Inspection on 23/08/05 for The Brambles

This inspection was carried out on 23rd August 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 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 03/04/07

The Brambles 14/12/05

The Brambles 28/10/04

The Brambles 25/05/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOME ADULTS 18-65 The Brambles Suffolk Close Massetts Road Horley Surrey RH6 7DU Lead Inspector Denise Debieux Unannounced 23 August 2005 @ 10:00am rd 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 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Brambles Address Suffolk Close Massetts Road Horley Surrey RH6 7DU 01293 771644 01293 784478 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) Multiple Sclerosis Society Ms Kay Croll CRH - Care Home 28 Category(ies) of PD - Physical disability (28) registration, with number of places The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 - All persons admitted to the home may be those who require nursing care, or those who only require personal care. 2 - 6 persons for day care between 09:00 - 17:00 hours. 3 - At no time may the number of residents accommodated overnight exceed 28. Date of last inspection 28 October 2004 Brief Description of the Service: The Brambles Respite Care Centre provides short-term respite care for people who have been diagnosed as having Multiple Sclerosis, and who are aged 18 years or over. The Centre is owned by the MS Society and is a registered provider of both nursing and personal care for 28 adults. The Brambles was purpose built for people with a physical disability and all accommodation for guests is situated on the ground floor in single rooms. All rooms offer the facilities of a toilet, washbasin and hands free telephone systems, TV and video. All 28 bedrooms have overhead electrical ceiling hoists and the bathrooms have a variety of baths such as hi-lo, Jacuzzi and parker baths and one bathroom has a wheel-in, walk-in shower. There is a large lounge area, including a licensed bar, where alcoholic and soft drinks can be purchased by guests and visitors. There is also a dining room, conservatory and a separate smoking lounge where guests and visitors are permitted to smoke. The physiotherapy department also offers a hydrotherapy pool. The home is situated in a quiet cul-de-sac, close to Horley Town centre and set in pleasant, well maintained gardens. Parking is provided to the front of the building. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Denise Débieux, Lead Inspector for the service. Ms Kay Croll, Registered Manager and Ms Vanessa Lindsay-Smith, Responsible Individual, were present as representatives for the establishment. A tour of the premises took place. Two care plans were inspected in depth, the service users’ guide, terms and conditions, pre-admission documentation, policies and procedures and the complaint’s log were all sampled. Five of the service users were spoken to at length, with a further three service users and five on-duty staff being spoken with during the tour. Some of the comments made to the inspector during the inspection are quoted in this report. This was a positive inspection. The inspector would like to thank the service users, manager and staff for their time, assistance and hospitality during this inspection. What the service does well: The staff work hard to ensure that service users’ needs are assessed and that their care is planned with the service users to ensure that these needs are met in the way they prefer and that the service user is able to benefit from their respite care stay at the home. Service users spoken with all expressed their satisfaction with the care they receive at the home, one service user stated, ‘They are brilliant with care, the best thing is the physio.’ All interactions observed between the staff and service users evidenced that the home has a close and caring staff team. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 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 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 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 and 5 The home has a detailed and informative statement of purpose and service users’ guide. A statement of terms and conditions and a letter confirming that the home can meet their needs are provided to each service user. These documents, together with the home’s procedure of carrying out detailed assessments and offering visits prior to admission, enable service users and prospective service users to make an informed choice about a stay at the home. EVIDENCE: The manager has reviewed the service user’s guide which now includes the results of the yearly service user survey of the home. The home has now developed and introduced a new pre-admission assessment form that is sent to service users on their application for respite care. This is then returned to the home prior to the service user’s stay. On receipt, the staff are able to fully assess the needs of the service user and draw up an initial care plan. Additional information is sought from the service user’s GP and other health professionals as required. The form was seen by the inspector and found to cover all areas of healthcare, personal care, social care/activity requests and areas of potential risk and is signed by the service user or their representative. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 9 From observations made at this inspection, care plans sampled and service users spoken with, it was clear that the home is able to meet the assessed needs of the service users currently on respite care. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 10 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 and 9 The service users’ individual plans are clear and comprehensive including details of needs and goals. They also incorporate known or indicated preferences and choices, and include relevant risk assessments. EVIDENCE: Care plans are drawn up initially on receipt of the pre-admission form. During the service users’ initial stay the care plans are then completed in full. Prior to subsequent visits, the service user is asked to provide information of any changes and the care plan is then reviewed and amended as needed. Care plans sampled were comprehensive and set out actions which need to be taken by care staff to ensure that all aspects of the health and personal care needs of the service users are met. The care plans fully evidence that staff enable service users to take responsible risks. These risks are assessed and included in each care plan with appropriate actions identified to reduce the level of risk. Service users spoken with were complimentary regarding the care they receive at the home and confirmed that care is provided in the way they want. One service user commented that the staff are ‘always willing to help.’ The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 11 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 and 13 The service users have opportunities to take part in appropriate activities both within the home and in the local community. EVIDENCE: The home’s new pre admission assessment form now contains a section that asks service users if they have any hobbies or particular activities they would like to have provided for during their stay. As this information is now gathered prior to a service user’s stay, the home is able to incorporate these requests, where possible, into the activity schedule for that week. Activities available include: art; yoga; meditation; hairdresser; beautician; aromatherapy; massage; reflexology; evening, in-house musical and film entertainment; theatre trips. On the day of this inspection there was an outing to Hever Castle. Local community involvement includes: local churches; shopping; theatres; cinemas; pub lunches. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 12 One service user commented that some weeks there are lots of activities but on other weeks there is not much on. The home has recently rearranged their office staffing and the leisure organiser’s time is now spent exclusively on coordinating activities. The inspector was advised that development of the activity provision is currently being looked at. The home has a core group of local volunteers who assist with activities and outings (following appropriate training). There is also voluntary support provided by staff from local companies with areas such as gardening and redecoration. In conversation with some of the service users it was mentioned that there is sometimes a problem with getting drinks at the bar. This was passed on to the manager with the service users’ permission. Due to the home providing respite care, the service user groups change on a weekly basis. Some weeks many of the service users want to use the bar facilities and the following week there may be none, which makes it impractical to employ permanent bar staff. The manager advised the inspector that she will discuss this further with the staff group and look for a suitable solution. All service users spoken with were enthusiastic about the physiotherapy and hydrotherapy provided at the home, with one service user stating that ‘it’s great to have physio and now they have extra staff.’ The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 13 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 and 19 Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. EVIDENCE: Service users spoken with all confirmed that staff provide personal care and assistance, where needed, in the way they have indicated they prefer. This was seen to be clearly set out in their care plans. The care plans sampled also provided evidence that service users’ healthcare needs are being met. Staff contact the service users own GP’s, if needed, and referrals to other health care professionals are obtained, as necessary, from their GP surgery. All interactions observed between the staff and service users were seen to be respectful and caring. One service user commented that ‘nothing is too much if you ask them.’ The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 14 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 All required policies and procedures are in place to ensure that service users feel their views will be listened to. EVIDENCE: There have been eight complaints to the home in the past twelve months. These complaints had been well documented and the home’s policy followed in each case. Complaints were seen to be dealt with in an efficient and prompt manner. All service users spoken with stated that they knew who to go to if they had a concern. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 15 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 and 30 The location and layout of the home is suitable for it’s stated purpose. It is accessible, safe and well-maintained. The home was found to be clean and hygienic and to meet service users’ individual and collective needs in a comfortable and homely way. EVIDENCE: The home is purpose built and is equipped to meet the home’s stated purpose and the individually assessed needs of all service users. The home is suitable and accessible for the current service user group. All service user bedrooms are for single occupancy and have en suite toilet and wash hand basins. The home is currently inviting quotes and exploring ways to provide en suite showers for each room. They hope to be able to begin this work before the end of this year. On the day of inspection the home was found to be clean and tidy and provided a comfortable and relaxed environment for the service users, many of whom were enjoying the fine weather and sitting out in the garden. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 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 The home has a staff training programme which is designed to ensure that service users are supported by competent and qualified staff. EVIDENCE: The manager expressed a firm commitment and belief in National Vocational Qualification (NVQ) training and stated that she has seen clear benefits for the service users and staff alike. At present sixteen of the forty-two care workers are qualified to NVQ level 2, or above, in care. Ten additional care workers are currently undertaking NVQ level 2, and are expected to be qualified before the end of this year. Comments made during this inspection included: ‘the staff are very nice’, ‘they spoil me here’ and ‘the medical care is very good from the nurses.’ The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 17 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) 39 and 40 The home has a quality assurance and monitoring system in place that is based on seeking the views of the service users. Service users’ rights and best interests will be safeguarded by the home’s policies and procedures when the policy for the management of service users’ money and financial affairs has been completed. EVIDENCE: Once a year and for thirteen weeks, all service users visiting the centre for respite care are asked to complete a survey form. The results of these surveys are then correlated and analysed, with a plan drawn up to rectify any issues that have been highlighted. The survey for this year is due to commence in September. Once the report is completed, copies are included in the home’s service users’ guide. The inspector was advised that the manager plans to include GP’s, social workers, care managers, district nurses and relatives in this year’s survey. In addition, all service users are supplied with feedback forms at the end of their stay and invited to complete them, if they wish. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 18 All required policies and procedures are in place, with the exception of a policy on the ‘Management of service users’ money and financial affairs’. In discussion the inspector was advised that the policy is not available as the home does not become involved in service user’s financial affairs. However, it was agreed at the last inspection that a policy would be developed that makes the home’s position clear in this area. This work is currently underway and the home expects the policy to be in place in the near future. The previous recommendation has been carried forward to this report. The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 19 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 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x x Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Brambles Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 2 x x x 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 20 NO 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 40 Good Practice Recommendations It is recommended that the home develop a policy on The management of service users money and financial affairs The Brambles 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 20050930 H58 H09 S13356 The Brambles V231535 230805 Stage 4.doc Version 1.30 Page 22 - 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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