliances had been appropriately maintained. All hazardous substances had been stored securely and were not accessible to people living at the home. Accidents had been reported and recorded as required. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 1 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 3 3 3 3 3 The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 25 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 YA10 Regulation 12 (4) Requirement The manager must review the recording of nighttime checks to ensure that records uphold people’s privacy and complies with Data Protection legislation. All staff must receive training on the Protection of Vulnerable Adults. The home must ensure that appropriate hand washing facilities are available in all parts of the home where staff provide people with assistance with personal care. Staff must be provided with regular updates in moving and handling training so that they can safely care for people living at the home. Timescale for action 01/08/08 2. YA23 13 (6) 15/09/08 3. YA30 13 (3) 01/08/08 4. YA35 13 (5) 15/09/08 The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 26 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 YA20 Good Practice Recommendations Due to the complex needs of people living at the home, it is recommended that staff record how they decide whether to administer a PRN or as required medication for each person. The Brambles DS0000036187.V362601.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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