Inspection on 14/09/05 for The Brambles

This inspection was carried out on 14th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Brambles 21/05/07

The Brambles 15/05/06

The Brambles 06/03/06

The Brambles 16/11/04

The Brambles 04/05/04

The Brambles 02/12/03

The Brambles 02/05/03

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

CARE HOMES FOR OLDER PEOPLE The Brambles Park Avenue New Longton Lancashire PR4 4AY Lead Inspector Della Lovell Announced 14 September 2005 09:30 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 Older People. 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 F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Brambles Address Park Avenue New Longton Lancashire PR4 4AY 01772 614533 01772 614595 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) Miss Karpal Kaur Mr Harbhajan Singh Mrs Kamal Jeet Kaur Virdee Care Home 24 Category(ies) of OP - Old age (24) registration, with number of places The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16 November 2004 Brief Description of the Service: The Brambles provides 24-hour personal care and accommodation for up to 24 older people. The Brambles is privately owned. The owners own the one home.The Brambles is a detached residence, situated in a residential area of New Longton, Preston. Local shops and other amenities are close by. The home is currently undergoing a major refurbishment and rebuild programme, once completed there will be 8 additional bedrooms and all the bedrooms will have ensuite facilities. The home has a passenger lift. Communal areas are all on the ground floor. The Brambles is set in one and a half acres of grounds, which are mainly grassed areas with woods to the rear and side of these garden areas. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one day in September 2005. The management team had addressed a number of matters raised at the last inspection. The inspection involved discussion with the people who lived and worked at the home, examination of records and a tour of the home. What the service does well: What has improved since the last inspection? What they could do better: The home needs to improve the way it records and holds information in relation to staff recruitment and training. There was no clear system to identify training needs and no clear over view for the providers to ensure that staff are kept up to-date. Although one of the management team informed the inspector The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 6 that a programme of training was currently being developed it was difficult to see what was actually needed. Induction is undertaken by the home but again it was unclear to what had been offered, received and understood by staff. The registered person should ensure that this is recorded. The provider and manager was informed on the day by the inspector to ensure information is appropriately recorded with regards to staff employment checks. Five staff have been put forward for NVQ Level 2, the registered person needs to ensure that 50 of the staff team are trained to NVQ level 2. The registered person visits the home, however reports are not always undertaken and sent to The Commission for Social Care Inspection. This will need to be addressed. The registered manager does not hold the Registered Managers Award, the registered provider will need to ensure that the registered manager is provided with training to ensure they are qualified and competent in their role. There was no planned programme for social and recreational activities. The inspector noted that the needs of the service users living at the home varied greatly and could effect the range of activities offered. The registered person should develop a programme of activities which takes into consideration the needs and preferences of the service users. 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 F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home had a thorough assessment procedure in place to ensure that service users needs are met. EVIDENCE: The home had a comprehensive care needs assessment in place. Individual records are kept for each service user. Observation of one new service users file showed that the home had visited the service user prior to admission and undertaken a full assessment. Service users are provided with a terms and conditions and a letter to confirm the home can meet their needs. One service user told the inspector that she was given the opportunity to stay on a short term basis to see if she liked the home and that the home gave her as long as she wanted to make that decision. All service users spoken said that they felt the home was meeting their needs. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 9 and 10 There was a consistent care planning system in place, which provided staff with the information they need to satisfactorily meet service users needs. Service users are cared for in such a way that ensures the service users dignity and privacy is respected. EVIDENCE: The files of a two service users were viewed in detail as part of the inspection process. The service users care plans had been generated from the initial assessment and service users and their families had the opportunity to be involved in the process. The care plans showed detailed information on the care needs, any specialised equipment needed and input from the community nurses. On the day of the visit one service user was poorly and was being cared for in bed, the inspector noted that the doctor was visiting on a regular basis and up to date monitoring sheets were in the service users room. The service user was very comfortable and well cared for. Staff in attendance spoke to the service user in a very caring and sensitive manner. Service users spoken too told the inspector that the staff are very kind and treat them respectfully. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 10 The home had a number of bedrooms on the ground floor and the outside pathway takes you past each room. On the day of the visit the inspector was able to see from outside clearly into service users bedrooms. Staff spoken too said that the curtains are always closed if personal care is taking place. The registered person should consider fitting net curtains or blinds to the service users rooms on the ground floor. The standard with regards to medication was not fully assessed however an inspection of medication records were seen up to date and new storage facilities were being incorporated into the new build of the home. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The dietary needs of the service users are well catered for with a balanced and varied selection of food available, which ensures service users individual tastes and choices are catered for. Social activities are available but do not ensure that service users social and recreational needs are met. EVIDENCE: The food is cooked in the homes kitchen and fresh produce was seen being used. All service users spoken too said that the food was very good and that they were always offered a choice if they didn’t like what was on the days menu. Special diets were provided for those service users requiring one. One service user told the inspector that because she can not have a particular flour the cook bakes her bread each day. Service users told the inspector that they felt the home provided flexibility and choice with regards to the daily living. One service user said that her family can visit when they want and another service user told the inspector that she can get up in the morning when she wants. Activities are offered, however there was no set plan or programme in place. One service user said that they have exercises each week. The management team informed the inspector that due to the extensive building work in the home the activity programme had not been consistent. The management team informed the inspector that works in the home were coming to an end and consideration was being given to The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 12 employ an additional staff member to support this area. The inspector noted that the needs of the service users living in the home varied, therefore the registered person should consult with each service users and take into consideration the service users abilities and ensure that service users social and recreational interests are recorded and how they are to be met. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a complaints procedure, which ensures that all complaints would be acknowledged and investigated. Arrangements for the protection of service users ensures their safety. EVIDENCE: The home had not received any complaints. A complaints policy and procedure was in place and is made available to all service users. One service users told the inspector they had no complaints but knew who they could speak to if they had any concerns. The home had developed a specific format for recording all the details relating to complaints. The management team was advised to keep a log which would provided an overview for the providers with regards to complaints. The home had a procedure in place for dealing with allegations of abuse and the staff were able to confirmed the correct procedure they would follow to protect service users. The inspector made a minor recommendation on the day to include a named designated manager with specific responsibility for addressing and reporting concern. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The environment of the home ensures that service users live in a clean well maintained home. EVIDENCE: Over the past 9 months the Brambles has been going through a major rebuild and remodelling programme. The home has had a major refurbishment as well as a large extension, which will provide additional bedrooms and lounge space. On the day of the visit the inspector noted that the work is nearly complete and a further visit by the Commission for Social Care will be made once completed. The homes new build and refurbishment provides facilities and furnishings in accordance with the National Minimum Standards. Bedrooms and lounges have all new furniture and fittings, all rooms have been decorated to a high standard and all fittings and furnishing were of a good quality. All service users have an en suite facility and all the main bathrooms and toilets are suitable for the homes purpose. The grounds will be landscaped as apart of the programme. At the time of the visit work is still underway, therefore the grounds are not currently suitable for service users to use. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 15 The home employs domestic staff and all rooms were cleaned to a high standard. While work is ongoing the fire safety officer has been in regular attendance and the home has provided the Commission with the appropriate certificates with regards to electrical and a schedule of works. The home has risk assessments in place while work is in place and staff had been made aware of fire safety issues. The registered person will need to ensure that risk assessments are reviewed and updated on a regular basis. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29, 30 The policies and procedure for recruitment of staff ensure the safety of service users. Staff at the home are provided with training to ensure they are competent to do the job, however more detail is needed with regards to the homes recording and monitoring of staff training. EVIDENCE: The home had a recruitment procedure in place, which ensured the Protection of Vulnerable Adults. Personnel files showed that a recruitment and selection process had taken place and new staff had commenced work following a satisfactory POVA first check. The registered person informed the inspector that all the appropriate checks required by Law had been undertaken for all the existing staff as well as new. The registered person must ensure a record is maintained of all staff checks. The management team and the staff were able to explain the homes induction procedure for all new staff, however there was a lack of information and documentation on the staff files. The registered person should develop a proforma to record that the induction has taken place, that the staff understand the training and the content of what the induction covered. Training was available for all existing staff and some certificates were seen on the staff files, mandatory training is provided by the home, however there was no clear format to monitor or over see this. The manager informed the inspector that the home was currently developing a programme for future training. Staff spoken too said that they had been provided with training and that they felt they had adequate training to do the job competently. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 17 Since the last inspection 5 staff had been put forward by the home to undertake the NVQ Level 2 qualification. The registered person should ensure that 50 of the staff are trained to NVQ Level 2. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 36 The registered person does not ensure that the registered manager is qualified to manage the care home. Staff are appropriately supervised to ensure they are competent in their role, however information is needed with regards documentation on staff files. EVIDENCE: The home is managed by a team of managers. The registered manager provides hands on care and works alongside the carers in the home and another manager ensures that administration of the home is kept up to date. The registered manager has no management qualification and has not yet applied for the Registered Managers Award. The management team informed the inspector that consideration was being given to the registered manager position and the role within the home. The registered providers do visit the home however the Commission for Social Care Inspection are not receiving monthly reports by the providers in accordance with the Care Homes Regulations. This was discussed with the provider and provider on the day. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 19 Staff told the inspector that they felt supported by the management team and supervised was provided in their day to day work. The registered person must ensure that supervision is provided at least 6 times a year and appropriately recorded on the staff files. The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x x 2 x x The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 21 yes 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 12 Regulation 16(2)(m)( n) Requirement Following consulation with the service users the registered person must ensure that service users social, and recreational interests are met. The registered person must ensure that all staff are kept up to date with relavant training. The registered person must ensure that a record is kept of all all approprate checks on the staff team. The registered person must ensure that all a record of induction training is kept for all new staff. The registered person must visit the home at least once a month and prepare a written report on the conduct of the home. A copy must be provided to CSCI and the registered manager. The registered person must ensure that the registered manager has the qualifications, skills to manage the care home Timescale for action 31/12/05 2. 3. 28 29 18 (c ) 4b Schedule 2 18 ( c) 30/11/05 30/11/05 4. 30 30/11/05 5. 31 26 30/9/05 6. 31 9(b)(i) 31/12/05 The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 22 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. 2. 3. 4. 5. Refer to Standard 9 10 12 16 18 Good Practice Recommendations It is recommended that alternative provision be made for the storage of medication. the registered person should consider fitting net curtains or blinds to the ground floor bedroom windows. The registered person should develop a programme of activites for service users. The registered person should develop a complaints log to ensure that the provider has an overview of any complaints. The registered person should ensure that the homes policy for the protection of vulnerble abuse includes; - The designation of a senior manager with specific responsibility for addressing and reporting concern. - Guidance to help staff who have concerns about malpractise to raise the concerns with the right people on the basis of needs to know - A clear commitment that staff will protect against victimisation. The registered person should review the environmental risk assessmnets on a regular basis while work is ongoing. The registered person should ensure that 50 of the staff team is trained to NVQ Level 2 in Care. 6. 7. 19 28 The Brambles F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road, Chorley Lancashire, PR7 1NW 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 F57 F08 S5880 The Brambles V238186 140905 Stage 4.doc Version 1.40 Page 24 - 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. 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