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Inspection on 31/01/06 for Brendoncare Old Parsonage

Also see our care home review for Brendoncare Old Parsonage for more information

This inspection was carried out on 31st January 2006.

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.

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 service provides service users with a homely, clean and well-maintained environment. Service users spoken with commented that they liked their rooms and this was "home". Service users bedrooms seen were highly personalised and appropriate to the needs of the service users. The home has an ongoing programme of refurbishment in place. Staff said that service users bedrooms are redecorated when vacant. There are clear lines of accountability within the home. It was evident that staff and service users have developed good relationship with each other. The service users spoke fondly of the staff and confirmed that the core values of choice and privacy were maintained. The home has a robust recruitment procedure in place and all checks are undertaken to ensure that safety and welfare of the service users.

What has improved since the last inspection?

As part of the refurbishment an en suite facility has been added to one of the shared bedrooms. An automatic door is due to be fitted within the next week that would allow easier access for service users with limited mobility and wheelchair users. The kitchen has been redecorated and upgrade of equipments is planned for March.

CARE HOMES FOR OLDER PEOPLE The Old Parsonage Brendoncare Home Main Road Otterbourne Winchester Hampshire SO21 2EE Lead Inspector Anita Tengnah Unannounced Inspection 31st January 2006 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 Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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 Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Parsonage Brendoncare Home Address Main Road Otterbourne Winchester Hampshire SO21 2EE 01962 713977 01962 715866 sframe@brendoncare.org.uk 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) The Brendoncare Foundation Sally Elizabeth Frame Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: The old Parsonage is a registered care home providing personal care and nursing for 31 service users in the older person category. The Brendoncare foundation owns the service and has a sister home in the Hampshire area. Accommodation is provided on two floors and there is a passenger lift that allows access to all parts of the service. There is a number of equipment and adaptation within the home to maintain and promote independence of service users accommodated. The home benefits from well- maintained and enclosed gardens and accessible to wheelchair users. The service is situated in the village of Otterbourne on the outskirt of Winchester and has some local amenities close by. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken over one day on the 31st of January 206. This was the second inspection for the year 2005-2006. As part of the inspection process, a tour of the building was undertaken. The inspection took place over 4 hours. The inspector spoke to 9 service users, 7 staff and the manager. The process included examining care records, medication records and discussions with service users, visitors and staff. Positive comments were received from the service users regarding the care that they were receiving at the home. What the service does well: What has improved since the last inspection? The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 6 As part of the refurbishment an en suite facility has been added to one of the shared bedrooms. An automatic door is due to be fitted within the next week that would allow easier access for service users with limited mobility and wheelchair users. The kitchen has been redecorated and upgrade of equipments is planned for March. 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 Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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 Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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): 6 The intermediate care service was well managed and ensured that service users needs were met. EVIDENCE: The home has two shared dedicated rooms for the provision of intermediate care. There home works closely with the Patient Dependency Team (PDT) who are responsible for assessment and referrals of the service users admitted for intermediate care. Service users are admitted solely for intermediate care for a period of 2-6 weeks. A full programme of support is available form the PDT team including the key worker sister, physiotherapist and occupational therapist in order to help maximise their independence and return to their home. Staff reported that the length of the stays did vary at times depending if adaptations were needed. A pre-admission assessment of the service users was not undertaken as they were mainly short- term referral and emergencies. Information was sent via fax to the home with relevant details of the prospective service user. Staff reported that this system worked well. The manager maintains weekly contact The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 9 with the PDT staff to ensure that any issue is addressed. Care plans were in place and demonstrated how the assessed needs would be met. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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): 7,9 The care planning at the home was good and included detailed risk assessment to safeguard the service users. The wound care plans did not contain enough details to inform practice and can be to the detriment of the service user. The medication at the home was well managed. EVIDENCE: The home has in place detailed assessment and care plans that included personal hygiene, mobility, and nutrition that were reviewed at regular intervals to reflect any changes in the needs of the service users. Risk assessments with regards to falls and manual handling assessments were in place and care plans formulated to identify how those risks would be managed. Care plan was seen for a service user with pressure ulcers. It showed that this service user had ulcers to both legs and sore groins. However wound care plans were inadequate and did not contain clear information of action plan and detailed treatment plan to demonstrate how these would be achieved. Wound The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 11 care plans should contain details of wound grading/ sizes to inform practice. This was discussed with the manager and a review of wound care plans would be undertaken and individual care plan for each wound will be put in place. The home has a procedure for receipt and returned of medication that was followed by staff. All medication was stored appropriately and a sample of medication administered showed that these were recorded on the Medication Administration Record (MAR) sheet. Controlled drug was stored appropriately. It was noted that the home had a quantity of dressings that did not have the service users’ names. This was discussed as all dressings are prescribed and must contain the names of service users. The staff are aware that dressing should only be used as prescribed for the individual service users. A staff member confirmed that she was in the process of returning all the excess dressing to the pharmacy. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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): 12,14 The activities at the home are well managed offering choice and variety to suit the needs of the service users. The activities of daily supports and maintains the core values of choice, privacy and dignity of the service users. EVIDENCE: The home employs an activity coordinator and there is a planned programme of activities provided that service users said were “very enjoyable” and appropriate to their needs. A detailed list of the activities available was displayed in the communal lounge. Service users confirmed that they exercised their choice with regards to whether they attend the lounge for activities. One service user said that she preferred to spend time in her room and enjoyed her television programmes and sometimes joined others in the lounge. Another service user who was celebrating her 102nd birthday party said she was looking forward to the party that the home had organised for that afternoon. The inspector observed that a number of relatives and staff who were off duty joined in the celebration. Four service users spoken with confirmed that they had autonomy and choice with regards to the activity of daily living. They chose when they went to bed and whether to remain in their rooms or join others in the lounge. Comments from service users spoken to include“ this is home and it is lovely”. ”Nothing is The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 13 too much for the staff” Another said that “I am happy here and the staff are very good”. A visitor said, “ The staff make the home”. Practice observed showed that service users were treated with respect and staff attended to their needs in a compassionate manner. It was evident from the interaction and comments from service users that staff maintained good relationship with them. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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): 16,18 The home has a satisfactory complaint procedure in place and service users feel able to raise their concerns as required. Training and procedures are in place and information is available for the protection of service users. EVIDENCE: The home has a complaint policy and procedure in place. Service users spoken say that they would approach the manager or the person in charge if they had any concerns. A complaint log was maintained. Record shows that there has been one complaint since the last inspection. The manager investigated this within the timescale and detailed records of the investigation were maintained. This has been resolved. The complaint procedure was available in the service users’ guide. , There is a procedure in place that gave information to staff regarding reporting and recording all allegations of abuse. Training in adult protection was available and some further updates are planned. A whistle blowing policy was also in place. The manager is aware of the needs to report and refer all allegations of abuse to the appropriate authority for the protection of service users. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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): 23,26 The service users’ bedrooms were personalised and met their needs. The home was clean and good infection control procedures were observed to ensure the safety of the service users. EVIDENCE: The service users’ bedrooms seen were highly personalised and call bells were available in all bedrooms and accessible to the service users. Furnishing was of good standard, clean and appropriate to meet the service users’ needs. A number of the service users spoken to on the day were complimentary regarding their personal environment. Comments include “I have everything I need in here”. Others described their rooms as “homely”. It was evident that service users are encouraged to bring with them items of personal belongings. All the bedrooms seen had a variety of pictures and family photographs and other items of personal belongings. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 16 A tour of the premises was undertaken as part of the inspection. The home was clean and well maintained and no adverse odour was present. The home has an in house laundry and all the service users laundry was undertaken internally. The laundry was very well managed and good infection control procedures were followed. The washing machines were fitted with sluice facilities; the floor was impermeable and clean, hand- washing facility was prominently sighted and protective equipment was available. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 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): 29 The recruitment procedures at the home are very good and ensure that the welfare of the service users is safeguarded. EVIDENCE: The home has a robust recruitment procedure in place. The records of two recently employed staff was seen as part of the visit. The manager interviews all the applicants. Record showed that all checks were undertaken and records included interview notes, references, Criminal Record Bureau (CRB) and POVA first checks, health and safety updates and details of probationary reviews. Staff records were maintained securely and met the requirements of Schedule 2. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 18 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): 33,35 The home internal review process is good and ensures the service users’ interests are safeguarded. The pooling of service users’ personal allowance must be reviewed and money must be held in individual account of the service users’ name to ensure that their interests are safeguarded. EVIDENCE: The home is in the process of undertaking an audit of the service users views that started on the 26th of January 2006. A sample of the response received to date was seen and comments form service users and their relatives were positive regarding the care that they were receiving. The Responsible Individual also undertakes monthly reviews of the service as part of their internal audit. A report of the Regulation 26 visits is sent to the commission. The manager holds regular service users’ meetings as part of their internal auditing. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 19 A sample of 3 service users’ personal allowance as managed by the home was seen. Record showed that the service users’ personal allowance was held in the name of the Otterbourne’s Residents account. The provider has confirmed that all service users are issued with a statement of their individual account each month. There were detailed account of all transactions and receipts were available. The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 20 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 X X X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X X X X X 3 X X 3 STAFFING Standard No Score 27 X 28 X 29 4 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 21 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. 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. Refer to Standard Good Practice Recommendations The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Old Parsonage Brendoncare Home DS0000012226.V280957.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!