CARE HOME ADULTS 18-65
The Brambles Suffolk Close Massetts Rd Horley Surrey RH6 7DU Lead Inspector
Marianne Barham Announced Inspection 14th December 2005 10:30 The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 DS0000013356.V261442.R01.S.doc Version 5.0 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 DS0000013356.V261442.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Brambles Address Suffolk Close Massetts Rd Horley Surrey RH6 7DU 01293 771644 01293 784478 kcroll@brambles.org.uk 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) Multiple Sclerosis Society Ms Kay Croll Care Home 28 Category(ies) of Physical disability (28) registration, with number of places The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. All persons admitted to the home may be those who require nursing care, or those who only require personal care. 6 persons for day care between 09.00 - 17.00 hours At no time may the number of residents accommodated overnight exceed 28 23 August 2005 Date of last inspection Brief Description of the Service: The Brambles is a large purpose built property providing respite accommodation and personal and/or nursing care to up to 28 adults who have been diagnosed with Multiple Sclerosis. The home is owned and managed by the Multiple Sclerosis Society charity and is located in a quiet residential cul-de-sac, close to shops and other amenities of Horley Town Centre. There are pleasant, well-maintained gardens to the rear of the property and parking for several cars to the front. All bedrooms are single occupancy and have en-suite toilet and washbasin, electrical tracking hoists attached to the ceiling, TV and video and hands free telephones. The home is currently in the process of installing en-suite showers into five of the bedrooms and plans to install showers in all bedrooms over time. Communal areas consist of a large lounge which has a licensed bar enabling guests and visitors to purchase alcoholic and soft drinks. There is also a spacious dining room that has recently been refurbished, a garden room and a smoking lounge where guests and visitors may smoke. The home also has a physiotherapy department and a hydrotherapy pool for use by the guests. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection carried out at 10.30am by Marianne Barham, lead inspector for the service. The inspection was undertaken over a period of four hours and was the second inspection in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. The registered manager Ms Kay Croll was present and a total of fourteen service users and eight members of staff were spoken with during this inspection. Records relating to the care of service users and management of the home were also examined as part of this inspection. Several comment cards were received from guests, relatives and health professionals prior to this inspection, all of which were complimentary about the care and services provided by the home. The people who use the services of the home prefer to be known as guests and shall be referred to as such throughout this report. What the service does well:
There is a relaxed, informal atmosphere in the home and the environment is comfortable and homely. A wide range of complimentary therapies is offered to guests alongside the traditional medical therapies. The home is committed to giving the guests care and services in the way they prefer and there is a comprehensive assessment and process of care planning in place to make sure this happens. Members of staff and guests were observed to relate to each other in a friendly, informal manner with much joking and laughter to be heard from both parties throughout this inspection. Guests spoken with during this inspection praised the standard of care provided by the home and made comments such as ‘the staff are lovely’, ‘you couldn’t wish for a better place’, ‘I love coming here’, ‘I really like the physio’ and ‘its like a home from home’. Members of staff spoken with said they enjoy working at the home and feel that they are supported by the manager and receive enough training and supervision to carry out their jobs well. The meals provided by the home are of a high standard and alternative choices are offered for all meals. Guests spoken with were complimentary about the food served and made comments such as ‘the food is wonderful’, ‘I can have what I like’, ‘they ask me each day’, ‘food is excellent’, and ‘I like the food’.
The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 Page 6 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. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 DS0000013356.V261442.R01.S.doc Version 5.0 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): N/A These standards were not assessed at this inspection. Please see report dated 23rd August 2005 for detail on these standards. EVIDENCE: The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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): 8 and 10 The home consults guests and encourages participation in all aspects of everyday life in the home. Guests can be sure that information about them remains confidential and is kept appropriately. EVIDENCE: The home is committed to ensuring that the guests receive care and services in the way they are used to and prefer. Prior to their first visit to the home a comprehensive assessment is carried out that not only assesses the needs of the person but the way in which those needs are met in their own home. Guests are involved in the assessment and care planning process at every stage and those spoken with confirmed that their views on the facilities, services and care provided are sought by the home and acted upon. Records in the home were seen to be stored securely. Guests care plans are kept in their bedrooms and staff members have a confidentiality clause in the contracts. There is also a confidentiality policy in place and members of staff receive training on this at induction. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 the following standard(s): 11, 14, 15, 16 and 17 The home provides guests with the opportunity for personal development, to engage in appropriate leisure activities and to maintain relationships. Guests’ rights and responsibilities are recognised and respected by the home and they are offered a healthy diet that takes account of their individual needs and preferences. EVIDENCE: The home has a timetable of activities offering a wide range of leisure pursuits and therapies based on the individual needs and preferences of the guests. Guests’ interests and hobbies are recorded on the initial assessment. The home ensures that guests are able to maintain the same level of risk taking and independent living as they do in their own homes. This is achieved through the involvement of the guests at every stage of the assessment and care planning process. Guests are able to receive visitors at any time, either in their rooms or in the communal areas of the home. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 Page 11 The home has strong links with the local community, including the local secondary school that send pupils to the home as part of their ‘work experience’ during the last year of school. The home has a four weekly menu in place that offers alternative choices for all meals. The kitchen has recently been refurbished to a good standard with suitable appliances and storage for the type of service provided. All necessary health checks are carried out as needed and the food stored was seen to be fresh and of a good quality. Guests spoken with were complimentary about the meals served and choices offered. Several made comments such as excellent food and the food is lovely. Members of staff were observed to support the guests to eat their meals in a dignified manner. It was pleasing to the friendly, positive exchanges between the staff members and guests during the lunchtime meal. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 the following standard(s): 20 The homes’ policies and procedures for dealing with medicines protect the guests and they are able to administer their own medication as appropriate. EVIDENCE: Guests usually bring their own medication to the home on admission and robust procedures are in place for dealing with these. The home is registered with a local GP practice and prescriptions can be obtained through the GP if needed. Some of the guests administer their own medication and risk assessments are in place for those guests. All other medication is administered by, registered nurses who receive medication updates training regularly. Medication was seen to be stored correctly and securely and records maintained accurately. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 the following standard(s): 23 Guests in the home are protected from abuse. EVIDENCE: The home has it’s own policy and procedure on adult protection and also for whistle blowing. All members of staff are made aware of these at induction to the home. The home also has a copy of the Surrey Multi-Agency procedures. All members of staff have undergone training on the protection of vulnerable adults and those spoken with demonstrated a good knowledge and understanding of adult protection issues. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 the following standard(s): N/A These standards were not assessed at this inspection. Please see report dated 23rd August 2005 for detail on these standards. EVIDENCE: The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 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): 35 Guests’ needs are met by, a well-trained, competent staff team. EVIDENCE: The home has a programme of planned training in place that is produced annually. Training needs are identified through the appraisal process. Individual training records are maintained for all members of staff along with copies of certificates as evidence of training undertaken. A full induction programme is undertaken and recorded for all new members of staff. Training is carried out in the home, either by external trainers or the manager and senior staff members as appropriate. Members of staff spoken with confirmed that they receive a high level of training and felt that this enabled them to carry out their jobs more effectively. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 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 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): 42 The health, welfare and safety of the guests is protected by the home. EVIDENCE: All members of staff receive health and safety training at induction, with refresher training on an annual basis. The home has a health and safety policy and members of staff are made aware of this through supervision, meetings and training sessions. A copy of the policy is posted in the staff rooms to maintain awareness. The organisation has a health and safety manager and the home has a nominated health and safety representative. Audits of the premises are carried out regularly and any shortfalls identified and dealt with. The home employs two maintenance workers to deal with ongoing maintenance and repairs. General workplace risk assessments have been undertaken and are reviewed regularly. The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 Page 17 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 X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X 3 X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Brambles Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000013356.V261442.R01.S.doc Version 5.0 Page 18 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. 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. Refer to Standard Good Practice Recommendations The Brambles DS0000013356.V261442.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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