Inspection on 30/10/07 for The Brambles

This inspection was carried out on 30th October 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 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

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 The Brambles 103 Great Park Street Wellingborough Northants NN8 4EA Lead Inspector Stephanie Vaughan Unannounced Inspection 30th October 2007 09:00 The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 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 DS0000070123.V351977.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 and Care Homes for Adults 18 – 65*. 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 DS0000070123.V351977.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Brambles Address 103 Great Park Street Wellingborough Northants NN8 4EA 01206 224100 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) www.concensusupport.com Consensus Support Services Ltd Position Vacant Care Home 11 Category(ies) of Learning disability (11) registration, with number of places The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning Disability - code LD. The maximum number of residents who can be accommodated is 11. 2. Date of last inspection New Service Brief Description of the Service: The Brambles is registered to provide care for 10 people with Learning Disability. The premises comprise a large detached period house with garden areas and parking facilities. There are three communal areas, which are decorated and furnished to a good standard. There are ten bedrooms, which ensure that residents have their own bedrooms, these are fitted with ensuite facilities or washbasins. The home is located within a residential setting close to the town centre, local amenities and good transport links. Current fees range between £ 476:40 and £ 817:30 per week with additional charges for hairdressing, newspapers, outings, clothing and additional personal toiletries. The service makes inspection reports and other information available to existing residents through residents meetings. Reports are provided to prospective residents prior to admission. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to this statutory inspection, a period of two hours was spent in preparation. This comprised reviewing the registration report, the service history and other documentation. No Comment cards were returned from residents or their representatives, as the return of pre inspection documentation was delayed due to staff being on leave. The Commission have received no complaints, concerns or allegations about the service. The Commission have a focus on Equality and Diversity and issues relating to this are included in the main body of the report. This site visit to the home was conducted over a period of five hours during which the inspector made observations and spoke to residents and staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where of a sample of two residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. The Manager was present during this visit and the Group Manager was present for part of the visit. What the service does well: People who use the service have the right information to allow them to make decisions about the home. Staff make sure that they have the right information about new residents so that they can be sure that they can care for them properly. Admissions to the home are managed well and new residents are able to visit the home, meet the staff and other residents before deciding if they would like to live there. Each resident has an individual plan of care, which tells staff how the resident is to be cared for. These are of a good standard and are written from the resident’s point of view and are easy to understand. Residents are involved in the development and review of their individual plans of care. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 6 Residents said that they felt well cared for and were able to make choices about their clothing, routines and how to spend their time. Residents are able to take risks in their daily lives such as going out into the local community, cooking and gardening. Residents are treated as individuals and are supported to keep in touch with their families and friends. Residents are consulted about their views and are able to get involved in the running of the home. There are regular residents meetings where residents make decisions about the menu, activities and decor. Residents are also involved in the decisions about the staff that work with them. Residents are able to attend local day centres; clubs, sport and leisure facilities. The home has a car to transport residents to their activities and outings. The staff make sure that they have the right checks in place to make sure that resident stay safe when they take part in activities. Residents said that they liked the food that was provided. They are involved in the menu planning and are able to make choices about the food that they want for each meal, on the day. Residents can be are involved light household chores such as shopping, preparation of food and drinks if they wish. The staff make sure that the residents have the right health care by working closely with doctors and other specialists and residents receive their medication safely. There is a good complaints policy that staff and residents know how to use. Complaints are investigated properly and the right records a kept. Residents said that they felt safe living at The Brambles. The home is a safe and comfortable place for the residents to live. There are good-sized communal areas and resident have their own rooms with all the right fittings. Residents are able to personalise their rooms and bring their own things into the home. Improvements have been made to the home including refurbishment of the communal areas and replacement flooring. Further improvements are planned. There are enough staff working in the home to care for residents properly. Arrangements are in place to make sure that all staff have the right training at the right time. The management check to make sure that staff are doing their jobs properly. The new Manager has the right training and experience to run the home. Residents and their representatives are consulted about their views on the way that they are cared for and the way that the home is run. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 7 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 DS0000070123.V351977.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are appropriately assessed before they move into the home, ensuring that their needs can be met. EVIDENCE: The service has a Statement of Purpose which reflects the recent changes of ownership and which complies with the criteria set out in Schedule 1 of the National Minimum Standards. There is also a comprehensive Service Users The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 10 Guide, which is produced, in a user-friendly format suitable for the needs of the residents for whom the service is intended. Both documents are made available to existing residents. Prospective residents are also provided with this information to enable them to make informed decisions about the service before they decide whether they would like to live there. Commission for Social Care Inspection reports are also made available to existing and prospective residents. Individual plans of care demonstrate that the service obtains appropriate assessments from funding authorities to ensure that the service is able to meet the needs of a prospective resident. Unplanned admissions are avoided and residents were able to confirm that they had opportunities to visit the home, meet the existing residents and staff before deciding whether they would like to live there. All residents are offered a three-month trial period and regular reviews are conducted. There have been no admission to the home following the change of ownership, however one of the most recent admissions to the home was able to confirm satisfaction with the admission process, access to appropriate information, opportunities to visit the home and support to settle in. Individual plans of care demonstrated that each resident has a contract in place that is signed by the resident. However these predate the current ownership and are therefore out of date and should be reissued. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have control over their lives, which enables them to enjoy a lifestyle that promotes choice and independence. EVIDENCE: The preadmission assessments are used to develop individual plans of care for each resident. The format of the individual plans of care is currently being The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 12 developed to ensure that the plans are person centred and focus on the specific individual needs of each resident. The standard of individual plans of care is good; there is evidence that the resident is involved in the care planning process and subsequent regular reviews. The plans are written from the resident’s perspective and they also are being developed in a user-friendly format. Individual plans of care evidence that residents have key workers and that their relatives are able to act as advocates on their behalf. In the main the plans address all of the resident’s health, personal and social care needs and provide detailed instruction to staff about how the resident needs and wishes to be cared for. Individual plans of care also contain information about the management of challenging behaviour, however these would benefit from further review to ensure that they contain more detailed instruction to staff about potential triggers and de-escalation techniques. The new manager confirmed that this aspect was to be addressed in the ongoing review of the individual plans of care. Daily records indicate that the care of the residents is delivered as specified in the individual plans of care and that residents are supported to make decisions and work to short, medium and long term goals. Staff were able to demonstrate a good understanding of the mental capacity Act 2005 and the implications for their client group. Residents are supported to make decisions about all aspects of their lives and are involved in decisions about the running of the home. Any restrictions on the resident’s freedom are in their best interest and are supported by comprehensive risk assessments. Residents are supported to take risks in their daily lives and participate in a range of sporting and domestic activities. The appropriate support is provided to enable them to do this safely and risk assessments are in place. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 14 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are both managed well, are creative and provide daily variation and interest to people living in the home. EVIDENCE: Residents are supported to attend local colleges to pursue educational opportunities such as Arts and Crafts, numeracy and literacy skills. Occupational activities are accessed through local day centres. They are also able to access the local community for their chosen activities such as sporting and leisure facilities, shops, social clubs, pubs and restaurants. The service also supports residents with transport to various activities through the provision of a dedicated vehicle. There are also varied in house activities provided that reflect the residents personal interest such as cookery and gardening skills and Arts and Crafts. The organisation has secured access to an allotment to enable residents to participate in gardening skills and growing their own food. The home was decorated in preparation of a Halloween party. Residents were able to confirm satisfaction with the activities provided. Residents are encouraged to take part in the running of the home through attendance at regular residents meetings. Residents are also involved in the development of a local branch of the British Institute for Learning Disability. The management intend to further develop the individual plans of care to include a timetable of resident’s activities. The management confirmed that all residents were on the electoral register to enable them to participate in local and national elections. The person centred approach to the planning and delivery of care ensure that the residents are treated as individuals, are able to exercise personal choice thus ensuring that their equality and diversity needs are met. Management are mindful of the need to ensure that the staffing mix reflects that of the existing residents. The new manager is male which means that there are now two male staff working in the home. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 15 Residents confirmed that they were supported to maintain links with family and friends. Individual plans of care contained evidence that residents see their relatives regularly and that they are supported to celebrate family events. There was evidence that resident’s routines are flexible within the constraints of their planned activities. Residents are able to choose how and where to spend their leisure time. There is evidence that residents are offered a key to their bedrooms and that they are supported by staff to manage this, appropriate risk assessments are in place. However none of the residents have keys to the front door, discussion with management demonstrated that this was not offered for security reasons and due to the vulnerability of residents. However there was no evidence that formal risk assessments had been conducted to validate this decision. Residents confirmed that they were able to participate in decisions about the menu planning. The service has a photographic directory of meals that are available to assist residents in their choice. Recipes are also available to enable residents to participate in food preparation activities. Both residents confirmed satisfaction with the food provided by the Brambles. They were able to confirm that there was always a choice of main dishes and deserts, that their personal preferences were catered for and that the portions were of a good size. Meals are served in a separate dining room, however the lunchtime service was not seen as all residents were out for this meal. The supper menu comprised beef stew and dumplings, or cheese pancakes both served with potato wedges and peas. There was a choice of fresh fruit for desert. Staff spoken to confirmed that they were able to balance the resident’s choices whilst maintaining a health and varied diet with home cooked foods being prepared on the premises. Appropriate kitchen records and food hygiene practices were evident. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have an individual plan of care, which demonstrates that their personal and healthcare needs are fully met. EVIDENCE: Individual plans of care demonstrate that residents are supported to maintain their personal and health care. In the main the plans include detailed instruction to staff about the residents personal and health care needs. Where The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 17 appropriate residents have individual plans of care for the management of epilepsy, these would benefit form being further developed to ensure that all staff have detailed instruction into how to prevent serious complications arising in the event of a seizure. There is evidence that residents are supported with sensitivity to their needs and preferences and are consulted about the way that care is provided. There is evidence that residents have access to a range of healthcare specialists such as opticians, podiatrist, dentists, physiotherapists and hospital services. Each resident is registered with a General Practitioner and has access to regular health checks and referrals are made when problems are identified. Residents are able to exercise choice in their clothing, hairstyles and personal appearance. Residents appeared well presented and were able to confirm satisfaction with the way that they are cared for. Staff appeared to relate well to residents, to be respectful of resident’s privacy and to use their preferred form of address. Medication systems were reviewed and seen to be in good order. Each resident has an individual Medication Administration Record. These were well maintained and evidence that medication is given as prescribed a spot check was conducted and medication found to correspond to the remaining stocks. None of the existing residents self medicate, as they are not considered to have the ability. However a senior member of staff confirmed that previous residents had been supported to do this in preparation for more independent living arrangements. Nevertheless residents need to be consulted on their views regarding the self-administration of medication and any decisions need to be supported by appropriate risk assessments. Where it is deemed necessary for the staff to continue to administer medication the formal consent of the residents should be sought. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a comprehensive procedure for handling complaints and good staff awareness and attitudes towards the Safeguarding of Adults so that residents felt safe and were protected. EVIDENCE: The service has a robust complaints policy, which contains the necessary information, and this is displayed in the home. In addition residents have access to the Service Users Guide, which is written in a user-friendly style and informs people how to complain. Resident’s confirmed that they knew how to complain and that they were confident that any concerns would be handled appropriately. There have been no complaints about this service since registration. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 19 Residents confirmed that they felt safe living at The Brambles and that staff treated them well. The service has obtained a copy of the new local authority guidelines in the Safeguarding of Adults. Residents are supported to manage their money; the service maintains appropriate individual records of income, transactions and balances. There have been no allegations about this service since registration. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing residents with a safe and conformable place to live. EVIDENCE: The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 21 The premises are suitable for their stated purpose being a large detached period house located within a residential setting close to the town centre. The home is registered to provide care for 10 people with Learning Disability. There are three communal areas comprising a large sitting room, dining room and small conservatory. Appropriate furnishing and fittings are provided. There are ten bedrooms with single occupancy all of these are either fitted with washbasins or ensuite facilities. Bedrooms doors are fitted with privacy locks and the rooms have appropriate fixtures and fittings. Residents are able to bring in their own personal possessions and to personalise their rooms. Residents confirmed that they had been consulted about the décor and furnishings of their rooms. Since registration the new provider has made significant improvements to the standard of the environment, further improvements are currently being planned. All areas of the home appeared to be safe; clean and hygienic. The home is well light, heated and ventilated. Radiator guards are fitted to the radiators. The hot water was checked and found to be tepid, the service has identified that the home requires a new hot water boiler and arrangements are in place for this to be installed. Residents confirmed that there continues to be access to hot water at the times that it is required. Separate laundry facilities are provided. The garden areas appeared to be safe and well maintained. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service employs appropriate numbers of inducted and trained staff to ensure that residents needs are appropriately met. EVIDENCE: Staffing levels in the home are adequate for the current number of residents. There are two staff on duty throughout the day time shifts in addition to the The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 23 manager. There is one waking staff on duty throughout the night. The manager conformed that the provider had already conducted a staffing review and identified that an additional 20 hrs per week was required to cater for the existing level of residents. Further increases to staffing levels are also planned to accommodate the increased needs as the four existing vacancies become filled. The service is currently recruiting staff. Staff files were in good order and evidenced sound recruitment practices. All staff are required to attend an interview, to supply two written references and have the appropriate security checks prior to commencing employment in the home. Residents are involved in the recruitment process and have the opportunity to interview applicants and their views are sought before a staff member is appointed. The manager also confirmed that staff worked a three month probationary period, and that there were plans for residents to be involved in the review of this period. Staff files evidenced that new staff have appropriate induction training and that staff were supported to obtain National Vocational Qualification in Care level 2 and 3, which will ensure that the service exceeds the Department of Health recommendation. Staff files also evidenced that staff have access to appropriate and timely mandatory training such as Health and Safety, Safe Administration of Medication, Basic Food Hygiene, Infection Control First Aid and Fire Safety. In addition staff have training in specific topics relevant to the needs of individual residents such as the management of challenging behaviour. However some shortfalls were identified in that the staff who had been appointed more recently had not had training in the management of epilepsy, Safeguarding Adults and Movement and Handling. The management confirmed that a staff-training audit had been conducted and that arrangements were in place to ensure that all staff have access to appropriate and timely training. Staff files evidenced that staff have access to appropriate and timely supervision. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 25 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed so that residents are protected and their best interests promoted by the systems in place. EVIDENCE: The service has appointed a new manager to manage the Brambles. He has commenced induction training and a three-month probationary period. The manager has had several years experience of working with the category of residents for which this home is registered. He is also known to the Commission having been registered to manage other homes within the County. He has achieved the National Vocational Qualification in Care level 4 and the Registered Managers Award. Quality Assurance practices are established; there is evidence that regular audits are conducted on the individual plans of care, staff files, the environment, and systems such as the medication and residents money. There is also evidence that appropriate kitchen and fire records are maintained. The staff conduct regular satisfaction surveys for relatives and residents. A sample of the returned questionnaires were viewed and seen to demonstrate a good level of relatives satisfaction with the service provided. There are plans to conduct a survey for the residents to provide feedback in the near future. A limited tour of the premises was conducted, no hazards were identified, fire doors are fitted with automatic closing devices and radiator covers are fitted. There is evidence that appropriate checks on equipment are conducted on a regular basis and that the service has appropriate policies and procedures, which are up to date and regularly reviewed. Appropriate risk assessments are in place and arrangements are in place to ensure that the staff have appropriate and timely training. Appropriate accident records are maintained and management are aware of the need to notify the Commission of any incident, which affects the well being of the residents cared for. The Group Manager was present for part of the inspection and was able to confirm that the provider conducts appropriate The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 26 unannounced inspections to the service and confirmed that arrangements were in place for copies of these to be sent to the Commission. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 27 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Brambles Score 3 3 3 X DS0000070123.V351977.R01.S.doc Version 5.2 Page 28 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. 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. 2. Refer to Standard YA5 YA6 Good Practice Recommendations Residents contracts should be reviewed and reissued to ensure that they contain accurate an up to date information. Individual plans of care should be further developed to ensure that they contain comprehensive and detailed instruction to staff about the management of challenging behaviour. Formal risk assessments should be conducted to ensure that the residents right to hold a key to the front door is not unnecessarily compromised. Individual plans of care pertaining to the management of epilepsy should be further developed to ensure that all staff have detailed instruction into how to prevent serious complications arising in the event of a seizure. Residents should be consulted on their views regarding the DS0000070123.V351977.R01.S.doc Version 5.2 Page 29 3. 4. YA16 YA19 5. YA20 The Brambles 6. YA35 self-administration of medication and any decisions should be supported by appropriate risk assessments. Where it is deemed necessary for the staff to continue to administer medication the formal consent of the residents should be sought. All staff should have access to timely mandatory training and training specific to the individual needs of residents. The Brambles DS0000070123.V351977.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 DS0000070123.V351977.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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