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Inspection on 21/01/08 for The Browning Care Home

Also see our care home review for The Browning Care Home for more information

This inspection was carried out on 21st January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is able to offer one to one care due to the size and structure of the home. Staff employed by the home, tend to stay with the home providing consistency. The home is family run ensuring hands on management approach and daily contact with staff. The home provides prospective service users with sufficient information on which to make a decision. Service users are assessed prior to admission to the home. The home promotes the health and well being of its residents. The home has robust systems for managing medication. History of likes and dislikes and preferred activities feed into the care plan. The home is reviewing the way it collects information on its residents. Residents are encouraged to maintain contact with family friends and community. Residents have access to religious worship. The home offers a variety of food, which is of a good standard. The home consults service users as to the quality of the service it is providing. The home protects the legal rights of its residents. The home can provide an independent advocate for those who have no representative. The home can supply following assessment, specialist equipment. The home provides staff in sufficient numbers to meet the care needs of its residents. Staff indicated that they feel supported.

What has improved since the last inspection?

The kitchen area is now complete and the laundry has been moved away from the food preparation area. Recommendations made at the last inspection have been implemented.

What the care home could do better:

The home should take references written specifically for the job description they are recruiting to. The home should provide care staff with 4 formal and recorded supervision sessions per year. Staff training should be reviewed and brought up to date.

CARE HOMES FOR OLDER PEOPLE The Browning Care Home 19 Browning Road Banbury Oxfordshire OX16 9LA Lead Inspector Andy McGuckin Unannounced Inspection 09:30 21 January 2008 st 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 Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Browning Care Home Address 19 Browning Road Banbury Oxfordshire OX16 9LA 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) 01295 261496 01295 701027 daveheather@ackrill8400.fsnet.co.uk Mrs Heather Ackrill Mrs Heather Ackrill Care Home 4 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (4) of places The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 4. 13th April 2006 Date of last inspection Brief Description of the Service: Browning Care Home is the family home of the proprietors and is registered to provide personal care for up to four residents aged 65 years and over. Mrs Ackrill is the registered owner and manager and she and her husband are the main carers. The proprietor deals with all administrative matters concerning the business. The home is on the outskirts of Banbury, where there are clubs for older people The home has a combined lounge and dining room on the ground floor used by residents, and also by the proprietors. Bedroom accommodation is situated on the ground and first floors. The residents’ bathroom is on the first floor and has a washbasin, bath and toilet. A stair-lift is provided. The smallest bedroom upstairs, which does not come up to registration standards is being used for a staff sleeping in room come office. It was hoped that when the downstairs shower room was finished, the downstairs garden room would be brought back in as an office/ sleeping in room. Due to a family members ill health this has not yet happened. It is hoped that this work will be completed soon. Charges for the home services range between £500 and £600 dependant on the level of need. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good, quality outcomes. This inspection of the service was an unannounced “Key Inspection”. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that the CSCI has received about the service since the last inspection. The inspection took place on a weekday afternoon. One resident was in hospital, one resident was not well and was being looked after in her own room. Two remaining residents were in the lounge with a member of staff. The proprietor was present throughout the inspection. Improvements recommended at the last inspection have been implemented. The inspector received very positive comments from professional agencies who use the service and relatives of the homes residents. The inspection process involved the following activities: Visit to the property Inspection of core documentation Consultation with service users, relatives and professionals associated with home. Discussion and feedback from staff Discussion with the registered manager Tour of the building re Health and Safety Direct observation Review of AQAA From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 6 What the service does well: The home is able to offer one to one care due to the size and structure of the home. Staff employed by the home, tend to stay with the home providing consistency. The home is family run ensuring hands on management approach and daily contact with staff. The home provides prospective service users with sufficient information on which to make a decision. Service users are assessed prior to admission to the home. The home promotes the health and well being of its residents. The home has robust systems for managing medication. History of likes and dislikes and preferred activities feed into the care plan. The home is reviewing the way it collects information on its residents. Residents are encouraged to maintain contact with family friends and community. Residents have access to religious worship. The home offers a variety of food, which is of a good standard. The home consults service users as to the quality of the service it is providing. The home protects the legal rights of its residents. The home can provide an independent advocate for those who have no representative. The home can supply following assessment, specialist equipment. The home provides staff in sufficient numbers to meet the care needs of its residents. Staff indicated that they feel supported. The Browning Care Home DS0000013189.V347886.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 Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 8 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 Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides prospective residents with sufficient information on which to make an informed decision prior to joining the home. EVIDENCE: The home provides prospective residents and their families with a Statement of Purpose and a Service User Guide. These documents contain core information as to what the home is able to offer and what is not. It details whom it can care for and whom it cannot. A copy of the homes terms and conditions of residence state what is expected from the prospective resident and what will happen if there is a problem on either side. A copy of the written contract and the Statement of Purpose are given to the resident on acceptance to the home. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 10 Two new residents have joined the home since the last inspection. Both residents were given the opportunity to visit and assess the home prior to admission. Feedback from residents, relatives and professionals stated that visitors to the home are made welcome at all reasonable times and the home does not set standards times at which visitors can call. A full assessment of the prospective residents is undertaken prior to admission and where appropriate interested professionals are included in this assessment. Service users are encouraged to visit the home for lunch and short stays. The home does not provide an intermediate care service. All placements are reviewed shortly after admission to check suitability on both sides. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home places a high priority on maintaining the health and well being of its residents by regular monitoring of diet, weight and ensuring that healthcare professionals are seen regularly. EVIDENCE: The inspector viewed 4 service users files. These files are presented in a format, which is a standard tool for recording care plans within the care / healthcare profession. The current files contain the necessary information to enable carers to provide care for its residents in a manner, which is acceptable to them. These files are written in plain English and evidence that care is provided to residents in a dignified and private manner. The home has a policy on the administration and dispensing of medication this was viewed and found to be satisfactory. Medication is only given by those The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 12 staff who have been trained and deemed fit to so. At present no residents self medicate all require some level of assistance. Files read evidenced that past history, likes and dislikes, family contacts, physical and emotional history. Visits to health care professionals and medication are not recorded at present in the residents file. A recommendation has been made that these visits are recorded. A daily and nightly record is kept of any relevant information or change to the persons plan. This information is used at handover to inform the incoming carers of any changes or information they need to know, Residents are treated with respect and their wishes and requests are met where possible. Residents have made known to either family or representatives their wishes following illness or death and the home is very clear that it will carry out these requests. The proprietor stated to the inspector that as far as he is concerned the home is for life and they will care for the residents for as long as they are able or it is felt appropriate. A small but representative sample of the many comments received from residents follows: “ The care given is more like a family environment and exceeds our expectations “ “ Many times they go and get me special meals like fish and chips or a Chinese” “ The care home does everything that could be asked of it very well. In the years my Aunt has been there I have always been pleased with them. I would strongly recommend the smaller style residential homes because of the care and attention the clients receive “ The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good This judgement has been made using available evidence including a visit to the service. The home works hard to meet the social and emotional needs of its residents. EVIDENCE: Evidence was found that the home had built up a picture of the residents prior to moving into the home and took into account there past history of work and family and also what leisure activities they were involved in. Where this could be met within the home it was included in the residents care plan. Activities are planned to the willingness and ability of the resident group and often by request are centred in the home. The home does have transport and where a resident wants to go out this can be easily arranged. Much of the entertainment and activity takes place on a one to one basis due to the small The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 14 size of the home. Residents find this is a positive aspect of what the home has to offer. The home has a large screen TV and video. Games, jigsaws and books are all available. Papers are ordered daily. The home has a small friendly dog, which, is very well received by the residents and forms an important part in the homes life. Evidence was found at the inspection that the home encourages residents to maintain contact with family, friends and community. Many relatives and friends visit the home and are made welcome. The home offers residents the chance to attend church and or religious services. Some services may be offered within the home by request. The home can cater for all residents taste in food individually on a daily basis. Residents are asked in the Morning what they would like and this is then prepared fresh. The home uses fresh produce where possible. The home is very aware of the likes and dislikes of the residents and have structured menu’s accordingly. All staff preparing food has the appropriate training and certification. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home ensures that residents are happy with the service by direct consultation with them and receiving feedback from relatives and those who visit the home on a regular basis. EVIDENCE: Feedback from residents and their representatives indicated that, where there is cause for complaint or dissatisfaction, the home has formal processes for it to deal with them. The homes complaints procedure was viewed and found to be satisfactory. The home ensures, where possible, that residents’ legal rights are protected and that residents are not exposed to any form of abuse. Staff have been trained in the Identification of Abuse and are aware of their responsibilities in this area. Service users legal rights are protected by the appointment of relatives or friends to act on the resident’s behalf. Where this is not possible an independent advocate would be appointed. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 16 The inspector was informed that no complaints have been made since the last inspection but many letters of complement about the high level of care given to residents past and present were viewed. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a small friendly environment, which is very much run as a family home, this is very much appreciated by the residents. EVIDENCE: The home is situated on a small residential estate among houses of a similar nature. The home is close to transport links into Banbury and beyond. The home has its own transport, which can be used by residents with notice. The home was found to be well maintained and safe. Residents who require small items of specialist equipment are professionally assessed for them. This equipment is then regularly serviced and maintained. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 18 A new addition of a downstairs shower room has added to the resident’s comfort and is well used. All residents have there own room, which is furnished and equipped to their individual liking. Residents are encouraged to bring with them small items of personal furniture. On the day of the inspection the home was clean and hygienic all staff are involved in maintaining the cleanliness of the home. Plans for the future improvement of the home include decoration of the shower room, landing, hallway and stairs. The garden room will be refitted and refurbished, to bring it back to a staff room / office. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carers are employed in sufficient numbers to meet the needs of the homes residents. EVIDENCE: On the day of the inspection the home was being staffed appropriately for the number of residents All staff working in the home attend an induction training which is provided by the proprietors initially and backed up with video training and external trainers. The induction covers a range of topics including Health and Safety and Protection of Vulnerable Adults. Files evidenced that staff are being formally recruited and interviewed and that references are being taken up prior to staff starting work. One or two minor errors were found in the files one staff member had only one reference. Staff training and supervision need to be brought up to date. The inspector advised the proprietor not to accept “to whom it may concern references “ as the reference should match the job description. The proprietor took this on board for the future. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 20 Staff are well known to the proprietors and meet with them on a daily basis. The inspector has required that training and supervision are reviewed and formalised as soon as possible. Staff comments include: “ Browning Road is a small care home which is very welcoming to clients and visitors. The door is always open for staff, visitors and service users to air any concerns with the owners. They will do their up-most to sort things out “ The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a well- run family business with residents in the forefront of the homes decision-making. EVIDENCE: The home is managed by two proprietors, one acts as the Registered Manager and the other has day to day management responsibility and works as an extra carer. Due to family circumstances an experienced manager will take over the overall management of the home on a full time basis. The manager will live in and do three- week block’s assisted by care staff the proprietors will do the The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 22 following three week block. All staff are part time at present but this will be rearranged to accommodate this new way of managing the home. The home has robust policies and procedures to ensure that residents are safeguarded from physical, financial and emotional harm. All staff have been trained in adult abuse procedures and the home is subject to external financial audit. The inspector did not require the home to provide accounts. All records inspected were in the main found to be accurate and up to date. Information was presented in such a way as to enable those caring for residents to do so with as much information as was required. Good communication was found through both formal and informal methods. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The health and safety of both the residents and staff were found to be being safe guarded. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 8 9 10 11 3 3 3 3 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 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 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 Requirement The registered manager must have robust procedures in place for the collection of sustainable references. Timescale for action 01/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP30 OP36 Good Practice Recommendations The registered manager should ensure staff training is up to date and appropriate to the needs of its residents., The registered manager should ensure that all care staff are formally supervised at least 4 times per year and the content of these meetings is recorded. The Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Browning Care Home DS0000013189.V347886.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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