Inspection on 13/02/06 for The Brambles

This inspection was carried out on 13th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Brambles 10/06/08

The Brambles 02/08/06

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 09/07/2008.

CARE HOME ADULTS 18-65 The Brambles Six Acres Close Roman Road Taunton Somerset TA1 2BD Lead Inspector Stephen Humphreys Unannounced Inspection 13th February 2006 09:30 The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 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.V280746.R01.S.doc Version 5.1 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.V280746.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Brambles Address Six Acres Close Roman Road Taunton Somerset TA1 2BD 01823 423126 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) Somerset County Council (LD Services) Mrs Lynette Ann Taft Care Home 7 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two named residents with a physical disability No additional residents with physical disabilities to be admitted to the home until the work to extend the bedrooms has been completed and approved by the NCSC. Registered for 7 persons in categories LD and PD Date of last inspection 15th July 2005 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 residents. The Brambles is registered with the Commission for Social Care Inspection to provide care and accommodation for up to seven people with learning disabilities, including two people who have physical disabilities. The home run by Somerset Social Services. The Registered Manager retired in September 2005, the acting manager Mr Rob Philips has recently been appointed as the manager and will be applying to the CSCI to become the registered manager. The Responsible Individual is Mr. David Dick. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the planned annual programme of inspection. The inspection carried out by Mr Stephen Humphreys, a regulation inspector. The previous inspection was also unannounced and took place on 15th July 2005. On the day of the inspection there were six residents residing at the home and one other resident expected back from spending some time at the Halcon Centre. The support worker Nicki Shattock was on duty in charge of the home at the time of this visit. During the course of the inspection the inspector spoke to members of staff a relative and a resident. Other residents were observed in the home. Three of the residents were able to respond through smiles and body language. Staff also use a pictorial method of communication to determine the residents wishes. Care practice was observed, records examined and a tour of the premises was made. The inspector spoke with the housekeeper about her role in the team. The standard of housekeeping and care delivery is to be complemented. The staff team at The Brambles are very motivated and caring, ensuring the residents receive a quality service to meet their individual needs. What the service does well: What has improved since the last inspection? Since the last inspection the registered manager has retired and an acting manager has been in post. During this time the requirements from the last inspection have been met. The building work to the four bedrooms has been completed. The bedrooms are well decorated and individualised. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 6 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. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3, 5 Residents and their families are provided with appropriate information regarding the home. Appropriate assessments are completed to ensure that the home will be able to meet residents’ needs. Each resident has a contract detailing the terms and conditions of residency. 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 and the resident guide will need to be updated to include the name of the new manager and the revised room sizes. Pre-admission assessments were seen within resident care plans. Prospective residents are encouraged to visit the home, and spend short periods there, before deciding to move in on a permanent basis. A contract is provided for each resident setting out the terms and conditions of their stay. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 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 the following standard(s): 6, 7, 8, 9 A detailed care plan has been developed for each resident. Residents are supported to make choices regarding their life, and individuals’ decisions and preferences are respected. Records relating to residents are stored securely EVIDENCE: Care plans are maintained for each resident. These follow the standard model used by Somerset Social Services. Four care plans were examined in detail. The care plan recorded all the necessary information for the delivery of person centred care. Care plans provided information regarding residents needs, daily routines and preferences. Risk assessments had been completed where required. Care plans had been regularly reviewed. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 10 The review must also involve the updating of the manual handling assessment for each individual resident. Residents are encouraged to exercise choice regarding their daily routines. A board is displayed showing which staff will be on duty. Residents’ money is kept in a secure place. Records are maintained of all transactions involving residents’ finances. Residents’ monies were examined, and all seen tallied with records kept The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17 Residents are provided with a range of activities that are appropriate to their individual needs, and are supported in accessing the local community. Residents are provided with a well balanced diet, and offered support as required. EVIDENCE: Residents are able to participate in a wide range of activities. These include: music, light room, soft play, hydrotherapy, massage, walks and flexercise. On the day of the inspection residents were observed to be listening to pop music, two residents were walking around the home and watching TV. Three of the residents attend SCAT on a Tuesday and two residents access the gym for upper body exercise at Six Acres. Staff support residents in maintaining contact with friends and family members. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 12 A board near the dining room displays photographs of the meals planned for each day. The menus are decided at the residents meetings. The staff have access to and input on nutrition from the dietician who visits monthly. One resident needs a special diet requiring special foods. Staff are aware of the needs of this resident and are aware of the effects that can occur if the wrong foods are eaten. The main meal of the day is at lunchtime with a light meal provided in the evening. Residents also enjoy meals out at various places including the fast food outlets. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 18,19,20, Residents are provided with appropriate assistance to meet their personal care needs. The home supports residents in accessing healthcare services. Medications are managed appropriately EVIDENCE: Residents are provided with assistance to undertake personal care tasks as required. Personal care is provided in private. Two residents have hoists attached to the ceiling in their rooms to assist with mobility. Resident’s psychological well being is supported by staff being aware of their individual needs and how to address these when they occur. Staff can also call on professional support services. Staff support residents in their daily life skills, going shopping, helping them to choose and buy everyday goods. Going to the hairdresser or visiting their GP or dentist. Hearing and eye tests are provided to residents. Staff support residents in accessing health care services, and ensure that specialist advice is sought as required. Pressure-relieving equipment had been The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 14 provided for one resident. Care plans included details of epilepsy and nutritional guidelines. Staff at the home receive medications training. All medications are stored securely. Medication Administration Records were examined and found to follow good practice. A record is maintained of all medications entering the home. The medicine procedure followed adheres to the Royal Pharmaceutical Society guidance for care homes. The residents GP reviews all medications every six months. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 21,22 Staff showed through discussion their awareness of the appropriate actions to safeguard vulnerable adults. EVIDENCE: The complaints procedure has been developed by Somerset Social Services and includes details of external agencies that may be contacted, including CSCI. Somerset Social Services Department has also produced a video providing details of how to make a complaint. There have been no complaints received by the home or CSCI. There are policies relating to the Protection of Vulnerable Adults and Whistle blowing. Staff spoken to showed that they would know what to do if an incident occurred involving a vulnerable adult. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 16 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 the following standard(s): The Brambles continues to provide a warm homely and safe environment for all residents. See last inspection report. EVIDENCE: The inspector did a tour of the home and reviewed the recently finished bedroom extension work. All was found to be satisfactory. No further assessment was made of the environment at this inspection. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Staffing levels are appropriate to meet residents’ needs. Staff are competent and provide a good standard of care. Staff receive appropriate support and supervision EVIDENCE: Duty rotas are maintained. There are generally four care staff on duty in the morning, in addition to a cook and domestic assistant. There are three care staff during the afternoon, and one sleep-in and one waking staff throughout the night. Newly appointed staff are provided with Induction training. Staff are encouraged to attend further training, and are provided with regular updates in food hygiene, health and safety and fire safety training. Staff spoken with stated that they had also received training in PMLD and electrical testing. Training records were checked and found to be up to date regarding fire, manual handling, and infection control. Staff said they receive support and supervision regularly. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The acting manager has continued to maintain the high standards set in the home. EVIDENCE: The staff team is happy and were observed to be working and communicating well with each other. The home has appropriate policies and procedures in place to safeguard vulnerable residents. Staff showed in discussions their awareness of their health & safety responsibilities. All records relating to residents are stored securely in accordance with the Data Protection Act 1998. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 19 Hazardous substances had been stored securely and were not accessible to residents. The kitchen cleaning records were not up to date. The cleaning records are necessary to support and confirm safe working practice regarding hygiene and infection control. Accidents have been reported and recorded as required. Risk assessments were reviewed. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 20 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 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 x The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 14 (2) (a) Requirement The registered person must ensure all manual handling assessments are kept up to date and recorded in the residents care plan. The registered person must ensure up to date kitchen cleaning records are kept. Timescale for action 31/03/06 2 YA42 13(3) 31/03/06 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 YA6 Good Practice Recommendations It is good practice to involve were possible the residents relative / representative in the development, review, updating of the residents care plan and for them to acknowledge agreement of the plan by a signature recorded in the care plan. The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 The Brambles DS0000036187.V280746.R01.S.doc Version 5.1 Page 23 - 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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