Inspection on 24/05/05 for The Brambles

This inspection was carried out on 24th May 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 18/11/05

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 DY8 4JA Lead Inspector Mike Kirton Unannounced 24th May 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 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 E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Brambles Address 69a Vicarage Road, Amblecote, Stourbridge DY8 4JA 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) 01384 379034 01384 396892 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 E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 22nd November 2004 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 directly opposite Corbett Hospital, close to Stourbridge town centre. It is easily accessible by local public transport networks. Accommodation is provided over 2 floors with 13 single and 2 double rooms. Access to the first floor is via the main staircase or passenger lift. A major refurbishment and extension has now started which is expected to dramatically improve the homes environment and increase the occupancy. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection 5 residents and 6 staff were spoken with individually and time was spent in the main lounge. The buildings were toured and the kitchen and laundry room inspected. Additionally care plans, staff files and the medication records were examined. 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 E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 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 standard(s) 1,3,4&5 The homes admission procedures have improved since the last inspection and it was good to see that perspective residents were making an informed choice before moving into the home. EVIDENCE: The records for two residents recently admitted were examined. These contained evidence that they had the opportunity to visit the home before making a decision to move in on a trial basis. The home manager carried out assessments, although these contained only limited information. Other professionals involved, including social services, had also provided additional information. Discussions with residents also demonstrated that they had been made aware of the building work being undertaken and that they would have to move bedrooms during the process. The statement of purpose and service users guide remains out of date and will need to be updated in line with these standards and the upcoming changes. Standard 6 intermediate care is not provided. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 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 standard(s) 7,8,9&10 Improvements have been made to the quality and accessibility of information contained in residents care plans. It is now much clearer to see how individual’s needs are being met however action must be taken to address the incorrect or missing information. EVIDENCE: Care plans belonging to three residents were examined. These included a plan of daily routines and risk assessments with actions required to meet identified needs clearly recorded. Health care needs were also identified and a record sheet was used to track all appointments. Several problems were identified, for example the falls assessments did not accurately reflect the resident’s needs and no clear actions were taken to reduce the risk. When aggression had occurred there was no plan in place to reduce this and assessments had not identified all needs, for example mental health issues. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 9 Residents were seen to be treated very well by the staff and they were reported to be ‘marvellous and very caring’. Consultation regarding the building work has been maintained however compromises have had to be made regarding moving or sharing rooms. Medication records were examined and found to be complete and accurate. Residents who self medicated had a risk assessment completed, and when needed this responsibility was taken over by staff. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards were not fully assessed on this occasion. EVIDENCE: THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 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 standard(s) Standards were not fully assessed on this occasion. EVIDENCE: THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25&26 The standard of the environment has continued to deteriorate over the years and is now very poor. Whilst this can in part be explained by the intention of the proprietor to modernise the whole home once the extension is completed there is a general feeling that standards have been allowed to slip to0 far. EVIDENCE: The majority of the furniture and the decoration in the home is worn and often damaged. Bedding and towelling requires replacing and old notices taken down. Two of the bedrooms had an unpleasant odour, carpet was uneven, and mats were left on the floor, which may become a tripping hazard. Bedrooms facing the new extension also lacked natural light Fire doors to several rooms including the main lounge were not shutting correctly. The kitchen was found to be clean and tidy with food stored correctly and the appropriate safety checks carried out. Storage facilities were limited however by the work being undertaken. The laundry room still lacked procedures and facilities for the safe cleaning of soiled washing. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 13 The effect of the building work however was having an effect on residents who stated ‘I am not looking forward to the move’ and ‘some days it is very noisy’. Others have already had to move once and have to share a room for a short while. Staff also reported that they would be glad when the work had been completed. There was also a general concern that the homely atmosphere will be lost due to the increase in numbers and size. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29&30 All staff working at the home are providing a good service to the residents and better procedures to protect their health and safety have been introduced. This is despite the ongoing alterations and sometimes long working hours. EVIDENCE: All staff on duty during the morning were interviewed informally and two staff files were examined. Staff gave many examples of training they have recently received and demonstrated commitment to undertaking further NVQ qualifications. More than 50 are now qualified to NVQ level 2 or above. Records of training courses completed are now made on individual files. All staff have received the necessary health and safety checks including criminal history, references and providing proof of identification. They have also signed to say they have read the homes policies and procedures however this was not dated and may not have included updates. Supervision was carried out regularly with evidence on staff files. Induction procedures will need to be implemented for all new staff appointed. There is a senior and two care staff on duty all day except from 14:00hrs to 16:00hrs and either the manager or deputy in addition until 17:00hrs. The kitchen is staffed seven days with tea prepared for care staff to give out however domestic cover is only provided for six days a week. THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards were not fully assessed on this occasion. EVIDENCE: THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 1 1 1 1 1 1 1 1 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 17 Yes. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 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 the last inspection. The home must ensure that a comprehensive assessment covering all the areas identified under this standard is completed. This is an outstanding requirement from the last inspection. 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 the last inspection. Risk assessments must be Timescale for action 01/09/05 2. 3 14 01/07/05 3. 7 13,14&15 01/07/05 4. 8 12&13 01/07/05 Page 18 THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 5. 16 22 6. 19 23 7. 19 23(3)(b) 8. 20 23 9. 24 16&23 10. 25 16&23 completed accurately and used to inform on actions that are required. This is an outstanding requirement from the last inspection. The complaints policy must provide contact details for the CSCI and state that they can be contacted at any time. This is an outstanding requirement from the last inspection. 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 the last inspection. Sleeping accommodation shall be provided for staff when it is needed in connection with their work at the home. This is an outstanding requirement from the last inspection. Suitable facilities are to be provided for service users to meet visitors in private separate from their bedrooms. This is an outstanding requirement from the last inspection. 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 the last inspection. To ensure that all pipe work and radiators are guarded or have guaranteed low surface temperatures. Risk assessments must be undertaken with 01/07/05 01/08/05 01/09/05 01/09/05 01/09/05 01/09/05 THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 19 11. 25 16&23 12. 30 18&19 13. 34 25 14. 38 26 15. 38 12&13 16. 38 12&13 individual residents. This is an outstanding requirement from the last inspection. 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 the last inspection. Induction and foundation training to NTO specifications must be introduced. This is an outstanding requirement from the last inspection. A business and financial plan needs to be available at the time of the inspection. This is an outstanding requirement from the last inspection. The proprietor must complete monthly Regulation 26 reports and forward copied to the CSCI. This is an outstanding requirement from the last inspection. Soiled items must be placed in a separate bag (preferably disposable red sacks) and clothing must not be sorted on the floor. The COSHH cupboard must be kept locked at all time. Fire doors must not be wedged open and should close correctly. All portable electrical equipment must be tested annually and any loose wiring fixed. This is an outstanding requirement from the last inspection. Policies and procedures reflecting current practices must be developed, implemented and reviewed. They must be signed 01/09/05 01/08/05 01/09/05 01/06/05 01/06/05 01/09/05 THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 20 and dated by the manager then signed and dated by staff as being read and understood. This is an outstanding requirement from the last inspection. 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 Good Practice Recommendations THE BRAMBLES E55 S24978 Unannounced The Brambles V229186 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 E55 S24978 Unannounced The Brambles V229186 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. 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!