Care Home: 10 Brampton Court

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What the care home does well Each person living at the home has an individual service user guide, which they keep in their bedroom. These documents contain information about the service provision at 10 Brampton court. A Statement of Purpose is available for all prospective new service users, which enables them to decide if they wish to move into the home or not. Care plans are in place and kept under review. They contain guidance on how people prefer to have their care needs met. People are supported to make decisions about their lives, where possible. People are encouraged and supported to access the local and wider community. Links with family and friends are maintained. Meals appear well balanced and varied. People have access to the complaints procedure, if required. The home was found to be clean and tidy and generally in good decorative order. People living at the home are supported by staff that are properly recruited, inducted and trained. The manager is now registered with CQC. Within our surveys one member of staff commented ` I have worked here for many years, and service users have always been well cared for and all their needs met in every way. We have a very nice home and garden, our training is up to date and all the staff work well together and with our manager`. What has improved since the last inspection? At the last inspection four statutory requirements and three good practice recommendations were made. All requirements and two recommendations have now been met. One recommendation is no longer relevant as the home has recently changed their procedures for medication. What the care home could do better: 10 Brampton CourtDS0000028375.V375281.R01.S.doc Version 5.2 Contact details for CQC need to be updated on the Statement of Purpose, service user guide and the complaints procedure. Care plans appear to have some duplication in them, which could make it difficult for the reader to retrieve information. Risk assessments, which are in place in care plans, do not clearly demonstrate that they have been kept under review. Some assessments have not been dated or signed. Some activities, which may pose a potential risk should have a risk assessment in place. The home could further develop person centred planning and aids to communication. This might include staff attending a basic signing course. Protocols for the use of `as required` medication should be within individual care plans. When medication is received into the home, the MAR sheet should be signed and dated by the person that checked them in. This should be witnessed by another member of staff. The home could further develop opportunities for the people they support to share their views on the service being provided. The manager should receive supervision training. Within our surveys we asked what the home could do to improve. We received the following comments; Develop choice making skills for the service users. Provide communication training for the staff team. Provide more paperwork in a format that better meets the needs of the service users. Key inspection report CARE HOME ADULTS 18-65 10 Brampton Court 10 Brampton Court Melksham Wiltshire SN12 6TH Lead Inspector Pauline Lintern Key Unannounced Inspection 30th June 2009 09:15 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 10 Brampton Court Address 10 Brampton Court Melksham Wiltshire SN12 6TH 01225 707233 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) bramptonateam@btinternet.com Ordinary Life Project Association Mr Steven Godwin Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2008 Brief Description of the Service: 10 Brampton Court is run by the Ordinary Life Project Association (OLPA). The home is a domestic style, detached property and located in a residential area on the outskirts of Melksham. There are some local facilities although one of the nearby towns is used for most shopping trips and services. The home has its own vehicle for trips out. The accommodation is on two floors. Each person has their own room, one of which is on the ground floor. There is one communal room, which is used as a lounge and a dining area. Patio doors lead on to a garden at the rear of the home. There is a separate kitchen and a large ground floor bathroom, which includes a walk in shower. The people who live at Brampton Court receive support and personal care from a permanent staff team. Fees range from £837.58 to £976.96 per week. Inspection reports are available in the home and from the CQC website: www.cqc.org.uk 10 Brampton Court DS0000028375.V375281.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. The judgements contained in this report have been made from all the evidence gathered during the inspection; including the visit to the service and takes into account the views and experiences of people using the service. The site visit for this unannounced key inspection took place on Tuesday 30th June 2009, between the hours of 9.15 am and 3.35 pm. A random inspection was carried out on this service in March 2009. The manager Mr Steven Godwin was available throughout the day to assist us. During the day the service co-ordinator and the registered provider also visited the home. The home currently accommodates three people and they have one vacancy. At the time of our visit, two of the people using the service were at home and one person was at day services. Although we were unable to verbally obtain the views of the people living at the home, we were able to observe interactions between themselves and staff members. We took the opportunity to meet with two members of staff to obtain their views. One was a recently recruited member of staff and the other person being a long serving staff member. As part of the inspection process, we sent surveys to the home for people to complete, if they wanted to. We also sent surveys; to be distributed by the home to peoples using the service and staff members, care managers, GPs and other health care professionals. Three staff members, three healthcare professionals and three people using the service responded, with support from the staff at day services. The feedback received, is reported upon within this report. We sent Mr Godwin an Annual Quality Assurance Assessment (AQAA) to complete. This was the home’s own assessment of how well they are performing and it gave us information about their future plans. As part of this inspection, we reviewed records relating to care practices, risk assessments, staff recruitment and training, complaints, medication and health and safety. The homes own quality review was also sampled. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 7 Contact details for CQC need to be updated on the Statement of Purpose, service user guide and the complaints procedure. Care plans appear to have some duplication in them, which could make it difficult for the reader to retrieve information. Risk assessments, which are in place in care plans, do not clearly demonstrate that they have been kept under review. Some assessments have not been dated or signed. Some activities, which may pose a potential risk should have a risk assessment in place. The home could further develop person centred planning and aids to communication. This might include staff attending a basic signing course. Protocols for the use of as required medication should be within individual care plans. When medication is received into the home, the MAR sheet should be signed and dated by the person that checked them in. This should be witnessed by another member of staff. The home could further develop opportunities for the people they support to share their views on the service being provided. The manager should receive supervision training. Within our surveys we asked what the home could do to improve. We received the following comments; Develop choice making skills for the service users. Provide communication training for the staff team. Provide more paperwork in a format that better meets the needs of the service users. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1 and 2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a Statement of Purpose and Service User Guide, which provides information about the service. All people who use the service have lived at 10 Brampton court for many years. It was therefore not possible to look at the admission process in practice. EVIDENCE: We looked at the Statement of Purpose and Service User Guide. Both documents provided information to the reader on what they can expect from the service. It details the staff and managers qualifications. There is a copy of the complaints procedure to inform people how to raise concerns if needed. We noted that the contact details for CQC are in need of updating in all three documents. Since our last visit to the home there have been no new admissions. All of the people living at the home have done so for many years. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 10 At the last key inspection, this outcome was judged as good. There has been no information to conflict with this view. Based on this, we have made a judgement, that the assessment process would ensure the service could meet the persons needs. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 6, 7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a care plan, which reflects their assessed needs. People are able to make decisions with staff support. Potential risks have been assessed and strategies are in place to minimise these where possible. However there remain some activities that still need to be assessed. EVIDENCE: As part of the inspection process we examined the care plan of two people using the service. Both plans showed that they have been kept under review and record any changes. The manager reported that they are currently updating the plans to make them more person centred. We saw an example of the new plans being introduced. Mr Godwin confirm that many staff members have attended training in person centred planning. Care plans contain information on each aspect of the persons care such as their cultural needs, social needs, health and physical needs. We noted that 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 12 there was some duplication of documents within the care plans, which could result in confusion for staff when accessing information. We discussed this with Mr Godwin and he agreed that the files may benefit from being more ordered. The care plans explained how the person may communicate their needs such as Makaton signs or body language and gestures. We discussed whether it may be beneficial to some people using the service, if staff members attend a basic sign language course. This may enable them to develop one persons communication skills. Within our surveys we asked how the service might improve. One person commented provide communication training for the staff team. We discussed how the introduction of Life books might also aid communication for the people living at the home. Mr Godwin confirmed that he would be keen to develop these within the home. We observed staff members offering choices to people. One person was shown two options of sandwich fillings. From this they made their choice. One care plan states that staff should offer the person they support two choices of items of clothes when getting dressed. Within our surveys one staff member commented we ensure the safety of the service users and endeavour to encourage them to lead the lifestyle of their choice. We sampled risk assessments found in the personal files. Most of these indicated that they had been completed in 2003. They did not show that they had been kept under review. When we discussed this with the manager he reported that evidence of the review of these assessments is kept in a separate risk assessment file. We suggested that these be kept within the care plans, where they can be clearly linked to the specific area such as eating and drinking. We noted that a couple of risk assessments had not been dated or signed. For example there was an assessment for closing the car door, which had not been dated or signed. We identified some areas where an assessment had not yet been completed, such as why people do not have keys to their rooms and a specific need relating to eating. We discussed this in feedback with Mr Godwin. Overall the care plans and risk assessments contained sufficient information to meet peoples needs and minimise any potential risks. However, as mentioned earlier the files would benefit from being more ordered to ensure clarity of information. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: NMS 12, 13, 15, 16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to participate in activities in both the local and wider community. Staff members support people to maintain links with their families and friends, if they choose to do so. Menus showed that people are offered a varied and balanced meal. EVIDENCE: Care plans identify any cultural and spiritual needs that a person may have. One person has recently been attending a church group for disabled people called Shine. The manager reported that it has been a success and they are planning to introduce it to the other people they support, if they wish to attend. One persons care plan states that they will sometimes say the Lords Prayer before going to bed. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 14 Everyone at the home has an activities programme, which varies according to their interests and choices. People appear to enjoy going out in the homes vehicle. Daily diaries demonstrate that people attend day services, go on walks, visit garden centres and go on trips to the seaside. Staff members told us that one person really enjoys spending time in the garden. They have erected a gazebo over the garden tables and chairs. This enables the person to sit in the garden, even when the weather is inclement or the sun is strong. We observed this person having their lunch outside during our visit. During the day of our visit the registered provider arrived at the home to take photographs of the garden at the home. He explained that each year OLPA have a competition for the best kept garden. Staff reported that in August OLPA hold a summer fete in the large garden at the head office in Warminster. All of the people using the service have the opportunity to attend if they wish. One day centre staff commented on behalf of the person using the service X has activities each day. Xs body language and happy appearance makes me feel that X does make decisions regarding his day and when X is dropped off and collected at the day services it appears staff treat X well. We asked staff if they felt there was sufficient staff on duty to support people to attend activities and day trips. They confirmed that the rota is flexible and if need be, extra staff are brought in to ensure there is enough support available. Staff members told us that there are plans to visit Bristol Zoo in July. Another trip had recently taken place, which was to see the show Oliver in Bath. OLPA have a static caravan, which is available to people using the service. This is situated near Bowleaze Cove. Two people from the home have recently spent time at the caravan. The manager confirmed that the person who remained at home at this time had 1-1 (sometimes 2-1) quality time and really enjoyed this time. The manager reported that people are supported to meet up with families and friends if they choose to do so. Records are kept of meals eaten by people living at the home. The manager reported that they do not have a regular weekly menu. Meal choices are made on the day by the people living at the home. We saw that within the fridge and freezer there was plenty of food to enable choices to be made on a daily basis. Mr Godwin said that this system works well for the people being supported. We noted that there was plenty of fresh fruit and vegetables available. All opened food was dated when it had been opened. Tinned food is marked 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 15 clearly with the use by date so that staff can easily gather the information. The manager confirmed that all tins are regularly rotated. The home has had a visit from the Environmental Health Officer on 29/4/09. They were awarded 5 stars. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. 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. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 18, 19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Guidelines are in place to ensure that people receive personal care support in the way that they prefer. People have access to health care professionals to ensure that their emotional and physical needs are met. Polices and procedures are in place regarding medication. EVIDENCE: Each persons care plan details how they prefer to have their personal care needs met. This includes preferred times for going to bed and getting up in the morning. One file we sampled showed that the guidelines for morning and evening routines had been reviewed on 6/3/09. Records show that where there has been an identified need, peoples weight is regularly monitored. This ensures that people maintain a healthy weight. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 17 Medical appointments are recorded and indicate that people have access to healthcare professionals, when required. We received comments from three healthcare professionals. They all spoke positively about the service provision. Comments included an excellent service, the residents are without doubt content, happy and extremely well cared for, the contact with the manager and staff team is good. We are kept informed with two way conversation and when X was unwell recently staff acted well and responded to Xs needs. Staff told us that the chiropodist visits the home every six weeks. Records show that there is input from physiotherapist and consultant psychiatrist. Each persons care plan contains information about their current medication. We asked Mr Godwin to include protocols for as required medication, within individual plans. The home have recently changed their pharmacist and now receive medication within another system. There is a record of all medication ordered, received into the home and returned to the pharmacy. Currently when medication is received into the home it is checked in by a member of staff and recorded in a separate book. We suggested that staff also sign and date the medication administration sheet and that this is witnessed by another member of staff. At the previous inspection a requirement was set. This related to the administration of medication. The manager confirmed that this practice ceased on the day of the previous inspection. We also made a good practice recommendation at the previous inspection relating to the need to have a cupboard, which complies with the legal requirement of the storage of controlled drugs. The manager confirmed that they currently do not hold any controlled drugs. He added that the new pharmacy as confirmed that there is a cupboard which meets the legal requirement available to the home if someone is prescribed controlled medication. There is a letter in the medication file confirming this. All staff receive medication training before they are deemed competent to administer medication. On the day of our visit arrangements had been made for one new member of staff to complete her medication training. The service co-ordinator visited the home to carry out the training and ensure competency. The service co-ordinator told us that she is currently updating the medication policy and procedures for OLPA homes. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 22 and 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to raise concerns and make complaints if they are not happy. People using the service are protected from abuse, neglect and self harm. EVIDENCE: The home has a complaints policy and procedure, which is available to people using the service and external stakeholders. As mentioned previously the contact details for CQC need to be updated. Within our surveys we asked if people knew how to make a complaint and who to speak to if they were unhappy. Day services staff commented on peoples behalf. Comments included X would not be able to verbally complain. This would be achieved by body language and behaviour and we understand from body language and behaviours if X is not happy. X appears to be very happy. People using the service are provided with a pre addressed envelope, which can be sent to the registered provider, if they wish to raise a concern. These are kept within their service user guide. There is a complaints log at the home. The manager reported that the home has not received any complaints in the last twelve months. It was noted that the home had received compliments. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 19 CQC has not received any complaints about this service in the last twelve months. Local protocol guidance No Secrets was available for staff within the home. The manager reported that there was a flow chart on the notice board for staff to follow in the event of reporting suspected abuse. The manager reported that this year he has attended two training courses relating to safeguarding procedures. Staff members confirmed that they have attended safeguarding training. A recently recruited staff member told us that she had attended a two day safeguarding training course. Within the AQAA it states that over the last twelve months the home has improved by supplying family and friend of the people they support, with a copy of the Mental Capacity Act 2005 Deprivation of Liberties Safeguard guide. As part of the inspection process we looked at the arrangements for managing monies held on behalf of the people living at the home. We found that receipts are kept for all transactions. The receipts and cash held balanced with the record sheets. Records show that OLPA carry out annual financial audits. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 24 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a homely, comfortable, clean and safe environment for people to live in. EVIDENCE: 10 Brampton court remains a stable group of three people living together in an ordinary house. The house is in keeping with other homes in the street. As part of the inspection process we toured the premises on our arrival at the home. We found two people sitting in the lounge watching the television. Staff members were preparing to take one person out. The home was clean and tidy with no offensive odours. We found bedrooms to be decorated and furnished appropriately to suit peoples needs and preferred interests. The manager explained that people did 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 21 not have televisions in their rooms as they all appeared to prefer the company of others and only used their bedrooms to sleep in. The manager reported that he is in the process of obtaining quotes to have a conservatory erected. This would provide extra communal space as this is currently fairly limited within the home. The lounge has an area where there is a computer, desk and files are kept. Mr Godwin said that this means that he can work in the lounge and still be around to oversee things. The garden was a particularly pleasant area, which had been well tended and cared for. It is enclosed and has many shrubs and flowers. When touring the premises we noted that the bathroom was in need of updating. Some tiles were loose, where the pipe access panel is located. Mr Godwin confirmed that he was waiting for the go ahead for the bathroom to be re-fitted. We observed Mr Godwin raising this matter with the service coordinator later in the day. There is currently one vacant room at the home and this is being used to store items. In the main hall way there is a notice board, which informs the people using the service which staff are on duty on that particular day. There are photographs of all staff who work at the home. There is a separate utility room, which is kept locked. Within the utility room is a locked cupboard which holds any toxic materials. The home has a washing machine and a separate drier. It was noted that protective clothing, such as gloves were available for staff. One healthcare professional commented in our survey from my observations when attending meetings the home is fresh and clean. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 32, 34, 35 and 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Records demonstrate that people are sufficient in numbers, properly recruited and trained to meet the needs of the people they support. Staff receive regular supervision. EVIDENCE: We looked at the staff rota and found that generally there are two staff on duty during the day and one waking night staff. The manager reported that they have just appointed two new waking night staff. Both staff have a previous knowledge of the people being supported at the home. Mr Godwin confirmed that the home now have a full compliment of staff. Many staff members have worked at the home for a number of years and therefore have a sound underpinning knowledge of the people using the service. One person told us that they have worked at the home for twenty two years. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 23 Within the AQAA it states that 75 of the staff team hold a National Vocational Qualification level 2 or above and 25 of staff are working towards achieving a level 2 award. We met with one recently appointed member of staff. They confirmed that all appropriate safeguarding checks had been completed before they commenced her employment. This was confirmed when we sampled recruitment records. At the previous inspection a requirement was made relating to recruitment records being available for inspection. This has now been addressed and there was a checklist in place to confirm that all safeguarding checks have been completed and any gaps in employment history explored. Two satisfactory references are sought prior to someone being offered a position. A recommendation was made at the last inspection, which related to the manager taking part in the interview process for new staff. Mr Godwin confirmed that he how takes part in interviewing new staff. Mr Godwin reported that any potential new staff would be invited to the home to meet the people living there prior to attending an interview New staff are inducted into the service by completing a checklist as they are deemed compliant in different areas. This is completed during the probationary period. Each member of staff has a separate training file, which shows when training courses have been completed. The company has a training officer who arranges all mandatory training for new staff. This includes fire awareness, manual handling, basic food hygiene, first aid, health and safety, medication and safeguarding. Specific training is also offered in subjects such as equality and diversity and epilepsy. One staff member told us they had enjoyed the epilepsy training course. It was confirmed that fire awareness training is generally discussed at staff team meetings. The manager reported they now hold two team meetings a month and these are generally held at the head office. Relief staff cover is arranged at these times to ensure that all staff members have the opportunity to attend. Staff members we spoke to confirmed that they are receiving regular formal supervision. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. 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 home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): NMS 37, 39 and 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service benefit from a well run home. Mechanisms are in place to monitor quality assurance. However, methods of obtaining the views of the people using the service could be further developed. Policies and procedures are in place to ensure the health, safety and well being of people living at the home and members of staff. EVIDENCE: Mr Godwin has recently passed his fit person interview to become the registered manager of the home. He has the relevant qualifications and experience to run the home in the best interests of the people living there. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 25 The home does not have a deputy manager; therefore Mr Godwin takes responsibility for the day to day management of the home. We sampled Mr Godwins training records and established that he has attended training in various subjects since the beginning of 2009. Courses include Mental Capacity Act, infection control, drug awareness, person centred planning, safeguarding x 2, fire x 3, health and safety, COSHH and first aid. We discussed with Mr Godwin when he would feel it necessary to inform CQC of an event that may take place within the home. Mr Godwin explained the procedure. We asked if staff members would know how and when to submit a notification to CQC. Mr Godwin replied that staff would contact himself or another senior manager before submitting a notification to us. Monthly service audits are carried out by a senior manager. We looked at recent records from the audits and they showed that all aspects of the home are reported upon. The last visit took place on 19/6/09. Satisfaction questionnaires are sent out to stakeholders and a development plan for 2008/9 is in place. Mr Godwin explained that they have been holding Tennants meetings at the home. The last one being held on 27/6/09. This is where the key worker records events or issues that have taken place over the previous month. We agreed that it was important to record such events; however we suggested that it might be more beneficial if the people being supported could be involved in the process. This would ensure that comments were objective as possible and not staff members interpretation of an event. We would like to see further evidence that the views of the people who live at the home have been canvassed. Records demonstrate that health and safety checks are carried out in accordance with the health and safety policy. We noted that radiators are guarded and risk assessed. Hot water outlets are regulated to 43 degrees to avoid the risk of scalding. Windows are fitted with restrictors. Regular cleaning of shower heads take place. The fire log book was examined and showed that regular fire drills and fire instruction take place. The fire risk assessment was dated 30/01/09. Certificates are in place for the testing of portable electrical equipment and Gas safety. Records show that environmental risk assessments are in place and are kept under review. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 26 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. 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 X 5 X 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 4 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 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 Score 3 3 3 X 3 X 3 X X 3 x Version 5.2 Page 27 10 Brampton Court DS0000028375.V375281.R01.S.doc 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. 1. YA9 Standard Regulation 4 (a,b,c) Requirement Any potential risks to the people using the service must be assessed and minimised where possible. Timescale for action 30/07/09 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. 3. 4. 5. 6. 7. Refer to Standard YA1 YA6 YA7 YA7 YA9 YA20 YA20 Good Practice Recommendations Contact details for CQC need to be updated within documents such as Statement of Purpose, Service User guide and the complaints procedure. Care plans could be more ordered to ensure easy access of information. Consideration should be given to developing Life books. Consideration should be given to staff attending a basic signing course. Individual risk assessments should be kept within the persons care plan for easy reference. Protocols for as required medication should be detailed within the persons care plan. When medication is received into the home it would be good practice to sign and date the MAR sheet to confirm it is correct. This should be witnessed by another member of DS0000028375.V375281.R01.S.doc Version 5.2 Page 28 10 Brampton Court 8. 9. 10. YA24 YA37 YA39 staff. The tiles in the bathroom need replacing or repairing. The manager should receive training in supervision skills. House meetings could be further developed to ensure that the views of the people living at the home are obtained. 10 Brampton Court DS0000028375.V375281.R01.S.doc Version 5.2 Page 29 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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