Inspection on 15/07/05 for The Brambles

This inspection was carried out on 15th July 2005.

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

The inspector 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 13/02/06

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 Sally Murphy Unannounced 15 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 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 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) Lynette Ann Taft Personal Care Home Only 7 Category(ies) of Learning Disability registration, with number Physical Disability of places The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named service users with a physical disability. 2. No additional service users with physical disabilities to be admitted to the home until the work to extend the bedrooms has been completed and approved by NCSC. 3. Registered for 7 persons in categories LD and PD. Date of last inspection 21 December 2004 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 is currently taking place to increase the size of four service user bedrooms. The home is set in pleasant gardens that are accessible to service users. 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 is Lynette Taft, and the Responsible Individual is Mr. David Dick. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as part of the planned annual programme of inspection. The inspection was unannounced and carried out by one inspector over one day. The previous inspection was also unannounced and took place on 21 December 2004. On the day of the inspection there were three service users residing at the home. The remaining four service users had moved temporarily to another home, whilst building work was taking place. The Registered Manager was not on duty at the time of the unannounced inspection. During the course of the inspection service users and staff were spoken with. Care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that the fire alarm is tested on a weekly basis. Staff should also be provided with regular updates in manual handling training. It is recommended that a photo of the service user is added to Medication Administration Records and that the reason is recorded when medications are returned to the pharmacy. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 6 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 D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 & 5 Service users 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 service users’ needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at The Brambles. Pre-admission assessments were seen within service user plans. Prospective service users 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 service user setting out the terms and conditions of their stay. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,& 10 The home has developed an appropriate care plan for each service user. Service users are supported to make choices regarding their life, and individuals’ decisions and preferences are respected. Records relating to service users are stored securely. EVIDENCE: Care plans are maintained for each service user. These follow the standard model used by Somerset Social Services. Two care plans were examined in detail. Care plans provided information regarding service users needs, daily routines and preferences. Risk assessments had been completed where required. Care plans had been regularly reviewed and updated appropriately. Service users are encouraged to exercise choice regarding their daily routines. A board is displayed showing which staff will be on duty. The home will keep money securely for those service users who wish them to. Records are maintained of all transactions involving service users’ finances. Service users’ monies were examined, and all seen tallied with records kept. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 & 17 Service users are provided with a range of activities that are appropriate to their individual needs, and are supported in accessing the local community. Service users are provided with a well balanced diet, and offered support as required. EVIDENCE: Service users 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 service users were observed playing skittles and relaxing in the garden. There is also a tactile board in the hallway. One service user attends church. There are regular trips out to local attractions and amenities. Staff support service users in maintaining contact with friends and family members. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 11 A board near the dining room displays photographs of the meals planned for each day. There is a spacious dining room at the home. Service users are provided with a choice at each mealtime. Staff are aware of service users’ dietary needs and preferences. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 & 20 Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. Medications are managed appropriately. EVIDENCE: Service users are provided with assistance to undertake personal care tasks as required. Personal care is provided in private. Staff support service users in accessing health care services, and ensure that specialist advice is sought as required. Pressure-relieving equipment had been provided for one service user. 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. It is recommended that due to the dependency levels of the service user group that a photograph is added to each MAR sheet. The reason should also be recorded when medications are returned to the pharmacy. . The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has taken appropriate actions to safeguard vulnerable adults. EVIDENCE: The home has a complaints procedure that 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. The home has appropriate policies relating to the Protection of Vulnerable Adults and Whistle blowing. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 & 30 The home has been decorated and furnished to a good standard. Appropriate adaptations have been provided. There are sufficient communal areas and bathing facilities to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: As previously stated there is currently building work taking place at the home to increase the size of four service user rooms. Appropriate actions have been taken to ensure the safety of service users, and minimise disruption to those remaining at The Brambles during this period. Service users and their families are involved in the decorating of bedrooms. Service users are able to bring personal possessions with them into the home, and all rooms seen had been personalised to reflect individuals’ preferences and tastes. Adaptations have been provided as required. There are two assisted bathrooms at the home and handrails have been fitted as necessary. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 15 The lounge and dining room are spacious and have been decorated and furnished to a good standard. The garden has been well maintained and is accessible to service users. The kitchen is locked when not in use. Radiators have been guarded, and hot water outlets have been thermostatically controlled to reduce risks to service users. Fire doors have automatic closures fitted. The laundry was found to be clean and hygienic. Red alginate bags are used as required. The home follows good practice with regard to infection control. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 & 36 Staffing levels are appropriate to meet service users’ needs. Staff are competent and provide a good standard of care. Staff have not received appropriate updates in manual handling training. 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 Total Communication and My Day plans. Training records relating to manual handling training did not contain a date for some staff and for others indicated that this was last attended several years ago. Due to the dependency levels of the service user group, the home must ensure that staff receive regular updates in manual handling training. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 17 As the Registered Manager was not on duty at the time of the unannounced inspection, staff recruitment files could not be examined. This will be followed up at the next inspection. Staff confirmed that they feel well supported and receive regular supervision. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41, &42 The Registered Manager is an experienced and competent manager. There is a relaxed and open atmosphere within the home. Records relating to service users are stored securely. Fire tests must be tested on a weekly basis to promote the health and safety of staff and service users at the home. EVIDENCE: The Registered Manager is Ms Lynette Taft, who has considerable experience of providing care to people with learning disabilities. Due to the dependency levels of the service user group, it is not appropriate to hold residents meetings, therefore staff obtain feedback on the service provided through regular reviews and from service users on an individual basis. The home has appropriate policies and procedures in place to safeguard vulnerable service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 19 Fire safety records were examined. Weekly tests had not been completed during the period 1 July 2005 – 15 July 2005. All staff have received regular updates in fire safety training. Hazardous substances had been stored securely and were not accessible to service users. Accidents have been reported and recorded as required. The Brambles D53 - D02 S36187 The Brambles V238882 190705 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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Brambles Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 x D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? na 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. 2. Standard YA35 YA42 Regulation 13 (5) 23 (4) Requirement Staff must receive regular updates in manual handling training. The fire system must be tested on a weekly basis. Timescale for action 11.11.05 12.08.05 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 YA 20 Good Practice Recommendations It is recommended that due to the dependency levels of the service user group that a photograph is added to each MAR sheet. The reason should also be recorded when medications are returned to the pharmacy. The Brambles D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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 D53 - D02 S36187 The Brambles V238882 190705 Stage 4.doc Version 1.40 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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