Inspection on 27/10/05 for The Branches

This inspection was carried out on 27th October 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 Branches 15/08/07

The Branches 13/07/06

The Branches 12/04/05

The Branches 24/09/04

The Branches 29/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE The Branches Springwell Road Jarrow Tyne And Wear NE32 5TQ Lead Inspector Sam Doku Unannounced Inspection 27th October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Branches Address Springwell Road Jarrow Tyne And Wear NE32 5TQ 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) 0191 489 1208 0191 489 1208 Mr Abdul Majeed Khan Mrs Eileen Cromar Care Home 24 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (4), Old age, not falling within any other of places category (24) The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category of registration DE (Dementia Under 65 years of age) applies to the two current service users only. 12th April 2005 Date of last inspection Brief Description of the Service: The home is registered for 24 places and currently provides service for 2 people under 65 with dementia and 4 people over 65 with dementia. The home is not registered to provide nursing or intermediate care. The Branches is a large established property that has been converted into a care home, offering personal care for up to 24 older people. The home is located in a central position close to local amenities, with the added benefit of a large garden area that offers seclusion and privacy. All bedrooms are single rooms situated on two floors, and there are toilets and bathrooms situated throughout the building. There are no en-suite tiolet facilities in the home. The living areas are spacious and present a homely atmosphere, and there are ample car parking spaces to facilitate easy access. The home is clean and environmentally comfortable. There is a large well maintained garden to the front of home overlooking the Springwell Park. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out at 10:00. The atmosphere in the home was calm and orderly. There was no odour in the home and all areas of the home were clean and well ordered. The inspection process involved talking to service users, sitting in the lounge and observing staff interaction with the service users. It also involved discussions with the manager and care staff, tour of the house, examination of health and safety records and service users personal files including care plans. What the service does well: Proper assessments have been carried for all service users and care plans have been formulated which provided guidance to staff on how identified care needs are to be addressed. This ensured that the personal and healthcare needs of the service users are met consistently by all those who are involved in their care. Service users are offered choices, including when to retire or rise, choice of meals and opportunity to be involved in organised social and recreational activities. Service users confirmed that the staff respect their privacy and treat them with dignity. The home has good complaints procedure in place and staff have had training in recognising and dealing with any form of abuse in the home. Training is also provided in areas such as moving and handling, health and safety, fire safety, first aid and whistle blowing policy. The home was clean and maintained to good standard. All the bedrooms that were inspected were clean and appropriately furnished. The home encourages service users to bring personal belongings into the home and evidence of this was noted in those rooms that were inspected. The home has very good system for recruiting staff including clearance from the Criminal Records Bureau before new employees commence work. The staff turnover in the home is very low and the service users continue to express satisfaction with having long-standing staff to look after them. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 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 Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5. The home provides good information to service users, relatives and interested parties regarding the service offered in the home. This includes the opportunity to visit the home. The home obtains appropriate assessments before admission are arranged to ensure that the care needs of the service users are met. EVIDENCE: Service user guide and terms and conditions of residence are provided to all new service users either before or shortly after their arrival in the home. The manager confirmed that the details of these documents are discussed with both service users and their relatives. Copies of service user guide were found in some service users’ bedrooms. Also copies of terms and conditions of residence were found on individual files, which had been appropriately signed by service users or their representatives. Two service users confirmed that before they moved into the home, the manager discussed with them details of the contract and also gave them copies of the service user guide. They both stated that they found the process helpful because as well as being told about The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 9 the home and the routine, they were able to read about it in the service user guide. Service users spoke about the assessments carried out by the social worker and the manager of the home before they were admitted. The manager confirmed that the home sticks rigidly to its policy of carrying out an assessment and obtaining detailed social work assessment of prospective service users before admission is arranged. This enables to home to determine the care needs of the prospective service user and to plan for their care. This has meant that care plans reflect the care needs of the service users. Service users have benefited from such assessments, which promoted their care and welfare. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10. Suitable arrangements are in place for meeting the care needs of the service users. The service users are treated with respect and dignity by the staff. EVIDENCE: The care plans were found to provide details of service users care needs and how those needs are to be met by the staff. There was evidence in the care plans that some service users or their relatives have been encouraged to be involved in the formulation of their care plans. However, some of the care plans lack details of how best to support the individuals. For example, statements like “needs constant supervision with bath” is not particularly helpful to care staff as it does not give directions to staff about how the care task is to be carried out. The service users files that were examined showed evidence of health and personal care needs being met. The records provide details of visits by health professionals including GPs, District Nurses, Chiropodists, Opticians, and also visits by or to other specialist healthcare personnel such as hospital The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 11 consultants. The records also showed that the home has systems in place for monitoring the service users nutritional intake and observing their weights. Service users confirmed that their health care needs are met in the home and three people remarked on how wonderful the staff are in getting the doctors to them when they need it. Risk assessments have been carried out for those service users for whom it is thought necessary, and appropriate care plans have been formulated to address those risk areas. These include falls, nutrition and moving and handling. However, in the case of a service user who had recently been admitted, there was a history of falls but this had not been identified in the care plans. There was no mention of the hip protectors that she wears. This should have been mentioned in the care plan to alert the staff in making sure that she is assisted to put them on as advised. The lack of details about managing the high risk of falls has compromise her welfare. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Service users are encouraged and supported to lead active lifestyles based on their preferences, thus promoting their independence and sense of wellbeing. Service users are offered and receive varied, wholesome, nutritious diet. This contributes to their general health and wellbeing. EVIDENCE: In the majority of cases the care needs of the service users have been clearly identified and methods of addressing those needs have been stated. In some of the files, the sections on social care contained limited information on the recreational and religious needs. However, there is evidence of service users’ religious and recreational needs being fully met. Service users confirmed that they enjoy the activities organised for them. They also confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they did not want to. A number of art materials and board games are available for service users to use, which has enhanced the recreational activities for them. Two service users commented on the opportunities available to them to visit relatives and friends if they wanted. Two visiting relatives commented on the opportunities for service users to experience social outings and in-house social The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 13 activities. One other service user stated that the staff continue to support her to visit her local hairdresser once week. The two visiting relatives stated that they are able to visit at anytime convenient to them and were very appreciative of this level of flexibility. Service users confirmed that the daily routines are organised flexibly to take account of individual likes and dislikes. Two service users cited meal times and bed times as examples of such flexibility. The service users stated that although there are set times for meals, they can have their meals at separate times or in their room if they wish. This allows individuals to make choices about some aspects of their routines. A four-week rotational menu remains is operation in the home. The service users commented positively on the quality and quantity of the meals provided in the home. Examination of past menus indicated that the home provides wholesome and nutritious meals for the service users thus promoting good health. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. The home has a clear and easy to understand complaints policy, which is accessible to the service users and relatives. Suitable arrangements are in place to ensure that service users are protected from all forms of abuse and to protect their rights. EVIDENCE: The home has in place a satisfactory policy and procedural guidance on abuse and staff are aware of how to instigate the ‘Whistle Blowing’ policy should this become necessary. The Service User Guide and Statement of Purpose have summaries of the complaints procedure. Copies of these were available to service users and their relatives and therefore provide the opportunity for them to complain if they wish. It also reassures service users and their relatives that any concerns or complaints would be treated seriously with the view to safeguarding the welfare of the service users. Suitable training on POVA has been provided for the majority of the staff working in the home. The staff who were spoken with showed understanding of the POVA procedures and showed awareness of the need to protection service users from all forms of abuse. The complaints book shows that there had been no complaints in recent months. Previous complaints were appropriately dealt with under the home’s protection of vulnerable person’s procedure. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25, 26. The home provides accommodation of a good standard. It is a safe, clean and comfortable environment, which promotes the service users’ privacy, independence and welfare. EVIDENCE: The home was designed to accommodate older people, some of whom may have mobility problems. There is good access into and around all areas of the home. There are also specialist bathing facilities and shower rooms. The home is close to local shops, other amenities, and to local transport routes. These have provided the opportunity for service users to continue to exercise independence and choice in the way they are supported to lead their lives in the home. Heating and lighting in individual bedrooms was adequate at the time of the inspection. The type of heating system installed is of the kind that allows individuals to control the room temperature to suit personal preferences. One service user spoke about the opportunity this offers her in ensuring that she The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 16 maintains the room temperature that suits her. Individual rooms have good ventilation and natural lighting. These ensured comfortable surroundings for the service users. Window restrictors have been fixed to all windows and all radiators have suitable covering. However, some the window restrictor would need to be renewed to ensure a more secure environment. Checks of hot water at randomly selected bathing outlets confirmed that hot water did not exceed 43°c. thus protecting the service from accidental injuries. The home has written policies and procedures relating to safe handling of hazardous materials for staff to follow. The manager indicated that staff have had training in health and safety, infection control and food hygiene. At the time of the inspection the home was noted to be clean and free from offensive odour. However, in one of the rooms visited, it was noted that attention needed to be paid to cleanliness to avoid contamination with excrement. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. The above safety measures, practices and policies ensured that service users live in safe and comfortable environment. The kitchen was clean and all cookers and cooking utensils were clean and well maintained, thus promoting the welfare of the service user. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30. The home provides adequate staffing which to meet the needs of the service users. Suitable arrangements for staff training and supervision are in place, which ensured that staff are equipped to provide good quality service that benefited the service users. EVIDENCE: Details of past staff rotas indicated that the home consistently maintains adequate staffing levels and these meet the needs of the service users. The staff training records included moving and handling, first aid, protection of vulnerable adults, health and safety, fire safety, food hygiene and nutrition. The staff who were interviewed confirmed the training they had received and felt that these had equipped them to do their jobs better. Service users commented that the staff are properly trained and therefore are able to provide them with good quality care. The home’s recruitment procedures ensured further protection of service users from possible abuse by applicants who would otherwise be deemed as unsuitable to work with vulnerable people. Examination of staff records showed that the manager had consistently adhered to the policy on recruit, thus protecting the service users from possible abuse. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 18 There is a commitment by the provider to train the all care staff to NVQ Level 2 or above. Staff who have already acquired this training indicated that NVQ training had equipped them to provide better care for the service users. They also indicated that the training had boosted their confidence and are therefore confident in their care practices for the benefit of the service users. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38. Staff receive regular training and supervision from the manager which ensured that their practices support the health, welfare and safety of the service users. EVIDENCE: The manager has long experience of working in a care home and has had extensive management experience in care settings. She has acquired the registered managers award. This training has further enhanced her skills for the benefit of the service and the service users. The staff described the manager as efficient and indicated that she runs the service for the benefit of the service users and has positive relations with the staff. Similar comments were also made by two relatives and some of the service users. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 20 The home has detailed Health and Safety policies and copies of these were made available for inspection. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). The manager stated that staff have had training in food hygiene, fire precaution and first aid. Such training has ensured that the health and safety of the service users and the staff are assured. All portable appliances have been tested. A record is maintained of monthly water temperature tests in the home. There is evidence of regular servicing of fire equipment, gas and electrical appliances being carried out by the Company. All the servicing records that were examined were up to date. These included fire fighting equipments, servicing of hoists, lift servicing, water treatment, electrical installation and gas servicing. Up to date servicing and maintenance of these services and equipments ensure a safe environment for the service users and the staff who work there. The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 N/A N/A N/A N/A N/A 3 2 STAFFING Standard No Score 27 3 28 N/A 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 N/A 3 N/A N/A N/A N/A 3 The Branches DS0000000244.V253344.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 12(1)(b) Requirement Assessments and care plans must include details of risks to avoid service users’ safety being compromised. Attention must be given to cleanliness in one of the bedrooms to avoid contamination with excrement. Timescale for action 30/11/05 2 OP26 16(2)(j) 27/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations Window restrictors should be checked to make sure they meet with current safety standards. 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