Inspection on 21/05/07 for The Brambles

This inspection was carried out on 21st May 2007.

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 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 15/05/06

The Brambles 06/03/06

The Brambles 14/09/05

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 Mr Patrick Rooney Unannounced Inspection 21st May 2007 10:00 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 DS0000005880.V335145.R01.S.doc Version 5.2 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 DS0000005880.V335145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Brambles Address Park Avenue New Longton Lancashire PR4 4AY 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) 01772 614533 01772 614595 info@thebramblesresthome.co.uk Miss Karpal Kaur Mr Harbhajan Singh Mrs Kamal Jeet Kaur Virdee Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include:*Up to 32 service users in the category of OP (Old age not falling within any other category). 15th May 2006 Date of last inspection Brief Description of the Service: The Brambles provides 24-hour personal care and accommodation for up to 32 older people, it is privately owned. 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 has recently been extended and has had a major refurbishment. All the bedrooms have ensuite facilities and communal areas are varied and spacious. The home has a passenger lift for easy access to the first floor. There are assisted bathrooms available on all floors. The Brambles is set in one and a half acres of grounds, which are mainly grassed areas with woods to the rear and side. Landscaping is currently taking place and will provide pleasant garden areas for resident to use. Fees for the home currently range from £342.50 to £470 per week. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and took place over a period of six hours. Two inspectors carried out the inspection Mr P Rooney and Mrs F Lacey. The information in this report was gathered from a pre inspection questionnaire completed by management of the home, discussion with the manager and discussion with staff individually. Private discussions were held with relatives and residents. The care of five residents was case tracked, their assessments and care plans were seen and the inspectors interviewed them regarding the care they receive. Other residents were spoken to in the lounges. Questionnaires were received from residents and relatives and GPs serving the home. Letters were sent to social workers. A tour of the premises took place and the inspectors saw documents. Staff records were examined. What the service does well: The Brambles provides good personal care service to its residents and their relatives. The inspectors found this to be the case from discussion with residents, relatives and staff. Questionnaires completed by residents and relatives also confirmed this to be the case. Their comments include, “The home is kept very clean, all staff are pleasant and look after us very well.” “I couldn’t ask for better”.“ All my needs are taken care of and I get on very well with staff”. “This is a very good home it is next to being at home”. There is a good stable staff team which works well together the manager is approachable and has the confidence of residents and staff. The home provides an excellent and comfortable environment for residents to live in. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process prior to admission to the home is comprehensive and gives good detail about care required. EVIDENCE: Records were examined for four residents and these residents were spoken to about the care they receive. They confirmed that the home is able to meet their needs. There is a comprehensive needs assessment carried out prior to placement, this forms the basis for a care plan to be developed. Social work assessments were also available in files. All prospective residents are provided with information about the home and its facilities prior to accepting a place. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care plans ensure their health and personal needs are closely monitored. The home provides good personal service for residents and there are good relationships with residents, relatives and all support services. EVIDENCE: The inspectors looked at care plans for four residents and then spoke to those residents. They all expressed satisfaction with the care they receive saying that all their care needs are met. Residents are very happy with carers employed by the home and said that care is provided in a sensitive way ensuring privacy and dignity is maintained. Recording in care plans includes religious cultural and social needs. There was also good evidence of involvement from other medical professionals. The use of a report book containing details regarding all residents should be discontinued as this has implications for confidentiality if residents ask to see what is written about them. All personal recording should be done on individual care records. Reviews of care take place monthly and are currently recorded The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 10 on the resident’s record sheets. There is a revue form available, which is not currently being used. It would be of benefit for this to be used and residents or their representatives should be actively encouraged to sign the record to indicate their involvement in the process. The following are comments received from residents during the visit; “The home is kept very clean, all staff are pleasant and look after us very well.” “I couldn’t ask for better”.“ All my needs are taken care of and I get on very well with staff”. “This is a very good home it is next to being at home”. The inspectors observed good interaction between staff and residents and all looked well cared for. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily routines are flexible and take into consideration the individual needs and wishes of residents. EVIDENCE: The home has a hobby therapist who arranges various activities for residents. The inspector saw a varied programme of activities for residents, which includes entertainment sessions, library service, Talking books, quizzes, outings, and visiting shops. Residents told the inspector that there are always activities available to them if they wish to take part. There is a resident’s fund available to provide activities. Garden parties, Christmas and summer fairs have been organised. The atmosphere in the home was observed to be relaxed, residents told the inspector they are able to rise and retire when they wish and that mealtimes are flexible according to their needs and wishes. Meals may be taken privately if residents wish. Residents told the inspector that staff are very kind and caring. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 12 Resident told the inspector that food they receive is very good and there are always alternatives provided. Individual likes and dislikes are recorded and menus are discussed with residents. One of the inspectors had lunch with residents, this was good quality and the mealtime was relaxed. Visitors are made welcome in the home and are able to see resident in private. Local church ministers visit and residents are able to maintain community links id they wish. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are complaints and protection procedures in place, relatives and residents are confident that their concerns are listened to. EVIDENCE: The homes policies and procedures for complaints and protection were looked at and the complaints book seen. All residents have access to these procedures and a copy of the complaints procedure is in the service users guide, which all residents are given. Residents said that they knew what to do if they have any concerns and confirmed that they are able to raise issues with the homes managers. The contact address and phone number for CSCI needs to be updated. There is a new adult protection policy in place, which is in line with current requirements. While staff said they understood this records showed that only six members of staff had receive training in the protection of vulnerable adults, one dating from 1998. The home should ensure that all staff are provided with up to date training in the protection of vulnerable adults. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24,25 and 26 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home offers an excellent standard of environment décor and furnishings, which is clean and comfortable. EVIDENCE: The inspectors toured the home and viewed resident’s rooms, bathrooms, laundry and communal areas. The home has recently been extended and a major refurbishment programme has taken place. All areas of the home are very comfortably furnished and resident’s rooms contained items they were able to bring with them when they were admitted to the home. The refurbishment has greatly improved the homes facilities and there was evidence of meticulous attention to detail to ensure residents comfort. Doors around the home have been fitted with a delay mechanism to ensure residents can move more freely. Beds have been replaced and new duvets and pillows provided. All bathroom areas are very spacious and were spotlessly clean. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 15 Baths have assisted features and there is ample space for two carers if needed. Shower facilities are also available and there are ensuite facilities in all bedrooms. All corridors are fitted with automatic deodorant dispensers. The home has been tastefully decorated and pictures put up. Special daylight feature have been built in to the corridors, which ensure an inviting atmosphere. There are large garden areas, which are being landscaped to ensure residents can enjoy them. All residents spoken to said they were happy with accommodation and improvements provided by the home. There are very good infection control procedures in place and domestics employed to ensure the home is always kept clean. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment and training of staff are good and offer protection to people living in the home. EVIDENCE: The inspectors spoke to management and interviewed three staff. Rotas and staff records were examined. It was noted that there is a stable staff group who have the experience and skills to provide care needed for residents living in the home. There are improvements in the staff induction programme and the home has introduced the comprehensive “Skills to Care”(formally TOPPS) induction programme. This training programme takes six months and provides a good basic training for carers. Records show that 33 of the staff employed in the home are qualified to NVQ 2 or above in care. Eight overseas staff have nursing qualifications from their own countries. The home has a commitment to ensure that more staff are able to undertake NVQ training. At least 50 should have this qualification. Staff supervision and appraisal records ensure staff training needs are identified and appropriate training provided. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 17 Questionnaires received from residents and relatives confirmed that staff provide the right level of support to residents. Rotas showed that there are sufficient numbers of staff on duty to meet the needs of residents. Residents said that staff are very friendly and approachable and felt their care needs are fully met. The files of staff were viewed and showed that all necessary recruitment checks are made including Criminal Records Bureau checks. References are taken up and interviews held prior to a post being offered. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well managed, which ensures residents interests are protected and health and safety issues are promoted. EVIDENCE: The registered manager is experienced in management and there are clear lines of accountability in the home. Both staff and residents find the manager very approachable and are confident any issues they raise are dealt with. The manager has not yet completed NVQ 4 in management, however is due to begin this in September. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 19 Residents and staff are happy with how the home is run. Resident’s views are taken seriously and resident meetings are being introduced. The home has been awarded Investors In People, which includes an annual assessment. The manager ensures resident’s views are taken into account regarding formulation of menus and how they want any development to take place. This was confirmed in discussion with residents and staff. There is a business plan for the home to ensure standards are maintained. The home does not look after resident’s personal allowances, these are dealt with either by themselves or their relatives or representatives kept. There is a safe available in each of the resident’s rooms for them to store any valuables themselves. All the homes policies and procedures have been reviewed and updated. Health and safety is taken seriously and staff receive training in moving and handling, health and safety and first aid. All safety certificates and risk assessments are carried out and are up to date. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 4 X X X 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP31 Regulation 9(b)(1) Requirement The registered manager must be qualified with NVQ 4 in management. Previous timescale 31/10/06) Not met Timescale for action 30/09/08 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. Refer to Standard OP7 OP18 OP28 Good Practice Recommendations Use of a report book to record details concerning residents should be discontinued; all recording should be on individual records. All staff should receive training in protection of vulnerable adults. A minimum of 50 of staff should be trained to NVQ 2 or above. The Brambles DS0000005880.V335145.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000005880.V335145.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!