Inspection on 18/11/05 for The Brambles

This inspection was carried out on 18th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Brambles 05/06/07

The Brambles 08/01/07

The Brambles 25/09/06

The Brambles 24/05/05

The Brambles 22/11/04

The Brambles 02/06/04

The Brambles 05/08/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE The Brambles 69a Vicarage Road Amblecote Stourbridge West Midlands DY8 4JA Lead Inspector Mr Mike Kirton Unannounced Inspection 9:30 18 November 2005 th X10015.doc Version 1.40 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 DS0000024978.V262726.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 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 DS0000024978.V262726.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Brambles Address 69a Vicarage Road Amblecote Stourbridge West Midlands DY8 4JA 01384 379034 01384 396892 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) Mr Boota Singh Khangoure Mrs Melanie Mansell Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (10), Physical disability over 65 years of age (7) of places The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: The Brambles is a residential home providing 24-hour care and support for 17 people over the age of 65. It is located in a residential area of Amblecote opposite Corbett Outpatients Department and close to Stourbridge town centre. It is easily accessible by local public transport networks and there are a few parking spaces at the front. A major refurbishment and extension is underway which is expected to dramatically improve the homes environment and increase the occupancy. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours and included a tour of the buildings, examination of 3 individual care plans and other records as required under each standard. Verbal feedback was received from 9 residents, the manager and proprietor were interviewed and informal discussions took place with several staff members. On the day of the inspection a dementia-training course was being run for all staff members and building work was still continuing on the extension. What the service does well: 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 DS0000024978.V262726.R01.S.doc Version 5.0 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 7 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 the following standard(s): These standards were not fully assessed on this occasion. For further information please refer to the previous report dated 24th May 2005. EVIDENCE: Outstanding requirements were assessed. No changes have yet been made to the homes statement of purpose or service user guide (standard 1) however new residents had undergone an assessment of their needs (standard 3). The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 8 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 the following standard(s): These standards were not fully assessed on this occasion. For further information please refer to the previous report dated 24th May 2005. EVIDENCE: Outstanding requirements were assessed. Residents care plans and risk assessments were still not being completed accurately or reviewed as required (standards 7 & 8). A tablet was found on the floor in the lounge. Care must be taken to ensure residents take their medication and records are appropriately maintained (Standard 10). The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 12,13,14,15 No requirements were made under these standards, as it is clear that improvements are being made. However the renovations must be completed quickly to end the disruption to resident’s lives. A good variety of activities are provided and regular consultation is undertaken. EVIDENCE: Residents care plans examined contained a plan of daily living which showed when they preferred to get up and go to bed, meal times, and what activities they took part in. All those interviewed stated they were fed up with the disruption that was being caused by the renovations. Whilst they and their relatives have been consulted the work has long exceeded the expected completion date and restrictions on their movements around the home are in place. On the day of the inspection only 1 toilet was in use for 12 people seated in the main lounge/dining room. Comments received about the environment included ‘there is to much noise and mess’, ‘I’m fed up’, ‘there are not enough toilets’ and ‘I wish I had never come here’. Other comments about the home were more positive ‘there are a lot of good activities’, ‘some staff are very nice’, ‘staff always come when I need them’, and ‘the bedrooms are very nice’. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 10 The home provides a range of activities and events and has appointed 3 staff members as organisers. Bingo was being played on the day of the inspection. Both and organ player and a local vicar visit the home every fortnight and a specialist external activity worker (including singing, interactive puppets, exercises) attends every week. A Halloween party (including fireworks and quiz) was recently held to which relatives and visitors were invited and a Christmas meal at a local restaurant is being planned. The mobile library service also visits the home on a regular basis. Visitors can be received at any reasonable time or with prior agreement and residents may come and go from the home as they wish. Staff however should be informed when they leave and expected time of return. The building work does place some restrictions on privacy and there was only 1 main lounge and dining area available. A new kitchen has been built and is near to completion however the old dining area is still being used. Feedback from residents praised the standard of cooking and no complaints were received. All personal preferences and dietary requirements were recorded and catered for. Hot drinks are served on a regular basis and upon request, and residents were seen to have their own cold drinks. The cook is able to make an alternative to the main cooked meal however at least two choices must be offered. The manager stated that plans were being put in place to introduce more choice and variety. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16,18 The home has recently introduced good new complaints and adult protection procedures. Positive action is being taken to ensure all staff, residents, and visitors are aware of them and any concerns of abuse are reported. EVIDENCE: A new complaints procedure has been implemented which meets the requirements of the minimum standards and includes contact details for the Commission. These are being laminated and displayed around the home and in each resident’s room. No complaints have been received by the home or the Commission. Meetings have been held regularly for residents and their relatives to keep them updated with the developments at The Brambles. Newsletters have been sent out and agreement has been received prior to anyone moving room. Contact details for a local advocacy service are displayed if needed. A new adult protection procedure has been implemented (July 2005) which has been signed by the manager. She is in the process of ensuring these are read and understood by all staff through new induction procedures and supervision. The home also has a copy of Dudley Social Services policy and the Department of Health Guidance ‘No Secrets’. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 12 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 the following standard(s): These standards were not fully assessed on this occasion. For further information please refer to the previous report dated 24th May 2005. EVIDENCE: All outstanding requirements remain (standards 19,20,24, & 25) until the building work is completed. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 13 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not fully assessed on this occasion. For further information please refer to the previous report dated 24th May 2005. EVIDENCE: It was noted that some staff attending dementia training were not being paid. Where staff need more than 3 days training in order that they can carry out their duties this must be provided. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 14 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38 The current environment is not good and the risks to residents, staff and visitors are increased during the building work. The manager appears to be doing all she can to minimise the effects this is having. EVIDENCE: The manager has the necessary qualifications and experience to manage The Brambles. She demonstrated commitment to further training and improving the standards of care provided. The past 14 months have been a difficult time with constant building work and disruption continuing. There will be additional challenges once the home increases the number of residents from 17 to 35. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 15 The home is required to implement a quality assurance system, published annually, with an action plan to improve standards. This will take into account the views of service users, relatives, staff, and others people who come into contact with the home. The manager has updated the home fire risk assessment and evacuation procedures throughout the renovations. All equipment has been serviced annually and the required testing undertaken. Due to the current situation at The Brambles these standards cannot be fully assessed. However measures were being implemented to reduce the risk of harm to residents. This included escorting residents to their bedroom and positioning of staff at night to cover both the lounge and bedroom areas. The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 16 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X X X X 2 The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 17 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 OP1 Regulation 4&5 Requirement The Statement of Purpose and service user guide need updating and must contain all the information required under this standard. Consideration must also be given to making copies available for prospective and all existing service users in a format they can read i.e. large print. This is an outstanding requirement from 22nd November 2004. The care plan should set out in detail what action will be taken to meet identified needs and reviewed at least once a month or when a change occurs; they or their representative should then sign this. This is an outstanding requirement from 22nd November 2004. Risk assessments must be completed accurately and used to inform on actions that are required. This is an outstanding requirement from 22nd November 2004. DS0000024978.V262726.R01.S.doc Timescale for action 01/04/06 2 OP7 13,14&15 01/12/06 3 OP8 12&13 01/12/06 The Brambles Version 5.0 Page 18 4 5 OP9 OP19 13,18,19 23 6 OP20 23 7 OP24 16&23 8 OP25 16&23 9 OP30 18&19 10 OP30 18,19 Staff must ensure medication is taken by the resident before signing the record sheet. An inventory needs to be undertaken with an updated planned renewal of fabric and decoration produced and implemented with timescales. This is an outstanding requirement from 22nd November 2004. Suitable facilities are to be provided for service users to meet visitors in private separate from their bedrooms. This is an outstanding requirement from 22nd November 2004. Beds and bedroom furniture in the majority of rooms require replacing. Door locking devices for privacy and security require fitting. This is an outstanding requirement from 22nd November 2004. To ensure that all pipe work and radiators are guarded or have guaranteed low surface temperatures. Risk assessments must be undertaken with individual residents. The water system is risk assessed for Legionella and for the hot water to be stored at a minimum 60c. . This is an outstanding requirement from 22nd November 2004. Induction and foundation training to NTO specifications must be introduced. This is an outstanding requirement from 22nd November 2004. Staff must receive at least 3 paid training days a year or more as required for their duties. DS0000024978.V262726.R01.S.doc 18/11/05 01/01/06 01/01/06 01/01/06 01/01/06 18/12/05 18/11/05 The Brambles Version 5.0 Page 19 11 OP33 24 12 OP38 26 13 OP38 12&13 14 OP38 12&13 The home is required to implement a quality assurance system, published annually, with an action plan to improve standards. The proprietor must complete monthly Regulation 26 reports and forward copied to the CSCI. This is an outstanding requirement from 22nd November 2004. Fire doors must not be wedged open and should close correctly. This is an outstanding requirement from 22nd November 2004. Policies and procedures reflecting current practices must be developed, implemented and reviewed. They must be signed and dated by the manager then signed and dated by staff as being read and understood. This is an outstanding requirement from 22nd November 2004. This includes a policy regarding the use of students at the home. 01/03/06 18/11/05 18/11/05 01/03/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Brambles DS0000024978.V262726.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 DS0000024978.V262726.R01.S.doc Version 5.0 Page 21 - 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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